Combating Digital Vision Syndrome

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

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

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

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

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

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

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Scleral Contact Lenses: Are They For You?

Scleral contact lenses are large, gas permeable lenses that rest on the white part of the eye known as the sclera. This differs from soft contact lenses which we fit to the cornea, the dome-shaped front of the eye. This unique design allows the lens to functionally replace the irregular cornea with a smooth optical surface to correct vision problems such as keratoconus (thinning and conical protrusion of the cornea) and other corneal irregularities. The space between the cornea and the back surface of the scleral lens acts as a liquid reservoir. This reservoir is filled with tears and provides comfort by lubricating the surface of the cornea to reduce dry eyes. 

Practically a scleral lens is a prosthetic cornea that recreates a perfect optical surface and makes vision a whole lot better. Let’s look at the following images that show what these menses look like:

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Scleral contact lenses are custom-made for patients and can provide better comfort and vision for those who have severe forms of:

• Keratoconus

• Ocular surface diseases (Sjogren’s, Steven’s Johnson Syndrome)

• Irregular astigmatism

• Highly irregular corneal transplants

• Post-refractive surgery complications (LASIK, PRK)

• Dry eye

Previously, scleral lenses have been reserved for only complex corneal and contact lens cases but are now gaining popularity and are being used for normal patients. Its distinct design provides increased comfort and stability on the eye leading to consistent vision, reduced glare and reduced dryness. Patients that have experienced poor comfort or vision with regular contacts may be good candidates for scleral lenses. 

Sources:

http://www.reviewofcontactlenses.com/content/d/rgp_lenses/c/52262/
http://www.allaboutvision.com/contacts/scleral-lenses.htm
http://cdna.allaboutvision.com/i/contacts-2016/scleral-lens-diagram-330×220@2x.jpg
http://cdna.allaboutvision.com/i/contacts-2016/scleral-lens-in-eye-330×220@2x.jpg

Neurolenses

Eye Motor Deficiencies:  Teaming, Focusing and Muscle Deficiencies

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

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

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

Vision Correction for High Prescriptions

Implantable Collamer Lens (ICL)

What is ICL?

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

Who is a good candidate?

• High Myopes

•Patients between the ages of 21-45

• Patients with little or no astigmatism

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

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

• Dry eye patients

Procedure

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

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

Keep Your Eye On The Ball!

Does your son or daughter play soccer? Football? Baseball? Interestingly enough, optometrists can play an important role in their sports career! Especially if they want to continue on to the professional level, although it’s not always fun and games.

 

Former women’s U.S. soccer player, Cindy Parlow Cone’s career suddenly ended in 2006 due to a serious concussion. To this day, she still suffers from headaches, fatigue, visual and balance problems. Women’s soccer athletes are more likely to suffer from concussions and a new study seems to believe it’s due to this reason; having your eyes closed while heading the soccer ball! This study suggests that closing their eyes while going up for a header decreases the athlete’s visual awareness making the athlete more likely to collide with another athlete or having the ball hit awkwardly on his or her head.

 

On a more exciting note, optometrists can play an important role in the prevention, assessment and treatment of concussions; since they are sometimes unavoidable. When you think of vision training, you often think about athletes using it to enhance their skills. However, there could be another use for vision training and that is to protect athletes from serious head injuries. Joe Clark, a neurologist, ran a study over four years and saw a decrease of over 80 percent in concussions for the UC football team by simply putting them through regular vision training. Concussions are a major point of contention in many of today’s sports and with the help of starting vision training early, not only can optometrists help your child’s sports performance, it could help prevent serious injuries and keep them on the field!

Blog contribution by Alexis Romero, Optometry Intern, College of Optometry, Western University of Health Sciences.

Sources:

http://www.aoa.org/news/clinical-eye-care/vision-training-could-mitigate-soccer-related-concussions?sso=y

http://www.cnn.com/2015/11/12/health/cindy-parlow-cone-soccer-concussion/

http://healthnews.uc.edu/news/?/26057/

New Technology In Contacts

Who would have thought that a contact lens could be used for more than providing clear vision? In fact there are many researchers trying to take advantage of these lenses intimate relationship with the eye. One such project involves diabetes, a disease affecting almost 30 million people in the United States alone!

The current technology and procedure for monitoring diabetes is a rather invasive and primitive process. However, researchers from Oregon State University are working towards developing a bio-sensing contact lens that may advance the technique of medical care for diabetes. This lens will be able to utilize “ultra-thin transistor technology” and the biochemistry of glucose (sugar) to measure slight changes in glucose levels present in our tear film. When glucose shows up in the tears, chnages take place in the chemistry of our tears. This shift causes an electrical current to flow to a transistor in the contact lens, which can then be transmitted onto a personal device such as your iphone.

The prototype will allow diabetic patients to monitor their own blood glucose level with a simple contact lens rather than having to prick their finger every day! There is a lot of optimism and high hopes for this technology, despite the contact lens being in the very early prototype stages. Researchers want to expand the spectrum of diseases that the contact lens is able to detect to include glaucoma, renal failure, cancer and other debilitating ailments. As of right now, the researchers are hoping to be able to proceed to animal trials in the coming year.

 

http://www.diabetes.org/diabetes-basics/statistics/?loc=db-slabnav

https://futurism.com/new-bio-sensing-contact-lenses-will-utterly-transform-our-lives/

Blog contribution by Richard Nguyen Optometry Intern, College of Optometry, Western University of Health Sciences.

Yoga and Glaucoma (Say that 5 times fast)

Glaucoma is one of the leading causes of irreversible blindness because of damage to the optic nerve when fluid pressure increases in the eye. Doctors advise patients to live healthy and active lifestyles, but there are certain activities that should be avoided by glaucoma patients like pushups and lifting heavy weights due to elevated intraocular pressure (IOP). A new study has shown the potential risk associated with various yoga positions and exercises that involve inverted poses. In this research, both normal and glaucoma patients did four yoga positions. The greatest increase in pressure was found with the downward facing dog position where you place both feet and hands on the floor while looking at the ground. “The measurements were taken after the participants retuned to a seated position and again after waiting ten minutes, the pressure in most cases remained slightly elevated from the baseline.” In previous studies, participants in the headstand position showed almost two-fold rise in IOP. It is now advised to inform and educate glaucoma patients about the risks of physical exercises like yoga, so progression of glaucoma doesn’t get worse. Many times we consider a point or two of pressure increase to be a reason to prescribe additional eye drops or to recommend a glaucoma surgery. When patients go to yoga, patients should tell their instructors their disease to modify their yoga practice.

Mount Sinai Health System. (2016, January 7). Certain yoga positions may impact eye pressure in glaucoma patients. ScienceDaily. Retrieved January 20, 2016 from www.sciencedaily.com/releases/2016/01/160107105234.htm

Feeling Blue?

We all know how reliant we’ve become on our technology. We’re addicted to our cell phones, we can’t make a living without our computers, and we all want to have the most modern and up-to-date equipment. But how does this affect our health?

When I was busy playing Oregon Trail sometime in the 5th grade on my first computer, I never thought that something as seemingly harmless as the light from the screen could have such a ripple effect on our overall health. And yet according to the American Optometric Association it can not only affect our vision, but also our overall systemic health.

We spend increasingly more time glued to some sort of blue light producing technology. In fact, more than half of us in the modern world are spending more than 5 hours a day staring at a screen. With that comes an increase in eye strain. It also allows more of the free radicals associated with retinal injury to enter the eye (think about what tanning beds do to the skin). This can age our eye more quickly and may account for many of the age-related vision problems in younger patient groups. Blue light has also been associated with issues sleeping, from decreased sleep to less affective rest while sleeping. And while blue light might not have direct systemic influence, the dysfunctional sleep cycle can be linked to other issues, such as diabetes and some forms of cancer.

As health care professionals, it is important for us to be aware of the things that can not only affect the health of our patient’s eyes, but also their health overall. With that, it is important for us to do what we can to alleviate the issues as necessary, such as provide the various lenses and filters available to filter out blue light. The iPhone will even allow you set times where it will reduce the amount of blue light coming from the screen before you go to bed!

Blog contribution by Amy Pham, Optometry Intern, College of Optometry, Western University of Health Sciences.

Biotrue Multifocal Contacts Are Revolutionary

btod

For years we have had bi-focal or multi-focal soft contact lenses.  These lenses, aimed at providing both near and far vision without the use of reading glasses, often fall short of useful vision.  Problems include glare, haloing, and loss of stereo vision.  Fortunately a newly designed lens is available with 3 zone optics that place these obstacles in the past. Introducing the Bausch and Lomb Biotrue for Presbyopia contact lens. Never before have I achieved such great patient satisfaction. Last week, after being fit with the lens, a patient left saying “I cannot believe an eye examination could be so great”.

So what is the difference? There are two contributory factors. For one, the lens material is the same as the Biotrue Daily. A lens made of 80% water, it’s like placing a bag of water on the eye.  Literally you cannot even feel the lens on eye.  And this is extremely important. The feeling of a contact lens on the eye relates to how dry the surface of the lens becomes throughout the day. A dry eye will inhibit good optics through the lens and lead to blurred vision and tired eyes.  Biotrue contacts are designed to prevent loss of water.  Second, the fresh multi-focal design assures clean optics at 3 distinct zones.  In the past, contacts were focused mainly on 2 areas.  Now, distance, computer and reading vision are satisfied with Biotrue for Presbyopia’s optics.

These lenses are certainly a valuable part of my lens library.  I will say that they are lenses that require a careful examination. I study a patient’s visual demand by discussing occupation, daily routine and hobbies in detail.  Special time is set aside for each multi-focal contact lens evaluation. Additionally, these lenses require an adaptation period.  As with other advanced prescribing, I talk to patients about letting these lenses settle for the first 1 week or so.

Feel free to comment or send me your thought on using multi-focal contacts.

Makeup, Keep it Clean!

A light application of makeup can often help you to look and feel your best. Without proper care, however, it may impair your capacity to see your best.  Whether you are going for a natural look or something more dramatic, it is important to use discretion when applying around your eyes.

Keep it clean:                                   

Make sure your hands are washed before you begin.  Use only your own makeup and brushes.  It may seem fine to borrow a swipe of mascara, but even your BFF may have germs that are harmful to you.  Infections from poor hygiene or contamination may lead to itchy, swollen eyes and light sensitivity.

Do not disturb:                                   

Only apply eye makeup in a setting where you can be relaxed and focused.  Putting on makeup in a vehicle risks injury at every stop and bump during your commute.  Take your time and don’t rush; not only will you get better results, but you’ll do better to avoid poking yourself in the eye or scratching your cornea.

Contact lens wearers:                 

It is better to put in your soft contact lenses before your makeup routine.  When choosing a mascara, avoid mascara with lengthening fibers, which can scratch, and waterproof mascara, which may stain your lenses.  At the end of the day, remove your contacts, clean them, and place in fresh solution before you wash off your makeup.

It can be rewarding to use cosmetics, but safety should always be top priority.  If your makeup causes you to experience irritation or injury, discontinue use and contact your optometrist.

 

Blog contribution by Kaitlyn Sanchez, Optometry Intern, College of Optometry, Western University of Health Sciences.

 

http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/conjunctivitis?sso=y

http://www.aoa.org/patients-and-public/caring-for-your-vision/contact-lenses/contact-lenses-and-cosmetics?sso=y

http://www.fda.gov/Cosmetics/ProductsIngredients/Products/ucm137241.htm