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Dear Patients,

Both offices are now open and In order to avoid crowding and to stay on top of additional disinfection procedures, appointment slots will be limited. What you can expect:

  1. Face coverings required, non-touch temperature reading, hand washing upon arrival.
  2. Disinfection of touch surfaces in addition to our usual sanitation procedures as well as barrier films on certain high-touch areas.
  3. Digital frame measurement technologies for all spectacle orders to replace face-to-face measurements.
  4. On-site, but non-facing payment options.
  5. Elimination of paper and electronic forms in the office.

Your cooperation in completing medical questionnaires at home, prior to your visit, is greatly appreciated. Also while we welcome patients along with one guardian when needed, additional friends and family members who do not have an appointment may be asked to wait outside. We’re all excited to see you soon.

Advanced Eyecare Optometric Center in Irvine and Dana Point, California
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All About Vision

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.

Dry Eye After Menopause

Dry Eye Disease is a common eye condition – studies show that nearly 20% of North Americans middle aged and older suffer from dry eye disease. The probability of you developing dry eye if you are a woman, and older than 50, increases. Hormonal changes that older women undergo make it much more likely that they will suffer from dry eye as they age, including symptoms such as blurry vision and irritation of the eyes, according to the American Academy of Ophthalmology.

What are the biological changes that happen during menopause which affect your eyes? The tear film in the eyes relies on certain chemical signals to remain stable, and these signals get disrupted during and after menopause. Some doctors believe that androgen, a hormone implicated in menopause, may be the culprit causing dry eye problems for menopausal women. Eyes may become inflamed, which leads to decreased tear production, and possibly dry eye disease. Add in a dry environment and many medications and the risk factors for menopausal women increases exponentially.

Treatments for Dry Eye in Menopausal Women

Estrogen hormone replacement therapy (HRT) is sometimes used to treat menopausal symptoms, as the female hormone estrogen is one of the hormones that decreases during and after menopause. However, studies have shown that this treatment does not relieve symptoms of dry eye.

Refractive Eye Surgery

Refractive eye surgery, such as LASIK and PRK, may not be advised if you are 40 or older, and have dry eye disease. These procedures can affect nerve function in your cornea (the clear surface of your eye), which could worsen your dry eye problem. If you want to have a consultation regarding LASIK or PRK, it’s important that your eye doctor know about your dry eye condition. In that case, your eye doctor will know to do the appropriate tests to make sure that there is enough moisture in your eyes for laser vision correction.

There are other health conditions that are associated with dry eye and aging. These conditions include thyroid autoimmune disease, and rheumatoid arthritis. If you suffer from dry eye, make sure your doctor screens you for these diseases.

Allergies may cause eye inflammation, and may be the cause of your dry eye. Prescription and over-the-counter eye drops might relieve your dry eye and allergy problem. Your eye doctor will advise you as to which eye drops would be best for you.

Sometimes commonly prescribed medications can worsen, or even cause, dry eyes. Some of these medications are antidepressants and diuretics, which are often prescribed if you have a heart condition. Make sure to talk about this with your doctor if you suspect that one of the medications you are taking may be causing your dry eye problems. Perhaps changing your medication will be as effective, and won’t cause dry eye disease.

Multifocal Eyeglass Lenses

Multifocal lenses technically refer to any lens that provides more than one zone of corrective power and would therefore include bifocal, trifocal and progressive lenses. Multifocals are designed for the many individuals over 40 who struggle with presbyopia – the age-related near vision loss that requires us to use eyeglasses for reading and focusing on objects in our near vision. The multiple lens powers enable you to correct for near and distance vision with one pair of glasses.

Bifocal Lenses

Bifocal lenses are divided into two powers, one for distance vision and the second for near vision. Bifocals are created in a variety of designs with different sized and shaped viewing segments for near and far vision. While bifocals provide good distance and near vision, they are lacking in corrective power for intermediate areas, which is what has led to the development of trifocal and progressive lenses.

Trifocal Lenses

Trifocal lenses provide an additional lens power zone for intermediate vision (which is typically about an arm’s length away).

Some people are bothered by the visible lines where the lenses are divided in bifocal and trifocal lenses. In addition to aesthetics (the lines have become a sign of presbyopia which many associate with growing old), the harsh divisions in the zones can cause a distortion in the object you are viewing (an image jump) when you switch your gaze from one power to the next.

Progressive Addition Lenses (PALs)

Progressive lenses were designed to eliminate the “image jump” that results from the distinct zones in bifocal and trifocal lens design. By providing a smooth progression of many lens powers across the lens, PALs allow for clear vision near, far and every distance in between. Further, similar to natural vision, they just require a slight movement of the eye, rather than the whole head, for you to see through different lens powers. The smooth transition also eliminates the visible lines present on the other lenses which many view as tell-tale signs of age-related vision difficulties.

Pink Eye (Conjunctivitis)

Pink eye or conjunctivitis is one of the most common eye infections, especially in children. The infection is an acute inflammation which causes redness and swelling of the conjunctiva, which is the clear mucous membrane that lines the eyelid and the surface of the eye. Pink eye can be caused by a virus, bacteria or even allergies such as pollen, chlorine in swimming pools, and ingredients in cosmetics or other products that come in contact with the eyes. Some forms of pink eye can be highly contagious and easily spread in schools and at home.

Symptoms of Pink Eye

Pink eye develops when the conjunctiva or thin transparent layer of tissue that lines the eyelid and the white part of the eye becomes inflamed. Symptoms can occur in one or both eyes and include:

  • Redness in the white part of the eye
  • Itching or burning
  • Discharge
  • Tearing
  • Swollen eyelids and
  • Crusty eyes in the morning

Causes of Pink Eye

There are three main types of pink eye infections: bacterial, viral and allergic conjunctivitis.

Viral Conjunctivitis

Viral Conjunctivitis is usually caused by an adenovirus, the same virus that produces the recognizable red and watery eyes, sore throat, cough and runny nose of the common cold or upper respiratory infection. Viral conjunctivitis is highly contagious usually spread because of poor hygiene especially a lack of hand washing.

Symptoms of viral conjunctivitis usually last from five days to a week but may last longer. Since there is generally no medical treatment for a viral infection you have to wait for the infection to run its course. To avoid spreading the infection to others, it is recommended to stay home from school or work until the symptoms disappear which is usually after 3-5 days or up to a week.

Viral conjunctivitis typically causes a light discharge and very watery, red eyes. To relieve discomfort, you can apply cool compresses to the eyes and artificial tears.

Bacterial Pink Eye

Bacterial pink eye is usually caused by Staphylococcus or Streptococcus bacteria and is often characterized by a significant amount of yellow, sticky discharge. Also contagious, bacterial pink eye can be picked up from bacteria found anywhere and often spread to the eye by touching them with unclean hands. Contact lens wearers are at a higher risk for bacterial pink eye due to the handling of lenses and unclean contact lens cases.

Treatment is usually administered by antibiotic eye drops which should begin to show improvement after three or four days, however the infection can also resolve itself after a week to 10 days without treatment. If you do use antibiotic drops, you can return to work or school 24 hours after you being treatment.

Allergic Conjunctivitis

Allergic conjunctivitis is not infectious or contagious as it is an allergic reaction to something in the environment such as pollen, pet dander or smoke. Symptoms, which occur in both eyes, include redness, itching and excessive tearing.

The first step in treating allergic conjunctivitis is to remove or avoid the irritant, if possible. Applying cool compresses and artificial tears can help to relieve discomfort in mild cases. In more severe cases, non-steroidal anti-inflammatory medications and antihistamines might be

prescribed. In cases of persistent allergic conjunctivitis, topical steroid eye drops are used.

Pink Eye Prevention

In all cases of pink eye, practicing good hygiene is the best way to prevent from catching and spreading the infection. Wash your hands thoroughly and frequently and don’t touch your eyes with your hands, especially if you work with or around small children.

If you have allergies, try to stay indoors on days with a high pollen count and to keep doors and windows closed. Inside the house, clean air duct filters, vacuum and dust frequently to reduce the presence of allergens.

Eye Floaters and Spots

Eye floaters are spots, squiggles or flecks that appear to drift into your visual field. Usually they are harmless, a benign, albeit annoying sign of aging. If however, your floaters are accompanied by a sudden loss of vision, pain or flashes, they could be a sign of an underlying serious eye condition and should be checked out by an eye doctor as soon as possible.

What are Eye Floaters and Spots?

Floaters, like their name, are specks or spots that float in and out of your visual field. Usually they move away when you try to focus on them. They can appear as dark dots, threads, squiggles, webs, or even rings.

But what causes them to appear? Floaters are shadows from clumps of fibers within the vitreous, the jelly-like substance in your eye, that are cast on the retina at the back of the eye. Usually, floaters don’t go away, but you tend to get used to them and eventually notice them less. Patients usually see them more when they are looking at a plain background, like the blue sky or a white wall.

In most cases, there is no treatment for floaters, people just get used to them, however if there are more serious symptoms that accompany them, there could be an underlying problem such as inflammation, diabetes or a retinal tear that needs to be addressed and treated. If the floaters are so serious that they are blocking your vision, a surgical procedure to remove the clumps may be performed.

What Causes Floaters?

Age: Although floaters may be present at any age, they are often more apparent as a result of aging. With time, the fibers in the vitreous begin to shrink and clump up as they pull away from the back of the eye. These clumps block some of the light passing through your eye, causing the shadows which appear as floaters. You are also more likely to develop floaters if you are nearsighted.

Eye Surgery or Injury: Individuals who have previously had an injury, trauma or eye surgery are more susceptible to floaters. This includes cataract surgery and laser surgery as well as other types of eye surgery.

Eye Disease: Certain eye diseases such as diabetic retinopathy, eye tumors or severe inflammation can lead to floaters.

Retinal Tears or Detachment: Retinal tears or detachments can be a cause of floaters. A torn retina can lead to a retinal detachment which is a very serious condition where the retina separates from the back of the eye and if untreated can lead to permanent vision loss.

When to See a Doctor

There are some cases where seeing spots is accompanied by other symptoms that could be a sign that there is a more serious underlying problem. The most common of these is seeing flashes of light. This often happens when the vitreous is pulling on the retina which would be a warning sign of a retinal detachment. Retinal detachment must be treated immediately or you can risk a permanent loss of vision. Flashes of light sometimes also appear as symptoms of migraine headaches.

If you experience a sudden onset or increase in floaters, flashes of light, pain, loss of side vision or other vision disturbances, see a doctor immediately. Further, if you have recently had eye surgery or a trauma and you are experiencing floaters during your recovery, it is advised to tell your doctor.

Generally, floaters are merely a harmless annoyance but keep an eye on your symptoms. As with any sudden or serious change in your health, it is worth having them checked out if they are really bothering you. In some cases, they may be an early warning sign of a serious problem that requires swift treatment to preserve your vision.

Eye Allergies

Along with congestion, runny nose, coughing, sneezing, headaches and difficulty breathing, individuals with allergies often suffer from eye allergies or allergic conjunctivitis resulting in red, watery, itchy and sometimes swollen eyes. Just as irritants cause an allergic response in your nasal and respiratory system, your eyes also react with an oversensitive immune response, triggered by an environmental substance that most people’s immune systems ignore. Most individuals with allergies also suffer from eye allergies which affect millions of North Americans, particularly with seasonal allergic conjunctivitis (SAC) which is common during the spring, summer and fall.

What Causes An Eye Allergy?

Eye allergies, or any allergies for that matter, occur when the immune system is hypersensitized to a stimulus in the environment that comes into contact with the eye. The allergen stimulates the antibodies in the cells of your eyes to respond by releasing histamine and other chemicals that cause the eyes and surrounding tissue to become inflamed, red, watery, burning and itchy.

Eye allergens can include:

  • Airborne substances found in nature such as pollen from flowers, grass or trees.
  • Indoor allergens such as pet dander, dust or mold.
  • Irritants such as cosmetics, chemicals, cigarette smoke, or perfume.

Tips for Coping With Eye Allergies

Allergies can go from mildly uncomfortable to debilitating. Knowing how to alleviate symptoms and reduce exposure can greatly improve your comfort and quality of life, particularly during allergy season which can last from April until October.

To reduce exposure to allergens:

  1. Stay indoors and keep windows closed when pollen counts are high, especially in the mid-morning and early evening.
  2. Wear sunglasses outside to protect your eyes, not only from UV rays, but also from airborne allergens.
  3. Avoid rubbing your eyes, this can intensify symptoms and increase irritation. When the eyes get itchy, it is difficult not to rub and scratch them. However, rubbing the eyes can aggravate the allergic cascade response, making them more swollen, red, and uncomfortable.
  4. Check and regularly clean your air conditioning filters.
  5. Keep pets outdoors if you have pet allergies and wash your hands after petting an animal.
  6. Use dust-mite-proof covers on bedding and pillows and wash linens frequently.
  7. Clean surfaces with a damp cloth rather than dusting or dry sweeping.
  8. Remove any mold in your home.
  9. Reducing contact lens wear during allergy season or switch to daily disposable contact lenses.

Treatment for the uncomfortable symptoms of allergic conjunctivitis include over-the-counter and prescription drops and medications. It is best to know the source of the allergy reaction to avoid symptoms. Often people wait until the allergy response is more severe to take allergy medication, but most allergy medications work best when taken just prior to being exposed to the allergen. Consult your eye doctor about your symptoms and which treatment is best for you.

Non-prescription medications include:

  • Artificial tears (to reduce dryness)
  • Decongestant eyedrops
  • Oral antihistamines

Prescription medications include eyedrops such as antihistamines, mast-cell stabilizers, or stronger decongestants as well as non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids.

Immunotherapy which are allergy injections given by an allergist are sometimes also helpful to assist your body in building up immunity to the allergens that elicit the allergic response.

If no allergy medicine is on hand, even cool compresses and artificial tears can help alleviate symptoms.

Finding the right treatment for your allergies can make all the difference in your quality of life, particularly during the time of year when most of us like to enjoy the outdoors.

Dry Eye Syndrome

Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.

Signs and Symptoms of Dry Eye

Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the amount of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.

Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes, because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.

What Causes Dry Eyes?

In dry eye syndrome, the tear glands that moisturize the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.

Dry eye syndrome has several causes. It occurs:

  • As a part of the natural aging process, especially among women over age 40.
  • As a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications and birth control pills.
  • Because you live in a dry, dusty or windy climate with low humidity.

If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day.

Dry eyes are also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s Syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus).

Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.

Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, can increase your risk of dry eye syndrome. Dry eye has also been associated with incomplete lid closure following blepharoplasty – a popular cosmetic surgery to eliminate droopy eyelids.

Treatment for Dry Eye

Dry eye syndrome is an ongoing condition that treatments may be unable to cure. But the symptoms of dry eye – including dryness, scratchiness and burning – can usually be successfully managed.

Your eyecare practitioner may recommend artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. In some cases, your doctor may also prescribe a steroid for more immediate short-term relief.

Another option for dry eye treatment involves a tiny insert filled with a lubricating ingredient. The insert is placed just inside the lower eyelid, where it continuously releases lubrication throughout the day.

If you wear contact lenses, be aware that many artificial tears cannot be used during contact lens wear. You may need to remove your lenses before using the drops. Wait 15 minutes or longer (check the label) before reinserting them. For mild dry eye, contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary. Switching to another lens brand could also help.

Check the label, but better yet, check with your doctor before buying any over-the-counter eye drops. Your eye doctor will know which formulas are effective and long-lasting and which are not, as well as which eye drops will work with your contact lenses.

To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Wraparound styles offer the best protection.

Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that’s too dry because of air conditioning or heating.

For more significant cases of dry eye, your eye doctor may recommend punctal plugs. These tiny devices are inserted in ducts in your lids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist.

If your dry eye is caused by meibomian gland dysfunction (MGD), your doctor may recommend warm compresses and suggest an in-office procedure to clear the blocked glands and restore normal function.

Doctors sometimes also recommend special nutritional supplements containing certain essential fatty acids to decrease dry eye symptoms. Drinking more water may also offer some relief.

If medications are the cause of dry eyes, discontinuing the drug generally resolves the problem. But in this case, the benefits of the drug must be weighed against the side effect of dry eyes. Sometimes switching to a different type of medication alleviates the dry eye symptoms while keeping the needed treatment. In any case, never switch or discontinue your medications without consulting with your doctor first.

Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo.

If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.

Amblyopia (Lazy Eye)

Amblyopia, which is also called “lazy eye”, is a disorder that affects the visual development in children. Amblyopia is difficult to correct just with the use of contact lenses, or eyeglasses. Ambylopia can cause vision loss if it is not treated early and properly. This vision disorder affects 2-3% of the population.

What are the symptoms of Amblyopia?

Usually children that are born with amblyopia, the symptoms start in early childhood. Some signs of amblyopia in children are squinting, closing one eye in order to see better, poor general vision, headaches, and eyestrain. Usually caretakers such as parents, caregivers, doctors, or nurses notice these symptoms and recommend the child for treatment.

What are the causes of Amblyopia?

Strabismus is usually the cause of amblyopia. Strabismus is the eyes aligning incorrectly. Amblyopia can also be caused when there is a large difference between the eyes in refractive errors (prescription much higher in one eye than the other). For example, one eye is nearsighted, while the other is farsighted. If amblyopia is not treated, the brain will learn to disregard the vision in the eye with amblyopia. The eye that is disregarded does not grow with clear image and vision loss can be permanent. This is why it is very important to get early treatment and take your child to see your eye doctor if any signs are apparent.

How is Amblyopia treated?

There are several treatments for amblyopia, depending on the cause. Often children are treated using vision therapy, which usually includes a patch on the better eye. Other treatments are atropine eye drops, correct prescription eyeglasses, or surgery.

Vision Therapy

Vision therapy consists of eye exercises, which aim to teach the eyes to work together. In cases of amblyopia, the exercises require the brain to recognize the affected eye, which restores vision in that eye. Some doctors place a patch over the more functional eye, which forces the less functional eye to work harder and become stronger. The patch is generally worn for a few hours a day. Depending on the severity of the condition, treatment can last for weeks or months. Some children refuse to wear a patch, in those cases, a prosthetic contact lens is available. These contact lenses look like the regular eye, and are designed to block vision in that eye.

Atropine drops

Some doctors use atropine eye drops to treat amblyopia. These drops blur vision in the child’s better eye, forcing the weaker eye to work harder and get stronger. In the morning, one drop is instilled under eye doctor’s instructions. The advantage to this method of treatment is that the patch is avoided.

Prescription eyeglasses

If your child has developed amblyopia because of uncorrected vision, sometimes all that is needed is a pair of eyeglasses. When there is strong uncorrected prescription, or when there is a large difference in prescription between the two eyes, sometimes amblyopia can result. Your eye doctor may recommend eye patch therapy in addition to corrective lenses.

Surgery

Strabismus surgery is usually required if the amblyopia is due to a large eye turn. This type of surgery aligns the eyes and corrects the problem within the eye muscles. After the surgery the eyes will able to focus better. Additional vision therapy may be required after strabismus surgery.

Amblyopia must be treated as early as possible as there is no chance that it will resolve by itself. Untreated amblyopia can lead to permanent vision loss in that eye and reduced depth perception. Amblyopia needs to be treated promptly so that your child can have the best vision possible in childhood and later in life. When amblyopia is diagnosed and treated before age 9, the weaker eye can often develop significantly better vision. The most critical time to treat amblyopia is from 3 to 6 years of age. If you or anyone sees any signs of amblyopia, go to your eye doctor to find the best treatment for your child.

Corrective Eye Surgery Basics

In recent years there have been tremendous advances in the field of vision correcting eye surgery which is also known as refractive or laser surgery. Corrective eye surgery offers patients clear vision without the use of glasses and contact lenses. There are a number of types of refractive surgeries that are able to correct different vision problems, so if you are considering surgery here are some of the options you should know about.

LASIK

LASIK (laser-assisted in situ keratomileusis) surgery is perhaps the most well-known refractive surgery today. LASIK can help patients with myopia (nearsightedness), hyperopia (farsightedness) and astigmatism. During the procedure, the doctor makes a flap in the outer layer of the corner to reach the underlying tissue and then uses a laser to reshape the tissue which allows the cornea to then focus light properly. The procedure is usually painless and vision is usually clear within a few hours.

Recent advances in the field have developed subcategories of LASIK surgery such as Bladeless LASIK, which uses a laser rather than a mechanical tool to make the initial flap or Wavefront (custom) LASIK which uses computer mapping to guide the reshaping of the cornea and is able to create a much more precise visual correction for very subtle optical imperfections. There is also a procedure called Epi-LASIK in which following the procedure, the doctor applies a soft contact lens to protect the surgical area, holding the flap in place while it heals.

PRK

PRK (photorefractive keratectomy) also uses a laser to correct mild to moderate myopia, hyperopia and astigmatism. PRK was a precursor to LASIK which eliminated many of the complications of prior surgeries such as glare, seeing halos around lights, blurred vision and regression of vision. Unlike LASIK, the procedure only reshapes the surface of the cornea and not the underlying tissue. Consequently, there is often some discomfort for a couple of weeks until the outer layer of the cornea heals. Additionally, the patient may experience blurred vision during this period of healing. PRK does offer an advantage over LASIK in that there is less risk of certain complications. Wavefront technology is also available for PRK surgeries.

Due to the increased comfort of LASIK there was a period that PRK saw a decline. Recent studies show however that LASIK and PRK have similar long-term success for improved visual acuity and with the assistance of newly developed effective pain medications, PRK has become more popular again as an option.

LASEK

In LASEK or laser-assisted sub-epithelial keratomileusis, the doctor creates a flap smaller but similar but to LASIK, and then uses an alcohol solution to loosen the tissue around the cornea which is pushed aside, and then a laser is used to reshape the cornea itself. In an Epi-LASEK procedure, the doctor may apply a soft contact lens to hold the flap in place to assist in reattaching to the cornea as the eye heals. Patients that undergo LASEK generally experience less discomfort and quicker vision recovery than PRK patients. LASEK may be preferred over LASIK as a safer option for patients with a thin cornea.

Cataract Surgery

Cataract Surgery is a very common refractive surgery that removes the clouded natural lens of the eye and replaces it with an artificial lens called an IOL (intraocular lens). Many patients these days will receive a lens that also corrects any refractive error they have such as nearsightedness, farsightedness or presbyopia.

RLE

RLE or refractive lens exchange is a non-laser procedure the replaces the natural lens of the eye. This is the same as the surgery that is used to treat cataracts, ,yet for non-cataract patients, RLE is used to correct severe nearsightedness or farsightedness. The procedure involves the doctor making a small cut in the cornea, removing the natural lens and replacing it with usually a silicon or plastic lens. It is particularly useful for patients with minor corneal problems such as thin corneas or dry eyes.

RLE is more risky than the other procedures mentioned and can affect the patient’s ability to focus on close objects, possibly requiring reading glasses following the procedure. However, in cases of severe vision correction it is often the preferred method.

PRELEX

PRELEX or presbyopic lens exchange is for patients with presbyopia, the age-related condition in which you lose the flexibility of your lens and can no longer focus on close objects. Patients that prefer not to wear reading glasses or multifocals, can opt for a procedure in which the doctor removes the natural lens of your eye and replaces it with a multifocal artificial lens. This procedure is often done in conjunction with cataract surgery.

Phakic Intraocular Lens Implants

Phakic IOLs are implants that are used for individuals with very high nearsightedness who do not qualify for LASIK or PRK. The implant is attached to your iris or inserted behind your pupil, while the natural lens remains intact. Because this is a procedure that involves the inner eye, it is more risky than LASIK or PRK and is therefore also typically more expensive.

Conductive Keratoplasty (CK)

CK uses a hand-held radio wave device to shrink tissue on the cornea to reshape it. The procedure is typically used to treat mild farsightedness and presbyopia, particularly for patients who have already undergone LASIK.

Any surgical procedure has risks and may have some side effects or complications that you should research before you decide to go ahead with the surgery. Nevertheless, as technology advances these complications are being significantly reduced making refractive surgery a great option for vision correction in many patients.

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.

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