Saturday, October 24, 2009

Dry Eye or Ocular Surface Disease

In speaking about this subject, I feel the key is the word disease in the title of this post. Patients in particular need to begin to think of this condition more seriously as a disease. It is probably close to the number one reason for patients coming in to all of our offices today. While artificial tears are certainly a part of our therapy regimen and in mild cases may be all that is needed, there are a host of other cases that require much more attention. The etiology of this condition can be various and therefore treatment must address sometimes a variety of problems. Last year I talked about fish oil which remains an important item in our treatment regimen. The amount of fish oil is important. For maintance doses one should be taking 2 grams of EPA and DHA within the fish oil. With lid disease and inflammation one needs 3.5 to 4 grams of Omega 3. So if you are shopping for fish oil be sure you are getting high concentrations. Pro Omega and Lifeguard are 2 such products that offer these higher concentrations.
Sometimes good old fashioned warm compresses can help greatly with lid disease management. Cyclosporin or restasis is another drug which has become an important part of our treatment regimen. Very low dose doxycycline over a long period of time has become a great treatment option and is available in a kit form called Alodox with all of the other items one need.
If you are a patient with arthritis or other conditions with persistent dry eye problems talk to your doctor about getting a dry eye work up.

Sunday, August 9, 2009

Ketatoconus lenses that are comfortable

Today I would like to talk a little about a condition known as keratoconus. This condition is one in which the cornea slowly thins and starts forming a cone shape. The result optically is considerable. Early on large astigmatic changes start occurring and in advanced cases spectacles can no longer correct for the aberrations that occur. Rigid gas permeable lenses or RGP lenses have been our only option up till recently (with the exception of a corneal transplant) that will keep this condition in check and allow the individual to function with clear vision. There are special RGP lenses that are made for mid to advanced cases of this condition. These have worked well for many years but can sometimes be somewhat uncomfortable for some people. About 3 or 4 years ago a new company called Synergeyes came out with a new hybrid lens for this condition. This lens has an RGP center and a soft lens skirt. The end result is that the lens stays more stable on some of these advanced keratoconus eyes and is quite a bit more comfortable than a standard RGP lens. Patients have loved this newer lens and are quite happy with this new addition to our treatment options. If you are a keratoconus patient out there, I urge you to go to your doctor and ask about the synergeyes lens for keratoconus. I am sure you will be glad that you did.

Monday, June 29, 2009

Polarized Lenses

Now that we have officially entered the summer season, I feel this is a great time to talk about polarized sunwear. When patients are ordering prescription glasses, they have a choice of getting a tint on their lenses or getting polarized lenses. There is a huge difference between the two. A tint is exactly like it sounds. The lenses are dipped in dyes to tint them to the desired amount of darkness. This results in cutting the amount of light coming into the eye but there are no protections from UVA and UVB rays unless specifically ordered as extra coatings. If these coating are not specifically ordered and are not present(as is the case in many of the non rx sunwear that people purchase in drug stores,etc.)then the end result is worse. The pupil opens up with the darkened lens and allows UVA and UVB rays in a greater amount which in turn can help to cause cataracts. Many case studies aslo indicate this can also lead to macular degeneration.

Polarized lenses are actually layered lenses that cut glare and reflections from reflective surfaces such as water and snow. They also cut the UVCA and UVB rays as well. The glare and reflections are what usually cause visual discomfort. If you have never tried polarized lenses, do yourself a favor the next time you order and try out these great lenses. One company that we carry, Maui Jim Sunwear, has several proprietary coatings that make this lens what I consider to be one of the best lenses for sunwear in the world today. These can be ordered in prescription as well as non rx.

I hope you will try a separate pair of polarized sunwear this summer for a great and more comfortable experience.

Sunday, June 7, 2009

Reflection free or Antireflective coating

I heard feed back from my staff recently concerning this subject that disturbed me. Apparently a patient stated that this option was made up by optometrists just to make extra money. I am here to state that nothing could be further from the truth.

Just to put everyone out there on a level playing field as far as knowledge let me explain what this coating does. Just as the name implies, this coating cuts glare and reflection off of the surface of your lenses so that not only are objects clearer but night driving is improved. Oncoming headlights without reflection free can be very uncomfortable. With AR coating night driving and contrast sensitivity is greatly improved. Even reflections from your computer screen are cut and make every day tasks more comfortable.

Additionally on thin lens materials this coating is highly recommended and the thinnest of lenses are not even available without it. As lens materials become thinner, there are internal reflections within the lens itself that can be so disturbing that it would be almost impossible to wear the lens without this coating in place.

In Europe, Japan, and other places around the world, about 99% of lenses are sold as reflection free.

As part of everyone's exam, the patient is tested using reflection free coated lenses within the instrumentation. Therefore if a patient orders lenses without this coating they are not getting the acuity that they were tested with in the exam room.

For some odd reason in this country, many people feel this is an "add on" that is not necessary when in reality this provides the comfort and acuity that most everyone wants.

Wake up people and join the rest of the world in providing yourself with the very best acuity possible. After all, you deserve the best!