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All About Vision

Lens Options for Eyeglasses

If you thought the trickiest part of choosing a new pair of glasses was the frame selection, think again. You should be putting just as much thought and consideration into the lenses that you select for your new specs.

Here’s why:
The quality and type of lenses in your eyeglasses will not only correct your visual acuity, but they will allow you to continue to see your best through various conditions. Whether it is keeping the lenses free from scratches, fog, glare or UV rays, or making them stronger or more attractive, your eyeglass lenses can help to keep your eyes safe and comfortable wherever the day (or night) takes you.

Lens Coatings

Here are a variety of coatings that you can apply to your lenses to maintain optimal vision and comfort and to protect your lenses and your eyes.

Anti-reflective/Anti-glare Coatings

Anti-reflective (AR) also known as anti-glare coatings help reduce the reflections and glare on your lenses, improving your vision and comfort in high-glare environments, and the look of your glasses as well (you can see your eyes clearly without a reflection on the front of the lens). Reflections from the sun, television and computer screens and bright lights (especially when driving at night) can cause eye strain, headaches and difficulty seeing. AR coatings and lenses can reduce this effect, improving your vision quality and comfort in these circumstances.

Scratch Resistant Coatings

Scratches not only affect the smooth look of the surface of your glasses but they can disrupt your vision. A scratch-resistant coating adds an extra layer of protection on the surface of the lens to significantly reduce scratching. This coating is particularly great for kids who may tend to be a little more rough with their eyewear.

Ultraviolet Coatings

Ultraviolet (UV) coatings protect your eyes from harmful UV rays from the sun. This coating can turn standard lenses into UV blocking lenses that can block 100% of the UV light from entering your eyes. UV is linked to the development of a number of eye diseases such as cataracts, macular degeneration and retinal damage.

Anti-fog Coatings

Particularly if you live in a cold climate, you may have experienced walking indoors from the cold and having your glasses lenses fog up completely. This can take a few minutes to resolve and can be dangerous if you are driving or need to see clearly. Anti-fog coatings will eliminate this effect, creating a smooth transition from cold to hot environments.

Lens Options

You may want to go with an upgraded lens to improve the look, strength or functionality of your glasses.

High Index Lenses

High index lenses have a higher refractive index which means they reflect more light than standard prescription lenses. What this means for you, the consumer, is that they can be made thinner and lighter than traditional lenses. High index lenses are particularly popular with those that need a high prescription as they are able to avoid thick lenses, adding comfort and a smoother look, but a higher price tag.

Trivex or Polycarbonate Lenses

Trivex or polycarbonate lenses are impact resistant lenses – a fantastic choice for sports and safety eyewear as well as standard sunglasses and eyeglasses for active types or kids. These lenses also offer full UV protection and are lightweight for optimal comfort.

Polychromatic Lenses

Polychromatic lenses are made with special technology that turns them into sunglasses when exposed to sunlight. The lenses darken automatically when you go outside and return to normal when you go back indoors. Polychromatic lenses can come in a number of tint colors and are great when you need prescription sunglasses but don’t want to carry around or pay for another pair.

Aspheric Lenses

Aspheric lenses use advanced technology to create a slimmer, flatter and lighter lens than standard prescription lenses. While aspheric lenses can improve the appearance of any prescription lens, they are especially beneficial for those who are farsighted since those lenses tend to bulge out in the middle.

So the next time you are in the market for new eyeglasses, speak to your optometrist or optician about the best lens choices for your eyes, your vision and your lifestyle.

Contact Lens Basics

If you need vision correction for nearsightedness, farsightedness or astigmatism, contact lenses are a popular and effective option. In the United States, approximately 20% of the population who requires vision correction wears contact lenses. Currently dating back more than 125 years, contacts are presently available in a wide variety of materials and types. As opposed to the situation years ago, nowadays almost everyone can wear contact lenses.

Eyeglasses may be an attractive way to accessorize your outfit and make a fashion statement, yet you may sometimes prefer your appearance without glasses. Contact lenses allow you to have sharp vision without eyeglasses or costly vision surgery. Another benefit of contacts is that they grant a wider field of vision than glasses. This is a major advantage when it comes to playing sports or engaging in hobbies and professions such as photography.

If you are considering wearing contact lenses, you’ll need to schedule an initial eye exam and contact lens evaluation with your eye doctor. In the United States, contacts are regarded as medical devices that require a prescription by an eye care professional (ECP). In order to determine the best lenses for you, your ECP will assess your visual condition, structure of your eye and natural tear production.

Contact lenses are categorized depending upon the following factors:

  1. Material composition
  2. How long they can be worn before you have to take them out
  3. Life span- how long they can be used before you have to toss them and grab a new pair
  4. Design of the lenses

Material Composition of Contact Lenses

There are four different types of contact lens materials:

Soft Lenses

Over 90% of contact lenses on the market today are classified as soft lenses. These ultra-comfortable, thin contacts are constructed from gel-like plastics that contain a high percentage of water. They cover the entire cornea of your eye (clear front surface) and it is typically easy to adapt to wearing them.

First introduced in 1971, soft lenses used to be made from hydrogel materials. At present, silicone hydrogel is the most widespread, popular version. They permit a higher quantity of oxygen to reach the eye, which is healthy and comfortable.

Hard, Gas Permeable Lenses

Also called GP or RGP (rigid gas permeable) lenses, these contacts are smaller and made from plastics that have no water. They often provide the advantage of more acute vision, yet it generally takes longer to adapt to wearing them.

Hybrid Lenses

The center zone of these lenses is made from rigid gas permeable lenses, and a soft lens material encircles the border. Hybrid lenses thereby provide the best of both worlds – sharp vision from the center and a soft, comfortable border.

Wearing Time for Contact Lenses

The two primary kinds of contact lenses are daily wear and extended wear. Daily wear lenses must be removed on a nightly basis, and extended wear lenses may be worn up to seven days; a few brands of extended wear lenses are approved by the FDA for monthly wear (also known as “continuous wear” lenses). Extended wear lenses are very convenient even if you always remove them before going to sleep, as they are safe and comfortable for napping. Don’t sleep in your lenses unless you’ve discussed this with your doctor, since improper wear times can lead to corneal damage.

Life Span for Contact Lenses

All contact lenses must be discarded after a specified amount of time, even if you care for them well and properly. Soft contact lenses in particular accumulate lens deposits and contamination, which raises your risk of eye infections.

  • Daily disposable lenses: the most convenient and healthiest option, these lenses are replaced after one day of wear
  • Overnight disposable lenses (kept in your eyes overnight): must be replaced after one week
  • Monthly wear lenses: these are discarded after wearing for 30 days.
  • Gas permeable contact lenses: these are more resistant to lens deposits and can last up to a year or in many cases even longer with excellent care.

Designs for Contact Lenses

Contact lenses vary depending upon the type of vision correction that is required. The most common design is spherical, which works for nearsightedness, farsightedness and astigmatism. Toric lenses, which come in both soft and GP versions, possess multiple lens powers to correct astigmatism. Bifocal and multifocal lenses utilize a number of zones for different viewing needs, such as near, intermediate and far vision. They are often a good option for presbyopia. Orthokeratology (ortho-k) lenses are designed to reshape the cornea overnight, which corrects daytime vision without a need for eyeglasses or lenses.

Additional Features of Contact Lenses

Colored contacts: Lenses can be worn in color tints that enhance the natural color of your eyes or change your eye color totally. Blue eyes can be made more vibrant, or brown eyes can be altered to green.

Special-effect contacts: These lenses offer an extreme change to the color of your eyes and are generally used for costumes or theatrical effects. You can look like a zombie, an animal, or whatever you envision!

Prosthetic contacts: Disfigurations caused by disease or accidents can be masked by these colored contact lenses. With a medical orientation, prosthetic lenses are generally used to match the appearance of both eyes.

Contact Lenses that are Right for You

To identify the lenses that are ideal for your needs, you must first have a complete eye examination and contact lens evaluation performed by your eye doctor. Your ocular health will be inspected and detailed measurements of your eyes will be taken. Trial lenses will be inserted to check for the best possible and most comfortable fit and vision

After your initial fitting, follow-up visits for contact lenses are important. Your eye doctor will check that the fit is right and that no complications are developing. Your tolerance to contact lenses will be assessed. Sometimes a change in the fit or type of lens is necessary.

Your contact lens prescription will be issued after the fitting process is complete.

Proper Care and Handling of Contact Lenses

It is relatively simple to care for contact lenses. A single, multi-purpose lens solution is generally all that’s required for cleaning, disinfecting and storing your lenses. With daily disposables, routine care is totally eliminated and you can enjoy the feeling of a brand new fresh clean lens every day.

Your eye doctor or contact lens technician will instruct you how to take care of your contact lenses before you leave the office.

Computer Glasses

Digital devices have impacted our world in so many positive ways, allowing us to connect, work, play, and get information at the speed of light. In fact, many people have a hard time when they “disconnect.” But all of this good brings with it a measure of concern: Digital Eye Strain or Computer Vision Syndrome.

Nearly 70 percent of U.S. adults experience digital eye strain as a result of the growing use of computers and digital devices. Adults aged 18 to 34 report feeling eye strain at a higher rate (45%) than their older counterparts. New research also suggests that overexposure to blue light, also referred to as high-energy visible or HEV light, may contribute to vision problems such as cataracts and age-related macular degeneration (AMD). Implications are just now being studied, but the short-term impact of digital eye strain affects individuals on a daily basis. Eye care providers are noting a steady rise in the incidence of myopia as well, which research suggests could be correlated to the increase of screen time and near focusing.

Symptoms of Digital Eye Strain include:

  • Headaches
  • Blurred or double vision
  • Sore eyes
  • Dry or watery eyes
  • Sensitivity to light
  • Neck, shoulder or back pain

In addition to these symptoms, emerging research shows that blue light from digital devices causes sleep disturbances by interfering with the REM cycle of sleep.

As people move from their computer to their tablet to their phone, more and more of these symptoms are being seen, and in younger and younger people. Computer glasses offer a solution to reduce the strain on your eyes and your exposure to blue light radiation.

How Computer Glasses Work

Computer glasses reduce eye strain by adjusting the focus slightly so that your eyes feel like they are focusing on something further away. They also have a tint to remove the glare and block blue light from entering into your eyes.

Finding the Right Pair

There are a number of companies that make computer glasses, some that are designed for device users without a prescription or that would wear the glasses with contact lenses. Other manufacturers provide options to incorporate vision prescriptions into the lens.

When shopping for computer glasses you want to make sure you find the right pair. The eyewear should sit nicely on your face and provide a comfortable tint. Here are some of the options available:

  • Single Vision Computer Glasses: Provide the optimum lens power and field of view for viewing your computer screen without straining or leaning in to reduce symptoms of CVS. These are ideal for when the computer is at a fixed working distance, and work well if the user needs to view multiple screens at the same working distance.
  • Office Lenses or Progressive Lenses: No-line multifocal eyewear that can be made to correct near, intermediate and some distance vision with a larger intermediate zone for computer vision if indicated. Perfect for those with presbyopia which is the gradual loss of focusing ability that occurs naturally with age. Office lenses work like progressive lenses but provide a wider field of view for intermediate (1-3 m) viewing distance and near working distance (about 40 cm).
  • Blue-Blocking Lenses: Definitely recommended for this electronic age, blue-blocking lenses block blue light emitted from computer screens that is associated with glare, eye strain and possible sleep disturbances.
  • Anti-glare and filtering coatings (treatments): Eliminate reflections from the surfaces of your lens to reduce eye strain and discomfort from glare. Some coatings can also block blue light emitted from computer screens.

While all of these are good options for protecting your eyes, the 20/20/20 rule still applies – after every 20 minutes of near tasks, look at something beyond 20 feet away for at least 20 seconds…it’s a good time to stretch the rest of the body too.

Eye exams are important to test your focusing ability, and to ensure that both eyes are working and focusing at the same place. Many people do not have the same prescription in each eye.

Children and Computer Glasses

Children are using digital devices more than ever and this trend will only continue as smartphones take over and tablet and computer-based learning increases. Their use extends well beyond the school day , as they use computers for homework and gaming and smartphones to text with their friends.

Computer glasses should be used for children proactively before eye strain begins to keep their eyes healthy longer and prevent nearsightedness.

Children and Computer Vision Syndrome

The use of computers, tablets and other digital devices has become so commonplace in the daily lives of children that a report by The Vision Council in 2015 showed that close to 25% of children spend more than 3 hours a day using some sort of digital device. These numbers are only expected to grow. As these devices are becoming integrated into schools and becoming more common for use at a younger age, many experts and parents are wondering how the use of these devices can affect children’s eyes in the short and long term.

Computer Vision Syndrome (aka Digital Eye Strain)

Just like adults, children are susceptible to computer vision syndrome (CVS), also called digital eye strain, after extended use of computers or digital devices. Symptoms of CVS include eye fatigue and eye strain, dry eyes, headaches, blurred vision, and neck and shoulder pain.

Staring at a computer screen is a stress for the eyes, particularly for children whose eyes and visual system are less developed. This is because the computer-generated, pixelated images which appear on the screen are not what our eyes are accustomed to and therefore can cause the eye to strain after extended viewing. Some children find it uncomfortable to view screens for long periods because they simply don’t have the focusing power to spend extended amounts of time looking at these pixelated images.

Children don’t always have the self control to limit computer use or the awareness to know when they are experiencing eye fatigue or other symptoms of CVS. Because of this, they are more likely to overuse digital devices which can make symptoms worse.

Screen Use and Myopia

Myopia or nearsightedness is a growing concern as studies show the incidences of the condition are growing exponentially. In the past it was thought that myopia was primarily genetic, however recent research indicates a correlation between environmental factors and the growing exposure to and use of digital devices, particularly in children. As children increase their computer use and time spent on screen, the likelihood of developing myopia seems to also be increasing. According to a study done at the University of California at Berkeley School of Optometry which researched the incidence of myopia in 253 children between 6 years old and 10 years old showed a link with the amount of time spent on a computer.

The Effects of Blue Light

Blue light or high-energy visible (HEV) light is emitted from digital devices and is causing greater and greater concerns about long term exposure. It is already known that blue light can affect sleep and concentration but studies are also indicating that it can cause long term retinal damage, particularly in kids whose young eye have more sensitivity to environmental influences.

How to Protect Your Children from CVS

With the increasing use of and dependence upon digital devices it is important to teach your children good habits to protect their eyes while they are young. Understanding the risks and dangers of prolonged screen time should be taught at an early age. Here are some tips for safe computer and digital device use to reduce digital eye strain and prevent the negative effects it can have on your children’s eyes and vision.

  1. Limit Screen Time: When possible limit screen time to one or two hours a day, particularly for little children who don’t require computers for school work.
  2. Optimize Your Children’s Work Station: Ensure that children are positioned properly and that lighting is appropriate so that they do not have to bend or stretch in unnatural ways to see the screen adequately. The monitor should be slightly below the child’s eye line and about 18 – 28 inches away. The chair should also be adjusted so that the child’s arms comfortably rest on the desk and his or her feet touch the floor (when possible).
  3. Have Regular Eye Exams: Monitor your child’s eyesight, particularly an assessment of their near vision skills.
  4. Follow the 20-20-20 Rule: Every 20 minutes, take 20 seconds to look at something at least 20 feet away.
  5. Get in the Habit of Stretching: At regular intervals stretch the back, arms, shoulders and neck to relieve tension and reduce strain or soreness.
  6. Consider Computer Glasses: Computer glasses are made to help the eyes focus more easily on the computer screen. If your child already wears prescription eyewear, prescription computer glasses are available as well.
  7. Anti-glare: Anti-glare screens or coatings on eyeglasses can reduce glare and eye strain.
  8. Look for signs of eye or vision problems such as blurred vision or eye rubbing, redness or a stiff neck. If you notice any lasting vision problems see your eye doctor for an examination.

Computer Eyestrain

Digital eye strain is an increasingly common condition as digital devices become more ingrained into our daily lives. Digital eye strain, eye fatigue and computer vision syndrome (CVS) are conditions that result from extended exposure to digital screens such as computers, smartphones, tablets and televisions from a combination of factors including the blue light radiation emitted from the devices and the pixelated content that is difficult for our eyes to focus on.

Symptoms of computer or digital eyestrain tend to be noticed after someone has used a digital device for as little as 2 hours a day. Studies show that 60% of people spend more than 6 hours a day in front of a digital device and 70% of adults report some symptoms of computer vision syndrome (CVS) which include:

  • Eyestrain
  • Headaches
  • Blurred or double vision
  • Physical and mental fatigue
  • Dry or watery eyes
  • Red or irritated eyes
  • Difficulty focusing
  • Sensitivity to light or
  • Neck, shoulder or back pain (caused by compromised posture to adjust to vision difficulty).

Digital eye strain also impacts your ability to focus and lessens productivity. Most people do nothing to ease their discomfort from these symptoms because they are not aware of the cause.

Protecting Your Eyes from Digital Eye Strain and Blue Light

There are a number of options for reducing digital eye strain and your exposure to blue light which include workspace ergonomics, computer glasses, specialized lenses and protective coatings. The first step is to get a comprehensive eye exam, making sure you speak to your eye doctor about how often you use a computer and digital device. This will help your doctor to get the full picture of your eye and vision needs in order to determine which option is best for you. It was also help the doctor to identify any underlying issues that could be worsening your symptoms.

Alleviating Digital EyeStrain

Workspace Alterations

Proper Lighting and Screen Brightness: You want the screen to be as bright as the surrounding environment or the brightest object in the room (depending on what is most comfortable for you). Therefore interior lighting or sunlight from the outdoors should be dimmed or blocked. Use fewer light fixtures or lower voltage light bulbs and close curtains or blinds when possible. Adjust the brightness and contrast of your monitor to the levels that are most comfortable.

Reduce Glare: Glare is a significant cause of computer eyestrain so it is important to minimize it as much as possible. Set up your computer where glare from windows won’t affect your screen or cover windows when this is not possible. Glare can also reflect from walls and shiny finishes on desks and other surfaces. An anti-glare screen on your monitor or an anti-reflective (AR) or anti-glare coating applied to your eyewear can also help to minimize glare and the strain it causes to your vision.

Screen size and distance: You want to make sure you are using a high quality (such as a flat LCD) screen that has a relatively large display (look for a diagonal screen size of at least 19 inches) and is located directly in front of your line of vision. Your viewing distance should be about an arm’s length away with the top of the monitor at about eye level or slightly below.

Eye Care

Keep Eyes Moist: When viewing a digital screen or monitor for an extended period of time, we tend to blink less frequently (about ⅓ as often as we should). Blinking however, is critical for keeping the eyes moist, which allows them to remain clear and comfortable and to avoid dry eyes, irritation, blurry vision or eye fatigue.

Focus on blinking by setting a timer for every 20 minutes and slowly closing and opening your eyes 10 times. Keep a bottle of artificial tears handy to use when your eyes are feeling dry.

Give Your Eyes a Break: Schedule and take frequent breaks from your screen. Follow the 20-20-20 rule; every 20 minutes, look at something 20 feet away for 20 seconds. Take this time to stand up and stretch your back, neck and legs as well.

Computer Eyewear

Computer glasses reduce eye strain by adjusting the focus slightly so your eyes feel like they are focusing on something further away. They also have a tint to remove the glare and block blue light from entering into your eyes. There are a number of options for computer eyewear, both if you need prescription eyewear and not. Speak to your eye doctor about what the best options are for you.
Learn more about computer glasses here.

It is important to know that both adults and children alike are susceptible to computer eye strain from computers and digital devices. With the growing use of such devices in our everyday lives it is important to start educating ourselves and our children on how to combat the negative effects of these habits.

Corneal Transplant

The cornea refers to the clear, front surface of your eye. When a corneal transplant is done, officially termed keratoplasty (KP), the central part of the cornea is surgically removed and replaced with a “button” of clear and healthy corneal tissue donated from an eye bank.

According to the National Eye Institute, approximately 40,000 corneal transplants are performed annually in the United States. The overall success rate for keratoplasty is relatively high, yet up to 20% of patients may reject their donor corneas. Aggressive medical treatment with steroids is generally given in response to signs of rejection, and it is often effective at subduing the negative reaction and saving the cornea. At five to ten years after KP surgery, studies report an encouraging success rate of 95% to 99%.

Why are corneal transplants done?

Corneal transplants are typically done when the cornea becomes damaged or scarred in a way that uncorrectable vision problems occur. These types of vision conditions are not resolved by eyeglasses, contact lenses or refractive laser surgery (such as LASIK). Disease or injury is the usual culprit for the vision loss.

Keratoconus is a common reason for needing a corneal transplant. In this degenerative condition, the cornea thins and bulges forward in an irregular cone shape. Rigid gas permeable (GP) contact lenses can treat mild cases by flattening the cornea, yet contacts are not effective when it comes to advanced stages of keratoconus. The National Keratoconus Foundation reports that 20% to 25% of people with keratoconus will require corneal transplant surgery to restore vision. Other corneal degenerative conditions will also result in a need for keratoplasty.

Corneal ectasia is a thinning and bulging of the cornea that sometimes occurs after LASIK or other refractive vision correction procedures. In the event that this happens, a corneal transplant may be needed to restore vision.

Corneal scarring, due to chemical burns, infections and other causes, is an additional reason that a corneal transplant may be indicated. Traumatic injuries to the eye are also commonly responsible.

Corneal Transplant Procedure

Keratoplasty is generally done on an outpatient basis, with no need for overnight hospitalization. Depending upon age, health condition and patient preference, local or general anesthesia is used.

Using a laser or a trephine, this is an instrument similar to a cookie cutter, the surgeon cuts and removes a round section of damaged corneal tissue and then replaces it with the clear donor tissue.

Extremely fine sutures are used to attach the donor button to the remaining cornea. The sutures remain in place for months (sometimes years) until the eye has recuperated, healed fully and is stable.

Recovery from a Corneal Transplant

The total healing time from keratoplasty may last up to a year or longer. At first, vision will be blurred and the site of the corneal transplant may be inflamed. In comparison to the rest of the cornea, the transplanted portion may be slightly thicker. For a few months, eye drops are applied to promote healing and encourage the body to accept the new corneal graft.

A shield or eyeglasses must be worn constantly after surgery in order to protect the healing eye from any bumps. As vision improves, patients may gradually return to normal daily activities.

What happens to vision post-keratoplasty?

Some patients report noticeable improvement as soon as the day after surgery. Yet a great deal of astigmatism is common after a corneal transplant. A patient’s prescription for vision correction tends to fluctuate for a few months after the surgery, and significant vision changes may continue for up to a year.

Hard, gas permeable contact lenses generally provide the sharpest vision after a corneal transplant. This is due to a residual irregularity of the corneal surface. Even with rigid contact lenses, eyeglasses with polycarbonate lenses must be worn in order to provide adequate protection for the eye.

Once the sutures are removed and healing is complete, a laser procedure such as LASIK may be possible and advised. Refractive laser surgery can reduce astigmatism and upgrade quality of vision, sometimes to the point that no eyeglasses or contact lenses are needed.

Your Comprehensive Eye Exam

Your eyes are one of the most complex organs in your body. A comprehensive eye exam to assess your visual system and eye health involves a number of different of tests. Unlike a simple vision screening, which only assesses your vision, a comprehensive eye exam includes a battery of tests in order to do a complete evaluation of the health of your eyes and your vision.

The tests that you will undergo in a comprehensive eye examination may vary from eye doctor to eye doctor but here are are some common exams that you may encounter:

Patient Background and History

One of the most important parts in a comprehensive eye exam is your patient health history. This information will alert your doctor to any conditions that should be monitored closely, such as an allergy to any medications, current or family history of systemic or eye pathology or environmental conditions that could be affecting your vision or eye health. This will also help your doctor to determine any preventative eye care measures that are relevant to keep your eyes healthy for years to come.

Visual Acuity

Visual acuity is a measurement of your vision using an eye chart, the Snellen Eye Chart. In this test the patient is seated at a standard distance and is asked to read letters or symbols of various sizes, which get smaller as you move down the chart. The results are the familiar ratio of 20/20, 20/40 etc. which is a comparison of your vision compared to the average person with good vision, which is typically 20/20. For example, a patient that has 20/40 vision, can only see at 20 feet what the normal person can see from a distance of 40 feet. This test is a preliminary test of how clearly you are seeing in each eye but it does not give you a prescription for corrective lenses.

Refraction

Those who don’t have 20/20 vision have what is referred to in most cases as a “Refractive Error.” The patient may have nearsightedness, farsightedness, astigmatism or other eye conditions that prevent the patient from seeing 20/20. A refraction will tell the doctor which prescription lenses will correct your eyesight to achieve 20/20 vision or whichever amount your vision is correctable to.

A refraction may include a couple of steps.

Retinoscopy

Retinoscopy is a test that allows the doctor to obtain an approximate prescription for eyeglasses. In this test the doctor uses a hand-held instrument called a retinoscope that shines a light into the patient’s eye. The doctor then analyzes the reflex of the light from the patient’s eye to determine the patient’s prescription for glasses.

An instrument called a phoropter is something most patients associate with an eye exam. This space age appearing instrument, positioned in front of the patient’s face during the eye exam, gives the doctor the ability to determine the patient’s focusing ability as well as their eye alignment. The phoropter also determines which, out of the hundreds and hundreds of potential eyeglass prescriptions, will help the patient see as clear as possible. Using the phoropter, the doctor will ask the patient which series of lenses makes their vision the clearest.

While retinoscopy is quite effective for children and nonverbal patients, there are now a number of computerized or automated instruments available today to help doctors accurately determine a patient’s eyeglass prescription.

Autorefractors and Aberrometers

Autorefractors and aberrometers are computerized machines that are able to measure your refractive error to determine your prescription for glasses or contact lenses. These instruments are usually used in addition to testing described earlier:

– An autorefractor is similar to retinoscopy, which electronically analyses the light reflex from the patient’s eye.

– An aberrometer measures distortions or aberrations in the cornea and lens of the eye that disrupt proper focus of light on the retina. Using wavefront technology, the instrument measures the rays of light as they pass through your eye to look for imperfections which may indicate a refractive error.

Eye Focusing and Eye Teaming Tests

During the comprehensive eye exam, your eye doctor will also want to test how your eyes function individually and together from a mechanical perspective. In order to see clearly and comfortably, your eyes need to work together as a team.

Eye Health

The final and most important aspect of a comprehensive eye exam is a check of your overall eye health. These tests (below) are done to identify any eye conditions or diseases, both inside the eye as well as the external parts of the eye, that could affect your vision and general health.

Slit Lamp Test

The slit lamp or biomicroscope is an instrument that allows the doctor to examine the internal and external parts of the eye in detail, such as the conjunctiva, iris, lens, cornea, retina and the optic nerve. The patient rests their forehead and chin on a headrest to stabilize the head, while the doctor looks into the eye with the slit lamp microscope, which is magnified with a high-intensity light. A slit lamp test enables the doctor to evaluate the eyes for signs of normal aging and eye pathology, such as conjunctivitis, cataracts, macular degeneration or retinal detachment. Early diagnosis and treatment of eye diseases are essential for preventing vision loss.

Tonometry

Tonometry is a test to detect glaucoma by measuring the pressure inside your eye or IOP (intraocular pressure). Glaucoma can cause vision loss and even blindness if the IOP in the eye is too high and damages the optic nerve.

The applanation tonometer, typically attached to a slit lamp, is one of the most common instruments used to measure the pressure in the eye. Prior to doing this test the doctor will numb the patient’s eyes using an anesthetic, before gently applanating (putting pressure on) the patient’s cornea to measure the pressure in the eye.

Pupil Dilation

During your comprehensive eye exam, your doctor may decide to do a dilated eye exam. In this test, your doctor will instill dilating drops in each eye, which would enlarge your pupils to give the doctor a better view of certain parts of the back of the eye. Dilation is done at the discretion of the doctor, with some patients dilated every year and others at specified intervals; the frequency of dilation will vary for each patient.

Typically the drops take around 20 to 30 minutes to take effect and may last up to several hours following the exam; each patient is different. Since more light enters your eyes when your pupils are dilated, you will be more sensitive to bright light, especially sunlight. Although your doctor may provide disposable sunglasses, you may want to bring a pair of sunglasses to wear after the exam to make it more comfortable until the drops wear off.

A comprehensive eye exam is an important part of your overall general health maintenance and should be scheduled on a regular basis. The findings from your comprehensive eye exam can give your doctor important information about your overall health, particularly diabetes and high blood pressure.

Vision Therapy for Children

As a child’s eyes develop, it is not uncommon for a number of problems to occur. Beyond blurred vision due to refractive error including nearsightedness (myopia) and farsightedness (hyperopia), children can develop a number of other visual and perceptual problems that are often not detected by a simple vision exam. Even a child with 20/20 vision, can have underlying vision problems!

Some of these issues are functional vision problems having to do with the actual eyes, how they move individually and as a pair, as well as their ability to focus. Functions such as eye teaming, tracking, focusing, and hand eye coordination, all affect a child’s success in school, sports or general functioning. Often children that have difficulty with these functions will suffer physical symptoms as well such as headaches, eye fatigue or short attention spans. With these critical visual skills lacking, tasks such as reading and writing can be extremely difficult and exhausting which can lead to frustration and behavioral problems.

Just like we are able to train our bodies to build strength, speed and agility, our vision skills can be strengthened. Vision therapy offers a doctor-supervised program to guide children to develop these skills.

What is Vision Therapy?

Vision Therapy is a program of progressive eye exercises individualized for each patient designed to retrain or help the patient develop or improve upon particular visual skills or to improve processing and interpretation of visual information. It is used to treat conditions like strabismus (crossed eyes) and amblyopia (lazy eye) as well as eye movement, focus and coordination problems.

Typically, the sessions take place in the optometrist’s office weekly or bi-weekly and utilize a variety of tools such as therapeutic lenses or prisms. Often the patient will be asked to practice certain exercises or activities at home as well in order to reinforce the skills that are being developed. Through repetition of these tasks, the ultimate goal is to strengthen the skills such as focusing, and improving eye movement and alignment, to the point where the eyes and vision are working efficiently and comfortably. The duration of the therapeutic program usually lasts about 6-9 months.

Vision therapy has been scientifically proven to improve functional vision skills and is approved by the major optometric bodies such as the American Optometric Association and the Canadian Association of Optometrists. It does not improve refractive error and should not be mistaken for some of the alternative self-conducted eye exercises out there that claim to improve your vision.

Vision therapy has also been shown to be effective in adults. If you think that vision therapy could be right for your child or yourself, it is worthwhile to have an assessment by a trained vision therapist to determine whether it could help resolve the vision problems that are present.

Are Contact Lenses a Good Choice for Kids?

Many children who wear glasses want to switch to contact lenses, especially older children who are concerned with their appearance. So, how do you know if and when contact lenses might be an option for your child?

Contact lenses may not only improve a child’s confidence in their appearance but they can also be very convenient for active children who play sports or those who tend to lose or break their glasses.

Yet before you jump to schedule an appointment with the optometrist, it’s important to know that while contact lenses are a great solution for many, they are still medical devices that require care and responsibility. Carelessness with contact lenses can lead to infections, irritation, scratched corneas, pain, and sometimes even vision loss. So if you want to know if contact lenses are a good choice for your child, read below and think about whether your child is mature and responsible enough to take proper care of his or her eyes.

At What Age Can a Child Start Wearing Contact Lenses?

The recommended age for kids to start considering contact lenses varies however it is generally accepted that sometime between 11 and 14 is ideal. Some doctors will recommend them even for children as young as 8 years old who have shown that they are responsible enough to use them. Contact lens use requires good hygiene and cleanliness so if your child shows those traits, she may be ready. Additionally, if he is highly motivated to wear contacts and if he has the support of his parents, this will help in ensuring that the daily regimen is a success.

What is the Process of Getting Fitted for Contacts?

The first step is to schedule an appointment for a contact lens exam with your optometrist. The eye doctor will perform a vision exam and go over the different options for contact lenses, depending on the prescription, the health of the eye and lifestyle and personal preferences. Contact lenses are designed with a number of options including the lens materials used (soft or rigid gas permeable), the replacement schedule (if disposable, how often you replace the pair – daily, weekly, biweekly or monthly) and the wear schedule (daily or extended overnight wear). Often doctors will recommend daily lenses for children because they are thrown away after each use so there is less care involved, less buildup and less risk for infection.

Then the doctor will give a training on inserting and removing the lenses as well as instructions for proper care. Your child will probably be given a schedule for wearing the lenses for the first week or so in order to allow their eyes to adapt. During this time you may have to be in touch with your eye doctor to assess the comfort and fit of the lenses and you may have to try out a couple of options in order to find the best fit.

Purchasing Contact Lenses

As a medical device, contact lenses require a prescription and should only be purchased from a licensed distributor such as an eye doctor. Unauthorized or unmonitored contact lenses can cause severe damage to your eyes that could result in blindness. This is true also for cosmetic lenses such as colored lenses or costume lenses. Any time you are putting a lens in your eye, you must have a proper prescription.

Following are some basic contact lens safety tips. If your child is responsible enough to follow these guidelines, he or she may be ready for contact lens use:

  1. Always follow the wearing schedule prescribed by your doctor.
  2. Always wash your hands with soap before applying or removing contact lenses.
  3. Never use any substance other than contact lens rinse or solution to clean contacts (even tap water is a no-no).
  4. Never reuse contact lens solution
  5. Follow the eye doctor’s advice about Don’t swimming or showering in your lenses
  6. Always remove your lenses if they are bothering you or causing irritation.
  7. Never sleep in your lenses unless they are extended wear.
  8. Never use any contact lenses that were not acquired with a prescription at an authorized source. Never purchase cosmetic lenses without a prescription!

Contact lens use is also an ongoing process. As a child grows, the lens fit may change as well, so it is important to have annual contact lens assessments. Plus, new technology is always being developed to improve comfort and quality of contact lenses.

Contact lenses are a wonderful invention but they must be used with proper care. Before you let your child take the plunge into contact lens use, make sure you review the dangers and safety guidelines.

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