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Ortho K

Many patients come to us every day struggling to get through their daily lives with their current choice of vision correction. Some have eyeglasses that do not sit properly on their face or feel that their peripheral vision is hindered by the frames. While contact users may find the lenses uncomfortable or have them fall out at inconvenient times. For these patients, we are pleased to offer orthokeratology, or Ortho-K, a revolutionary way to help you see clearly throughout the day without having to wear glasses or contacts and without having to get laser eye surgery.


What is Ortho-K?

Generations ago, eye doctors knew that the tissue in the eye was soft and somewhat malleable. This knowledge caused them to wonder if they could push the eye back into the proper shape, would an individual be able to see clearly even if they were not wearing their prescription lenses. With the development of gas permeable contact lenses, a few eye doctors began to notice that their patient’s prescriptions did not change as rapidly as previously noted and that they appeared to be able to see correctly even when they were not wearing their contacts.

From these early discoveries, the world of Ortho-K was born. Ortho-K is a special treatment to help patients see clearly even when they are not wearing a prescription lens. Instead, a special gas permeable contact lens is placed into the eye each night before bed and the lens gently pushes the eye into the proper shape while you sleep. In the morning, you can remove the lenses and still see clearly throughout the day. Some patients can even see clearly for up to three days after wearing them for just one night!
 

Who Should Consider Ortho-K?

  • There are a number of issues that our patients can have with prescription lenses. If you have one of the following conditions or concerns, call our office today to schedule an appointment.

  • Allergies to the materials in contact lenses

  • Dry eye that is made worse by wearing prescription lenses

  • Dirt or other debris that gets under contact lenses

  • You play sports and do not want to worry about glasses or contacts

  • The ability to wake up at night and see clearly

  • A general dislike of glasses or contacts


How Long Does It Take?

Once you receive your custom Ortho-K contact lenses, it will take anywhere from one to four weeks to fully see all the benefits to your vision that they will provide. However, some of our patients find that their vision has improved after only wearing their lenses for a single night! During the first few days, you may also still need to wear prescription lenses to see clearly enough to drive or get through your normal day, but that is generally quickly resolved. Also, some patients experience some mild discomfort for the first few nights, but as your eyes adjust over a few days, you should no longer be bothered by the feel of your lenses. Is the Procedure Safe? Orthokeratology was approved by the Food and Drug Administration (FDA) in 2002. The procedure is considered safe, effective, and reversible. However, there are some side effects associated with Ortho-K. Most of these side effects are a result of improper cleaning of the lenses that can lead to a minor infection. These infections are usually remedied fairly quickly with the use of antibiotic eyedrops. Overview If you are sick and tired of wearing contact lenses or glasses every single day and would like an alternative way to correct your vision, consider trying Ortho-K. If you would like more information on Ortho-K, please call our offices today and see how we can improve your everyday life.


Scleral Lenses

Contact lenses come in a variety of shapes and styles to suit the range of needs for individual patients. What this means is that there is almost certainly a type of contact lens that will both feel comfortable for you and improve your vision. 
 

Some types of contact lenses are known as speciality lenses. This is because they are designed specifically to overcome some eye issues which may prevent a patient from wearing the most common and generic styles of contact lenses. In fact, speciality contact lenses have transformed the vision options of many patients who would otherwise have only had the choice between wearing glasses or undergoing laser vision correction. There are numerous types of speciality contact lens, including scleral lenses.
 

What are scleral lenses?

Scleral contact lenses get their name from the fact that, unlike regular contacts, they vault over the entire corneal surface and rest on the white part of the eye, which is called the sclera. This makes them larger than standard contacts, which in turn provides a variety of benefits. Their size makes them easier to handle and more stable when on the eye, which in turn provides the patient with sharper and more reliable vision. They are also less likely to become dislodged and come out. 


Scleral contact lenses are also gas permeable, which means that oxygen can pass right through them and reach the surface of the eyes. This is important for comfort, particularly for patients who experience dry eyes. The gap that is created between the back of the contact lens and the front surface of the eye can also trap tear film, acting as a fluid reservoir which will keep the eyes moist and healthy. 
 

Types of scleral lenses

Within scleral lenses there are several different sizes to choose between. These are based on where the lenses meet the surface of the eye and are as follows:


Full scleral lenses: the largest type, they provide the greatest amount of clearance between the cornea and lens and rest on the outer sclera. 


Mini scleral lenses: the mid-size variety, make contact with the eye on the anterior sclera. 


Semi-scleral lenses: although larger than conventional lenses, they are not huge, and the edge of the contact lens rests on the junction between the cornea and the sclera. 


Your scleral lens provider will be able to make a recommendation as to the correct size for you, which will be based on your individual requirements. 
 

Who are scleral lenses recommended for?

Although technically anyone can wear and benefit from scleral lenses, they are a particularly good option for patients who have eye conditions or irregularities that for which regular contacts are not suitable. This includes patients with:


Dye eye syndrome. Contact lenses float on a fine layer of tear film, which keeps them comfortable and in position. Patients with dry eye syndrome either do not have enough natural tear film, or what they do have drains away too quickly. This can
make wearing regular contact lenses difficult and uncomfortable. However, the design of scleral lenses keeps moisture on the surface of the eyes, eliminating some of the effects of dry eyes. This makes scleral lenses a great choice for patients with dry eyes. 


Irregular corneas. The cornea is the clear dome that covers the front part of the eye and many people have a cornea that is a slightly, or significantly, irregular shape. This causes light to be refracted incorrectly when it enters our eyes, triggering vision problems. Issues arising from irregularly shaped corneas cannot be completely corrected using glasses or conventional contact lenses. Therefore, scleral lenses, which provide sharper and more accurate vision, are recommended. 


For more information about scleral lenses, please do not hesitate to call our expert eye care team. 


Amblyopia

Amblyopia, also known as a “lazy eye”, is described as a reduced vision in one eye compared to the other. There are some rare forms of amblyopia that involve both eyes. Amblyopia is the most common cause of partial or total blindness in one eye in children.

The term lazy eye is misleading because the eye is not actually lazy. In fact, it is a developmental problem in the nerve connecting the eye to the brain, affecting the brain’s ability to use both eyes together. It is not a problem in the eye itself, but in the brain which actively ignores the visual input from the misaligned eye, leading to amblyopia in that eye.

In addition to poor visual acuity, people with amblyopia are more prone to having difficulties with depth perception, eye movements related to reading, and visual decision making while driving.
 

What Are The Causes of Amblyopia?

Amblyopia develops in childhood due to:

  • Significant differences in the prescription (refractive) status between the two eyes due to nearsightedness, farsightedness or astigmatism;

  • Constantly misaligned eyes or crossed eyes (strabismus);

  • An obstruction of vision in early childhood i.e. cataract, ptosis (droopy eyelid)
     

It is important to note that, because amblyopia is typically a problem of infant vision development, symptoms of the condition can be difficult to detect. Symptoms may include noticeably favoring one eye over the other, an eye turn (either upward-downward outward or inward) or a tendency to bump into objects on one side.

The best way to identify children who are at risk for or already have amblyopia is by performing comprehensive eye examinations.
 

How Is Amblyopia Treated?

Amblyopia can be treatable at any age, although the earlier the problem is found and treated, the more successful the outcomes tend to be.


Contact Lens Exam

If you’ve never worn contact lenses before, it can seem a bit intimidating. After all, you’re inserting something into your eye! Let’s ease your mind about the first step – your contact lens exam. This post will walk you through what’s involved in a contact lens exam and what you can expect every step of the way.
 

It begins with a comprehensive eye exam.

Your eye doctor will first determine your overall eye health and vision. This includes a discussion of your health history and then a series of standard eye tests. These tests will evaluate eye focusing, eye teaming, depth perception, color vision, peripheral vision, and the response of your pupils to light. The doctor will also measure your eye’s fluid pressure to check for glaucoma, evaluate your retina and optic nerve, and test your vision with different lenses to assess whether contact lenses can improve your vision.
 

Then, a discussion about your contact lens preferences.

If contact lenses are appropriate for you, it’s time to talk about your contact lens preferences. For example, do you want to enhance or change your eye color? Would you prefer daily disposable lenses or overnight contacts? Ask about the benefits or drawbacks of each, so that you make the best decision. If you’re over 40, your doctor will likely discuss age-related vision changes and how contact lenses can address these issues.
 

Next, the eye doctor will conduct eye surface measurements.

Contact lenses require precise measurements of your eyes to fit properly. Using an instrument called a keratometer, your doctor will measure the curvature of your eye's cornea, the clear front surface of your eye. Next, the size of your eyes pupil is measured using a card or ruler showing different pupil sizes which is held next to your eye to determine the best match.
 

You may also need a tear film evaluation.

If you have dry eyes, your eye doctor will perform a tear film evaluation to measure the amount of tear film on the surface of your eye. If your tear film is insufficient or you have chronic dry eyes, contact lenses may not be a good option for you. However, some newer contact lenses deliver moisture to the surface of the eye, making them a better choice for individuals with dry eye issues.
 

Its time for the contact lens fitting.

The final step is to fit you with a trial pair of contact lenses. Once inserted, your eye doctor will examine the lenses in your eyes to ensure a good fit. He/she will check the alignment and movement of the lenses on the surface of your eye and if the fit looks good, the last step is to ensure the prescription is correct with a few more tests.
 

Now it’s your turn to test it out.

Your contact lens exam is over, but you’ll need to come back. Your doctor will usually have you wear the trial lenses for a week. After that, you’ll have a short follow-up exam to confirm that the lenses are working well for you and you can then order a supply of contact lenses.


Importance of Routine Eye Exams

Routine eye exams are an important aspect of maintaining one's overall health. As with an annual physical or dental exam, it is extremely important to have your eyes examined regularly. Regardless of how great your eyesight is, scheduling regular eye exams is a great way to stay on top of your overall health.

Adults should have an eye exam every 1-2 years, depending on any existing vision problems, eye conditions or being diagnosed with significant risk factors, such as diabetes, high blood pressure, thyroid disease, previous eye injuries or family history. The doctor will recommend a frequency for routine follow-up exams based on the patient’s medical history. For instance, a diabetic patient will need a dilated eye exam every year while contact lens wearers need exams every year in order to look for changes that might affect lens fit and eye health.

Regular eye exams will also ensure that prescriptions for glasses or contact lenses are current as well as offer an opportunity to check for early signs of certain diseases. Adults older than 60 should have an eye exam each year, as age-related eye problems are more common.

It may be important to see a doctor more frequently if one is experiencing any of the following:

  • Blurry vision or loss of vision.

  • Difficulty seeing things near and/or far away and perform basic tasks.

  • Flashing light in the eye.

  • Eye floaters, or small spots that appear in vision.

 

Why Should You Have Regular Eye Exams?

While eye exams are important for one's vision, routine eye exams can also help to identify a variety of problems ranging from cognitive decline to diabetes. Since the eye is an extension of the brain and the only part of the body where blood vessels and tissue are visible, it allows an eye doctor to detect warning signs of the early stages of different health problems, such as diabetes which can present as bleeding in the eye or swelling in parts of the retina.

Besides diabetes, there are several other health problems that may be detected during a routine eye exam such as brain tumors that may cause swelling of the optic nerve and rheumatoid arthritis or other autoimmune disorders which may be the reason behind dry eyes.

Skin cancer on the eyelid is another health risk as the eyelid is very sensitive to ultraviolet rays and may be one of the first places affected by different types of skin cancers. Any spots or affected areas may be detected before skin cancer can spread to other parts of the body.

Addition, high blood pressure which would show as blood vessels in the back of the eye appearing bent or leaking, the narrowing of the vessels in the retina, swelling of the optic nerve, and hypertensive retinopathy in its earliest stages can be looked for during the exam.

There are also some progressive eye diseases that are not immediately apparent and should be tested for during regular eye examinations including:

  • Glaucoma which is the buildup of pressure within the eye that causes damage to the optic nerve and can lead to a loss of peripheral vision or a complete loss of vision. Glaucoma is a chronic, progressive eye disease that doesn't show any symptoms or pain in the initial stages.

  • Macular degeneration is an eye condition that causes damage to the retina.

  • Cataracts which is the most common cause of blindness in the world. Cataracts occur when the lens of the eye becomes less flexible with age. Blurred or foggy vision and sensitivity to light are common symptoms. Cataracts are easily corrected with outpatient surgery.


Vision changes can have a profound effect on a person’s day-to-day life, but early treatments can help to slow or stop vision loss and regular eye exams can help ensure a lifetime of clear sight


How Exercise Benefits the Eye

It is common knowledge that exercise plays a critical role in healthy living. Exercise can help improve energy levels, lower blood pressure, aid in weight loss, helps to build muscle and so much more. But one benefit of exercise that is not as well known is the profound impact on your eyesight. 

Based on recent research, eye conditions are usually a direct result of a health issue such as high blood pressure, diabetes, high cholesterol level, etc. While some of these diseases are unavoidable, exercising regularly can definitely help in the prevention of these diseases and in doing so, help keep the eyes healthy. In addition to physical exercise, there are even some eye exercises that can be done to keep your vision healthy. Some examples are focusing on certain points, rolling your eyes in different directions, writing with the eyes, etc.
 

Cataracts and Exercise

According to a study in 2003 and another in 2006, a relationship was discovered between an increase in exercise and a decrease in cataract. It emphasized that there is a greater chance for cataract if there is an absence of physical activity. This implies that taking a light walk or jog around your house or on a field track consistently can contribute to the fight against cataracts.
 

Macular Degeneration and Exercise

According to one study, exercising three times or more on a weekly basis reduces ones’ chances of developing exudative macular degeneration. Exudative macular degeneration occurs when blood vessels grow beneath the retina that are not needed and then leak fluid and blood into the eyes.
 

Glaucoma and Exercise

One major cause in the development of glaucoma is an increase in ocular perfusion pressure. Very light exercises like jogging or walking at least three times weekly helps to reduce the intraocular pressure and improves the flow of blood to the optic nerve and retina.
 

The benefit of eye exercises

  • Protects against dry eyes. Eye exercises help maintain and improve the fluid level in the eyes, thus eliminating the probability of dry eyes because as the eyes are being exercised say by rotation, there is the tendency that fluid is produced.

  • Reduces eye strain and tension. Exercising the eyes daily helps in reducing the strain and tension that has been placed on the muscle. Exercises like rolling the eyes and writing with the eyes help in the contracting and relaxing of the eye muscles. Long hours of study or use of a computer can cause blurry vision, but through exercise, clarity can be achieved by eliminating tension and unnecessary pressure.

  • Make the eye muscles flexible. Exercises like shifting and swinging the muscles of the eyes help promote flexibility in the muscles of the eyes. Just like exercise helps the body muscles, the same thing applies to eye exercises.
     


Keratoconus and Your Treatment Options

Keratoconus is a terrifying diagnosis to those that have experienced it. To compound issues, many patients complain that they had poor initial treatment due to a lack of understanding about the disease. If proper treatment is not achieved, individuals may experience a rapid deterioration in their ability to see. This leads to a reduced quality of life. You can reduce the stress related to a keratoconus diagnosis and increase the benefits of treatment by understanding your treatment options.
 

Understanding Keratoconus

Keratoconus is an eye disease that causes the cornea to thin and bulge. This bulge generally takes on the appearance of a cone. As light enters the eye, it becomes distorted by the cone causing vision abnormalities.

Modern research is connecting keratoconus with an enzyme imbalance in the cornea. This imbalance leaves the eye susceptible to oxidative free radicals. Keratoconus has also been linked to UV damage, excessive eye rubbing, poorly fitting contacts, and chronic eye irritation.
 

Treatment Options

While your eye professional will have the best understanding of what treatment option is right for you, we have compiled ten of the most common treatments here.

  • Corneal Cross-linking (CXL) – There are two different types of this procedure, but they both introduce riboflavin to the cornea in order to strengthen the corneal tissue and stop the bulging from progressing.

  • Custom Soft Contact Lenses – Soft contacts are generally more comfortable to wear than gas permeable lenses. Recently, some contact companies have been able to create a contact specifically to correct the issues related to mild and moderate cases of keratoconus.

  • Gas Permeable Contact Lenses – Gas permeable lenses are a hard contact lens that physically forces the eye to adhere to the lens shape. This allows for the correction of keratoconus. The fit is often time-consuming and may take several different lenses to achieve the proper fit.

  • Piggybacking Contact Lenses – This method is used for individuals who require a gas permeable lens but cannot tolerate wearing rigid contacts. Piggybacking utilizes a soft lens placed on the eye first, and then a gas permeable lens is placed over the top. This offers the comfort of soft contacts with the rigidity and clarity of the gas permeable lenses.

  • Hybrid Contact Lenses – Hybrid contact lenses were designed specifically for keratoconus. This technology blends a rigid contact lens center with a softer edge, or skirt, of the contact
 
  • Scleral and Semi-Scleral lenses – These lenses are gas permeable lenses but cover a larger area of the eye than a standard rigid lens. These lenses don’t put pressure onto the cone shape of the eye. The reduced pressure results in a more comfortable fit for patients.
 
  • Prosthetic Lenses – This lens is used specifically for patients that have very advanced keratoconus and have ruled out other options. The advanced scleral lens also doubles as a protective prosthetic shell. There are special requirements to qualify for this lens though, so check with your eye care professional if this is an option for you.


Sports Vision

Sports vision is a growing niche in the eyecare industry, helping athletes improve their performance skills through the enhancement of visual skills. While regular eye exams are important for checking the health of your eyes and your visual acuity (how clearly you can see a still object at different distances), sports vision testing is recommended for anyone who takes their athletic performance seriously. 
 

Visual skills needed for sports performance

There are several key visual skills that are enhanced through sports vision programs for athletes that aim to achieve their optimal sports performance, these include:


Dynamic visual acuity: this refers to the patient’s ability to see objects clearly while in motion. This is exceptionally important as hand-eye coordination and reflex reactions are essential for success in most sporting activities.


Contrast sensitivity: good contrast sensitivity is needed to determine the difference between an object and its surroundings. Contrast sensitivity is particularly important in situations where there may be low light, fog or glare that could diminish the natural contrast between objects and backgrounds. 


Eye tracking: this refers to the ability to follow a fast-moving object, such as a ball or puck.


Switching eye focus: athletes need to be able to change their focus quickly and accurately from one distance to another. 


Binocular vision skills: also known as eye teaming skills, these skills determine how well your eyes work with one another to produce a single, clear image.


Processing speed: visual processing speed is defined as the amount of time it takes to make a correct judgement about a visual stimulus – for example, how fast a ball is travelling towards them. 


Peripheral awareness: athletes also need to be able to be aware of what is happening at the edges of their vision while also concentrating on a fixed object in front of them.



Sports vision testing can enable your eye doctor to spot any weaknesses that you may have in any of these key visual skills. By identifying them, it is possible for you to undergo treatment to overcome theses issues and meet your specific goals that will ultimately enhance your overall athletic performance. This is known as sports vision training.
 

What’s involved in sports vision training?

Sports vision training refers to a personalized treatment plan that is designed to train the brain to achieve maximum efficiency in the way that it receives, processes, and responds to visual input. Exactly what is involved in your sports vision training will depend on your athletic activity and the visual skills that your eye doctor identifies for improvement after comprehensive sports vision testing. Your treatment program will use a variety of tools, techniques, and exercises. You may also be asked to complete some exercises at home to further enhance your progress. With sports vision training, the ultimiate goal is for athletes to continue to see faster and clearer, giving them a distinct competitive edge. 


For more information about sports vision and how it can benefit amateur and professional athletes, please contact our team.


Considering Your Face Shape When Choosing Eye Glass Frames

When it’s time to select a new pair of eyeglasses, it can be challenging to find the frame that feels the best for you. Eyeglass makers have become increasingly aware of their clients’ desire to customize frames as well as offer a variety of colors, designs, and frame shapes. Understanding more about your face shape and the types of frames that would look best on you can help to reduce the amount of time you spend trying on frames that don’t complement your face shape. Here are a few useful tips to help you find glasses best suited for your face shape.
 

Face Types

While there are thousands of different frame shapes, there are only seven different face shapes.
 

Round

This face type is as wide is it is long. There are no specific or well-defined angles to this face type. Most people with this facial type look for frames that will elongate their face in order to draw out their natural features as well as give their face a thinner appearance. A good choice is often to select a frame that is angular and narrow.


Heart

If you can imagine the shape of a traditional heart, this face shape is easy to identify. The top 1/3 of the face is wider while the rest of the face tapers to a narrow chin. Individuals with this face shape will often seek frames that are wider at the bottom of the lens. This helps to balance the face and give the appearance of a narrower face at the top. Another great fit for this face type would be rimless frames.
 

Base Down Triangle

This face type contains a wide jaw and cheekbones but is narrow at the forehead. Cat-eye type frames are great for this face type, as are frames that are heavier near the eyebrow to provide more balance.
 

Diamond

This face type is the rarest. The diamond face is like the base-down triangle but differs because it has a narrow chin, thus appearing like a diamond. When selecting eyeglasses, look for oval-shaped frames, or frames that have more detail along the brow line.
 

Oblong

This face type looks like an oval, but these individuals have a straight cheek line. This face is fuller than it is long. Frame types that add some depth are ideal for this face. This can be done by finding frames that have decorative pieces along the temples or that have more depth with a reduced width.
 

Oval

Oval faces are the most common face type. They are considered to have balanced proportions so that most frame types will work well. An oval face is longer than it is wide and includes plump cheekbones. Walnut shaped eyeglasses are an ideal choice, but frames that are as wide or wider than the broadest part of your face would work as well.
 

Square

These individuals have a broad forehead and jaw that gives the appearance of the face having equal and straight sides. These face types usually do well with narrow or oval-shaped frames which will help to soften their features.
 

Additional Tips

Your hair color may play a role in the best frame color for you. Individuals with warm hair colors (brown or black hair) do best to choose a lighter colored frame to add contrast. People that have hair on the lighter end of the spectrum can pick just about any frame color that they would like and may look to other features like eye color or skin tone to help make their decision.

Skin tone has the opposite effect from hair color on the best choices for the frame color. Those with lighter skin hues do best with similar frame colors, and those with warmer skin tones can pick and choose options that they enjoy the most.

Above all else, you should pick a frame that you like best. There may be additional factors to consider when choosing the right frame for you, but perhaps the most important factor is your overall happiness and comfort.


Pediatric eye exams

Regular eye exams are important for children since their eyes can change significantly in as little as a year as the muscles and tissue develop. Good eyesight is critical for a child’s life and achievements since success in school is closely tied to eye health. School demands intense visual involvement, including reading, writing, using computers, and blackboard/smartboard work. Even physical activities and sports require strong vision. If their eyes aren’t up to the task, a child may feel tired, have trouble concentrating, have problems in school or have difficulty playing their favorite games which may affect their overall quality of life.
 

When to Perform a Pediatric Eye Exam?

According to research, a child should have an initial screening between 6 and 12 months of age. After that, routine eye health and vision screenings throughout childhood should be performed in order to help detect any abnormalities as their eyes develop. Then, unless otherwise recommended, every two years thereafter until the age of 18.

For a newborn, an optometrist should examine the baby’s eyes and perform a test called “red reflex test” which is a basic indicator that the eyes are normal. In a case that the baby is premature or at high risk for medical problems for other reasons, has signs of abnormalities, or has a family history of serious vision disorders in childhood, the optometrist should perform a comprehensive exam.

A second eye health examination should be done to infants between six months and the first birthday. This examination includes tests of pupil responses to evaluate whether the pupil opens and closes properly in the presence or absence of light, a fixate and follow test to determine whether the baby can fixate on an object such as a light and follow it as it moves, and a preferential looking test which uses cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes and thus vision capabilities can be assessed. Infants should be able to perform this task well by the time they are 3 months old.

For a Preschooler, between the ages of 3 and 3½, a child’s visual acuity and eye alignment should be assessed. If the child is diagnosed with misaligned eyes (strabismus), "lazy eye” (amblyopia), refractive errors (astigmatism, myopia, hyperopia) or any other focusing problems, it’s important to begin treatment as soon as possible to ensure successful vision correction and life-long benefits.

At School age or upon entering school, the child’s eyes should be screened for visual acuity and alignment. In this age group, nearsightedness (myopia) is the most common refractive error and can be corrected with eyeglasses.


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