Tetris therapy for amblyopia? Yes, please.

Nathan Bonilla-warford — Wed, 24 Apr 2013 14:24:07 +0000

A new study, about amblyopia, has been published and it is really getting attention. From CBS news to Huffington Post to CNET, everyone is covering it, probably because they get to use the word “Tetris” in the title. Tetris, of course, is the hugely addictive block-stack game that, at least in my memory, was the first hand-held videogame blockbuster.

Amblyopia, known to many people as “lazy eye” is a visual adaptation to conditions that interfere with visual development. On a simple level, it means that even with the best glasses or contact lenses, the eye does not see and function as well as expected. It is not due to disease or injury, but rather a situation where the brain doesn’t communicate well with one eye and can’t use the eyes as a team.

Think of the brain being someone on the internet, and one eye is a friend with 14.4K dial up and the other has a 4G smart phone. Yes, you can communicate with both eyes, but you are going to prefer the 4G because it is faster and can do more things. Trying to use both eyes simultaneously as a team is hard because one is lagging behind and missing information.

I am extremely glad to see this study and I do have some thoughts on it:
First, do not get too excited about the Tetris part. While I really have no doubt that Tetris and similar games stimulate visual planning and cognitive development, I suspect that the main benefit of using Tetris in this study is that it is very engaging, requires attention to visual detail, and requires the player to make decisions based on visual information. Basically this is true for most video games (and real world games, for that matter). So Tetris is not the magic here.

What IS a big deal about this study is the goggles – they required the eyes to work together to play the game. If you play, you can’t just shut off the amblyopic eye, or you’ll lose because you won’t see the falling blocks. And that isn’t motivating or good therapy. It isn’t patching or covering the good eye because you won’t see the blocks on the bottom. You still won’t win. This is like conventional patching. You can stimulate the amblyopic eye (upgrading the modem), but that alone only helps somewhat.

What this study shows is that only when both eyes can see and are given the opportunity to work together to achieve a common visual goal is there significant improvement in the amblyopic eye. In my internet analogy, this is not only giving the amblyopic eye a 4G smartphone but making sure it is net savvy. Both eyes are now friends on Facebook and Twitter so they can work together in real time to solve visual-spatial problems efficiently. (Just to be clear: the eyes do not use Facebook, and they do not communicate directly – all that happens in the brain).

So why is this so exciting? Because this is exactly what we do in vision therapy every day. We “upgrade” the eyes to work well individually (4G) but also “network” them to work together (Facebook, Twitter). We don’t use Tetris, but we do use paper & pens, balls, special glasses, computer programs, 3D art, optical illusions and lots of other fun tools to make it fun and productive.

It is great to see more research on this on adults with amblyopia. For too many years, patients have been told that after early childhood there is no hope of improving the vision in the amblyopic eye. It simply is not true. I did a blog post awhile back on the science behind amblyopia. You can see that here. For a great look at binocular treatment of amblyopia, see this recent post on the VisionHelp blog.

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
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Our Virtual Tour Scavenger Hunt

Nathan Bonilla-warford — Mon, 08 Apr 2013 18:13:44 +0000

It is the brand new Google Virtual Tour!

As you may know, a year ago we moved a few hundred feet into our new space. We love the new office and get compliments on it all the time. Well, we are very excited to be able to show off the new space not just in person, but from the comfort of your computer, tablet or cell phone!

And because we are SO EXCITED about our new Virtual Tour, we are holding a virtual scavenger hunt! Use it to look around the office and see if you can find the answers to these questions:

Name 3 brands of glasses you can buy at Bright Eyes.
How many Bright Eyes green coffee mugs can you find?
Dr. Nate is sitting somewhere in the office. Where is he?
What stuffed animal can you find?
Name 3 differences between the exam rooms.
What the jersey number of the football player on the plaque in waiting area?
How many prescription swim goggles are on display at the counter?
What image can you find in the 3D poster in the hallway?
In West Park Village, what are our two neighbors?
How many plants can you find inside the office?
Where is the light bulb that is out?
What is the brand on the glowing tower in the optical?
What is Dr. Nate’s alma mater?
Where do we keep the trampoline?
What is your favorite part of the office?

Answer as many or as few of the questions as you want. Some are easier than others! The person with the most correct answers will win FREE SUNGLASSES! You can choose from Polaroid, Marc by Marc Jacobs, Coach, Nike, and others! Summer is coming up and you know you want them!!

Just enter your answers here. You have until Friday, 4/19 to enter. Then we will announce the winner!

Oh, and while you are at it, consider leaving a review of Bright Eyes, if you are so inclined. :)

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care

Eyewear Sale this Saturday!

Nathan Bonilla-warford — Wed, 03 Apr 2013 14:06:02 +0000

Join us on Saturday, April 6th from 9am to 2pm for an Eyewear Show, featuring these fantastic eyeglass brands: Banana Republic, Marc by Marc Jacobs and the all new Polaroid polarized sun glass collection. All styles, all colors, for men and women.

25% OFF first pair of glasses + 40% OFF a second pair! Plus pop a balloon for door prizes.

YES WE WILL BE OPEN ON SATURDAY, APRIL 6th for appointments, so call to schedule ASAP.

Summer is just around the corner, so consider getting prescription swim goggles early! Starting at only $55, these are great for both kids and adults.

Need a backup? We are still running our $99 Salefor a complete pair of select frames and single vision lenses, including sun-wear! There are many men, women and kids styles. Stop by!

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Love us? Tell the world with a review:

Dr. Nate Interviewed about Google Glass

Nathan Bonilla-warford — Tue, 26 Feb 2013 15:27:15 +0000

If you have even a tiny interest in either technology or eyewear, then you sure have heard about Google Glass. If you aren’t familiar, they are glasses that capture and display information for you. Think Geordi Laforge’s visor from Star Trek Next Generation. Better yet, watch this concept video from Google:

Mashable interviewed me to get an eye doctor’s take on the new glasses. While very few people have seen working examples of Google Glass, including me, I have read quite a lot about them and talked to people with experience with it. While the technology is undoubtedly very, VERY cool, there are two concerns from a visual stand-point.

The first is physical – our eyes are not best suited to the set up of the device. Even though it is a Heads Up Display, you do have to look up and out at the image, potentially causing eye strain and can result in symptoms including headaches, burning, gritty eyes, back and neck pain and short-term difficulty focusing in the distance after long periods of computer work.

The second is mental – people can only pay attention to one thing at a time. So if they are watching their Google Glass display, they are not watching the world around them. Additionally, some people have a very hard time simultaneously processing visual information while controlling their body movements (such as walking).

Click on the image below to read the entire article:

I can’t wait to get a pair and try them out for myself. Google is running a contest to select people who want to purchase Google Glass early.

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

Anniversary Eye Exam Harlem Shake

Nathan Bonilla-warford — Thu, 21 Feb 2013 15:52:59 +0000

We have officially been in the new office for 1 year! Woohoo! We have greatly enjoyed the new space and patients always comment on it when they come in.

So we decided to celebrate — with the world’s only Harlem Shake Eye Exam!

What do you think of that? Want this kind of fun in your life? Request an appointment with us or call 813-792-0637. :)

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

Tuesday Night Pig LASIK

Nathan Bonilla-warford — Mon, 18 Feb 2013 19:21:29 +0000

On Tuesday I finally completed all of my continuing education (CE) hours required to renew my optometry license. Frequently CE classes mean sitting through a pretty tedious lecture about something that I am pretty familiar with. If I am lucky, I will learn something new. If I am REALLY lucky, I will have some fun, too. Well on Tuesday, I did get lucky. I got to do something that I’ve never done before and will not forget any time soon – I got to practice LASIK at TLC Laser Eye Center!

For accuracy’s sake, a few notes. First, it wasn’t on people, but on pigs…and it wasn’t even on a live pig, just a pig’s eye. Second, I didn’t actually do LASIK to correct the refractive error (nearsightedness, farsightedness, or astigmatism) of the pig’s eye. What I did learn, was how to use a femtosecond laser, the step used in “bladeless LASIK” procedures.

Pig eye holder and surplus pig eyes.

Here are the steps that typically occur in the LASIK procedure:

During a pre-procedure visit, the doctor and staff determine if the patient is a good candidate for LASIK and precisely the amount and type of treatment needed to correct vision.
The patient arrives on the big day and is put at ease in the pre-procedure room. Their eyelashes and eyelids are cleaned, and numbing and antibiotic eye drops are placed in their eyes.
In the procedure room, patient lays down and relaxes. The surgeon uses a computer to track the eye, ensuring that treatment is delivered as determined beforehand.
A special femtosecond laser is used to create a very thin flap of the outer, central layer of cornea.
The surgeon carefully lifts the flap by hand and pulls it back to reveal the treatment area of the cornea.
Another computer-controlled excimer laser is then used to change the shape of the cornea to eliminate refractive error, providing clear vision for the patient.
The flap is carefully replaced and begins healing without stitches.
Several post-procedure evaluations are performed to ensure that the eyes are healthy and the vision is clear.

Me lifting the flap

Since I co-manage LASIK, I get to do steps #1 and #8 regularly. And I have observed the rest of the steps in person several times, but I have NEVER gotten to do steps 4,5,6,and 7 – not even on pig eye. I still haven’t done step 6, but 4, 5, and 7 were pretty cool. What I can say is this: I’ve always had tremendous respect for ophthalmologists that perform LASIK surgery. I look under the microscope at patient’s eyes and see the results every day. But I have even more respect after lifting the LASIK flap and trying to smooth it back down without damaging it! Let me tell, it is a pretty delicate matter. Knowing that the pig didn’t have to worry about the outcome certainly helped.

If you are interested in LASIK, or are wondering if you are a candidate, request an appointment with us or call 813-792-0637.

A huge thanks to TLC Laser Eye Center, Louis Probst, M.D. and Christine Hair, O.D. for arranging this “eye-opening” experience! (I never get tired of eye puns….)

Nathan Bonilla-Warford, OD

Bright Eyes Family Vision Care

Located in the Westchase area of Tampa.

Justin Timberlake has the 20/20 Experience

Nathan Bonilla-warford — Fri, 08 Feb 2013 13:27:57 +0000

We all know that having good vision and eye health is important. But not everyone realizes how cool it is to have 20/20 vision. Well, I’m happy to say that one gentleman that you might recognize does think that experiencing life with 20/20 vision is important – important enough to title his next CD “The 20/20 Experience“. I am talking about Justin Timberlake. Even optometrists know who he is. Check out his latest album cover:

Here we can see JT clearly enjoying his subjective refraction. And after this he’ll surely have his eye coordination and health checked. Then he’ll select one or a dozen pairs of glasses which he will rock all over the world. But because glasses can get sweaty on stage, he’ll probably also be fitted for the best in contacts – probably daily disposable contacts that will keep his eyes healthy and comfortable during his busy travel schedule.

Of course, this isn’t the first time that a musical artist has tried to establish some street cred by playing up their eye care connection. DJ Spooky had a very influential CD called Optometrist in 2002. As long time patients know, we usually play jazz, bossa nova, and downtempo music in the office, I suppose that we will have to get the CD and play it when it comes out in March.

Do you want “The 20/20 Experience”? You can request an appointment with us – and you don’t even have to wear a tux!

Nathan Bonilla-Warford, OD

Bright Eyes Family Vision Care

Located in the Westchase area of Tampa.

Congrats to our newest Vision Therapy grad!

Nathan Bonilla-warford — Tue, 05 Feb 2013 14:53:44 +0000

The entire staff and I want to extend a special congratulations to DS, our newest vision therapy graduate! She has worked very hard and has done extremely well. She should be quite proud of herself!

DS was referred by her excellent tutor who I have known for several years and is skilled at suspecting vision problems when they are interfering with learning activities like reading and writing. When DS came in our office, she was struggling with words that appeared to run together while reading, skipping lines while reading and generally avoiding activities like homework. Her COVD Quality of Life Survey score was 39, indicating that visual problems were likely causing her symptoms. (A lower score is better, and anything over 20 is raises suspicion of a vision problem).

DS’s symptoms were explained by her convergence insufficiency (difficulty turning eyes inward when looking up close), accommodative insufficiency (difficulty focusing) and pursuit dysfunction (difficulty with tracking).

Now after completing vision therapy, all of that has changed! As her mom said, “It is like she’s a different child. She understands more of her reading because of her eyes tracking better. Homework is not a struggle anymore. In fact, she has it done before she gets home most of the time. ”

And what I love to hear from parents: ”She is more excited about reading than ever before!”

Recently report cards came out, and her mom was so excited at the improvement that she emailed us a copy. There has been improvement not just in reading but improvement in many areas (especially in science) as you can see in this little section of the grade report:

I’m quite happy that through vision therapy, DS has overcome her visual problems, and this is reflected in her COVD Quality of Life score that dropped from 39 to 8! As DS lives quite a long distance from our office, I’m sure they will not miss the weekly drive. But we will miss seeing her in the office! We are very proud of her. If she works as hard at everything else as she has in VT, we have no doubt she will succeed beyond her wildest dreams!

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

Welcome Jade and Tia!

Nathan Bonilla-warford — Thu, 31 Jan 2013 18:53:28 +0000

Bright Eyes is very happy to introduce two new staff members! This month Jade and Tia have joined Justin, Jamie-Lee, Edna, Cristina and me behind the counters and equipment to serve you better!

Jade and Tia

Jade Kowalick: Frame and Lens Specialist

Originally from Reading, Pennsylvania, Jade has 6 years of experience in the optical industry, working for private and commercial businesses. She prefers private offices because of the opportunity to build relationships with patients. She is currently working towards her Florida Optician License. She owns 8 pairs of glasses and wears them to match her wardrobe. Her hobbies include shopping and spending time with her two beautiful children. She loves pickles and Hibachi; shoes and chewing gum; social networking and McDonalds….

Jade is definitely increasing the diversity here at Bright Eyes!

Tia Coleman: Administrative Coordinator and Vision Therapy Assistant

Originally from upstate NY, Tia has been living in Florida on and off since 1979. Tia was the wife of an Air Force MSgt and has lived in several places over the years: Albuquerque, NM, Plattsburgh, NY, MacDill, FL and Cape Cod, MA.

Tia is an avid golfer with a handicap of 2. Tia has won women’s golf club championships in each and every location at one time or another. Aside from her love of golf, Tia is most proud of her two daughters: Sandy and Katie. Sandy lives in Schenectady, NY, works full time while getting her masters in teaching. Katie’s a recent graduate of UCF in theater and living back in the Tampa area.

Please join us in welcoming Jade and Tia!

Bright Eyes Family Vision Care

50% off Full Eye Exam for Cyber Monday!

Nathan Bonilla-warford — Mon, 26 Nov 2012 14:45:49 +0000

Our first Cyber Monday deal ever - today only!

50% off Full Eye Exam if scheduled on Cyber Monday!

Book online here:
http://www.brighteyestampa.com/make-an-appointment.html

(Sorry – offer not good w/ discounts & vision plans.)