You may remember a blog I wrote a while back which answered this age old questions.
Well, Dr. Eyenstein and I decided to tackle it in vlog form as well. Enjoy!
Well, Dr. Eyenstein and I decided to tackle it in vlog form as well. Enjoy!
Showing posts with label 20/20. Show all posts
Showing posts with label 20/20. Show all posts
Thursday, March 12, 2015
Wednesday, January 22, 2014
The Path of Least Resistance
Over the past few weeks I've had some distressing discussions and experiences at my new office, Highstreet Eyecare, in Abbotsford BC (shameless self promotion). These incidents are what compelled me back to my blog today.
I'll refer to one specific phone conversation which, I think, fairly represents the other similar situations as well.
A very pleasant young lady (in her mid-20's) called the office with some questions about her vision. I'll briefly summarize the conversation...
--
Young lady: I've noticed some changes in my vision. I can't see as well with my glasses on anymore. I recently went back to the place where I usually buy my glasses. They did an eye exam and said they couldn't get my vision to 20/20.
Me: Do you know if it was an optometrist who did the exam?
YL: I'm not sure. What's the difference between an optometrist and the people I get my glasses from?
Me: (I proceeded to explain the differences between optometrists, ophthalmologists, and opticians. I explained how they are all different from the many random optical stores that have no accreditation what so ever. I also compared a complete eye exam, which includes a thorough assessment of ocular health as well as a refraction for a glasses prescription, and vision testing, which is essentially the automated refraction many unaccredited places will conduct unlawfully refer to as an eye exam.)
YL: Oh, I didn't know any of that. They just checked my vision and said the new glasses would make my vision better.
Me: (I explained again all the different things we would examine to determine her prescription and rule out any underlying conditions that could be limiting her vision)
YL: Ok. I'll see...
--
You'll see??? If I'm not mistaken, isn't that exactly what you're having trouble with right now... Seeing?!
Ok, I didn't say that. I can be a little sarcastic and condescending sometimes, but I'm not mean. Especially not to my patients.
These types of conversations bring to light many different concerns. A few of which I will try to address here.
But first, lets time a quick step back... way back... back into time... (Blackstreet reference... anyone?)
A few years ago, when I had first started practicing optometry, I wrote multiple blogs about the impending changes that my profession was about to endure. Changes that were brought on by crony politicians, whose only concern was to fill their pockets with little regard for the public, whom they were elected to serve (I'll try not to name any names... but, lets just say it was a certain "Health Minister"... who's name may or may not start with Kevin... and end with Falcon...). These were changes which ultimately contributed to the lowering of health care standards in British Columbia. And they were changes which led to the fall of a childhood hero from his perch upon a pedestal... I'll never look at Trevor Linden the same way again. But, I digress...
Today, ONLY in British Columbia, a person can walk into any store operated by any individual with absolutely zero credentials and no experience in eye care to buy glasses or contact lenses without a valid prescription. I think that makes it hard to disagree that our standards of health care, at least eye care, are lower than those of any other place in North America.
The Health Minister defended himself by saying that the average individual who has healthy eyes should not have to bother with regular exams and those who do have eye conditions will simply know to have their eyes checked regularly. So much for preventative care. I wonder if Mr. Falcon would be so kind as to describe the symptoms of the early stages of glaucoma, a disease which is one of the leading causes of blindness and affects tens of millions of people worldwide... Oh that's right, there aren't any! It is a silent disease. By the time a patient notices the symptoms, there has already been irreparable, irreversible damage. But I'm sure the average person would somehow know, right?
There is also supposed to be a regulation which, loosely translated, states that if an optical store cannot improve a person's vision to 20/20 or sees any reason for concern, they must send that patient over to an optometrist or ophthalmologist for further testing. Clearly, in the case of the young lady in the above conversation (and many others), they have not been doing that. Which means there are a lot of people walking around with a lower quality vision than they deserve AND, more importantly, potentially suffering from a vision threatening condition.
So, what needs to be done?
I've spent a lot of time pointing fingers at different people for tearing down the foundations of our health care. And there definitely are a lot people who are responsible for the failure of our system. Yes, the big companies and the crony politicians play their part. And they play it well. But, it is important to understand that WE must also bear some responsibility. By we, I mean both health care providers AND the public. It is absolutely my responsibility as a health professional to educate my patients and the public about their health. If I don't do it, then who else will? But, it is also the responsibility of the individual to actively seek out what is best for them. To ask questions, get regular exams, and do what ever else necessary to keep yourself healthy. If you don't, who else will?
Too often, I hear patients say "I've had issues for a long time, but I kept putting it off". As terrible as it sounds, I can understand, I can relate. We build routines for ourselves and follow them, often blindly (pardon the pun). Call it complacency, laziness, or anything else... We put important things off because it means going out of our way or changing our schedule.
Our bodies are made up, at the most basic level, of cells and nerves and chemical reactions. All of which are following the path of least resistance. So it is only human nature that we do what is easiest for us, to follow the simple route. But on our highest level, we are able to make the decisions about what's best for us. And I urge you, when it comes to your health, whether its your eyes or your teeth or your heart, take the time to get it done. And get it done right.
Thanks for reading. Please feel free to leave comments or questions. I'm always happy to discuss!
I'll refer to one specific phone conversation which, I think, fairly represents the other similar situations as well.
A very pleasant young lady (in her mid-20's) called the office with some questions about her vision. I'll briefly summarize the conversation...
--
Young lady: I've noticed some changes in my vision. I can't see as well with my glasses on anymore. I recently went back to the place where I usually buy my glasses. They did an eye exam and said they couldn't get my vision to 20/20.
Me: Do you know if it was an optometrist who did the exam?
YL: I'm not sure. What's the difference between an optometrist and the people I get my glasses from?
Me: (I proceeded to explain the differences between optometrists, ophthalmologists, and opticians. I explained how they are all different from the many random optical stores that have no accreditation what so ever. I also compared a complete eye exam, which includes a thorough assessment of ocular health as well as a refraction for a glasses prescription, and vision testing, which is essentially the automated refraction many unaccredited places will conduct unlawfully refer to as an eye exam.)
YL: Oh, I didn't know any of that. They just checked my vision and said the new glasses would make my vision better.
Me: (I explained again all the different things we would examine to determine her prescription and rule out any underlying conditions that could be limiting her vision)
YL: Ok. I'll see...
--
You'll see??? If I'm not mistaken, isn't that exactly what you're having trouble with right now... Seeing?!
Ok, I didn't say that. I can be a little sarcastic and condescending sometimes, but I'm not mean. Especially not to my patients.
These types of conversations bring to light many different concerns. A few of which I will try to address here.
But first, lets time a quick step back... way back... back into time... (Blackstreet reference... anyone?)
A few years ago, when I had first started practicing optometry, I wrote multiple blogs about the impending changes that my profession was about to endure. Changes that were brought on by crony politicians, whose only concern was to fill their pockets with little regard for the public, whom they were elected to serve (I'll try not to name any names... but, lets just say it was a certain "Health Minister"... who's name may or may not start with Kevin... and end with Falcon...). These were changes which ultimately contributed to the lowering of health care standards in British Columbia. And they were changes which led to the fall of a childhood hero from his perch upon a pedestal... I'll never look at Trevor Linden the same way again. But, I digress...
Today, ONLY in British Columbia, a person can walk into any store operated by any individual with absolutely zero credentials and no experience in eye care to buy glasses or contact lenses without a valid prescription. I think that makes it hard to disagree that our standards of health care, at least eye care, are lower than those of any other place in North America.
The Health Minister defended himself by saying that the average individual who has healthy eyes should not have to bother with regular exams and those who do have eye conditions will simply know to have their eyes checked regularly. So much for preventative care. I wonder if Mr. Falcon would be so kind as to describe the symptoms of the early stages of glaucoma, a disease which is one of the leading causes of blindness and affects tens of millions of people worldwide... Oh that's right, there aren't any! It is a silent disease. By the time a patient notices the symptoms, there has already been irreparable, irreversible damage. But I'm sure the average person would somehow know, right?
There is also supposed to be a regulation which, loosely translated, states that if an optical store cannot improve a person's vision to 20/20 or sees any reason for concern, they must send that patient over to an optometrist or ophthalmologist for further testing. Clearly, in the case of the young lady in the above conversation (and many others), they have not been doing that. Which means there are a lot of people walking around with a lower quality vision than they deserve AND, more importantly, potentially suffering from a vision threatening condition.
So, what needs to be done?
I've spent a lot of time pointing fingers at different people for tearing down the foundations of our health care. And there definitely are a lot people who are responsible for the failure of our system. Yes, the big companies and the crony politicians play their part. And they play it well. But, it is important to understand that WE must also bear some responsibility. By we, I mean both health care providers AND the public. It is absolutely my responsibility as a health professional to educate my patients and the public about their health. If I don't do it, then who else will? But, it is also the responsibility of the individual to actively seek out what is best for them. To ask questions, get regular exams, and do what ever else necessary to keep yourself healthy. If you don't, who else will?
Too often, I hear patients say "I've had issues for a long time, but I kept putting it off". As terrible as it sounds, I can understand, I can relate. We build routines for ourselves and follow them, often blindly (pardon the pun). Call it complacency, laziness, or anything else... We put important things off because it means going out of our way or changing our schedule.
Our bodies are made up, at the most basic level, of cells and nerves and chemical reactions. All of which are following the path of least resistance. So it is only human nature that we do what is easiest for us, to follow the simple route. But on our highest level, we are able to make the decisions about what's best for us. And I urge you, when it comes to your health, whether its your eyes or your teeth or your heart, take the time to get it done. And get it done right.
Thanks for reading. Please feel free to leave comments or questions. I'm always happy to discuss!
Monday, January 17, 2011
What Parents Should Not Do: An Eye Doctor's Perspective
I was initially going to break this topic into multiple segments. Each would described my experience with a different young patient (and his or her parents). Instead, to my surprise, I recently encountered a 6 year old boy whose mother unfortunately embodied all of the poor tendencies that doctors try their hardest to discourage.
To maintain the annonymity of this dynamic duo, let's call the boy John and his mother Jane.
Jane brought John in for his eye exam and mentioned that he had (not so recently) lost his glasses and may need another pair.
As I entered the exam room, I immediately noticed that, while he fiddled with all of my instruments as his mother sat idle, little John's left eye had an outward turn (aka Exotropia). I took my seat and asked Jane about the eye turn. She responded very casually with "Oh yes, his dad and his older brother both have the same thing. Its no big deal." No big deal?? I controlled my initial urge to scold this mother of two and I politely suggested to Jane that this is something we will need to discuss at the end of the exam.
Next came the refraction. Trying to determine John's glasses prescription was about as easy as teaching my dad how to use the bluetooth function on his phone (not easy). Both tasks required a lot of patience and reiteration of instructions. At the end of it all, I was able to improve John's vision with a prescription that involved a lot of astigmatism, but he still was not seeing as well as I would have liked. Especially with the left eye.
While we normally aim to have our patients seeing 20/20 with both eyes, John was only seeing 20/40 with the right eye and 20/60 with the left.
What we are seeing here is the development of amblyopia, or a lazy eye. Basically, if the brain is receiving a blurry image or double vision, it will start to shut the blurry (or turned eye) off in an effort to make vision more comfortable.
This process occurs at a young age. In fact, after the age of 8 it is very difficult to recover the quality of vision that is lost. And the older the patient gets, the harder it is. Eventually, no amount of glasses, contacts, or lasers will help. From this point on, it is a problem with the brain and not the eyes.
In John's case, because of the high prescription in both eyes, he is at risk of both eyes becoming lazy.
Luckily he is still young and with aggressive therapy, I am confident that most, if not all, of his vision can be recovered.
But what is required? The first step is a pair of glasses with the full prescription worn every waking moment of the day. The second, is the use of a patch. It is worn over the right eye (the one that is not turned) for a certain number of hours a day to force the left eye back into action. If the eye turn is not resolving, surgery to help straighten the eye is a possibilty.
After discussing all of this with Jane, she conceded that she was provided most of this information by another optometrist a couple of years earlier. In fact, that eye doctor had also scheduled a follow up visit a couple of months after the initial exam. But, since her older son and husband have similar problems and are "doing fine", she figured that it was "no big deal" and didn't follow up. I was really beginning to lose my patience with Jane's nonchalant attitude towards her young son's vision.
After all of the things I had just finished explaining to her, Jane asked if it was ok not to get the glasses yet. She was hoping to let John decide when he was older if he wanted to wear glasses or get laser surgery. That way she didn't feel like she was forcing it on him. What??
NO THAT IS NOT OK. AND IT IS A BIG DEAL!
When your child's vision is at stake, its a big deal. When his aptitude to read and learn is affected, its a big deal. When his ability to see and experience the world is degraded, its a big deal! How could anything be more important???
While Jane is an extreme example, there are a lot of people who exhibit this type of behaviour to a lesser degree. For as long as I can remember, as a student and now as a doctor, I have watched far too many people carry a complacent disposition regarding their health. Too often, I've heard people say "its no big deal" or "it'll get better". I'm guilty of it myself. But, if there is one situation in which I can't ever imagine having that kind of attitude, it is when a child's health is in question.
In British Columbia, annual eye exams are free for all children under the age of 19. If there's one thing our government is doing right, this is it.
So bring your kids in. We'll be happy to see them :)
To maintain the annonymity of this dynamic duo, let's call the boy John and his mother Jane.
Jane brought John in for his eye exam and mentioned that he had (not so recently) lost his glasses and may need another pair.
As I entered the exam room, I immediately noticed that, while he fiddled with all of my instruments as his mother sat idle, little John's left eye had an outward turn (aka Exotropia). I took my seat and asked Jane about the eye turn. She responded very casually with "Oh yes, his dad and his older brother both have the same thing. Its no big deal." No big deal?? I controlled my initial urge to scold this mother of two and I politely suggested to Jane that this is something we will need to discuss at the end of the exam.
Next came the refraction. Trying to determine John's glasses prescription was about as easy as teaching my dad how to use the bluetooth function on his phone (not easy). Both tasks required a lot of patience and reiteration of instructions. At the end of it all, I was able to improve John's vision with a prescription that involved a lot of astigmatism, but he still was not seeing as well as I would have liked. Especially with the left eye.
While we normally aim to have our patients seeing 20/20 with both eyes, John was only seeing 20/40 with the right eye and 20/60 with the left.
What we are seeing here is the development of amblyopia, or a lazy eye. Basically, if the brain is receiving a blurry image or double vision, it will start to shut the blurry (or turned eye) off in an effort to make vision more comfortable.
This process occurs at a young age. In fact, after the age of 8 it is very difficult to recover the quality of vision that is lost. And the older the patient gets, the harder it is. Eventually, no amount of glasses, contacts, or lasers will help. From this point on, it is a problem with the brain and not the eyes.
In John's case, because of the high prescription in both eyes, he is at risk of both eyes becoming lazy.
Luckily he is still young and with aggressive therapy, I am confident that most, if not all, of his vision can be recovered.
But what is required? The first step is a pair of glasses with the full prescription worn every waking moment of the day. The second, is the use of a patch. It is worn over the right eye (the one that is not turned) for a certain number of hours a day to force the left eye back into action. If the eye turn is not resolving, surgery to help straighten the eye is a possibilty.
After discussing all of this with Jane, she conceded that she was provided most of this information by another optometrist a couple of years earlier. In fact, that eye doctor had also scheduled a follow up visit a couple of months after the initial exam. But, since her older son and husband have similar problems and are "doing fine", she figured that it was "no big deal" and didn't follow up. I was really beginning to lose my patience with Jane's nonchalant attitude towards her young son's vision.
After all of the things I had just finished explaining to her, Jane asked if it was ok not to get the glasses yet. She was hoping to let John decide when he was older if he wanted to wear glasses or get laser surgery. That way she didn't feel like she was forcing it on him. What??
NO THAT IS NOT OK. AND IT IS A BIG DEAL!
When your child's vision is at stake, its a big deal. When his aptitude to read and learn is affected, its a big deal. When his ability to see and experience the world is degraded, its a big deal! How could anything be more important???
While Jane is an extreme example, there are a lot of people who exhibit this type of behaviour to a lesser degree. For as long as I can remember, as a student and now as a doctor, I have watched far too many people carry a complacent disposition regarding their health. Too often, I've heard people say "its no big deal" or "it'll get better". I'm guilty of it myself. But, if there is one situation in which I can't ever imagine having that kind of attitude, it is when a child's health is in question.
In British Columbia, annual eye exams are free for all children under the age of 19. If there's one thing our government is doing right, this is it.
So bring your kids in. We'll be happy to see them :)
Thursday, October 21, 2010
Whats Your Eye-Q?
The American Optometric Association published the results from their 5th annual Eye-Q Survey. The survey asks men and women all sorts of questions about their eye health including allergies, UV protection, nutrition, and aging. Interestingly, men and women didn't always see eye to eye (yes, pun intended).
Check out this year's Eye-Q Survey Results here.
Grade yourself as follows: 19-20, I understand my eyes very well; 17-18, my view of my eyes is pretty clear; 15-16, my concept of my eyes is a little fuzzy; 13-14, the way I see my eyes could use a little correcting; and 12 or under, my eyes need much more understanding.
ANSWERS: 1.T. 2.F. 3.T. 4.F. 5.F. 6.F. 7.T. 8.T. 9.F. 10.T. 11.T. 12.F. 13.F. 14.T. 15.F. 16.F. 17.T. 18.T. 19.T. 20.T.
Check out this year's Eye-Q Survey Results here.
Take a simple Eye-Q Test for yourself!
Grade yourself as follows: 19-20, I understand my eyes very well; 17-18, my view of my eyes is pretty clear; 15-16, my concept of my eyes is a little fuzzy; 13-14, the way I see my eyes could use a little correcting; and 12 or under, my eyes need much more understanding.
| True | False | Questions |
| 1. At a distance of ten inches, my eyes can detect an object as small as four thousandths of an inch in size. | ||
| 2. My eyes can distinguish only four colors. | ||
| 3. My eyes can see a candle 14 miles away. | ||
| 4. Ten percent of what I know comes through my eyes. | ||
| 5. Reading in dim light can put a strain on my eyes. | ||
| 6. When viewing the TV, I should sit a distance equal to twice the width of the screen. | ||
| 7. A lack of vitamin A in my diet can cause reduced night vision. | ||
| 8. Dilation of the pupils allows my doctor to see a better view of the inside of my eyes. | ||
| 9. The best color for sunglasses is blue. | ||
| 10. Tears contain substances that slow down bacterial growth. | ||
| 11. My eyelids work much like a car's windshield wipers. | ||
| 12. Sunglasses will allow me to look directly at the sun. | ||
| 13. Many prescriptions for eyeglasses are identical. | ||
| 14. Smoking can effect my vision. | ||
| 15. If I have 20/20 vision, I don't have any eye problems. | ||
| 16. Air pollution affects only my lungs and breathing. | ||
| 17. If I am nearsighted, I see near objects more clearly than distant ones. | ||
| 18. If I am farsighted, I see distant object more clearly than near ones. | ||
| 19. Glaucoma is a serious eye disease that can cause blindness. | ||
| 20. Regular eye examinations can help protect my eyes and general health. |
ANSWERS: 1.T. 2.F. 3.T. 4.F. 5.F. 6.F. 7.T. 8.T. 9.F. 10.T. 11.T. 12.F. 13.F. 14.T. 15.F. 16.F. 17.T. 18.T. 19.T. 20.T.
Tuesday, September 28, 2010
What does 20/20 mean?
This week's topic is something I get asked almost everyday. Unfortunately, the answer is never as simple as it may seem. I will do my best to explain it here.
Simple definition: 20/20 is the size of letter that the average person should be able to see when fully corrected (assuming that there are no visual opacities or retinal problems). It is what we aim to achieve when correcting patients with contact lenses, glasses, and laser surgery.
More specifically: A 20/20 letter is exactly 8.726mm in height at a distance of 20 feet.
FAQ:
Q: Does 20/20 mean "perfect vision"?
A: No, this is a common misconception. There really isn't such a thing as perfect vision. The sharpest estimated human visual acuity is about 20/8. Which, with a little math, equates to a minuscule 3.49mm letter at 20 feet!
Q: How is the size of the letter determined?
A: The letter size for 20/20 is based on the average spacing of the light-sensing cells in the retina, thus the average eye's ability to discern spaces between letters
Q: Why 20 feet?
A: That is the approximate distance at which the internal focusing system of the eye (used for near vision) is relaxed thus allowing your eyes to effectively see into the distance.
Q: What if I can't see any of the letters without my glasses? Does that mean I'm Legally Blind?
A: Vision without correction does not really provide any significant information about your eyes (other than the fact that correction may be needed).
The definition of Legal Blindness in Canada and USA is 20/200 in the better eye with correction. Thats 10 times the size of a 20/20 letter.
Q: Do I need to see 20/20 to drive?
A: No. This may come as a surprise. But, the legal requirement for driving is 20/40 in one eye. That's double the size of a 20/20.
Thanks for reading. Please feel free to pass this info on to anyone who may find it useful and don't hesitate to send me your questions and comments.
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