What Are The Benefits Of A Comprehensive Eye Exam?

Comprehensive eye exams evaluate all aspects of your vision and eye health.

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

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

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

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

Comprehensive eye exams look at your total health history.

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

Comprehensive eye exams are performed by eye professionals.

Eye doctors are highly trained. Optometrists examine the eyes for visual defects, diagnose problems or impairments, and prescribe corrective lenses. After a bachelor's degree, optometrists complete a four-year program to obtain their Doctor of Optometry degree.

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

What Is Dry Eye?

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

Preventive Self-Care

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

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

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

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

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

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

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

Artificial Tears

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

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

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

Prescription Dry Eye Treatments

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

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

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

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

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

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

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

Dry Eye Procedures

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

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

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

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

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

What Is The Goal Of Glaucoma Treatment?

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

What Are The Limitations Of Standard Glaucoma Treatments?

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

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

What Are Recent Advances In Glaucoma Treatment?

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

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

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

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

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

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

• Tear duct plugs that release medication

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

Minimally Invasive Glaucoma Surgery

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

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

Monitoring Eye Pressure

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

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

Every patient is different and so are their eyes. This means that there need to be different types of contact lenses to suit each individual. Some patients have corneal abnormalities which mean that conventional lenses won’t sit comfortably on the surface of their eyes, while others suffer from eye conditions that mean normal contact lenses won’t be comfortable or could irritate their eyes.

As you may have guessed from the name, specialty contact lenses are unconventional contacts that are designed for patients that regular contacts might not be suitable. Here are some of the main types of speciality contact lenses and who they are recommended for.

Who Might Be A Good Patient For Specialty Contact Lenses?

Some of the patients that might benefit from specialty contact lenses include those who:

• have been diagnosed with dry eye syndrome

• have corneal scarring

• have been diagnosed with keratoconus, a condition characterized by the bulging of the cornea

• suffer from strabismus, a condition where the patient has an eye that turns in or out relative to the other

• have suffered an injury to the eye

• suffer from a peripheral corneal thinning disorder

• are intolerant to other types of lenses

Your eye doctor or contact lens provider will be able to tell you if you need specialty contact lenses and if so, which lenses would be best based on your individual requirements.

Rigid Gas-Permeable Lenses

Also known as RGP lenses, these are made from a special material that allows oxygen to pass through them and reach the surface of the eyes. This helps to keep the eyes hydrated and comfortable, making these lenses easier to wear, especially for patients who suffer from dry eyes. Dry eyes aren’t just a symptom, but a very real condition, characterized by dry, stiff, and uncomfortable eyes, blurred vision, and eye fatigue. RGP lenses are more rigid than soft lenses, and this helps to keep them stable and secure on the eyes so that patients can enjoy sharper vision. They also help the cornea to maintain its shape, which helps to minimize the effects of some corneal abnormalities.

Scleral Contact Lenses

Scleral contact lenses are very different to standard contact lenses. This is because scleral lenses are much larger in diameter, with three different sizes available depending on your specific needs. This size difference means that the edges of the contact lens fall on a white part of the eye, called the sclera rather than the cornea. Scleral lenses are also different in that they vault over the surface of the cornea rather than touching it, leaving a space between the front surface of the eye and the back of the contact lens. This makes scleral lenses a good choice for patients with dry eyes and corneal abnormalities. Space can trap tear film which keeps the eyes hydrated, while space also accommodates many corneal abnormalities, such as the bulge associated with keratoconus.

Limbal Fit Contact Lenses

Limbal contact lenses are another type of specialty lens that falls between rigid gas-permeable lenses and scleral varieties in terms of their size. Their larger overall diameter helps to increase their stability on the surface of your eyes. They also offer minimal interference with the eyelids, which helps to ensure comfort and clarity of your vision.

Hybrid Contact Lenses

Hybrid contact lenses are a combination of both soft and gas-permeable contact lenses, giving patients the opportunity to enjoy the best parts of both designs. The middle part of hybrid lenses is made from gas-permeable material that lets oxygen pass through to the eyes. However, the gas-permeable part of the lens is more rigid, and this firmer center gives the lens greater stability and the patient enhanced clarity. The RGP portion of the lens also helps to trap a tear film between the cornea and the lens so that the eye remains hydrated. Meanwhile, the outer edge of hybrid lenses is a soft lens skirt. This means that patients don’t have to deal with the hard edges associated with RGP lenses that may be uncomfortable. Instead, the comfort levels that patients experience are more like wearing fully soft lenses.

For more information about specialty contact lenses, don’t hesitate to speak to our dedicated eye care team.

Many patients come to us every day struggling to get through their daily lives with their current choice of vision correction. Some have eyeglasses that do not sit properly on their face or feel that their peripheral vision is hindered by the frames. While contact users may find the lenses uncomfortable or have them fall out at inconvenient times. For these patients, we are pleased to offer orthokeratology, or Ortho-K, a revolutionary way to help you see clearly throughout the day without having to wear glasses or contacts and without having to get laser eye surgery.

What Is Ortho-K?

Generations ago, eye doctors knew that the tissue in the eye was soft and somewhat malleable. This knowledge caused them to wonder if they could push the eye back into the proper shape, would an individual be able to see clearly even if they were not wearing their prescription lenses. With the development of gas permeable contact lenses, a few eye doctors began to notice that their patient’s prescriptions did not change as rapidly as previously noted and that they appeared to be able to see correctly even when they were not wearing their contacts.

From these early discoveries, the world of Ortho-K was born. Ortho-K is a special treatment to help patients see clearly even when they are not wearing a prescription lens. Instead, a special gas permeable contact lens is placed into the eye each night before bed and the lens gently pushes the eye into the proper shape while you sleep. In the morning, you can remove the lenses and still see clearly throughout the day. Some patients can even see clearly for up to three days after wearing them for just one night!

Who Should Consider Ortho-K?

• There are a number of issues that our patients can have with prescription lenses. If you have one of the following conditions or concerns, call our office today to schedule an appointment.

• Allergies to the materials in contact lenses

• Dry eye that is made worse by wearing prescription lenses

• Dirt or other debris that gets under contact lenses

• You play sports and do not want to worry about glasses or contacts

• The ability to wake up at night and see clearly

• A general dislike of glasses or contacts
  
  

How Long Does It Take?

Once you receive your custom Ortho-K contact lenses, it will take anywhere from one to four weeks to fully see all the benefits to your vision that they will provide. However, some of our patients find that their vision has improved after only wearing their lenses for a single night! During the first few days, you may also still need to wear prescription lenses to see clearly enough to drive or get through your normal day, but that is generally quickly resolved. Also, some patients experience some mild discomfort for the first few nights, but as your eyes adjust over a few days, you should no longer be bothered by the feel of your lenses. Is the Procedure Safe? Orthokeratology was approved by the Food and Drug Administration (FDA) in 2002. The procedure is considered safe, effective, and reversible. However, there are some side effects associated with Ortho-K. Most of these side effects are a result of improper cleaning of the lenses that can lead to a minor infection. These infections are usually remedied fairly quickly with the use of antibiotic eyedrops.

Overview

If you are sick and tired of wearing contact lenses or glasses every single day and would like an alternative way to correct your vision, consider trying Ortho-K. If you would like more information on Ortho-K, please call our offices today and see how we can improve your everyday life.

Dr. Pham is prescribing Atropine 0.025% ophthalmic solution in order to attempt to stop or slow the progression of nearsightedness in your child. This is an off-label use for this medication. Studies have shown that this medication is effective in slowing the rate of progression of nearsightedness in children.

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MiSight® 1 day is FDA-approved to slow the progression of myopia in children aged 8-12 at the initiation of treatment. Don't let your child's near sightedness hold them back in school and their future.

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