Eyecare Services

If you’ve had a vision screening recently, you might say, “My vision is fine! I don’t need a comprehensive eye exam.”

But a vision screening provides a limited perspective on the overall health of your eyes. It’s a bit like getting your blood pressure checked and not getting the rest of your annual physical. You’ll have useful information, but it’s not the whole picture.

What are the Limitations of a Vision Screening?

Vision screenings only test your ability to see clearly in the distance. This is called visual acuity and is just one factor in your overall vision. Others include color vision, peripheral vision, and depth perception. The screening also doesn’t evaluate how well the eyes focus up close or work together. Most importantly, it doesn’t give any information about the health of the eyes.

Vision screenings are conducted by individuals untrained in eye health.

Vision screenings are offered in many places – schools, health fairs, as part of a work physical or for a driver’s license. Even if your physician conducts the screening, he/she is a generalist and only has access to a certain amount of eye health training. Most individuals don’t have the tools or knowledge to give you a complete assessment of your vision or eye health.

Vision screenings use inadequate testing equipment.
In some cases, a vision screening is limited to an eye chart across the room. Even when conducted in a physician's office, they won’t have the extensive testing equipment of an eye doctor. They also won’t be aware of nuances such as room lighting and testing distances all of which are factors that can affect test results.

What are the Benefits of a Comprehensive Eye Exam?

Comprehensive eye exams evaluate all aspects of your vision and eye health.
The comprehensive eye exam looks at your eye externally and internally for any signs of eye disease, then tests your vision in a variety of ways.

• External Exam – This is an evaluation of the whites of your eyes, the iris, pupil, eyelids, and eyelashes.

• Internal Exam – This is an evaluation of the retina and optic nerve while your eyes are dilated.

• Visual Function and Eye Health – This includes testing depth perception, color vision, peripheral vision, and the response of the pupils to light, as well as an evaluation of eye focusing, eye teaming, and eye movement abilities.

• Glaucoma Testing – This is a test of fluid pressure within your eyes to check for the possibility of glaucoma.

• Visual Acuity – Your doctor will test your vision with different lenses to determine if glasses or contact lenses can improve your vision.
  
  

Comprehensive eye exams look at your total health history.
Even though you visit a separate office for your eye health, that doesn’t mean your eyes shouldn’t be treated holistically. Your eye doctor will discuss your overall health and that of your immediate family, any medications you’re taking, and whether you have high blood pressure or diabetes. They’ll also want to know if you smoke and how much sun exposure you get. All these factors help the eye doctor properly assess your eye health.

The American Optometric Association recommends an eye exam every two years if you aren’t having any problems and you’re aged 18-60. After the age of 61, you should schedule a comprehensive exam annually or as recommended by your eye doctor.

While dry eye isn’t a serious condition, it can have a major impact on your quality of life. You may find your eyes get tired faster or you have difficulty reading. Not to mention the discomfort of a burning sensation or blurry vision. Let’s take a look at dry eye treatments – from simple self-care to innovative prescriptions and therapies – to help you see clearly and comfortably.

What is Dry Eye?

Understanding dry eye will help you determine the best treatment option. Dry eye occurs when a person doesn't have enough quality tears to lubricate and nourish the eye. Tears reduce eye infections, wash away foreign matter, and keep the eye’s surface smooth and clear. People with dry eyes either do not produce enough tears or their tears are poor quality. It’s a common and often chronic problem, especially in older adults.

Preventive Self-Care

Before we delve into more serious dry eye treatment options, here are a few simple self-care options that can manage minor cases of dry eye.

• Blink regularly when reading or staring at a computer screen for a long time.

• Make sure there’s adequate humidity in the air at work and at home.

• Wear sunglasses outside to reduce sun and wind exposure. Wraparound glasses are best.

• Take supplements with essential fatty acids as these may decrease dry eye symptoms.

• Drink 8 to 10 glasses of water each day to avoid dehydration.

• Find out if any of your prescriptions have dry eye as a side effect and if so, see if you can take an alternative.
  
  

Artificial Tears

For mild cases of dry eyes, the best option is over-the-counter eye drops. Here are a few tips for selecting the right one:

• Low viscosity – These artificial tears are watery. They often provide quick relief with little or no blurring of your vision, but their effect can be brief, and sometimes you must use these drops frequently to get adequate relief.

• High viscosity – These are more gel-like and provide longer-lasting lubrication. However, these drops can cause significant blurring of your vision for several minutes. For this reason, high-viscosity artificial tears are recommended at bedtime.
  
  

Prescription Dry Eye Treatments

There are several prescriptions that treat dry eye differently. Your eye doctor can advise the best option for your situation.

• Contact Lenses – There are specialty contact lenses that deliver moisture to the surface of the eye. They’re called scleral lenses or bandage lenses.

• Antibiotics– If your eyelids are inflamed, this can prevent oil glands from secreting oil into your tears. Your doctor may recommend antibiotics to reduce inflammation.

• Anti-inflammatory drugs – These are eye drops to control inflammation on the surface of your eyes (cornea) using the immune-suppressing medication cyclosporine (Restasis) or corticosteroids.

• Eye Inserts – If artificial tears don't help, another option may be a tiny eye insert. Once a day, you place the hydroxypropyl cellulose (Lacrisert) insert between your lower eyelid and your eyeball. It dissolves slowly, releasing a substance to lubricate your eye.

• Tear-stimulating drugs – Available as pills, gel or eye drops, cholinergic (pilocarpine, cevimeline), these help to increase tear production.

• Autologous blood serum drops – For serious dry eye that’s not responding to other treatment, these eyedrops are made with a sample of your blood. It’s processed to remove the red blood cells and then mixed with a salt solution.
  
  

Dry Eye Procedures

• Punctal Plugs – Tear ducts can be plugged with tiny silicone plugs to reduce tear loss. By partially or completely closing your tear ducts, it can keep your tears from leaving your eye too quickly.

• LipiFlow Thermal Pulsation – This treatment helps to unblock oil glands. Placed over your eye, the device delivers a gentle, warm massage to the lower eyelid over about 15 minutes.

• Intense-Pulsed Therapy – This utilizes pulses of light to liquefy and release hardened oils that have clogged glands in the eyelids.

You don’t have to suffer from the symptoms of dry eye. Talk to your optometrist about dry eye treatment options designed to address the underlying cause of your condition.

If you’ve been diagnosed with glaucoma, you’re probably already familiar with the typical options in glaucoma treatment – eye drops, laser treatment or traditional surgery. While these are certainly effective, especially when glaucoma is diagnosed early, researchers have been working hard to offer new glaucoma treatments. Their goal is not only to improve outcomes but also reduce the treatment’s side effects and frequency of use.

What is the Goal of Glaucoma Treatment?

Before we dive into the new options, it’s important to understand the goal of any glaucoma treatment. At present, glaucoma is not curable. However, treatment can significantly slow the progression of the disease. Glaucoma damages your eye's optic nerve. Extra fluid builds up in the front part of your eye (cornea), which increases the pressure in your eye. Reducing this pressure is the primary objective of any glaucoma treatment. This is often referred to as intraocular pressure or IOP.

What are the Limitations of Standard Glaucoma Treatments?

Eye drops for glaucoma treatment seem like an easy option but there are several challenges that can reduce its effectiveness. It can be difficult to get all the medicine in the eye, especially for older adults with less of a steady hand. In addition, since it must be applied daily, individuals may forget. Since the drops have no perceivable benefit because early stages of glaucoma have no symptoms, patients might make it a lower priority which is understandable since it may also have unpleasant side effects like burning, red eyes.

Beyond eye drops, laser surgery is a less invasive option. The laser opens clogged tubes and drains fluid. It can take a few weeks to see the full results. If laser surgery or drugs don’t relieve your eye pressure, you may need a more traditional operation. You would have to go into the hospital and will need a few weeks to heal and recover. Although usually effective, glaucoma surgery can make you more likely to get cataracts later on. It can also cause eye pain or redness, infection, inflammation, or bleeding in your eye.

What are Recent Advances in Glaucoma Treatment?

Alternatives or Improvements to Eye Drops
The Glaucoma Research Foundation reported several new developments on the horizon. These technologies focus on reducing patient error in applying eye drops which would make the medication more effective and improve the quality of life for the patient. Here are some of the products underway:

• A polymer, like a contact lens, would contain the drug; it would sit under the eyelid and release the medication over several months

• Microneedles would inject medication into a specific spot to be most effective

• Implantable extended-release devices using engineered highly-precise microparticles and nanoparticles

• Polymer-based intraocular delivery technologies that would allow customizable sustained release

• Drops that allow the medication to get into the eye more easily

• Tear duct plugs that release medication
  
  

In addition, people with glaucoma who take more than one eye drop per day are beginning to see those medications available as a single, combined eye drop. New products include Cosopt (timolol and dorzolamide), Combigan (timolol and brimonidine) and Simbrinza (brinzolamide and brimonidine).

Minimally Invasive Glaucoma Surgery

Minimally Invasive Glaucoma Surgery (MIGS) procedures are small cuts or micro-incisions through the cornea that cause the least amount of trauma to the surrounding tissues. Doctors implant a tiny device to allow fluid to drain from the eye, reducing internal pressure. Some devices (iStent) are implanted during cataract surgery. Cataract surgery alone lowers pressure, but the combination of both is more effective and can lower the need for medication.

These new techniques minimize tissue scarring, allowing for the possibility of traditional glaucoma surgery in the future if needed. They also give doctors the opportunity to treat patients earlier and more safely than older surgeries.

Monitoring Eye Pressure

An easy, accurate way to measure eye pressure is critical to monitoring the progress of glaucoma and adjusting treatment as needed. For patients that require more frequent testing of their eye pressure, there’s now an at-home tonometer called iCare HOME. There’s no puff of air and no eye drops. The patient can easily share the information with their eye doctor.

If you have a glaucoma diagnosis, you can feel confident that your glaucoma treatment options are only going to improve in the years ahead. Although the disease is not curable, it is very manageable with the right treatment.

Eye disease that is caused by diabetes is currently the number one cause of blindness and vision loss. Due to the increased risk in diabetic patients, doctors recommend that people over 30 with diabetes get an annual dilated eye exam. Diabetic patients under 30 should get this exam five years after they have been diagnosed.

Diabetic retinopathy is a condition that is caused by damage to the retina. Patients that have diabetes may also have experienced extended periods of time where their blood sugar was elevated. The high levels of blood sugar damage the retina’s walls which leave them susceptible to leaking. When fluid accumulates in the retina or macula, it causes vision loss.

To make these matters worse, if prolonged high blood sugar levels are seen again, the retina will be oxygen-depleted. This causes the abnormal growth of new blood vessels. This condition is called neovascularization. This blood vessel type is weak and prone to leaking. As these blood vessels leak, they introduce blood into the eye. Excessive bleeding into the eye can cause blindness.

Treatment

While a healthy diet and exercise can be beneficial to your optical health, diabetic retinopathy is a condition that is caused by damage to the retinal wall. While this damage can sometimes be corrected, simple diet changes won’t reverse the effects.

It is essential to catch the condition in the earlier stages to reduce the effects. This can also help patients understand the importance of monitoring their blood sugar so that repeat events can be limited. Treatment options are even more successful when diabetic retinopathy is caught early. These options include vitrectomy, scatter photocoagulation and focal photocoagulation.

During both scatter, and focal photocoagulation the doctor will use lasers to help alleviate the condition. The lasers make small burns on the retina aimed at the blood vessels. These burns will help to seal the blood vessels to prevent more leakage and stop them from growing larger.

When using scatter photocoagulation, hundreds of small burns are made in a specific pattern during two additional appointments. Scatter coagulation should be used on patients who do not have advanced diabetic retinopathy.

Focal photocoagulation specifically targets the leaking blood vessels that are in the macula. Unfortunately, this procedure is not aimed to correct the blurry vision associated with diabetic retinopathy, but it does stop it from progressing further. Once the retina has detached, neither form of photocoagulation can be used.

Vitrectomy is a surgery that helps to remove scar tissue and/or the fluid that is clouded with blood that has been leaked into the eye. This operation is the most successful when performed before the disease has progressed too far. When the operation only targets removing the fluid, success rates are very high for the procedure. When the procedure also aims to reattach the retina, the failure rate is around 50%.

Living with Retinopathy

Retinopathy affects every person and even the same pair of eyes differently. A one size fits all approach isn’t possible, and it is important to talk to your medical professional about which options or treatment plans are right for you.

It’s important to continue to learn about how you can manage diabetes to help keep the progression of diabetic retinopathy at bay. Make sure to use the tools that are available to you. Test your blood glucose daily, schedule your regular doctor appointments and annual exams, and learn to listen to your body. We can often start to detect that something is going on when things just don’t feel right.

Managing your diabetes with a complete health plan can lead to an increase in the quality of life and help to stop further vision loss.

Regular eye exams are important for children since their eyes can change significantly in as little as a year as the muscles and tissue develop. Good eyesight is critical for a child’s life and achievements since success in school is closely tied to eye health. School demands intense visual involvement, including reading, writing, using computers, and blackboard/smartboard work. Even physical activities and sports require strong vision. If their eyes aren’t up to the task, a child may feel tired, have trouble concentrating, have problems in school or have difficulty playing their favorite games which may affect their overall quality of life.

When to Perform a Pediatric Eye Exam?

According to research, a child should have an initial screening between 6 and 12 months of age. After that, routine eye health and vision screenings throughout childhood should be performed in order to help detect any abnormalities as their eyes develop. Then, unless otherwise recommended, every two years thereafter until the age of 18.

For a newborn, an optometrist should examine the baby’s eyes and perform a test called “red reflex test” which is a basic indicator that the eyes are normal. In a case that the baby is premature or at high risk for medical problems for other reasons, has signs of abnormalities, or has a family history of serious vision disorders in childhood, the optometrist should perform a comprehensive exam.

A second eye health examination should be done to infants between six months and the first birthday. This examination includes tests of pupil responses to evaluate whether the pupil opens and closes properly in the presence or absence of light, a fixate and follow test to determine whether the baby can fixate on an object such as a light and follow it as it moves, and a preferential looking test which uses cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes and thus vision capabilities can be assessed. Infants should be able to perform this task well by the time they are 3 months old.

For a Preschooler, between the ages of 3 and 3½, a child’s visual acuity and eye alignment should be assessed. If the child is diagnosed with misaligned eyes (strabismus), "lazy eye” (amblyopia), refractive errors (astigmatism, myopia, hyperopia) or any other focusing problems, it’s important to begin treatment as soon as possible to ensure successful vision correction and life-long benefits.

At School age or upon entering school, the child’s eyes should be screened for visual acuity and alignment. In this age group, nearsightedness (myopia) is the most common refractive error and can be corrected with eyeglasses.

There are some signs that parents can tell if their child has a vision problem. For example, the child may squint, hold reading materials very close to their face, or complain about things appearing blurry. However, there are some less obvious signs that may indicate vision problems, such as having a short attention span, quickly losing interest in games, projects or activities that require using their eyes for an extended period of time, or losing their place when reading. As well as choosing to avoid reading, drawing, playing games or doing other projects that require focusing up close. Another sign is that a child may turn his or her head to the side when looking at something in front of them. This may be a sign of a refractive error, including astigmatism, so by turning their head helps the child see better.

That’s why it is so important for kids to have regular eye screenings with an optometrist. The earlier a vision problem is found and treated, the better off your child will be in and out of school.

Eye emergencies cover a range of incidents and conditions such as; trauma, cuts, scratches, foreign objects in the eye, burns, chemical exposure, photic retinopathy, and blunt injuries to the eye or eyelid. Since the eye is easily damaged, serious complications can occur from an eye injury thus, any of these conditions without proper treatment can lead to a partial loss of vision or even permanent blindness. Likewise, certain eye infections, other medical conditions, such as blood clots or glaucoma, and eye problems such as a painful red eye or vision loss that are not due to injury also need urgent medical attention.

Depending on the type of injury, any of the following symptoms may be present:

• Bleeding or other discharge from or around the eye

• Bruising

• Decreased vision

• Double vision

• Loss of vision, total or partial, in one eye or both

• Pupils of unequal size

• Eye pain

• New or severe headaches

• Itchy eyes

• Redness or bloodshot appearance

• A sensation of something in the eye

• Sensitivity to light

• Stinging or burning in the eye

• One eye is not moving like the other

• One eye is sticking out or bulging

• Nausea or headache occurring with eye pain (this may be a symptom of glaucoma or stroke).

A black eye is usually caused by direct trauma to the eye or face, causing a bruise resulting from bleeding under the skin. The skin around the eye turns black and blue, gradually becoming purple, green, and yellow over several days. Swelling of the eyelid and tissues around the eye may also occur. The abnormal color usually disappears within 2 weeks.

A blow to the eye can potentially damage the inside of the eye. Trauma is also a common cause of hyphemia, which is blood inside the front of the eye and is often due to a direct hit to the eye from a ball. Besides, certain types of skull fractures can cause bruising around the eyes, even without direct injury to the eye.

A chemical injury to the eye can be caused by a work-related accident, common household products such as cleaning solutions, garden chemicals, solvents, or other types of chemicals. Fumes and aerosols can also cause chemical burns. With acid burns, the haze on the cornea often clears and there is a good chance of recovery. However, alkaline substances such as lime, lye, drain cleaners, and sodium hydroxide found in refrigeration equipment may cause permanent damage to the cornea. It is important to flush out the eye with large amounts of clean water or salt water (saline).

Photic retinopathy, also known as foveomacular retinitis or solar retinopathy, is damage to the eye's retina, particularly the macula, from prolonged exposure to solar radiation or other bright light, e.g., lasers or arc welders. It usually occurs due to staring at the sun, watching a solar eclipse, or viewing an ultraviolet, Illuminant D65, or other bright light. Immediate evaluation by your doctor is advised.

In case of an eye injury, cut or trauma, gently apply a clean cold compress to the eye to reduce swelling and help stop the bleeding. Do not, however, apply pressure to control bleeding. If blood is pooling in the eye, cover both eyes with a clean cloth or sterile dressing. And, call your doctor immediately.

In case of eye injury be sure NOT to:

• rub or apply pressure to your eye

• try to remove foreign objects that are stuck in any part of your eye

• use tweezers or any other tools in your eye (cotton swabs can be used, but only on the eyelid)

• put medications or ointments in the eye

As for contact lenses wearers, attempting to remove your contacts can make the injury worse. The only exceptions to this rule are in situations where there is a chemical injury and the lenses didn’t flush out with water, or where immediate medical help cannot be received.

How to prevent eye injuries

Eye injuries can happen anywhere. Accidents can happen during high-risk activities, but also in places where you least expect them. There are things that can be done to decrease the risk of eye injuries, including wearing protective eyewear when using power tools or engaging in high-risk sporting events, following the directions carefully when working with chemicals or cleaning supplies, keeping scissors, knives, and other sharp instruments away from young children, and keeping a distance from amateur fireworks.

To decrease the chances of developing permanent eye damage, immediate medical evaluation is necessary in the event of an eye injury.

If you’ve never worn contact lenses before, it can seem a bit intimidating. After all, you’re inserting something into your eye! Let’s ease your mind about the first step – your contact lens exam. This post will walk you through what’s involved in a contact lens exam and what you can expect every step of the way.

It begins with a comprehensive eye exam.

Your eye doctor will first determine your overall eye health and vision. This includes a discussion of your health history and then a series of standard eye tests. These tests will evaluate eye focusing, eye teaming, depth perception, color vision, peripheral vision, and the response of your pupils to light. The doctor will also measure your eye’s fluid pressure to check for glaucoma, evaluate your retina and optic nerve, and test your vision with different lenses to assess whether contact lenses can improve your vision.

Then, a discussion about your contact lens preferences.

If contact lenses are appropriate for you, it’s time to talk about your contact lens preferences. For example, do you want to enhance or change your eye color? Would you prefer daily disposable lenses or overnight contacts? Ask about the benefits or drawbacks of each, so that you make the best decision. If you’re over 40, your doctor will likely discuss age-related vision changes and how contact lenses can address these issues.

Next, the eye doctor will conduct eye surface measurements.

Contact lenses require precise measurements of your eyes to fit properly. Using an instrument called a keratometer, your doctor will measure the curvature of your eye's cornea, the clear front surface of your eye. Next, the size of your eyes pupil is measured using a card or ruler showing different pupil sizes which is held next to your eye to determine the best match.

You may also need a tear film evaluation.

If you have dry eyes, your eye doctor will perform a tear film evaluation to measure the amount of tear film on the surface of your eye. If your tear film is insufficient or you have chronic dry eyes, contact lenses may not be a good option for you. However, some newer contact lenses deliver moisture to the surface of the eye, making them a better choice for individuals with dry eye issues.

Its time for the contact lens fitting.

The final step is to fit you with a trial pair of contact lenses. Once inserted, your eye doctor will examine the lenses in your eyes to ensure a good fit. He/she will check the alignment and movement of the lenses on the surface of your eye and if the fit looks good, the last step is to ensure the prescription is correct with a few more tests.

Now it’s your turn to test it out.

Your contact lens exam is over, but you’ll need to come back. Your doctor will usually have you wear the trial lenses for a week. After that, you’ll have a short follow-up exam to confirm that the lenses are working well for you and you can then order a supply of contact lenses.

If this is your first contact lens exam, don’t worry. Choose a qualified optometrist and they’ll answer all your questions as you go. Just be sure to let them know you’re interested in contact lenses so that they know to allow for extra time in your appointment for the consultation and any specialized tests.

Myopia is a very common issue throughout the world. Approximately 1/3 of the population in the United States have the condition and over 90% of several East Asian countries suffer from myopia. While myopia may seem like such a common condition that it shouldn’t be cause for concern, it is actually associated with several very serious conditions that can threaten one’s ability to see.

What is Myopia

Myopia, more commonly known as nearsightedness, is a condition where individuals are able to see objects that are close to them but may have difficulty distinguishing things at a distance, such as road signs or leaves on a tree. These individuals often squint at objects that are further away to try and help bring them into focus.

Currently, there is no known cure for myopia and recent studies suggest that the more advanced your myopia gets, the more serious the effects can be on your vision. This has led eye professionals to look for ways to slow the progression of myopia in children and young adults as the eyes typically change more rapidly during this time and slowing down myopia progression during these years has a huge payoff.

Types of Myopia Control

There are a few different treatments for myopia that have proven to be effective in a number of studies. Of course, to ensure you find the most effective choice for you, be sure to visit with your eye doctor so they can review your case and recommend the best options for you.

Ortho-K | Ortho-K or Orthokeratology is one practice being used to slow down the progression of myopia. Ortho-K utilizes a special rigid gas-permeable contact lens that is placed into the eyes just before you go to bed. This hard lens helps to gently hold your eye in the proper shape throughout the night. Then when you wake up in the morning and remove the lenses, your eye continues to maintain that shape. This means that people who are nearsighted can see clearly throughout the day, even without wearing contact lenses or glasses. This approach is often preferred for athletes or other active individuals.

Atropine Eye Drops | One of the thoughts about the progression of myopia, is that it is associated with eye strain. The additional stresses that are placed on the eye when straining push the eye further out of its proper shape. Atropine eye drops are specifically designed to help stop the eye from straining and help the muscles relax. Atropine is similar to the eye drops that are used when you get your eyes dilated but lasts throughout the entire day rather than just a few hours. Atropine dilates the pupil of the eye and prevents them from closing too tightly and limiting your vision. This treatment has been shown to be especially effective in slowing the progression of myopia in children.

Multifocal Eyeglasses and Contact Lenses | These specialty contact lenses are designed to help reduce strain on the eyes. They have shown great success at slowing the progression of myopia over a three-year period when compared with individuals who wore a standard prescription lens.

Overview

If you notice that your child is having a difficult time seeing objects that are far away, contact us today to schedule an appointment. Many parents notice changes in their children with their behavior or grades at school, their ability to play sports, or that they may even be pulling back from playing with friends. Treating myopia as quickly as possible can help to reduce your child’s chances of developing a serious eye condition that can threaten their ability to see the world around them. Call today and schedule an appointment to see how we can help your child.