Helpful Links:
American Optometric Association:
http://www.aoa.org/x5924.xml
EMEDICINE: www.emedicine.com
NATIONAL EYE INSTITUTE: www.nei.nih.gov
OPTOMETRISTS NETWORK: www.visiontherapy.org
How often should I have my eyes checked?
Eye health is the primary reason why a yearly exam is recommended for most patients. Eye diseases such as glaucoma present no symptoms at all until it is too late to help. Allowing the doctor to view the back of the eyes through dilated pupils can often detect impending retinal detachments, allowing for referral for preventive surgery. Patients with diabetes, high blood pressure, and high cholesterol should definitely be seen yearly. In addition, most patients experience at least a small prescription change each year. Many do not notice the change until they put on the new lenses and see what they were missing. Often patients find a significant change in their visual comfort after updating their prescription. Finally, the technology of vision care is growing at a very exciting rate. New eyewear and contact lens products are becoming available almost yearly. The new campaign for the American Optometric Physicians Association is: “Check Yearly, See Clearly.” www.checkyearly.com
Why are the eyes dilated during the eye exam?
The pupil is basically a hole in the iris that allows light to focus on the retina. The pupils constrict with bright light and dilate in low light. During the health check of the vision exam, the doctor shines a light into the eye to see the structures inside. He will use a mild medication that relaxes the muscles of the iris to dilate the pupil. This is the only way he is able to see all the structures of the eye clearly. Without this procedure it is possible to miss important health concerns such as retinal detachments and ocular tumors. Although these conditions are rare, it is imperative that they receive immediate treatment to avoid loss of vision or even loss of life! Many ocular diseases have no symptoms until it is too late. Some offices charge an additional fee for eye dilation. Express Optical believes it is in everyone's best interest to have this procedure done at every full exam, and includes this service at no additional charge. The side effects of eye dilation are mildly annoying, but not painful. “Haziness” of your distance vision, light sensitivity (well-tolerated with sunglasses or temporary shades provided), and difficulty focusing at near. Most people are affected by these symptoms for a period of 3 to 5 hours. Very few people report difficulty with driving during this time, as long as they wear sunwear, but some patients prefer to bring a driver with them. If you do not wish to have the procedure done you may discuss it with the eye doctor. Sometimes an alternate visit can be arranged if circumstances permit.
Do you use the “air puff machine?”
The dreaded “air puff” test is just one of the techniques used to measure the ocular pressure inside the eyes. This test is primarily used to check for glaucoma. Dr. Coffman prefers using a test called Goldmann Tonometry. This test has no puff, making it more gentle and less of a surprise. It also is slightly more accurate, and is the industry standard for measuring and monitoring glaucoma.
When should children have their eyes checked?
An infant should have his/her first eye exam at six months of age. Another exam should be scheduled at age three, and then again prior to your child entering first grade. A lot of information can be gathered regarding the child's refractive status, tracking, eye teaming, and ocular health without requiring the child to answer questions. Generally, glasses are not prescribed for infants unless the child has a significantly large prescription or an eye turn. School age children sometimes benefit from a spectacle or contact lens prescription to assist or enhance reading skills. It is a good idea to let the office know the age of your child when you make the appointment, so that we can make any preparations necessary to accommodate them.
When can children use contacts?
The easy answer to this question is: “When the child and the parents are ready.” Basically, if a child has the dexterity to handle the lenses and has the maturity to accept a lens on their eye, then there is no age limit to use contact lenses. Dr. Coffman 's youngest contact lens patient started at age 3. Often, parents are trained to remove and insert the lenses along with the child as a precaution, but it is a good idea for the child to be the one responsible for insertion and removal of the contact lenses. Now that new disposable options are available, along with multi-purpose solutions, the concern about losing or ripping a contact lens is not as much of an issue. In addition, the cost for soft disposable contacts is much lower than it used to be. Sometimes a patient (of any age) can be fit for a cost of about $10 per month. There are recent studies investigating the positive emotional and psychological effects of contacts versus glasses in children and teenagers. Questions and concerns regarding contacts for children are discussed during the eye exam.
Why do some children wear bifocals?
The word “bifocal” has unfortunately been automatically linked to the aging process – particularly presbyopia. In fact, a bifocal or progressive (no-line bifocal) can be useful for many patients regardless of age. Often a patient's distance glasses are actually detrimental to that patient's near vision. This can result in headaches, eyestrain, and progression of near-sightedness over time. If this is the case, then the option of using a multifocal lens is offered. It is up to the patient, the family, and the doctor to decide as a team if a multifocal lens is the right lens to use.
What do you think about LASIK?
LASIK and other refractive surgeries are fast becoming viable options for many patients. During an eye exam, most of the numerical data required to screen patients for refractive surgery is collected, allowing for discussion. When a patient is very eager or motivated to pursue surgery, a few more data points are collected, and a very long discussion with the doctor is scheduled. Dr. Coffman feels that such an important decision should not be taken lightly, and he makes sure all the benefits as well as the limitations of the procedure are revealed during this visit. The risks, as well as the rewards need to be discussed fully to prevent any misunderstanding or disappointment. “LASIK is a good surgery in the hands of a good surgeon,” says Dr. Coffman . “Personality, expectations, and risk factors are just as important as what the numbers tell us.”
How do I put eye drops or ointment in my
eyes?
I
PLEASE FOLLOW YOUR
DOCTOR’S ORDERS IF THEY DIFFER FROM THIS SHEET
1.
Wash you hands with soap and water.
2.
Look toward the ceiling with both eyes open.
3.
Pull lower lid down steady your hand on your forehead.
4.
Put a drop of medicine or small strip of ointment (1/4
inch) in the sac behind the lashes of the lower lid.
5.
The tip of the dropper or ointment tube should not touch
the eyeball itself.
6.
Do not give more than one eye medicine at a time – wait 5
minutes between medicines.
7.
When using both ointments and drops, use the ointment AFTER
the drops.
8.
Try to keep your eyes closed for one minute after
instilling drops to obtain maximum benefit from medications.
What is a chalazion?
The eye is surrounded by small
oil-producing glands that help lubricate it.
Occasionally, the gland becomes plugged, and a hard and
sometimes a painful lump called a chalazion (ch lae zee on) forms.
Symptoms
The pimple-like chalazion is a
small annoyance that can become a big problem.
What starts out as a small annoying lump can become
infected and cause great discomfort.
The eye may become red, swollen and sensitive to light.
In the worst cases, it can even affect eyesight, causing
blurry vision. This
is due to pressure placed on the eye from the inflammation
(swelling) of the eyelid and the growing chalazion.
Treatment
Luckily, most chalazion’s stay
small and are just a minor annoyance.
They can be treated at home with warm compresses and gentle
massaging of the affected area to loosen the plugged oil glands.
They often resolve on their own within a few weeks.
Chalazion that are a greater nuisance or become infected
can be treated with antibiotics and other medications.
In the worst cases, the
chalazion can be surgically drained and/or removed in the
doctor’s office. If
the chalazion returns or if you have had them over a long period
of time, your doctor may send the removed chalazion to a
laboratory to be tested.
What
is a subconjunctival hemorrahage?
A sudden filling or partial
filling of the whites of the eye with blood is referred to as a
subconjunctival hemorrhage. It
usually follows a trauma to the eye or even occurs after coughing
or sneezing. The use
of alcohol or certain drugs that thin blood (anticoagulants) can
contribute to a subconjunctival hemorrhage during the coughing or
sneezing episodes.
Symptoms
A bright red blood patch
covering a portion of the whites of the eye is the most obvious
symptom. The red
patch may become larger the day following the initial hemorrhage.
The condition is usually painless.
Mild discomfort may result from swelling on the outermost
layer of the eye. Vision is usually not affected but your eye doctor will want
to perform some simple tests to be certain.
Treatment
The bright red blood spot will
fade and disappear after a few weeks.
To relieve any discomfort from swelling and to prevent
additional bleeding, apply cold compresses several times a day for
the first day or two.
After a couple of days, you can
apply warm compresses several times a day to aid in the healing
process. A clean washcloth dipped in cold or warm water works but a
hot water bottle works best.
Note:
If vision begins to change, call your doctor immediately. Something else may have been affected.
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Vision Glossary
(Some common eye health
conditions)
Macular Degeneration
Waste products can build up in the back of the eye in the macula. The macula (also called Fovea) is the centermost visual point, where all the light rays are focused inside the eye. Patients with “dry” macular degeneration may or may not notice a vision change, but “dry” can evolve into “wet” degeneration, which can have a devastating effect on your central vision. Dry degeneration means the macula has waste product in the area. Wet refers to bleeding or leaking that leads to permanent scarring of the macula. Preventive measures such as ultra-violet light protection, nutritional supplements, and limiting risk factors such as smoking are key to helping the eye to “clean up it's mess.”
Age-Related Macular Degeneration Info. Website
National Eye
Institute on Macular Degeneration
Cataracts
The lens inside the eye can become cloudy or splotched, resulting in blurred vision, glare, and color perception differences. Thankfully, the solution to cataracts is cataract surgery. This surgery is very easy and has rare complications.
Glaucoma
Pressure inside the eyeball builds up over time, causing damage to the optic nerve and destroying the patient's peripheral vision. Left undetected and untreated, this can lead to total blindness. During a vision exam, pressure readings are taken and the optic nerve is evaluated. If glaucoma is diagnosed, the treatment is usually simple. One or two medicated eye drops to control the pressure almost always controls glaucoma, resulting in no vision loss.
http://www.glaucoma.org/
Eye Infection
Bacterial, fungal or viral infections can be treated with modern medications and supportive therapy.
Retinal Detachments
One of the main reasons the eyes are dilated during the vision exam is to search for holes or tears in the peripheral retina. These lesions can occur in almost anyone with little or no warning. A full retinal detachment can mean emergency surgery and high risk of permanent vision loss. Therefore, early detection and preventive treatments are the best way to prevent this problem.
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Visual Conditions
Amblyopia ("Lazy Eye")
Many patients mistake “lazy eye” for strabismus. Strabismus can be a cause of amblyopia, but there are other, less visible causes as well. Amblyopia means the brain has learned to actively suppress one eye. This can be due to an eye turn or large difference in spectacle prescription. Basically, if the brain has the choice of “paying attention to” an eye with clear vision and an eye with poor vision, it will usually choose the clear image and try to ignore or suppress the blurred image. Also, the brain does not like double vision, and will effectively “turn off” one eye to avoid double vision. Both of these examples can lead to amblyopia. The brain can be trained to re-activate the connection to the poorer eye with eye exercises and patching of the better eye. This treatment works best if started very young, but can still be effective in later years.
Prevent Blindness in America Kids Center
Strabismus (Eye Turn)
A constant or intermittent eye turn either inward (esotropia) or outward (exotropia).
Strabismus can be treated with spectacles, vision training, and / or surgery.
Astigmatism
A difference in spectacle prescription between two meridians. For example, if you have one spectacle power needed in the horizontal meridian of one eye, you would need a different power for the vertical meridian. The light is focused into two different focal points. Astigmatism is simply an imperfection in the optics of the eye – not a disease or degeneration. Untreated astigmatism means a blurred image both in the distance and up close. Glasses, contacts, and refractive surgery can compensate or correct for astigmatism.
Nearsightedness (Myopia)
Blurred distance vision. Myopia is the result of having an eyeball that is too long or whose cornea is too steep. Nearsightedness can be inherited and / or caused by environmental factors such as prolonged reading or computer use. Sometimes the progression of nearsightedness can be halted or slowed by using reading glasses or multifocal lenses.
Farsightedness (Hyperopia)
Farsighted patients can sometimes see well in the distance (and often at near, too), but to do so requires an awful lot of work focusing. It is the result of an eyeball that is too short or whose cornea is too flat. Sometimes patients who are farsighted may not have a specific clarity problem, but rather comfort or efficiency issues – especially when reading or working on the computer. For higher levels of hyperopia, distance and near blur is the main symptom.
Presbyopia
Everyone's focusing system decreases in effectiveness after childhood. Usually around the age of 38 to 45, patients begin to notice a significant difficulty seeing clearly up close. Over time, the lens inside the eye gradually loses its flexibility and focusing ability. There is no proven method to reverse or prevent presbyopia. Many options are available to correct for the loss of near clarity.
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