Archive for the ‘Preventive Health’ Category

My friend and occasional collaborator, Jessica Barnett asked me a question on Twitter the other day: “Random thought.. Do you have any blogs about the dangers of wearing contacts for too long/way too long?”

My first thought was, “Oh, man. She must be in big trouble.” Most people don’t think about the possible harm contacts can do until they have red, angry, painful eyes. It turns out that, no, she just has a lot of friends who push their contacts WAY past their limits. And she wanted some info to share with them.

First, let’s clarify a bit of terminology. When patients do not follow the recommendations regarding their contact lenses, they usually refer to it as “wearing contacts for too long.” Sometimes they say they just “over-wear” contacts. What doctors call it is “contact lens abuse.” Because, like almost anything, contacts can be used properly to provide safe, clear, and comfortable vision, or they can be used in a way that causes unnecessary risk.

When people abuse their contacts proteins, oils, bacteria, and allergens build up on the surface of the lenses. These are then in constant contact (get it? 8)) with the sensitive lining of your eyeball and eyelids. If you do not take your contacts out, or you wear them longer than you are supposed to, you limit the ability of your eyes to clean and recover. This increases the likelihood of a problem that can range from something mildly annoying to something permanently blinding  - like acanthamoeba.

So what is the worst that can happen? Check out this video to illustrate “the worst week of my life.”

Or this quieter patient saying  that it felt like ” my eye was going to burst out of my face”

Most contact lens complications are certainly not this bad. Most commonly, people first develop dry, red eyes as a result of the eyes not getting enough oxygen, the lenses not fitting correctly, or as a reaction to components of the contact lens cleaning solution. You do not want to let these initial problems develop into an infection or a corneal ulcer as described in the videos above. As a general rule, if you experience any pain, redness, watery eyes, sensitivity to light, or the feeling that something is in your eye or stuck on the contact take out the contacts and schedule a visit with the eye doctor that prescribed your lenses.

Here are some things you can do to reduce the chances of problems with contacts:

1. Throw away your contacts as recommended.
2. Do not sleep in your contacts unless specifically allowed by your doctor.
3. NEVER use tap water when cleaning lenses.
4. Wash your hands before handling contacts.
5. Ignore the “no rub” label. Clean your contacts as instructed.
6. Never reuse contact lens solution.
7. Keep your contact lens case clean and replace it regularly.
8. Own an up-to-date pair of back-up glasses to give your eyes a break.

You may not have realized it but July is UV Safety Month. And Bright Eyes is celebrating by offering a discount on all of our sunglasses! This includes brands like Costa Del Mar, Coach, Tiffany & Co. and more! Just stop in to find a pair right for you!

And remember, sunglasses aren’t just for July. They should be worn all year to protect your eyes!

The American Optometric Association recently held a School Readiness Summit: Focus on Vision in which doctors, nurses, educators and advocates for children’s health gathered to examine learning-related vision issues that are keeping children from achieving in the classroom. This summit was created to address the concerns that our current system is flawed and a policy shift is needed. The problem is that currently, the U.S. educational system and some health care providers rely heavily on vision screenings to discover the kids that need comprehensive exams. These screenings do catch some types of vision problems but they can miss about 75% of those children that have learning-related vision problems. Detecting these vision problems is very important as “studies show that much of what children learn comes though vision, and undetected and untreated eye and vision disorders in children, such as amblyopia and strabismus, can result in vision loss, additional costly treatments, delayed reading and poorer outcomes in school.”

The take-home statement that the summit produced is that comprehensive eye exams must serve as the foundation to determine school readiness in school-aged children. Another important point established at this meeting is the establishment of the link between healthy vision and classroom learning.

This historic summit is an important step in ensuring that children receive the proper detection and treatment of vision problems before they become detrimental to their learning. Here at Bright Eyes Family Vision Care, we are excited to see these changes being made, since it has been our goal from the beginning to not only catch vision problems at an early stage, evidenced by the InfantSEE program that we offer that provides free eye exams to infants between the age of 6 months and 1 year of age, but to also treat certain types of problems through our extensive one-on-one vision therapy program.

If you have any questions regarding the InfantSEE program, vision therapy program, or would like to schedule a comprehensive eye exam for your child before they start school, give our office a call or come in to schedule.

All the best,

Justin Schoonover, CPO

Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

For months, I’ve been reading, writing, and speaking about the Nintendo 3DS, all without actually seeing or using it. I was finally able to change that yesterday. After helping put the kids to bed, I slipped off to Best Buy and purchased a shiny black 3DS. I brought it home and Cristina and I spent a few hours setting it up and using it. We’ve had a Nintendo DS at Bright Eyes for years that we use as a reward activity during vision therapy, so it was immediately very familiar.

3D Effects

One of the biggest selling points of the 3DS is that the user does not need to wear special glasses to see the 3D effects. This is called autostereoscopic 3D and is definitely where 3D technology is going. It works surprisingly well, considering the small screen. You do have hold the screen flat relative to your head. If you angle the screen, you will either see double or lose the 3D effect.  The 3D does work from positions other than dead-center. This means that, while not ideal, it is possible for more than one person to see the 3D effect at one time.

I was particularly interested to see how well the “3D volume” slider worked. This allows users to adjust the amount of 3D shown to suit their tastes and the particular game. It works amazingly, seamlessly well. I was able to adjust the 3D anywhere from none, to just-noticeable, to full with just a flick of my thumb.

Augmented reality

One of the most intriguing aspects of the 3DS is its use of AR (augmented reality) as part of the game. This allows the viewer to play the game within the room or area that they are really in. (See picture to the right).  Not only is this extremely fun, there are some potential visual benefits to this. If the game is getting further away, it is more likely that the user will hold the game further away and look further away, potentially reducing some strain on the eyes. (I should note that I don’t have any research on this, but it occurred to me while playing.)

3DS vs. DS

One of the biggest visual concerns with 2D game systems such as the original Nintendo DS is that children tend to hold the screens incredibly close – as close as 3 or 4 inches. A person of any age should not hold a book or game closer than their Harmon Distance (or the distance from the knuckle to the elbow). With the 3DS, the 3D effect is better when the game is held a foot or so away from the eyes, so this will naturally encourage users to stay within their Harmon distance.

Safety

Much has been made, appropriately, of the potential adverse effects of using 3D technology, due to the differences of 3DS and real-life 3D.  Nintendo’s official warning of “vision damage” occurring for those six and under has gotten a lot of attention. While I haven’t seen any proof of this, I think it is reasonable because a person has to pretty visual sophisticated to use the 3DS. So I do recommend keeping it away from the young kids. They should be building with blocks and playing outside anyway,

For the older kids and adults (like Justin, on the left) who use the 3DS, eyestrain is possible. Already, I’ve talked to patients who have experienced headaches, nausea, and blurred vision from the 3DS. I’m happy to report that after an hour neither Cristina nor I experienced any of these symptoms. However, we routinely do activities during vision therapy that require visual skill and flexibility. For that reason we are much more accustomed to the visual demands required by the 3DS.

The #1 thing to remember: moderation. Take frequent breaks, even if you feel OK. Use the 20/20/20 Rule – Every 20 minutes, look away from the screen at something 20 feet away for at least 20 seconds. Even Nintendo recommends that players take a 10 minute break every hour.

If you or your children do experience symptoms, or don’t see the 3D even with the 3D on “full” be sure to get a through eye exam to look for vision or eye coordination problems. And remember that eye exams are recommended at age six months, three years, and before kindergarten.

For more on potential health effects of the Nintendo 3DS, see my interview with PCWorld. See also the American Optometric Association’s press release on the subject

Overall

In summary, the Nintendo 3DS easy to use and fun. The 3D effects are effective and being glasses-free is very nice. The augmented reality really works well. When used in moderation for the appropriate ages, I do not see any harm. If you do have concerns, schedule an appointment at Bright Eyes either on our webpage or calling 813-792-0637.

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

It can come with no warning and no noticeable symptoms. It is the second most common cause of blindness in the United States. “IT” is Glaucoma, the Silent Thief of Sight.

January is National Glaucoma Awareness Month and we encourage all people, especially those at higher risk for this disease, to familiarize themselves with the potential symptoms and need for regular eye examinations. A regular eye examination is especially critical since a person with early-stage Glaucoma may not notice any symptoms at all. While the early stage symptoms may not be noticeable, persons with more advanced Glaucoma may notice blurred vision, the presence of halos around lights, loss of peripheral vision and difficulty focusing on objects.

Glaucoma affects an estimated 4 million Americans.   Some people are more at risk than others. Those at higher risk include:

• People over the age of 60
• African-Americans over age 40
• People with diabetes
• Individuals that have experienced a serious eye injury
• Anyone with a family history of glaucoma

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

In Florida in the summer, this message cannot be stated enough:

WEAR YOUR SUNGLASSES!

The Miami Herald reported that, according to Tim Murray, MD, of the University of Miami’s Bascom Palmer Eye Institute, “both types of ultraviolet radiation — UVA and UVB — can damage various parts of the eye,” which “can cause cataracts and an increased risk of macular degeneration.” In addition, “extreme UV exposure can also cause growths on and around the eyes, and an increased risk of cancer in the tissues around the eye and the eye itself, he said.”

To reduce the risk of sun-related eye damage in children and adults, “the American Optometric Association recommends” sunglasses that “absorb at least 99 percent of UV rays, a number verified by the FDA that can be found on the labels attached to sunglasses.”

And, “for those who spend extended periods of time outdoors,” the AOA “recommends wearing wrap-around sunglasses that cover the temple area, as light can enter the eyes from the sides of the face.” In fact, optometrist Judi Schaffer, OD, “often recommends polarized sunglasses to her patients because they are the best for blocking out harmful rays.” (from AOA first look by Custom Briefings.)

Be Well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

A friend and colleague, optometrist Jeffrey Anshel, appeared on television yesterday to discuss Computer Vision Syndrome.

It is a little light-hearted reminder to pay attention to your eyes when you are at the computer. And if you experience discomfort or fatigue at the computer, be sure to get your eyes examined.

See Well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

There can be no doubt that all of us, especially children, are doing hand held work more frequently and more intently than ever before.   All you have to do is look around any restaurant, doctor’s waiting room, or mini-van, and you will see people of all ages do this.  They are reading, playing hand held video games such as the Nintendo 3DS or the PSP, or using their iPhone or Blackberry to watch videos and keep in touch with others.

All of this technology is great, but it can come with a cost – visual discomfort that can interfere with proper vision.

In addition to using proper posture and taking frequent visual breaks from intensely focusing up closely, another important element is how close  a person is to the object they are looking at in their hands.  A good way to tell if it is the right distance is by using the “Elbow Distance” rule.

Research on human ergonomics has determined that the optimal  visual distance for reading and other close work is the Harmon Distance or “Elbow Distance”.  This distance is measured by placing a closed fist at the eyes. The point at the end of the elbow represents the closest distance a person should be from their near work.

The beauty of applying Elbow Distance is that as we grow, so do our arms. You would expect a child to hold objects closer to his face than  an adult.  So instead of a “one size fits some” rule of a certain number of inches, the “Elbow Distance” can apply to almost everyone.  Go ahead and try it on yourself now and see if you hold a magazine or cellphone at your Elbow Distance or a little further.

Some people get so absorbed in their games or reading that when they get very close to their work, they are placing undue stress on their vision.  I am also very guilty of this.  When I get 4 to 5 inches from what I’m writing, my eyes have to work harder to keep the words clear because of the close distance.  But if I keep the right distance, the visual system relaxes and performs more efficiently – and I can really tell a difference.

If children or adults frequently get extremely close to their books or games, this may just be a bad habit.  But it can also be sign of a visual problem. Either way, it is best to get an exam performed by an eye doctor who specializes in visual efficiency.  They can determine if there is a problem and if glasses or vision therapy might be needed.

Be well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

I have been telling my patients for quite some time that omega-3 fatty acids are good for the eyes. These essential fatty acids can help people with dry eye disease.

A recent study also shows that it can reduce the risk of sight-stealing macular degeneration, too:

Two studies released this week in the Archives of Ophthalmology show adults who followed a Mediterranean-style diet high in omega-3 fatty acids found in fish, nuts, and olive oil and low in the trans fats found in baked and processed foods have a much lower risk of developing the sight-robbing disease.

This is one more reason to pay attention to your diet and talking to your doctors about omega-3 supplements if you think you don’t get enough.

Eat well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

People often think about eye injuries related to sports and the 4th of July. And that is a good thought. But also remember that many eye injuries occur around the home.

“Almost 40 percent of eye injuries happen to people doing yard work or gardening at home, yet few people think about wearing eye protection during these times.”

You can follow these  steps from Prevent Blindness America to protect your eyes:

• Wear safety glasses with side protection or goggles when mowing or using a weed eater or power cutting tools, like saws or trimmers.
• Check your yard and remove debris before mowing.
• Turn off power tools when near an unprotected bystander, especially young children. Bystanders and helpers should have eye protection when tools are in use.
• Wear goggles to protect your eyes from fertilizers, pesticides and other yard chemicals, including lime dust.
• Read and follow all product instructions. Obey warnings on yard chemicals and equipment.
• Wear eye protection when using any chemical. After any project, wash hands thoroughly before touching the eyes or face.

You can read more here: http://www.healthday.com/Article.asp?AID=619112

Be Well!

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.