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 eye exam. Show all posts
Showing posts with label eye exam. 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, March 4, 2013
Contact Lens Addicts Anonymous
Its been a while since I've written a blog post. So long, in fact, that blogger.com emailed to tell me that my site had developed virtual cobwebs... kidding!
Well, I'm back. And its all thanks to a crazy day at the office. This past Sunday (yes, I work Sundays... and yes, I am a little bit crazy... thank you for asking), I felt like I was working in some sort of contact lens emergency clinic. It was like Clearly Contacts was having a sale on eye infections or something! I'm sure the Liberal government backed them on it and I must have missed Trevor's ads on TV...
Moving on...
A while back, I wrote a blog titled Contact Lens Addicts, which explained how some patients become so dependent on their contact lenses that they put themselves at risk of suffering many different problems, some of which could lead to permanent vision loss. Well, Sunday was like a Contact Lens Addicts Anonymous meeting at Metropolis Eye Care.
The CL-AA meeting started with a pleasant, 50-something woman whose contact lens had folded up and tucked itself so far behind her upper eyelid that I almost wished I had a third hand to help flip her eyelid, and/or hold a q-tip, and/or grab the forceps.
Now, lets just take a quick second to answer the question that is likely swirling around in some of your minds... No, the contact lens cannot go so far back that it ends up behind the eyeball. Luckily, the conjunctiva (the thin skin that covers the eye ball) actually folds over itself and covers the inside of the eyelids as well. Effectively creating a natural contact lens catching contraption (and you thought conjunctiva was hard to say).
Next up was a very friendly lady in her mid-thirties who is actually quite good at taking care of her contact lenses. She doesn't over wear them, she replaces them on schedule, and she's good at cleaning them every night (sounds too good to be true, but I believed her). However, despite all of the regular care and maintenance, she managed to fall asleep in her lenses.
Now, we all know that one night stands are a bad idea (right?). Well, sleeping with your contacts is a lot like a one night stand... There's usually booze involved, it seems like a good idea at the time, you wake up in the morning with something feeling itchy and/or irritated (we're talking about eyes folks!), and then you're doing the walk of shame... into my exam room!
Even for someone who takes care of her contacts, one night with her lenses was enough to cause a small corneal ulcer, secondary to a bacterial infection. Yes, an ulcer. Yes, its as unpleasant as it sounds.
Last, and certainly not least, is the poor little girl who forced me out of blog-writing retirement to tell you her unfortunate story. A 16 year old kid who has been wearing Ortho-K lenses. I won't go into detail, but basically these are lenses you only wear at night while sleeping. Hopefully the "only wear at night while sleeping" part raised a red flag or two for most of you. To make matters worse, she was fit for and bought the lenses overseas, so I have no idea what she's been wearing. Not all that different than buying contacts online without being fit for them by a professional, might I add. But I digress...
The poor kid was in so much pain, she could not open her eye if her life depended on it. When I finally got a look, this is what I saw...
A very red and upset eye with a large, central corneal ulcer. Long story-short, she is and will be in need of a lot of eye drops (as much as every 30-60 minutes all day AND night) and maybe even some oral medications. The worst part of it is that when the infection is finally controlled, this ulcer will likely leave a large scar right in the center of her vision thus causing a permanent decrease in vision in that eye.
These were just three of the multiple cases I dealt with during the CL-AA meeting on Sunday.
Its extremely important to understand the consequences of taking our vision for granted. Online sales and deregulation have made it easy to overlook the fact that contact lenses are actually medical devices. They are pieces of plastic that we put on our eye ball to help improve our vision. We should not lose sight of that (pun intended).
I am genuinely concerned and upset about this young girl and so many other patients who suffer from serious issues due to improper contact lens wear and poor ocular hygiene. So, if you or your kids wear contacts, be sure to have the lenses fit by a professional and never hesitate to come in and have your eyes checked if you think something is wrong. As with most things, if we catch it early, its much easier to treat.
Please feel free to comment here and message me via Facebook or email if you have any questions or comments.
Note: The pictures are not of my patients, but are accurate representations of their respective issues.
Well, I'm back. And its all thanks to a crazy day at the office. This past Sunday (yes, I work Sundays... and yes, I am a little bit crazy... thank you for asking), I felt like I was working in some sort of contact lens emergency clinic. It was like Clearly Contacts was having a sale on eye infections or something! I'm sure the Liberal government backed them on it and I must have missed Trevor's ads on TV...
Moving on...
A while back, I wrote a blog titled Contact Lens Addicts, which explained how some patients become so dependent on their contact lenses that they put themselves at risk of suffering many different problems, some of which could lead to permanent vision loss. Well, Sunday was like a Contact Lens Addicts Anonymous meeting at Metropolis Eye Care.
The CL-AA meeting started with a pleasant, 50-something woman whose contact lens had folded up and tucked itself so far behind her upper eyelid that I almost wished I had a third hand to help flip her eyelid, and/or hold a q-tip, and/or grab the forceps.
Now, lets just take a quick second to answer the question that is likely swirling around in some of your minds... No, the contact lens cannot go so far back that it ends up behind the eyeball. Luckily, the conjunctiva (the thin skin that covers the eye ball) actually folds over itself and covers the inside of the eyelids as well. Effectively creating a natural contact lens catching contraption (and you thought conjunctiva was hard to say).
Next up was a very friendly lady in her mid-thirties who is actually quite good at taking care of her contact lenses. She doesn't over wear them, she replaces them on schedule, and she's good at cleaning them every night (sounds too good to be true, but I believed her). However, despite all of the regular care and maintenance, she managed to fall asleep in her lenses.
Now, we all know that one night stands are a bad idea (right?). Well, sleeping with your contacts is a lot like a one night stand... There's usually booze involved, it seems like a good idea at the time, you wake up in the morning with something feeling itchy and/or irritated (we're talking about eyes folks!), and then you're doing the walk of shame... into my exam room!
Even for someone who takes care of her contacts, one night with her lenses was enough to cause a small corneal ulcer, secondary to a bacterial infection. Yes, an ulcer. Yes, its as unpleasant as it sounds.
The poor kid was in so much pain, she could not open her eye if her life depended on it. When I finally got a look, this is what I saw...
These were just three of the multiple cases I dealt with during the CL-AA meeting on Sunday.
Its extremely important to understand the consequences of taking our vision for granted. Online sales and deregulation have made it easy to overlook the fact that contact lenses are actually medical devices. They are pieces of plastic that we put on our eye ball to help improve our vision. We should not lose sight of that (pun intended).
I am genuinely concerned and upset about this young girl and so many other patients who suffer from serious issues due to improper contact lens wear and poor ocular hygiene. So, if you or your kids wear contacts, be sure to have the lenses fit by a professional and never hesitate to come in and have your eyes checked if you think something is wrong. As with most things, if we catch it early, its much easier to treat.
Please feel free to comment here and message me via Facebook or email if you have any questions or comments.
Note: The pictures are not of my patients, but are accurate representations of their respective issues.
Monday, January 9, 2012
The Eye-Heart Connection
Happy New Year! I hope everyone enjoyed their new year's eve celebrations. And hopefully there weren't too many cork-to-eye incidents.
You may have heard the saying "The eyes are windows to the soul". I've looked into a lot of eyes but I'm not sure how many souls I've seen. So I thought we could re-phrase that statement a little. How does "The eyes are windows to your overall systemic health" sound? I guess thats not as magical, but its proably a little more accurate.
A couple of weeks ago, a friend sent me this picture and asked "do you know about this?"
Well, yes Harvinder, of course I do! But, thanks for asking :)
I spend a lot of time on a daily basis explaining to patients how the eyes can present signs for all sorts of systemic health issues especially those related to blood vessels. The one I stress the most is diabetes because it is seen most commonly and can have profound visual consequences. However, high blood pressure, high cholesterol, anemia, and more can all be detected by changes in the blood vessels inside the eye.
In patients who have cholesterol build up in larger arteries, it is possible for small pieces of plaque to break off and travel through the blood stream into the eye (these are called emboli). The emboli can get stuck in the small blood vessels and cause a blockage.
The particular signs mentioned in the article above are called xanthelasma. These are elevated patches around the eyelids due to fatty deposits under the skin. These are usually considered to be benign but as the article mentions, recent studies have shown a link to higher rates of heart disease. To read the full New York Times article click here.
Another ocular sign which is related to cholesterol is arcus senilis. This is a very common finding in older patients and is due to cholesterol deposits in the cornea (the clear dome at the front of the eye). Patients with arcus will develop a greyish ring around the outer part of the cornea. While arcus is related to cholesterol, it does not necessarily indicate high cholesterol or heart disease.
If there is ever any concern about systemic health issues affecting vision or eye health, please visit your friendly neighborhood optometrist and they will be happy to do a detailed examination :)
And as always, regular eye exams are recommended for all!
You may have heard the saying "The eyes are windows to the soul". I've looked into a lot of eyes but I'm not sure how many souls I've seen. So I thought we could re-phrase that statement a little. How does "The eyes are windows to your overall systemic health" sound? I guess thats not as magical, but its proably a little more accurate.
A couple of weeks ago, a friend sent me this picture and asked "do you know about this?"
I spend a lot of time on a daily basis explaining to patients how the eyes can present signs for all sorts of systemic health issues especially those related to blood vessels. The one I stress the most is diabetes because it is seen most commonly and can have profound visual consequences. However, high blood pressure, high cholesterol, anemia, and more can all be detected by changes in the blood vessels inside the eye.
In patients who have cholesterol build up in larger arteries, it is possible for small pieces of plaque to break off and travel through the blood stream into the eye (these are called emboli). The emboli can get stuck in the small blood vessels and cause a blockage.
The particular signs mentioned in the article above are called xanthelasma. These are elevated patches around the eyelids due to fatty deposits under the skin. These are usually considered to be benign but as the article mentions, recent studies have shown a link to higher rates of heart disease. To read the full New York Times article click here.
Another ocular sign which is related to cholesterol is arcus senilis. This is a very common finding in older patients and is due to cholesterol deposits in the cornea (the clear dome at the front of the eye). Patients with arcus will develop a greyish ring around the outer part of the cornea. While arcus is related to cholesterol, it does not necessarily indicate high cholesterol or heart disease.
If there is ever any concern about systemic health issues affecting vision or eye health, please visit your friendly neighborhood optometrist and they will be happy to do a detailed examination :)
And as always, regular eye exams are recommended for all!
Monday, October 17, 2011
Like Pulling Teeth
This past weekend I had the wonderful pleasure of attending the American Academy of Optometry's annual conference in Boston. I had the chance to reconnect with a lot of classmates and friends, as well as visit my school and attend lectures at the meeting. One evening, as we were enjoying a night out on the town, a current 4th year student approached me and said "Harbir, you need write a blog about the importance of regular eye exams!". I told him that I'm sure I've mentioned it a few times already. "Yeah, but why is it that people are willing to go the dentist to get their teeth cleaned every 6 months but they refuse to have their eye health checked every 2 years?!" (Yes, he was both inquisitive and exclamatory all at the same time).
This particular discussion has been a long time coming. I talk about it daily with patients, friends, family, and random unsuspecting people walking down the street who I unwittingly coerce into coversation. But, to this day, I have avoided writing about it because I was afraid that I would end up writing a novel, or it would open up a can of worms, or that all the dentists in the world would hate me and I would never be able to recieve adequate oral care (I guess its a good thing I've never had a cavity!). But, with this recent encouragement from the enthusiastic intern, I decided to give it a shot. And I will try to keep it short!
Less 24 hours after being newly inspired, I had the most convient and fortuitous encounter with friend of a friend who just happened to be a dental student. True story. After restraining myself to allow an appropriate amount of time to become acquainted (maybe 30 or 40 seconds), I jumped at the chance to talk about having my teeth examined bi-annually.
Allow me to summarize.
Harbir: Why do dentists have patients come back every 6 months to have their teeth checked?
Dental student: Because we can.
Ok fine, thats not exactly what she said. But, the gist of the story was, dentists have convinced the world that having your teeth scraped with sharp tools and gargling fluoride every six months are absolutely necessary. When, in fact, according to my new acquaintance who now probably hates me, there is no direct correlation between oral hygeine and dental health. Having your teeth cleaned is not the important part. The few minutes at the end of the visit where the dentist pokes and prods around with another sharp instrument, thats the important part. But even that doesn't need to happen every 6 months. Nonetheless, oral care professionals have done an amazing job of convincing people that these regular visits are obligatory.
I'm not mad at them. In fact, I applaud them. I reach out to them and ask them how I can convince my patients to have their eye health examined more frequently.
I know this is a bit crude but honestly, what happens when your teeth fall out? You get new ones. Crowns, or veneers, or dentures. In any case, you can smile and bite and eat again. But what happens when you lose your vision? Nothing. Once its gone, its gone.
But we don't clean or polish. We refract and dilate. Maybe thats not as exciting for patients. Maybe we should start a new division of eye care where we have people come in to have their eye lids cleansed and eye drops instilled every six months. We'll call it ocular hygeine. Maybe then I'll have patients in my chair more regularly so I can check for silent eye diseases like glaucoma that can cause irreversible vision loss in asymptomatic patients. Because convincing people of the latter alone does not seem to be enough.
Note: This blog was not inteded to question the importance of the dental profession. It was just a reference to help outline the importance of regular eye exams.
This particular discussion has been a long time coming. I talk about it daily with patients, friends, family, and random unsuspecting people walking down the street who I unwittingly coerce into coversation. But, to this day, I have avoided writing about it because I was afraid that I would end up writing a novel, or it would open up a can of worms, or that all the dentists in the world would hate me and I would never be able to recieve adequate oral care (I guess its a good thing I've never had a cavity!). But, with this recent encouragement from the enthusiastic intern, I decided to give it a shot. And I will try to keep it short!
Less 24 hours after being newly inspired, I had the most convient and fortuitous encounter with friend of a friend who just happened to be a dental student. True story. After restraining myself to allow an appropriate amount of time to become acquainted (maybe 30 or 40 seconds), I jumped at the chance to talk about having my teeth examined bi-annually.
Allow me to summarize.
Harbir: Why do dentists have patients come back every 6 months to have their teeth checked?
Dental student: Because we can.
Ok fine, thats not exactly what she said. But, the gist of the story was, dentists have convinced the world that having your teeth scraped with sharp tools and gargling fluoride every six months are absolutely necessary. When, in fact, according to my new acquaintance who now probably hates me, there is no direct correlation between oral hygeine and dental health. Having your teeth cleaned is not the important part. The few minutes at the end of the visit where the dentist pokes and prods around with another sharp instrument, thats the important part. But even that doesn't need to happen every 6 months. Nonetheless, oral care professionals have done an amazing job of convincing people that these regular visits are obligatory.
I'm not mad at them. In fact, I applaud them. I reach out to them and ask them how I can convince my patients to have their eye health examined more frequently.
I know this is a bit crude but honestly, what happens when your teeth fall out? You get new ones. Crowns, or veneers, or dentures. In any case, you can smile and bite and eat again. But what happens when you lose your vision? Nothing. Once its gone, its gone.
But we don't clean or polish. We refract and dilate. Maybe thats not as exciting for patients. Maybe we should start a new division of eye care where we have people come in to have their eye lids cleansed and eye drops instilled every six months. We'll call it ocular hygeine. Maybe then I'll have patients in my chair more regularly so I can check for silent eye diseases like glaucoma that can cause irreversible vision loss in asymptomatic patients. Because convincing people of the latter alone does not seem to be enough.
Note: This blog was not inteded to question the importance of the dental profession. It was just a reference to help outline the importance of regular eye exams.
Friday, February 11, 2011
Vodka Eyeballing: Let's Stop Talking About It
Google Search: vodka eyeball. 1,060,000 results (0.52 seconds). Wow, that is an absurd number of results for a practice that doesn't even exist (as long as you don't count the 5 people in world who do not, unlike the rest of us, suffer the burden of common sense and have actually attempted it).
What is it? Apparently, it is a "recent trend" that is popular with college students as a way to get drunk faster. The process is simple. Pour the vodka onto your eyeball.
Have you seen these people? It got the feeling they were auditioning for a spot in the next Jackass movie. Hey, why don't you guys try snorting wasabi or go bull fighting blindfolded? That might get you the gig.
Anyway, for almost a year now, stories of this nonsensical behaviour have been spiraling out of control. Although it has been covered by every possible news and media outlet multiple times, no one can put a finger on where it began and who is actually doing it (other than the aforementioned 5 people, lets call them the Fabulous Five!). This fiasco was created purely by the media and perpetuated by the upset parents who have been watching the reports and then calling their kids who are probably too busy taking regular vodka shots to even understand what Mommy and Daddy and talking about.
I know what you're going to say. "Harbir, you're just adding to it and fueling the fire by writing this blog!". Erroneous! Erroneous, I say! The sole intention of this blog is to stop people from talking about this fictitious form of alcohol consumption and concentrate on more meaningful and consequential topics of discussion such as How Trevor Linden Sold Out.
Now, to answer the questions that are likely circling your minds.
#1) Does it work? No.
Imagine putting an eye drop into your eye. Now put a second drop right after. And now a third. What happens? It spills over. Each individual drop from an eye drop bottle is approximately 0.05ml. And your eye can't handle more than a few drops.
1 ounce of fluid (vodka, in this case) = 30 ml. So, less than 0.1% of the alcohol in an eyeball shot will stay in your eye. Furthermore, an even smaller amount will actually be absorbed.
#2) Does it hurt? Since I am not one of the Fabulous Five, my answer is purely presumptive. Yes.
#3) Is it dangerous? Yes.
Alcohol can cause breakdown of the epithelium (outer covering) of the cornea and conjunctiva thus leaving the ocular surface susceptible to insults such as corneal abrasions, keratitis, conjuctivitis, and infections.
Vodka Eyballing. Lets Stop Talking About It.
What is it? Apparently, it is a "recent trend" that is popular with college students as a way to get drunk faster. The process is simple. Pour the vodka onto your eyeball.
Have you seen these people? It got the feeling they were auditioning for a spot in the next Jackass movie. Hey, why don't you guys try snorting wasabi or go bull fighting blindfolded? That might get you the gig.
Anyway, for almost a year now, stories of this nonsensical behaviour have been spiraling out of control. Although it has been covered by every possible news and media outlet multiple times, no one can put a finger on where it began and who is actually doing it (other than the aforementioned 5 people, lets call them the Fabulous Five!). This fiasco was created purely by the media and perpetuated by the upset parents who have been watching the reports and then calling their kids who are probably too busy taking regular vodka shots to even understand what Mommy and Daddy and talking about.
I know what you're going to say. "Harbir, you're just adding to it and fueling the fire by writing this blog!". Erroneous! Erroneous, I say! The sole intention of this blog is to stop people from talking about this fictitious form of alcohol consumption and concentrate on more meaningful and consequential topics of discussion such as How Trevor Linden Sold Out.
Now, to answer the questions that are likely circling your minds.
#1) Does it work? No.
Imagine putting an eye drop into your eye. Now put a second drop right after. And now a third. What happens? It spills over. Each individual drop from an eye drop bottle is approximately 0.05ml. And your eye can't handle more than a few drops.
1 ounce of fluid (vodka, in this case) = 30 ml. So, less than 0.1% of the alcohol in an eyeball shot will stay in your eye. Furthermore, an even smaller amount will actually be absorbed.
#2) Does it hurt? Since I am not one of the Fabulous Five, my answer is purely presumptive. Yes.
#3) Is it dangerous? Yes.
Alcohol can cause breakdown of the epithelium (outer covering) of the cornea and conjunctiva thus leaving the ocular surface susceptible to insults such as corneal abrasions, keratitis, conjuctivitis, and infections.
Vodka Eyballing. Lets Stop Talking About It.
"If you think metaphorical beer goggles are bad, imagine what literal vodka goggles will make you do!" -Stephen Colbert
Wednesday, January 26, 2011
How Trevor Linden Sold Out: The Prequel
OK, OK, I get it... People in Vancouver loooooove Trevor Linden. I know, I'm from here. So I expected a few people to be a little ticked off with me for recently writing a blog titled "How Trevor Linden Sold Out".
But, like any great story, there is always a pre-story; the prequel that provides you with greater insight into the original saga and how things came to be. Batman had Batman Begins. James Bond had Casino Royale. And Star Wars had (however unfortunately) Episodes 1, 2, and 3. This, my friends, is the Hobbit to my Lord of the Rings.
It all started in 2007. A company named clearly contacts (aka coastal contacts) that sells contact lenses online, had a lawsuit filed against them in BC Supreme Court because they were breaking the law by not requiring their customers to present valid prescriptions before ordering contacts. The law in all Canadian provinces and US states is that all patients must have a valid prescription and the online company must confirm it with the eye care professional who provides it.
This rule is in place to help prevent the misuse and incorrect fitting of contact lenses which can lead to serious, potentially vision threatening complications.
In 2009, the courts made a decision. clearly contacts must start abiding by the law OR have it changed. They decided to pursue the latter.
Abracadabra...
In 2010, Health Minister Kevin Falcon created new legislation that allowed online sales without the requirement of a prescription from an eye care professional. I can hear the gasps... He did what?? He changed the rules, with no regard for public health, to suit the needs of one corporation.
Apparently, Health Minister Falcon believed that buying contacts and glasses for cheaper was in the public's best interest, but having regular eye health examinations was not. Are these the types of decisions a HEALTH minister is supposed to be making?
MLA Adrian Dix put it well when he said "Health Minister Kevin Falcon will lower eye care standards to satisfy the commercial interests of one company, ignoring the open opposition from the Canadian National Institute of the Blind, physicians, and several health professional bodies..."
How is it possible that British Columbia is the only place in North America that is satisfied with these third world standards of health care? We often refer to American health care as an example of a flawed system, one that does not promote wellness and disease prevention. But now Americans (and other Canadians) are looking at us and wondering how or why we would possibly allow our standards to be lowered in such a way. The answer, my friends, is money.
That last point to resonates quite loudly in recent news articles which shed light on some large endorsements that the "honorable" Kevin Flacon has been receiving from a certain online company. *Cough* clearly contacts *Cough*
http://www.news1130.com/news/local/article/173102--falcon-may-be-too-cozy-with-business-community
By the way, this person is planning on becoming the next Premier of British Columbia.
So, What About Trevor Linden?
Our captain joined clearly contacts as their spokesperson early in 2010. Please refer to the original conversation of How Trevor Linden Sold Out for more information.
Someone recently said to me "...that's what celebrities and athletes do. Companies give them money to promote their product, and they do it... what's the big deal?"
Is that not the definition of selling out? Doing something ethically questionable for money. Especially when the very thing you are promoting is ultimately causing a decline in the overall well being and quality of care in the same community that has raised you and embraced you as its hero and idol.
But, like any great story, there is always a pre-story; the prequel that provides you with greater insight into the original saga and how things came to be. Batman had Batman Begins. James Bond had Casino Royale. And Star Wars had (however unfortunately) Episodes 1, 2, and 3. This, my friends, is the Hobbit to my Lord of the Rings.
It all started in 2007. A company named clearly contacts (aka coastal contacts) that sells contact lenses online, had a lawsuit filed against them in BC Supreme Court because they were breaking the law by not requiring their customers to present valid prescriptions before ordering contacts. The law in all Canadian provinces and US states is that all patients must have a valid prescription and the online company must confirm it with the eye care professional who provides it.
This rule is in place to help prevent the misuse and incorrect fitting of contact lenses which can lead to serious, potentially vision threatening complications.
In 2009, the courts made a decision. clearly contacts must start abiding by the law OR have it changed. They decided to pursue the latter.
Abracadabra...
In 2010, Health Minister Kevin Falcon created new legislation that allowed online sales without the requirement of a prescription from an eye care professional. I can hear the gasps... He did what?? He changed the rules, with no regard for public health, to suit the needs of one corporation.
Apparently, Health Minister Falcon believed that buying contacts and glasses for cheaper was in the public's best interest, but having regular eye health examinations was not. Are these the types of decisions a HEALTH minister is supposed to be making?
MLA Adrian Dix put it well when he said "Health Minister Kevin Falcon will lower eye care standards to satisfy the commercial interests of one company, ignoring the open opposition from the Canadian National Institute of the Blind, physicians, and several health professional bodies..."
How is it possible that British Columbia is the only place in North America that is satisfied with these third world standards of health care? We often refer to American health care as an example of a flawed system, one that does not promote wellness and disease prevention. But now Americans (and other Canadians) are looking at us and wondering how or why we would possibly allow our standards to be lowered in such a way. The answer, my friends, is money.
That last point to resonates quite loudly in recent news articles which shed light on some large endorsements that the "honorable" Kevin Flacon has been receiving from a certain online company. *Cough* clearly contacts *Cough*
http://www.news1130.com/news/local/article/173102--falcon-may-be-too-cozy-with-business-community
By the way, this person is planning on becoming the next Premier of British Columbia.
So, What About Trevor Linden?
Our captain joined clearly contacts as their spokesperson early in 2010. Please refer to the original conversation of How Trevor Linden Sold Out for more information.
Someone recently said to me "...that's what celebrities and athletes do. Companies give them money to promote their product, and they do it... what's the big deal?"
Is that not the definition of selling out? Doing something ethically questionable for money. Especially when the very thing you are promoting is ultimately causing a decline in the overall well being and quality of care in the same community that has raised you and embraced you as its hero and idol.
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 :)
Wednesday, January 12, 2011
Reading in the Dark is Bad for Your Eyes
Myth or truth?
I get asked about this almost every day at work. Will it make my eyes worse? Is it why my eyes feel tired? Should I turn the lights up? No. Probably. Yes.
Our eyes have to work to focus every time we are reading or looking at things up close. It's called accomodation. Little muscles inside the eye cause the little lens inside the eye to change shape so near objects come into focus.
It doesn't take a genius to figure out that things are harder to see in the dark. So, in the dark, the stimulus for accomodation is decreased and our eyes lose focus.
Our eyes will continually lose focus and then re-focus causing them to fatigue and strain.
There is a little myth to it though. Your eyes won't "get worse" from reading in the dark. By this I mean there won't be any change in prescription or need for stronger glasses.
I get asked about this almost every day at work. Will it make my eyes worse? Is it why my eyes feel tired? Should I turn the lights up? No. Probably. Yes.
Our eyes have to work to focus every time we are reading or looking at things up close. It's called accomodation. Little muscles inside the eye cause the little lens inside the eye to change shape so near objects come into focus.
It doesn't take a genius to figure out that things are harder to see in the dark. So, in the dark, the stimulus for accomodation is decreased and our eyes lose focus.
Our eyes will continually lose focus and then re-focus causing them to fatigue and strain.
There is a little myth to it though. Your eyes won't "get worse" from reading in the dark. By this I mean there won't be any change in prescription or need for stronger glasses.
Wednesday, December 29, 2010
Migraines and Your Eyes
Migraines affect a lot of people and those who suffer from them know, they can be very debilitating.
What causes migraines?
The exact cause is still not fully understood. But most evidence generally points to fluctuations in the size of blood vessels in the brain and over-active neurons.
Auras
The changes that occur in the brain slowly spread into the areas that control eye sight (occipital cortex). Eventually causing distortions in vision. These are called Auras.
Often, people will notice flashes of light, zigzag patterns, or even loss of certain parts of vision for up to 15-20 minutes.
Visual Migraines
It is possible to experience these visual side effects without the headaches. It is important to separate these signs from flashes of light that can be associated with retinal detachments.
FAQ:
Q: How can I tell the difference between visual migraines and retinal detachments?
A: Generally flashes associated with retinal detachments are very brief and tend to be in peripheral parts of vision. Visual migraines tend to last for at least a few minutes and can involve up to half of you field of vision. If you ever notices flashes of light or changes in vision, see your eye doctor to be sure.
Q: How do you treat migraines?
A: For some people simple pain killers like Aspirin and Ibuprofen are sufficient. In more serious cases doctors my prescribe neuro-inhibitor like gabapentin or even anti-depressants like amitriptyline.
Q: Does caffeine help?
A: For some people caffeine can be a trigger. But it has been shown in studies that caffiene can actually help reduce migraines. Possibly because caffience causes blood vessels to constrict so it decreases the fluctuations that are occuring. Excedrin is aspirin plus caffeine.
Thanks for reading. Please feel free to pass this information on to anyone who may find it useful. And as always, questions and comments are welcome and appreciated.
See you all in the new year :)
What causes migraines?
The exact cause is still not fully understood. But most evidence generally points to fluctuations in the size of blood vessels in the brain and over-active neurons.
Auras
The changes that occur in the brain slowly spread into the areas that control eye sight (occipital cortex). Eventually causing distortions in vision. These are called Auras.
Often, people will notice flashes of light, zigzag patterns, or even loss of certain parts of vision for up to 15-20 minutes.
Visual Migraines
It is possible to experience these visual side effects without the headaches. It is important to separate these signs from flashes of light that can be associated with retinal detachments.
FAQ:
Q: How can I tell the difference between visual migraines and retinal detachments?
A: Generally flashes associated with retinal detachments are very brief and tend to be in peripheral parts of vision. Visual migraines tend to last for at least a few minutes and can involve up to half of you field of vision. If you ever notices flashes of light or changes in vision, see your eye doctor to be sure.
Q: How do you treat migraines?
A: For some people simple pain killers like Aspirin and Ibuprofen are sufficient. In more serious cases doctors my prescribe neuro-inhibitor like gabapentin or even anti-depressants like amitriptyline.
Q: Does caffeine help?
A: For some people caffeine can be a trigger. But it has been shown in studies that caffiene can actually help reduce migraines. Possibly because caffience causes blood vessels to constrict so it decreases the fluctuations that are occuring. Excedrin is aspirin plus caffeine.
Thanks for reading. Please feel free to pass this information on to anyone who may find it useful. And as always, questions and comments are welcome and appreciated.
See you all in the new year :)
Wednesday, December 22, 2010
Sunglasses: Fashion Or Function?
Function:
UV light from the sun is the biggest environmental factor related to two of the most common eye diseases: cataracts and macular degeneration.
Also, the eyelids have the thinnest skin of any part of the body which makes them more susceptible to damage from sunlight.
Sunglasses provide protection from these harmful rays of light.
Fashion:
A survey by the American Optometric Association showed that a large percentage of patients believed that brand name sunglasses provided more protection than non-brand name glasses. MYTH!!
Even the $10 sunglasses you can buy at the gas station block at least 95% of UV rays.
Yes, some of the more expensive lenses can provide more comfortable vision with better lens material and polarization. But this does increase protection from UV.
So, when you're looking at buying those $300 Prada shades, remember that you're paying mostly for style and branding. Not like that has stopped anyone in the past :)
FAQ:
Q: Is it important for kids to wear sunglasses?
A: YES!! Most of the damage done to our eyes by UV rays from sunlight is during the first 17 years of our lives. Protect your child's long term eye health by putting on them in some shades.
Q: Why are polarized lenses good?
A: Polarized lenses cut down the amount of reflections seen off surfaces like glass and water. This means clearer, more comfortable vision especially when driving or boating.
Q: Are Transitions (lenses that change from light to dark outdoors) better for protecting your eyes?
A: Clear plastic lenses actually provide a lot of UV protection. Transitions don't increase the UV protection but they provide more comfortable vision when outside.
Q: I heard Transitions don't go dark when in a car. Is this true?
A: Yes. Car windows block 100% of UV light so the lenses will not change.
Q: Do my Ed Hardy shades make me look cool?
A: Ummmmmm....
Thanks for reading. Hope you all found this info useful. Please feel free to pass it on to anyone who may find it interesting.
UV light from the sun is the biggest environmental factor related to two of the most common eye diseases: cataracts and macular degeneration.
Also, the eyelids have the thinnest skin of any part of the body which makes them more susceptible to damage from sunlight.
Sunglasses provide protection from these harmful rays of light.
Fashion:
A survey by the American Optometric Association showed that a large percentage of patients believed that brand name sunglasses provided more protection than non-brand name glasses. MYTH!!
Even the $10 sunglasses you can buy at the gas station block at least 95% of UV rays.
Yes, some of the more expensive lenses can provide more comfortable vision with better lens material and polarization. But this does increase protection from UV.
So, when you're looking at buying those $300 Prada shades, remember that you're paying mostly for style and branding. Not like that has stopped anyone in the past :)
FAQ:
Q: Is it important for kids to wear sunglasses?
A: YES!! Most of the damage done to our eyes by UV rays from sunlight is during the first 17 years of our lives. Protect your child's long term eye health by putting on them in some shades.
Q: Why are polarized lenses good?
A: Polarized lenses cut down the amount of reflections seen off surfaces like glass and water. This means clearer, more comfortable vision especially when driving or boating.
A: Clear plastic lenses actually provide a lot of UV protection. Transitions don't increase the UV protection but they provide more comfortable vision when outside.
 |
| Notice how she becomes happier as the lens tint gets darker. Amazing! |
A: Yes. Car windows block 100% of UV light so the lenses will not change.
Q: Do my Ed Hardy shades make me look cool?
A: Ummmmmm....
Thanks for reading. Hope you all found this info useful. Please feel free to pass it on to anyone who may find it interesting.
Ocular Dominance
The same way we are right or left- handed, we also have one eye that dominates over the other. However, these two concepts are not all related and it is possible to be left-handed and have right eye dominance or vice versa.
Knowing which eye is dominant is important in eye surgeries and when fitting contact lenses. It's also important for athletes, especially in sports that require precise aim, such archery.
So how do you know which eye is dominant? I have devised a little test (follow with pictures below):
- Form a diamond shape with your hands
- Holding this diamond, stretch your arms out ahead
- With both eyes open, view a small object at a distance through the diamond (such a clock or light switch on the wall)
- Close one eye at at time
When your dominant eye is closed, the object will be hidden by your hands. When your non-dominant eye is closed, the object will be visible.
I have attached pictures with examples of a person who is Right eye dominant.
Thanks for reading. Please feel free to send any questions or comments my way. Merry Christmas!
Knowing which eye is dominant is important in eye surgeries and when fitting contact lenses. It's also important for athletes, especially in sports that require precise aim, such archery.
So how do you know which eye is dominant? I have devised a little test (follow with pictures below):
- Form a diamond shape with your hands
- Holding this diamond, stretch your arms out ahead
- With both eyes open, view a small object at a distance through the diamond (such a clock or light switch on the wall)
- Close one eye at at time
When your dominant eye is closed, the object will be hidden by your hands. When your non-dominant eye is closed, the object will be visible.
I have attached pictures with examples of a person who is Right eye dominant.
Thanks for reading. Please feel free to send any questions or comments my way. Merry Christmas!
Wednesday, December 15, 2010
Flashing Lights: It's A Camera... It's Lightning... No, It's Your Retina!
It's not uncommon for patients to come in to the clinic and mention they have recently seen something that looked like a streak of lightning or a flash bulb going off in some part of their vision.
How does this happen?The retina is a thin film that covers the inside of our eyes. It is the part of the eye responsible for receiving light signals and sending them to the brain. As you can expect, it needs to be very sensitive.
Due to this high sensitivity, any small movement of the retina can cause signals to be fired back to the brain, making us think that eye is sensing light.
3 most common situations in which flashes are noticed:
1) Patients with near-sighted prescriptions. Near-sightedness is mostly due to the eye ball being larger than average. As the eye grows, the retina becomes stretched. This can lead to areas of thinning and tension.
2) The vitreous gel inside the eye is attached to the retina in multiple areas. Movement of the vitreous can pull on the retina leading to the sensation of flashes.
3) Pressing on the eye. Mechanically releases the chemicals (Phosphenes) that start the signal to the brain.
FAQ:
Q: Are flashes a sign of something bad?
A: Potentially. Flashes could be the first signs of the retina is being pulled, torn, or detached.
If you notice flashes in your vision, especially if combined with new floaters, it is very important to see your eye doctor right away to make sure there are no signs of any tears or detachments.
Q: Do people who have had laser eye surgery still need to worry about their retinas?
A: YES YES YES!!! It is vital for patient's who have had any kind of surgery to have regular eye exams.
Thanks for reading. Please feel free to send me questions and comments about this or any other topic.
How does this happen?The retina is a thin film that covers the inside of our eyes. It is the part of the eye responsible for receiving light signals and sending them to the brain. As you can expect, it needs to be very sensitive.
Due to this high sensitivity, any small movement of the retina can cause signals to be fired back to the brain, making us think that eye is sensing light.
3 most common situations in which flashes are noticed:
1) Patients with near-sighted prescriptions. Near-sightedness is mostly due to the eye ball being larger than average. As the eye grows, the retina becomes stretched. This can lead to areas of thinning and tension.
2) The vitreous gel inside the eye is attached to the retina in multiple areas. Movement of the vitreous can pull on the retina leading to the sensation of flashes.
3) Pressing on the eye. Mechanically releases the chemicals (Phosphenes) that start the signal to the brain.
FAQ:
Q: Are flashes a sign of something bad?
A: Potentially. Flashes could be the first signs of the retina is being pulled, torn, or detached.
If you notice flashes in your vision, especially if combined with new floaters, it is very important to see your eye doctor right away to make sure there are no signs of any tears or detachments.
Q: Do people who have had laser eye surgery still need to worry about their retinas?
A: YES YES YES!!! It is vital for patient's who have had any kind of surgery to have regular eye exams.
Thanks for reading. Please feel free to send me questions and comments about this or any other topic.
Wednesday, December 8, 2010
Computer Vision Syndrome
I have a lot of patients who come in with complaints of eye strain while on the computer, while at work and home.
This is a condition referred to as Computer Vision Syndrome (CVS).
What causes CVS?
1) Need glasses? Uncorrected refractive error (learn more here) can make viewing the computer monitor very uncomfortable.
2) Looking at a computer monitor requires the focusing system inside our eyes to work constantly. Essentially fatiguing the tiny muscles inside our eyes.
3) Reflections from the screen can make it difficult for our eyes to focus accurately, thus causing our eyes to work harder.
4) Incorrect viewing angle can force the muscles on the outside of our eyes to work harder and fatigue.
5) People tend to blink less when at the computer. This leads to dry eyes.
What can be done?
1) First and foremost, get an eye exam. Even if you don't need glasses for other things in life, a simple pair of computer glasses may cure all woes.
2) Take breaks!! Remember 20/20/20. Every 20 minutes, look into the distance (at least 20 feet away) for at least 20 seconds. This will help relax your eyes.
3) Screen protectors are useful. Also, anti-reflective coatings on glasses are very helpful.
4) Ergonomics! Our eyes are most comfortable when looking slightly downward. There are very detailed workplace guidlines available for positioning and posture at the computer. The American Optometric Association recommends that the center of the monitor should be approximately 15-20 degrees below eye level.
5) Blink more. Make a conscious effort. Also, using artificial tears can help moisturize your eyes. Remember our last discussion on Visine. Always best to ask your eye care professional which drops are best for you.
Thanks for reading. As always, questions are welcome and please feel free to forward this information on to anyone who may be interested.
This is a condition referred to as Computer Vision Syndrome (CVS).
What causes CVS?
1) Need glasses? Uncorrected refractive error (learn more here) can make viewing the computer monitor very uncomfortable.
2) Looking at a computer monitor requires the focusing system inside our eyes to work constantly. Essentially fatiguing the tiny muscles inside our eyes.
3) Reflections from the screen can make it difficult for our eyes to focus accurately, thus causing our eyes to work harder.
4) Incorrect viewing angle can force the muscles on the outside of our eyes to work harder and fatigue.
5) People tend to blink less when at the computer. This leads to dry eyes.
What can be done?
1) First and foremost, get an eye exam. Even if you don't need glasses for other things in life, a simple pair of computer glasses may cure all woes.
2) Take breaks!! Remember 20/20/20. Every 20 minutes, look into the distance (at least 20 feet away) for at least 20 seconds. This will help relax your eyes.
3) Screen protectors are useful. Also, anti-reflective coatings on glasses are very helpful.
4) Ergonomics! Our eyes are most comfortable when looking slightly downward. There are very detailed workplace guidlines available for positioning and posture at the computer. The American Optometric Association recommends that the center of the monitor should be approximately 15-20 degrees below eye level.
5) Blink more. Make a conscious effort. Also, using artificial tears can help moisturize your eyes. Remember our last discussion on Visine. Always best to ask your eye care professional which drops are best for you.
Thanks for reading. As always, questions are welcome and please feel free to forward this information on to anyone who may be interested.
Wednesday, December 1, 2010
Visine
Picture this: You're eyes are a little irritated, possibly even a little red. You're not sure why this is happening, but you figure an eye drop could help. You walk into the eye drops section in the pharmacy and you're bombarded by about 131,239 different types of eye drops that tell you they do all sorts of wonderful things. So you pick the one with the name you've heard and claims to do what you want... Visine.
Sometimes it works, sometimes it doesn't. But you give it a try nonetheless.
So, is Visine bad for your eyes and why?
So, is Visine bad for your eyes and why?
1) The active ingredient in the original Visine is Tetrahydrozaline Hydrochloride. It works by constricting blood vessels. Over time, the blood vessels will stop responding to it and even have a rebound effect, where they get more dilated and red than before.
2) The preservative used in all Visine drops is Benzalkonium Cholride (aka BAK). It has been shown to be one of the most likely to cause ocular toxicity and irritation. Most pharmaceutical companies don't BAK in their medicated eye drops for this reason.
If you insist on using Visine for dry eyes, consider using the preservative-free formula.
FAQ:
Q: Can I use Visine to get rid of Pink Eye?
A: No. Pink eye is a viral infection of the eye and should be looked at by your doctor. He or she can then determine which drops (if any) are needed. Learn more about Pink Eye Here.
Q: What other drops should I use?
A: There are many options for dry eyes, allergies, contact lenses, and infections. Its best to ask your friendly neighborhood eye doctor what is best for your eyes.
Q: Is it true that a few drops of Visine in someone's drink can give them an upset stomach (like in Wedding Crashers)?
A: A few drops probably wouldn't do much. However, a lot would likely make a person very sick. Aside from vomit and/or diarrhea, it could affect a person's vision, heart rate, and body temperature. So, I would not recommend trying it :)
Wednesday, November 24, 2010
Stye In My Eye
What is a Stye?
A stye is basically a blocked gland in the eyelid which becomes infected. Kind of like getting a pimple on the eyelid. Bacteria, skin cells, and oil can cause the blockage.
The medical term for a stye is Hordeolum. They tend to be painful and they can be either internal or external.
How are styes treated?
Simple therapy involves applying heat the affected area to express the gland and release the blocked material.
In more difficult cases, doctors may prescribe ointment and/or oral meds.
And in the some cases, minor surgery may be require to remove the stye.
How do you prevent styes?
Lid hygeine. Simple things such as warm compresses and gentle lid scrubs can help keep the eyelids clean and healthy.
To do this you simply warm up a cloth or towel with warm water and apply the heat to closed eyelids for 5 minutes. At the end of the 5 minutes use the warm towel to gently massage your eyelids and then lightly scrub at the eyelid margin to wipe away any debris.
Doing this on a daily basis will help prevent blockage and inflammation of the eyelid glands.
For patient who have Blepharitis (eyelid inflammation), it is important to do these warm compresses twice daily. Click here for more info on Blepharitis.
Thanks for reading. Please feel free to pass this information on to anyone who may find it useful.
A stye is basically a blocked gland in the eyelid which becomes infected. Kind of like getting a pimple on the eyelid. Bacteria, skin cells, and oil can cause the blockage.
The medical term for a stye is Hordeolum. They tend to be painful and they can be either internal or external.
How are styes treated?
Simple therapy involves applying heat the affected area to express the gland and release the blocked material.
In more difficult cases, doctors may prescribe ointment and/or oral meds.
And in the some cases, minor surgery may be require to remove the stye.
How do you prevent styes?
Lid hygeine. Simple things such as warm compresses and gentle lid scrubs can help keep the eyelids clean and healthy.
To do this you simply warm up a cloth or towel with warm water and apply the heat to closed eyelids for 5 minutes. At the end of the 5 minutes use the warm towel to gently massage your eyelids and then lightly scrub at the eyelid margin to wipe away any debris.
Doing this on a daily basis will help prevent blockage and inflammation of the eyelid glands.
For patient who have Blepharitis (eyelid inflammation), it is important to do these warm compresses twice daily. Click here for more info on Blepharitis.
Thanks for reading. Please feel free to pass this information on to anyone who may find it useful.
Wednesday, November 10, 2010
Contact Lenses
They come in a variety of shapes, sizes, and colours...
Soft contact lenses (SCL):These are the most common and they are disposable.
Rigid Gas Permeable (RGP):AKA Hard lenses. Considered older technology but actually provide better optics, better oxygen flow, and less infections. Less popular simply because they are uncomfortable to begin with. But patients who get used to them, stick to them.
Hybrid Lenses:Combination of a hard lens with a soft "skirt". Supposed to provide superior vision of RGPs without being as uncomfortable. But, they haven't been as successful as expected.
Orthokeratology (Ortho-K):Contact lenses that are worn while you sleep. Over night, they flatten the cornea and temporarily correct near-sightedness. Also mentioned in my post Laser Eye Surgery.
Important things to REMEMBER:No matter how good a contact lens claims to be at allowing oxygen pass, or keeping your eyes hydrated, or preventing bacteria from sticking to it, at the end of the day it is still a piece of plastic in your eye.
Contact lenses are considered to be medical devices and, as such, should be looked at by a doctor before they are dispensed and any time the patient experiences any problems.
Three big NOs:
Other uses:Contact lenses are not only used to improve vision. Here are a couple of other interesting uses:
Q: How often should I replace my contact lens case?
A: Usually every 3 months or when your solution runs out. Whichever comes first.
Q: If I wear contact lenses, do I still need a pair of glasses?
A: Yes, you should always have a good pair of glasses to give your eyes a break and just in case something happens to the contacts.
Q: What if I'm on vacation and I forgot my contact lens solution and my contacts are bothering me and there isn't a pharmacy close by and my cousin says its no big deal, can I just store my contacts in tap water?
A: No. No tap water. Ever. I hope that is clear enough :)
Soft contact lenses (SCL):These are the most common and they are disposable.
- This means that after wearing the lenses for a period of time, they are disposed of and a new, fresh pair is used
- Lenses can be monthly (ex. Air Optix, Frequency 55, Proclear, Biofinity, etc), two week (Acuvue Oasys), and daily disposable (CIBA Dailies, Acuvue 1-day, etc)
- Also available for astigmatism and patients over 40 who need reading glasses (more information in my post All Kinds of Blurry)
Rigid Gas Permeable (RGP):AKA Hard lenses. Considered older technology but actually provide better optics, better oxygen flow, and less infections. Less popular simply because they are uncomfortable to begin with. But patients who get used to them, stick to them.
Hybrid Lenses:Combination of a hard lens with a soft "skirt". Supposed to provide superior vision of RGPs without being as uncomfortable. But, they haven't been as successful as expected.
Orthokeratology (Ortho-K):Contact lenses that are worn while you sleep. Over night, they flatten the cornea and temporarily correct near-sightedness. Also mentioned in my post Laser Eye Surgery.
Important things to REMEMBER:No matter how good a contact lens claims to be at allowing oxygen pass, or keeping your eyes hydrated, or preventing bacteria from sticking to it, at the end of the day it is still a piece of plastic in your eye.
Contact lenses are considered to be medical devices and, as such, should be looked at by a doctor before they are dispensed and any time the patient experiences any problems.
Three big NOs:
- No sleeping
- No swimming
- No tap water
Other uses:Contact lenses are not only used to improve vision. Here are a couple of other interesting uses:
- Diabetic patients
- Lens changes colour when sugar levels in tears increase
- Bandage
- Used to cover scratched corneas or after LASIK surgery
- Administer drugs over long periods of time
- Tracking eye movements in ocular studies
FAQ:
Q: Can I get coloured contact lenses even if I have no prescription?
A: Yes. But FYI, these lenses tend to be the least healthy for your eyes.
Q: How often should I replace my contact lens case?
A: Usually every 3 months or when your solution runs out. Whichever comes first.
Q: If I wear contact lenses, do I still need a pair of glasses?
A: Yes, you should always have a good pair of glasses to give your eyes a break and just in case something happens to the contacts.
Q: What if I'm on vacation and I forgot my contact lens solution and my contacts are bothering me and there isn't a pharmacy close by and my cousin says its no big deal, can I just store my contacts in tap water?
A: No. No tap water. Ever. I hope that is clear enough :)
 |
| Healthy Cornea |
 |
| Acanthamoeba infection (from tap water) |
 |
| Corneal Ulcer due to overwear |
Tuesday, November 2, 2010
Lazy Eye
"Contrary to what some believe, a lazy eye is not one that doesn't like to wake up and go to work in the morning."
- Anonymous Eye Doctor with a sense of humour
The medical term for Lazy Eye is Amblyopia
So why do eyes become lazy?
And as the saying goes, "you can't teach an old dog new tricks".
So, once the brain has made all the connections it wants to make, it is very difficult to make it go back. This is why it is important to catch it early! (Before age 7 or 8)
After this cutoff, even providing a patient their full prescription may not improve their vision because no matter how clear the image is, it is not being sent to the brain.
FAQ:
Q: Can a person have 2 lazy eyes?
A: That is a fantastic question! And, yes. I recently blogged about a patient I had seen who had high astigmatism in both eyes. So the connections for both eyes were not fully formed during childhood due to blurry vision and at this point in her life, glasses did not help very much.
Q: What is astigmatism?
A: The answer to this can be found in am earlier post called "All Kinds of Blurry" along with info on other causes of blurry vision
Q: How early should kids have their eyes checked?
A: Both the Canadian and American Association of Optometrists recommend that children have their first eye exam at 6-12 months and again at age 3.
Thanks for reading. I hope this information was helpful. Please feel free to send me any questions or comments. And also pass this on to anyone who may find it useful.
- Anonymous Eye Doctor with a sense of humour
The medical term for Lazy Eye is Amblyopia
So why do eyes become lazy?
- The brain is very picky! When it is not receiving a clear image or if it is receiving double images, it begins to shut off connections to the eye that is causing it the most grief
- This process usually happens during childhood and if it is caught before the age of 7, it can be reversed depending on how bad the situation is and how cooperative the patient is
- Eye turn
- In this case, the patient probably has double vision so the brain will stop communicating with the eye that is turned in/out, which will stop the double vision
- Sometimes surgery is needed to straighten the turned eye, other times simple wearing a patch over the good eye will help force the turned eye back
- Difference in prescription
- If there is a large difference and one eye is very blurry, the brain will again shut it off because it doesn't like dealing with two eyes producing different images
- Glasses are the obvious answer. Sometimes a patch over the good eye will help force the blurry eye to work harder
And as the saying goes, "you can't teach an old dog new tricks".
So, once the brain has made all the connections it wants to make, it is very difficult to make it go back. This is why it is important to catch it early! (Before age 7 or 8)
After this cutoff, even providing a patient their full prescription may not improve their vision because no matter how clear the image is, it is not being sent to the brain.
FAQ:
Q: Can a person have 2 lazy eyes?
A: That is a fantastic question! And, yes. I recently blogged about a patient I had seen who had high astigmatism in both eyes. So the connections for both eyes were not fully formed during childhood due to blurry vision and at this point in her life, glasses did not help very much.
Q: What is astigmatism?
A: The answer to this can be found in am earlier post called "All Kinds of Blurry" along with info on other causes of blurry vision
Q: How early should kids have their eyes checked?
A: Both the Canadian and American Association of Optometrists recommend that children have their first eye exam at 6-12 months and again at age 3.
Thanks for reading. I hope this information was helpful. Please feel free to send me any questions or comments. And also pass this on to anyone who may find it useful.
Tuesday, October 26, 2010
Night Vision
Remember to find me on Twitter and Facebook for more interesting Eye Info.
Night Vision:
As was mentioned in an earlier blog, there are two types of cells in the eye that detect light: Rods and Cones.
Night Vision Goggles (NVG)
There are multiple steps to NVG function:
Humans vs. Animals:
Human night vision is very poor compared to most animals. This is because a lot of animals have an extra layer in the retina called tapetum lucidum
FAQ:
Q: What if a person had only rods, and no cones?
A: This person would be completely colour blind because rods cannot detect colour. They would also have very poor vision since cones are needed for central vision.
Q: How many rods are there in the retina?
A: There are approximately 120 million rods and about 7 million cones. Cones are packed tightly in a tiny central area called the macula. Rods are spread out over the rest of the retina.
Q: Do night vision goggles always show a green image?
A: Yes. This is done deliberately because human vision works best with greens and yellows.
Q: Can I get night vision goggles?
A: Yes, but don't expect them to be as cool as what you see in movies. Goggles that are available to consumers are older technology and lower quality. The newer, better stuff is reserved for military use only!
Q: Can I get tapetum lucidum?
A: Not unless you plan on stealing a raccoon's eyes. Good luck.
As always, thank you for reading. Please feel free to pass this information on to anyone who may find it useful. Questions, comments, and suggestions are welcome.
Night Vision:
As was mentioned in an earlier blog, there are two types of cells in the eye that detect light: Rods and Cones.
- Cones are for bright light and colour vision. Rods are for night vision and detecting motion in our peripheral vision.
- Rods are very sensitive to small amounts of light because they have a high amount of pigment to absorb light and because there are many more rods than cones.
Night Vision Goggles (NVG)
There are multiple steps to NVG function:
- First, light is gathered
- Sensors detect small amounts of light that are reflected off objects (this includes low levels of infra-red light which is not visible to the human eye)
- Then, light is amplified
- Just like turning the volume up on a stereo, the small amounts of light are made brighter
- Finally, an image is projected
- The new amplified image is shown on a small LCD screen
Humans vs. Animals:
Human night vision is very poor compared to most animals. This is because a lot of animals have an extra layer in the retina called tapetum lucidum
- This extra layer reflects light within the eye, basically making it more intense (kind of like NVGs)
- It is also the reason why we see different coloured reflections through the pupil of most animals
FAQ:
Q: What if a person had only rods, and no cones?
A: This person would be completely colour blind because rods cannot detect colour. They would also have very poor vision since cones are needed for central vision.
Q: How many rods are there in the retina?
A: There are approximately 120 million rods and about 7 million cones. Cones are packed tightly in a tiny central area called the macula. Rods are spread out over the rest of the retina.
Q: Do night vision goggles always show a green image?
A: Yes. This is done deliberately because human vision works best with greens and yellows.
Q: Can I get night vision goggles?
A: Yes, but don't expect them to be as cool as what you see in movies. Goggles that are available to consumers are older technology and lower quality. The newer, better stuff is reserved for military use only!
Q: Can I get tapetum lucidum?
A: Not unless you plan on stealing a raccoon's eyes. Good luck.
As always, thank you for reading. Please feel free to pass this information on to anyone who may find it useful. Questions, comments, and suggestions are welcome.
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.
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