Skip to main content
Home »

All About Vision

FAQ’s

What are the typical treatments used to help people suffering from Dry Eyes?cactus eye (series C)

Treatment varies according to the severity of your dry eyes and what type of dry eye you have. Options may include prescription medications, lubricating drops, gels, or ointments, dietary supplements, and warm compresses. You and your optometrist can work together to help you decide which treatment is best for you.
.

I have a friend in whose eyes are frequently overly watery. That isn't Dry Eye, is it?

It's ​likely​. Poor tear film quality and/or quantity can often lead to ocular surface irritation and an associated increase in tear production leading to excessive tearing or "watery eyes." Some people also have a type of "oil deficient" dry eye in which the tears themselves don't have enough of a moisturizing oil component. So even though your eyes are watering, they are not moisturizing the eyes.
.
How often should I get my eyes examined?

We recommend that everyone get a complete eye exam every year. This insures good ocular health, and insures we catch a problem while it's still a small one. This is especially important if you are a contact lens wearer. You have an increased risk of serious complications that may not be evident until examined. Don't be fooled into thinking your eyes are healthy just because you think you're seeing clearly. Your eyes are also a good source of information regarding your overall systemic health. Diseases like high blood pressure, diabetes, M.S., high cholesterol, and many others frequently show up in the eyes, and regular eye exams can help to monitor or detect these conditions. Ask yourself this . . . would you rather lose your teeth, or your vision. Don't take your vision for granted! Don't let your insurance company dictate how often you should be seen either. Do you think they care about the health of your eyes like we do, or do you think maybe they just want to cut costs? Get your eyes examined every year.

What are floaters?

Floaters are usually a normal thing that most people experience under the right conditions, but there are a few situations that might indicate a serious condition. If a sudden increase in the number of floaters is seen, or if associated with flashes of light, you should seek care immediately. In most cases, these are normal things floating around in our eyes. These may be blood cells, or strands of collagen which have clumped together that make up part of the gel in the eye, or remnants of tissue when our eyes first developed. These structures in the eyes are not entirely transparent, and will block some light. So when light comes in the eye, what is seen is actually a shadow of these things floating in the gel. They are most noticeable when in a brightly lit room while looking at a uniform white wall, but they are always there, we just don't notice them. Although floaters can be very annoying, they should present no threat to the health of your eyes.

What are cataracts?

Cataracts occur when the lens inside the eye becomes cloudy and less transparent. You may experience light sensitivity, blurry vision, and distorted colors. Studies suggest that antioxidants in the diet may lower the risk for developing cataracts. Smoking also contributes to the development of cataracts. The most common reason for the development of cataracts is the natural aging process. Other causes are trauma to the eye, excessive ultraviolet exposure, and certain systemic diseases, such as diabetes.

Why do I need my eyes dilated?

The only way to get a good view of all the structures in the eye is to dilate them, or open the pupil up very big. If the eyes weren't dilated with eye drops, if we tried to look in them with a light, the pupils would just get very small and it would be very hard to see inside. It would be like trying to look through a keyhole, we would only see a small area, but when dilated, it sort of opens up the door to the eye so we can view everything. Everyone should have their eyes dilated on a regular basis. If your doctor is not doing this, he or she could be missing a possible sight-threatening condition like a retinal detachment or retinal hole to name just a few. Also, anyone who has diabetes should be having a dilated eye examination at least annually, as the leading cause of blindness in the working population is from diabetic retinopathy. The dilation typically lasts about 4 to 6 hours and will cause it to seem very bright outside, so remember to bring your sunglasses. It may also make things blurry up close, especially for reading or work, so keep this in mind when scheduling your appointment.

What is Astigmatism?

First of all it is nothing to be ashamed of! It is not a disease, and is nothing that cannot be easily corrected with glasses or contact lenses. Astigmatism is simply a refractive condition that has to do with the way light focuses into one's eyes. The cornea is the clear front part of the eye that focuses most of the light into the eye. If the cornea is spherical, like a baseball or basketball, when light comes into the eye in different directions, all the light is focused into one point. If the cornea is shaped like a football, where one meridian or direction is steeper than the other, light will be focused differently as it enters the eye in different directions 90 degrees apart. This will cause blurred vision at distance and near if it is not corrected.

What's the difference between farsighted and nearsightedness?

Both are refractive conditions, meaning that they are problems related to how the light is focused as it enters the eye. Ideally, as light enters the eye, without any additional effort, the light would be perfectly focused onto the inside lining of the eye which detects the light, called the retina. The brain would than see a clear view of the world. This person would not need glasses for the distance. If a person is farsighted (hyperopic), the optics of the eye are too weak (or the eye is too short), and the rays of light would focus behind the retina, causing a blurred image to be on the retina. This person in general would see better at distance than near, or be "farsighted." If a person is nearsighted (myopic), the light rays focus in front of the retina because the optics are too strong (or the eye is too long). This also causes a blurred image to fall on the retina. This person would see better at near, or be "nearsighted.

What's the difference between an optometrist and an ophthalmologist?

Both are eye doctors that diagnose and treat many of the same eye conditions. The American Optometric Association defines Doctors of Optometry as: primary health care professionals who examine, diagnose, treat and manage diseases and disorders of the visual system, the eye and associated structures as well as diagnose related systemic conditions. They prescribe glasses, contact lenses, low vision rehabilitation, vision therapy and medications as well as perform certain surgical procedures.

The main difference between the two, is that ophthalmologists perform surgery, where an optometristwould not. For instance: cataract, refractive, or glaucoma surgery.

Optometrists would be involved in all of the pre- and postoperative care of these patients; collecting accurate data, educating the patient, and insuring proper healing after the procedure. An ophthalmologist is more of a specialist, who would need only to be involved if some kind of surgery were being considered. An optometrist can treat most any eye condition, including the use of topical or oral medications if needed. This might include the treatment of glaucoma, eye infections, allergic eye conditions and others, to name just a few.

A third "O" that often comes up and confuses people is an optician. An optician is not a doctor, and they do not do eye examinations. They do play an important role though in most eye doctors' offices. An optician most often handles the optical and glasses side of things. They help patients pick out the correct eyewear, including the frame and lenses. Many also are trained in the making of glasses in the lab. In some states, opticians must be licensed to do their job, though Colorado is not one of them.

I'm over 40 and I can't read well up close. Why?

The closer we hold something, the more focusing our eyes have to do to keep things clear. As we get older and reach the age of about 40 to 45, the lens inside our eyes becomes less able to change shape and focus for up close, and we have to hold things further away to keep them clear. This is called presbyopia. Some people begin to think their arms simply aren't long enough! Reading glasses or some type of bifocal will take care of this problem easily enough.

What is glaucoma?

It is a hereditary disease in which increased fluid pressure in the eyeball causes damage to the optic nerve, which causes a loss of peripheral or side vision. The worst thing about glaucoma, is that it is almost always a "silent" disease, meaning we don't have any idea we have it, and don't realize we are losing vision until the vision is lost forever. The most effective way to treat glaucoma is to catch it early and lower the pressure in the eye before the damage is done. The best and only way to insure this is to have annual eye exams including an evaluation for glaucoma. The most common way to treat glaucoma is the use of eye drops on a daily basis to help lower the pressure of the fluid in the eye. There are also a number of laser and conventional surgeries which can be performed, but typically are done in conjunction with eye drops, or if poor control is obtained with eye drops alone. There are a number of factors that also put certain people at risk for the disease. These include being over the age of 60, a family history of the disease, diabetes, high blood pressure, smoking, and being of colored decent.

What is Diabetic Retinopathy?

It is a common complication of diabetes that occurs when tiny blood vessels in the retina are damaged by the load of sugar they are carrying. Your vision may become blurred and night vision impaired. All people with diabetes should have an exam with dilated pupils at least once a year. Laser surgery can help shrink abnormal vessels in the early stages of the disease. Diabetic Retinopathy is the leading cause of blindness in American adults, and the saddest part of that statistic is that most of these cases could have been prevented with regular eye exams. People with diabetes are also at a greater risk of developing cataracts and glaucoma.

What is Macular Degeneration?

Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in people over 65 in the United States. It is a slow, progressive, and painless condition that affects the macula, the small central part of the retina that allow you to see fine detail clearly. The exact cause is not yet known, and currently there is no permanent effective treatment or cure for the condition. A growing body of research seems to suggest that nutrition plays an important role in AMD. Many of the studies are focusing on the role of a group of antioxidants called carotenoid (the pigments that give fruits and vegetables their color). Two of these carotenoids, lutein and zeaxanthin, are the only pigments found in the macula. A diet including at least two to four serving a week of vegetables high in lutein and zeaxanthin may help lower your risk of developing AMD. Leafy, green vegetables highest in these carotenoids include kale, raw spinach, and collard greens. Nutritional supplements may be a beneficial alternative to this type of diet.

Should I buy my contact lenses over the phone or Internet?

The first thing you need to remember is that price is not the only thing that determines value. Other factors need to be considered.

  • How much will I pay for shipping?
  • How long will it take to get the lenses?
  • Are they in stock, or will it take even longer than they advertise it will?
  • Can they even get the lenses my doctor thinks are the best lenses for me?
  • Will they give me free replacement lenses if I tear or break a lens?
  • Where is this company located? Are they helping my community?
  • Will you get any rebates that the manufacturer is offering?

Of course, we prefer you let us handle taking care of your lenses, and that you purchase them from us. Sometimes we're a bit more expensive, but often not . . . especially if you are being charged for shipping. We can almost always get your lenses within 2 days, with no extra charges for shipping or handling. If you purchase a minimum number of boxes, we can even ship them directly to you at no extra charge . . . that's as convenient as it gets! That means while you're in the office for your appointment, we take care of it all right then, no time wasted on the phone or on the Internet searching to try to save a few bucks or to find out we're actually less. Everything's all done at your one visit.

We even give you free replacement contacts should you rip or break a lens. That's big. The few bucks you save can easily be made up in no time if for example, your 12 months supply of lenses only lasts 9 months. You will not get lenses free over the Internet should this happen, that's one thing I'm sure of!

Often, we have manufacturers rebates that are not available from any of these places. These can more than make up for any price difference in itself. The most important thing to keep in mind is that we care about your eyes! We are your local office who is here for you should you have a problem. We contribute to the local economy and help out the community in a number of ways. Unfortunately, these mail order places really don't care about you or the health of your eyes, just the money that you spend buying their product.

These companies are not looking out for the well-being of your eyes, as much as they might say they are. Standards are clear for contact lens prescriptions . . . they expire after 1 year. And for good reason. To make sure your eyes are healthy. Contact lenses are medical devices that can cause problems that can lead to blindness! These companies do not live by these standards, and replace lenses illegally with expired prescriptions. I can't support a practice that does not look out for the well-being of my patients. Ignoring all the other good reasons I've listed here, this one to me is by far enough!

Besides, where would you rather spend your money, here locally in Larimer County, where you'll see the person you bought your lenses from at your local store, or would you rather put it into some other stranger's pocket in some other state whom you'll never even meet. Is it really worth it buying from a mail order place? You'll be the judge.

DRY EYE SYNDROME (DES)

Tears function to keep the eyes lubricated and comfortable. Dry eyes are caused when the tear glands do not produce enough tears and/or the tear ducts drain too much tears off the eye surface. Dry eyes can also be produced by a poor tear quality, and not necessarily a volume problem. Either situation causes the eyes to feel irritated, scratchy, burning, red and uncomfortable. DES is the most common of all eye disorders, affecting about 20% of our population in the U.S. Due to the altitude and dry climate here in Colorado, this is even more of a problem.

Your eyes are lubricated by two different types of tears, lubricating and reflex tears. Lubricating tears are produced continuously to moisturize the eye and contain natural infection-fighting antibiotics. Reflex tears are produced in response to sudden irritation, injury or emotion. Ironically, the irritation from dry eyes can trigger reflex tears, which flood the eye. But because reflex tears do not have the proper lubricating composition, the discomfort persists. Thus, "watery eyes" can actually be a symptom of DES.

What causes DES?

DES has many causes. The most common causes include:

  • Aging process. Tear flow normally decreases with age. About 75% of individuals over age 65 suffer from DES symptoms.
  • Contact Lens Wear. This dramatically increases tear evaporation, causing discomfort, infection, and/or increases protein deposits. DES is the leading cause of CL intolerance.
  • Hormonal Changes in Women. Pregnancy, oral contraceptives, and menopause contribute.
  • Environmental Factors. People who are exposed to smoke, air pollution, high altitude, sunny, windy, cold, dry air conditions are at risk for DES.
  • Side Effects of Disease/ Medications. Several diseases and medications decrease your ability to produce tears.

Treatment of DES: Depending on the severity of the condition, numerous things can be done to help the situation, but DES is a chronic condition, and will likely always be present. Treatment may be as simple as using artificial tears a few times a day. Other things that help are using a humidifier, drinking lots of water, and keeping your lid margins extra clean. In more persistent cases, a simple non-surgical procedure is available in our office that provides long-term relief through the use of tiny plugs called "punctal occluders or punctal plugs". As the name suggests, the device occludes the punctum, or tear duct, which is the drainage duct that carries tears away from the eye. Blocking these drainage ducts prevents tears from draining away too quickly. Punctal occlusion can be compared to putting a stopper in a sink drain. This widely performed procedure is safe, quick, painless, and totally reversible.

Punctal occluders are made of a very soft flexible silicone, similar to that used in soft contact lenses. Though they are barely visible to the naked eye, they are carefully manufactured into an extremely smooth and precise design. Untreated, symptoms will most likely intensify, making daily life unpleasant, or worse, deteriorate your visual acuity. If you suffer from any of the symptoms discussed here, schedule an appointment today to discuss these options with Dr. Vosseteig.

Why are Eye Exams Important?

For both adults and children alike, eye exams are an important part of one’s general health maintenance and assessment. Your eyes should be checked regularly to ensure that you are able to see as best as possible. Regular eye health exams will also check for signs of eye disease or conditions that can affect not only your vision but your overall health. Vision and eye health is such a critical part in learning and development, therefore, we highly recommend eye exams for infants and children.

Vision Screening vs. an Eye Exam

When we recommend regular eye exams, this should not be confused with a vision screening. A vision screening is a basic test that indicates if you have difficulty seeing and require further assessment and corrective measures. It can be performed by anyone, whether it is a school nurse, a pediatrician or even a volunteer at a vision clinic. A vision screening usually only checks vision, it does not check eye health. Also, most vision screenings for kids only check for nearsightedness (when you can not see far), but what happens when the majority of children are farsighted? Most of the time many of these kids get overlooked.

A comprehensive eye exam on the other hand, can only be performed by an eye doctor as it requires special knowledge and equipment to look around and into your eye to check your eye and vision health. Such an exam can assess whether there are underlying causes for vision problems and whether there are any signs of disease which can threaten your site and the health of your eye. A comprehensive eye examination can also diagnose symptoms of diabetes, high blood pressure, high cholesterol, tumors, cancer, autoimmune disorders, and thyroid disorders. A comprehensive eye examination will also provide an accurate prescription for eyeglasses or contact lenses.

Eye Exams for Eye Health

Eye exams are critical because many vision threatening eye diseases such as glaucoma, macular degeneration, cataracts, or diabetic retinopathy have no or minimal symptoms until the disease has progressed. In these cases, early detection and treatment is essential to halting or slowing down the progression of the disease and saving eyesight. During a comprehensive eye examination, your eye doctor will be looking for initial signs of these diseases. If a problem with your eyes arises such as red eyes, eye allergies, dry eyes, eye swelling,eye pain, always seek an eye doctor as your first doctor to call since they are specifically trained to treat eye diseases.

Eye Exams and Children

If your child is having developmental delays or trouble in school there could be an underlying vision problem. Proper learning, motor development, reading, and many other skills are dependent upon not only good vision, but your eyes functioning together. Children that have problems with focusing or hand-eye coordination will often experience frustration and may exhibit behavioral problems as well. Often they don’t know that the vision they are experiencing is abnormal so they aren’t able to express that they need help. Many conditions are much easier to treat when they are caught early while the eyes are still developing, so it is important to diagnose any eye health and vision issues as early as possible.

Eye Exams Over 40

Just like the rest of our bodies, our eyes begin to weaken as we age. There are a number of common age-related eye conditions such as presbyopia, cataracts, and age-related macular degeneration that can begin to affect your vision and your daily life. While some of these conditions are more of an inconvenience, others could lead to vision loss and dependency.

In addition to regular yearly eye exams, it is important to be aware of any changes in your eye health and vision. Also know your potential risk factors as well as your family ocular and medical history. Over half of the vision loss worldwide is preventable with proper treatment and care.

Astigmatism

Many people have never heard of astigmatism, although it is an extremely common eye condition.

Astigmatism is one type of refractive error. Nearsightedness and farsightedness are other types of refractive error. Refractive errors are not eye diseases. Refractive error is a result of and imperfection of the size and shape of the eye, which results in blurry or double vision.

If left untreated, astigmatism may cause eyestrain, headaches, and blurry vision. If you have astigmatism you may not see objects in the distance or near without some form of distortion.

Symptoms of Astigmatism

Small amounts of astigmatism can go unnoticed, however, you may be suffering from eye fatigue, eyestrain, and headaches.

Astigmatism is a condition that usually can develops early in childhood. According to a study from The Ohio State University School of Optometry, 28% of school age children suffer from astigmatism. Parents should be aware that their children might not notice that their vision is blurry, not understanding that this is not normal. Nevertheless, astigmatism should be treated because vision problems can lead to learning problems and in extracurricular activities. Make sure to have your child’s eyes examined at an eye doctor’s office at least once a year.

Causes of Astigmatism

Astigmatism is generally caused by a cornea with an irregular shape. The cornea is the front, clear layer of the eye. With astigmatism, the cornea is not round and spherical and is instead irregular having two curves instead of one curve. Astigmatism in some cases could also be caused by the lens located inside the eye that is irregular in shape.

Eyes with astigmatism distort the light that comes into the eyes because the cornea is irregularly shaped. This causes the light rays entering the eye to create two images in the back of the eye (because of the two curves), instead of one image. This is what causes the distortion in sight.

Treatments for Astigmatism

For most people, their astigmatism is fully corrected using prescription glasses or contact lenses. If you select contact lenses to correct your vision, soft contact lenses are the most common option. If for whatever reason soft contact lenses are not an option, rigid gas permeable (RGP or GP) are also a great choice. Rigid gas permeable lenses usually give the clearest vision but the adaptation process will be significantly longer. Another option are hybrid contact lenses. These contacts have a center made from a rigid gas permeable (RGP) lens and an outer ring made of soft contact lens material. This type of lens provides both excellent clarity and comfort. LASIK could be another option to correct astigmatism. LASIK usually only corrects low levels of astigmatism and some patients with higher levels of astigmatism might not be candidates.

Preparing for an Eye Exam

For both adults and children, an eye exam is a critical part in maintaining your overall health and well-being, and therefore, regular eye exams should be incorporated into your health routine. Comprehensive eye exams assess your vision and the health of your eye, looking for early signs of disease that may not have obvious symptoms. You should not wait until you experience a vision problem or symptoms of an eye condition to schedule a routine exam.

Depending on your age, family history, general health and eye health, it is recommended to have an eye exam every one to two years. Of course if you experience any serious symptoms that affect your eyes or your vision, you should contact your eye doctor immediately.

The Difference Between an Optometrist (OD) and an Ophthalmologist (MD or DO)

Confusion about the difference between optometrists and ophthalmologists is common, and many people are not aware of how the two eye care professionals differ.

Optometrists

Optometrists or Doctors of Optometry attend optometry school which is usually at least four years of graduate level training. They are able to perform eye exams, provide prescriptions for eyeglasses and contact lenses, and diagnose and treat eye diseases as as glaucoma, dry eyes, or eye infections that may require medication or drops. They can consult with and co-manage patients in pre- or post-op surgical care, however they do not perform surgery.

Ophthalmologists

Ophthalmologists are medical doctors that attend medical school and later specialize in ophthalmology. They are able to do all of the services mentioned above but also perform eye surgeries such as cataract surgery, refractive surgery such as LASIK and deal with more urgent eye conditions such as retinal detachment.

Infant and Child Eye Exams

According to the American Optometric Association (AOA) children should have their eyes examined by an eye doctor at 6 months, 3 years, at the start of school and then at least every 2 years following. If there are any signs that there may be a vision problem or if the child has certain risk factors (such as developmental delays, premature birth, crossed eyes, family history or previous injuries) more frequent exams are recommended. A child that wears eyeglasses or contact lenses should have his or her eyes examined yearly.

Adult Eye Exams

Healthy adults under 40 with good vision and who do not wear eyeglasses or contact lenses are recommended to have an eye exam at least every two years. Those that do use vision correction or have a health issue such as diabetes, high blood pressure or another health condition that can have an impact on your eye health should schedule a yearly exam, unless the eye doctor recommends more frequent visits.

Once you reach 40, you become susceptible to a number of age-related eye conditions such as presbyopia, cataracts or macular degeneration, therefore annual or bi-annual exams are strongly recommended.

As you continue to age, particularly after age 55, the risks of eye disease increase, and early detection can be critical to preventing significant vision loss or blindness. Scheduling a yearly eye exam can make all the difference in maintaining your independence and quality of life.

How to Prepare for Your Exam

Prior to your exam you should decide whether you will be seeking special services such as a contact lens exam or LASIK consultation. These services may cost extra. Check with the doctor’s office or your insurance provider to see if they cover any of the exam expenses.

You need to know if you have medical insurance, vision plan coverage or both. Medical insurance usually does not cover “wellness/refractive” exams for glasses or contact lenses. Vision plans will cover exams for glasses or contacts, but usually cannot be used for red eyes, floaters, or other medical eye health problems. Please bring your insurance cards with you.

In addition to bringing your current pair of glasses or contacts if applicable, it is important to be aware of your personal and family history and to have a list of medications or supplements you are currently taking. Your pupils will probably be dilated as apart of your exam, so plan accordingly.

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.

Children’s Vision – FAQ’s

Most parents believe that if their child had an eye or vision problem they would know. However, this is far from the truth for a number of reasons. First of all, children often can’t express or don’t realize the difficulty they are having, and often vision problems will be overlooked by the associated behavioral issues that come as a result of frustration. Further, many eye or vision problems don’t show symptoms until they have progressed significantly which often makes the condition harder to treat.

Conditions such as amblyopia (lazy eye) or strabismus (crossed-eyes) can be corrected more effectively when they are diagnosed and treated early at a young age. Further, the sooner you diagnose and correct a vision problem, the sooner your child will be able to achieve his or her potential without struggling with these difficulties. This is why it is critical to have your child’s eyes examined by an eye doctor at regular intervals. Here are some FAQ’s and answers about Children’s Vision that every parent should know:

Q: At what ages should children have their eyes examined?

A: The official recommendations for the American and Canadian Optometric Associations are that infants should have their first eye exams at 6 months. Following that, children with no known vision issues should have another exam at 3 years and then prior to entering kindergarten. Children who do not require vision correction or therapy should have a vision checkup every year or two years and those who use vision correction should have an annual eye exam. Of course if your child is experiencing difficulty in school or after school activities that may be due to a vision problem schedule an eye exam immediately.

Q: My child passed a vision screening by the nurse at school. Does he still need an eye exam?

A: Yes. Many schools implement a basic vision screening test to assess whether the child sees clearly at a distance, however these tests are limited in scope. They do not assess functional vision such as the child’s ability to focus, track words on a page or the eyes’ ability to work in tandem. They also do not look at the health of the eye itself. These tests are essential to know the comprehensive picture of how healthy the eyes are and how well they are doing their job. In fact, studies shown that up to 43% of children with vision problems can pass a vision screening test! A comprehensive eye exam will assess all of these functions as well as color vision, depth perception, and eye coordination.

Q: My child was diagnosed with strabismus and amblyopia. Can this be treated and if so, what are the options?

A: Especially when diagnosed early, chances of a complete correction for strabismus and amblyopia are good when treated properly. The optimal age for this to occur is before 8-10 years old. Depending on the severity of the strabismus (crossed-eye), surgery may be required to straighten and properly align the crossed eyes. Amblyopia (lazy eye) can then be treated using eyeglasses, eye patching, or vision therapy to strengthen the weak eye and train the eyes to work together. A doctor that specializes in pediatric optometry can assess the condition and discuss treatment options on an individual basis.

Q: What is vision therapy?

A: Vision therapy is a doctor-supervised, individualized program of exercises to strengthen the functions of the eye. It is used to correct issues with eye alignment, focusing, coordination, tracking and more. Vision therapy often utilizes tools such as specialized lenses or prisms and involves exercises both during office visits and at home to reinforce the changes. The process usually takes about 6 months to see lasting improvement.

Q: My son’s nearsightedness keeps getting worse – he needs a new prescription every year. Is there a way to stop this?

A: There is research that shows that progressive myopia can be stopped or slowed during the childhood years. There are a number of therapies that are used for what is called “myopia control” including multifocal eyeglasses or contact lenses, orthokeratology (ortho-k) or atropine eye drops. Speak to a pediatric optometry specialist to learn more about the options and what might work best for your child.

Q: Every morning it is a fight to get my child to wear her glasses. What can I do?

A: It may take time for your child to adapt to the feel of the glasses and to be comfortable seeing with them. For little children, you can find glasses that come with integrated headbands that can help to hold the glasses in place. It helps to be consistent in putting them on to allow the child to adapt to the feel of the glasses.

Very often, especially for small children that can’t tell you what is bothering them, the reason for a child’s refusal to wear glasses is that something is not comfortable. It could be that the prescription is not right, that the glasses pinch or that are feeling heavy. It could be worthwhile to take the glasses back to the eye doctor to ensure that they are in fact a proper fit.

Q: At what age is it acceptable for a child to wear contact lenses?

A: Contact lenses can be a great convenience, especially for kids that are active or tend to break or lose their glasses. However, they are a medical device that must be treated with proper care and hygiene. If a child is not responsible enough to take care of them properly he could end up with a serious eye infection, a scratched cornea or worse. Most experts agree that the youngest age that contact lenses should be considered would be between 10-12 depending on the child’s maturity and cleanliness. Consult with your eye doctor about what would be best for your child.

Your Infant’s Visual Development

Your baby’s visual system is not fully developed at birth and continues to develop gradually over the first days and months of life. In fact, from your baby’s perspective at birth, the world is black and white, blurry and rather flat. As the days and months go on, they begin to focus, move their eyes and start to see the world around them. While each child will grow and develop on his or her own schedule, knowing an infant’s vision milestones will help you ensure that your infant is on track to achieving good vision and eye health and start treatment early if there is a problem.

Birth – 3 months

Because newborn babies’ eyes and visual system are underdeveloped, they can not focus their eyes on close objects or perceive depth or color. Babies need to learn to move, focus and coordinate eye movements to team the eyes (have them move together as a team). The brain also needs to learn how to process the visual information from the eyes to understand and interact with the world. In fact, until about 3 months, the optimal distance a baby can focus on is about 8 – 10 inches from their face, about the distance their parents face will be during feeding.

Your baby will start to be able to perceive color within the first 2-3 weeks, however it will take a few months to learn how to focus and use the eyes, to track objects, differentiate between two objects and shift from one object to the other. During this time you may notice that the eyes appear crossed and do not work together or team. This is quite common at the early stages of development, however if one eye appears to be constantly turned in or out, seek a doctor’s evaluation.

At around three months, as hand-eye coordination begins to develop, a baby should be able to follow a moving target with their eyes and reach for objects.

4-6 Months

By 6 months, your baby will begin to move his eyes with more speed and accuracy, seeing at farther distances and focusing well. Color vision should be fully developed and the eyes should be able to work as a team and follow moving objects with relative ease. Hand-eye coordination and depth perception should be greatly improved as your baby will begin to understand the 3-dimensional world around them.

At six months, you should take your baby for his or her first comprehensive eye exam to ensure that the eyes are developing on track and there are no signs of congenital or infant eye disease.

7-12 Months

At this stage of development babies will be coordinating vision and body movements by crawling, grasping, standing and exploring the surrounding world. They should be able judge distances accurately, throw a ball toward a target and pick up a small object with their fingers. Delays in motor development can sometimes indicate a vision problem.

The First Eye Exam

While at 6 months, your baby will not be able to read an eye chart, eye doctors can perform an infant eye exam through non-verbal testing to assess visual acuity (for nearsightedness, farsightedness or astigmatism), eye teaming abilities and eye alignment. The eye doctor will also be able to see inside the eye for any signs of disease or problems that could affect eye or vision health.

InfantSEE®

InfantSEE® is a public health program in which participating optometrists provide a free comprehensive infant eye exam to babies between 6 and 12 months of age. The program was initiated to provide accessible eye and vision care for infants to ensure they have the best chances for normal development and quality of life.

If your child has any unusual symptoms such as excessive tearing, constant eye misalignment, red or crusty eyes or extreme light sensitivity consult an eye doctor as soon as possible.

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.

Controlling Nearsightedness in Children

Childhood myopia or nearsightedness is a common condition that causes blurred distance vision and can usually be easily corrected with either glasses or contact lenses. Unfortunately, simply getting a pair of glasses doesn’t always solve the problem, because often myopia is progressive which means that every year the vision gets worse. This usually continues until sometime around the child’s 20th birthday when his eyes stop growing and eyesight levels off.

It can be worrisome and quite disconcerting for both the parent and the child when each visit to the eye doctor results in a higher prescription. There could be a number of factors involved in progressive myopia, involving hereditary factors as well as possible environmental or behavioral factor such as frequent close-up tasks such as reading or using an electronic device. In fact, studies show that children that spend more time outdoors playing have a lower incidence of myopia. Much research is currently being done into treatments for slowing or stopping myopia progression in children. Here are some of the treatment options currently being offered:

Orthokeratology (Ortho-k)

Ortho-k is a process that uses specially designed rigid gas permeable contact lenses worn at night to gently reshape the cornea, eventually allowing clear vision during the day. The lenses are worn every night or every couple of nights depending on the results of the individual. Ideal for mild to moderate myopia, ortho-k usually takes a few weeks to show results, during which time the patient may need to temporarily continue wearing glasses or contact lenses.

Studies show that the use of ortho-k can permanently reduce the progressive lengthening of the cornea which is responsible for nearsightedness and can therefore slow or stop the childhood progression of the condition. Therefore, in addition to being used for myopia correction, it is now also being offered as a therapeutic treatment to halt myopia progression in children.

Multifocal Eyeglasses or Contact Lenses

Bifocal or multifocal soft contact lenses or glasses have been shown in some studies to slow myopia progression. This therapy is based on the idea that the eye is strained from accommodating to see close up and that by providing multiple focusing powers, this allows the eye to relax when doing near work, which reduces the progression of the refractive error. This treatment has been shown to delay or slow the advancement of myopia in some children.

Atropine Drops

Treatment with atropine drops is another therapy that is used to relax the eye from “focusing fatigue” which may be a culprit in myopia progression. Research is still being done but some studies show that daily use of low doses of atropine drops do slow the progression of myopia. Atropine drops dilate the pupil which temporarily prevents the eye from being able to focus, thereby allowing this mechanism to relax. Research is still being done to determine dosages, but the results are promising.

If your child has progressive myopia, seek out a pediatric optometrist who is knowledgeable about the options available. Finding the right treatment could give your child the gift of better eyesight for life.

x

Please Note: Face Masks are required per the CDC and state of Connecticut Health Guidelines