While certainly most young children do not need to use contact lenses, a few do. When I tell people this, they usually think it is impossible to put contacts in their kid’s eyes. Well, this video shows how easy it can be!

(Click here if video doesn’t play)

Click here to read more about babies and contacts.

See Well!

Dr. Bonilla-Warford,
Bright Eyes Family Vision Care
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Welcome to 2010, everyone!  I hope you are enjoying the start of a brand-new decade.

Readers of this blog know that it is a Bright Eyes News tradition to create an eye related Top Ten List of New Years Resolutions. For 2008, wrote about resolutions for eye health. For 2009, I wrote about resolutions for children’s vision.

Thinking back to 2009, I’ve talked to a number of patients who had lost – or were about to lose – their jobs.  It was an economically challenging year for many.  So I thought this year I would take this issue head-on and make a list for people who want to save money on eyecare. But, as a doctor, it wouldn’t be appropriate to just say, “Skip your exams, squint instead of updating your glasses, and wear your contacts until your eyes fall out.” First, it isn’t sound advice. Second, many of these actually cost more money in the long run.

So here is a list of New Years Resolutions to Save Money on Eyecare (Without Sacrificing Quality). I hope that you find it helpful.

1) Maintain a regular schedule for eye exams.

Many people feel that they are saving money by skipping their recommended eye exams.  Did you know that eye exams are primarily about eye health, not just clarity of sight?  There are some blinding conditions with no symptoms that can only be detected with a thorough eye exam. If caught early, they can often be treated early with much simpler treatments. This can save hundreds or thousands of dollars of complicated treatment, including ocular surgery. This doesn’t even factor in the lost income and quality of life that can come from the loss of vision.

2) Get the exam that you pay for.

This may seem very obvious, but you should be sure that you are getting a complete and thorough eye exam. After all, if you are paying for something, you should get it.  Sometimes people are reluctant to have their pupils dilated during an exam, but if they don’t, the doctor cannot look for signs of disease in the back of the eye. Find out if there is a charge to come back and finish the exam at a later date. If you bring your child to eye doctor because you have concerns that vision may be affecting school performance, ask beforehand what type of tests are included.  Not all vision plans will cover this specialized testing, so you should find out how much it costs.

3) Utilize InfantSEE.

As with all health issues, prevention is more cost effective than treatment. This is particularly true for infants. An eye early eye exam can detect potential problems such as extreme nearsightedness and farsightedness as well as strabismus and amblyopia. To assist in this, the American Optometric Association created the public health initiative called InfantSEE. Optometrists who participate in the program will provide one visual and eye health exam to infants between six and twelve months old at no charge.

4) Understand your Vision Plan, Medical Insurance, Flex and HSAs.

Some medical plans have coverage for eye exams. Some plans specifically cover medical problems such as eye infections and glaucoma. Other plans are specifically for vision and will have coverage for a vision exam, glasses, or contacts, but not medical visits. If you or your employer pays for these benefits, use them wisely. Find out what the annual benefits are. Ask the doctor’s staff to help you maximize your benefits. For example, you are getting both glasses and contact lenses and your plan only covers one of these, you may save more money applying the benefits to the glasses.  Also know that you cannot ask that the vision plan be billed on a different date than you actually received the service.  However, you CAN use your Flex and HSA accounts for eyecare and optical purchases.

5) Select your eyewear carefully.

When you are picking out eyewear, try on the styles and brands that you like. But keep in mind the purpose of each pair of glasses you buy. You might love the Tiffany & Co. frames with crystals, but if you work or play hard, it might make more sense to get some less expensive frames that are built to be durable. Costa Del Mar sunglasses are durable, but if you are prone to losing them(or dropping them in the gulf!) spend a extra few dollars on a glasses strap. And when shopping  around, be sure you compare apples to apples. A discount store or online retailer may be cheaper,  but consider material quality and customer service when making your choice.  Will your optical service remake lenses in the case of an error?  What happens if the coating flakes off within a few months?

6) Get the right lens materials and coatings.

Find out what the doctor or optician recommends for lens options, but don’t just assume that more expensive is better. Some lens options are worth a little extra: Crizal Alize or VisoXC will improve the clarity of your lenses, reduce glare, and resist scratches.  Some fabulously high-tech lens materials are essential for someone with a very high prescription but may be a waste of money if you have a low prescription. We always recommend UV protection for all general purpose glasses, but if you only use glasses for reading indoors, then it may not be needed. I encourage you to get glasses that meet your needs, but that doesn’t mean that every pair has to have all the bells and whistles. If the optical staff do not explain your options to your satisfaction – ask. They may be able to help you save money when they understand how the glasses are to be used.

7) Try multipurpose lenses.

Do you own just one pair of shoes? Not likely, because most people have different shoes for different purposes. Your eyes also have different needs and no one single pair of glasses will meet all those needs.  But you don’t need to own a baker’s dozen pairs of glasses either. If you have a different prescription for reading and distance (like most people over 45), save money with just one pair of bifocals or progressives. In Florida, it is best to have a dedicated pair of prescription sunglasses.  But eyewear with clip-on sunglasses or Transitions (that darken in the sun) are a cost-effective and protect your eyes from UV and bright sun.

Make use of your warranties.

If you are spending hard-earned money on glasses, you expect them to work well for you. Always inquire about what warranty is included in your purchase. At Bright Eyes, all of our eyewear frames come with a 2 year, unconditional breakage warranty. If you get premium scratch coating, it also includes 2 year scratch warranty. See if your optical offers similar coverage and if they do, make use of it.

9) Learn about your contacts.

Talking to your optometrist about your contact lens options.  Monthly lenses may be a cost-saving option for full-time wearers;  daily lenses are a good deal for occasional contact wearers, especially when you factor in the solution costs.  RGP (hard) contacts frequently outperform their soft counterparts and can be up to half as expensive.

10) Consider alternative financing options.

Many offices, including ours, accept Care Credit, a health care credit card with options for 6-months interest-free financing.  This is helpful for more expensive treatments not covered by insurances, such as Corneal Reshaping (orthokeratology), an method of providing glasses- free vision, or vision therapy, which allows people to overcome visual challenges to live life up to their potential.  Even eyeglasses and eye exams qualify for Care Credit purchases. Ask about Care Credit or similar programs at your doctor’s office.

I hope that this has been helpful in ensuring that you get best eyecare possible! Happy New Year!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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My son has Duane Syndrome and the doctor today said that he has to wear contact lenses as he is not cooperating to wear glasses ……. What do you think?

Does wearing glasses or contacts ever help people with Duane? I get mixed messages on this.

First, a couple of things. I haven’t examined your son so I can only give you general advice. Also, I always recommend that you should follow the advice of your doctor or get a second opinion from another if you don’t feel comfortable with the advice. If you live in the Tampa area, I would be happy to evaluate your son and give specific recommendations.

Now, on to your questions. First, can your son wear contacts? Well, as I discuss in this post, even very young babies can wear contacts with the help and training of your doctor. Of course, the younger your son is, the more help he will need. As he gets older, he’ll become better and more independent with them. There indeed are some conditions that glasses cannot help but contacts can.

Second, can contacts help the Duane Syndrome? Duane syndrome is a condition of the nerves and muscles of the eyes so contacts will not improve the Duane Syndrome directly. Surgery or, less commonly, vision therapy may be helpful. But it is extremely common for there to be other vision problems that occur at the at same time. Treating these problems may minimize the head turns and double vision that are caused by Duane syndrome.

If you haven’t seen these, you can get more detailed info here, here, and here.

I hope this helps!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
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Since about half of my patients wear contact lenses, I thought this video from the Discovery Channel would be interesting to some.

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL
Connect with Us:  YelpFacebookTwitter

Dr. B: I love my contact lenses. Do you think my son is old enough to wear them safely?

The definitive answer is: Probably. Regarding children and contacts, there is one thing that matters most: is the entire family is motivated?

There are some instances where contact lenses are necessary for children (and even babies) for proper visual development. These parents need lots of training, especially if they do not wear contact lenses themselves, but they are very motivated to do what is best for their child.

The most common reason children might benefit from contacts is that they are beginning to play sports or other activity and they find their glasses get in the way. This can be a motivating factor. (Teens often want contacts for cosmetic reasons, but that is less common for pre-teens.)

Because contact lenses require patience and consistency in caring for contacts, everyone in the house needs to be determined to help the child succeed. If either parent, or a sibling, has bad contact lens habits, these will be quickly picked up by children.

It has been thought in the past that children should be 13 years old (i.e. teenagers) before they were allowed to use contact lenses. I feel that if motivation is there, children much younger can safely wear contact lenses.

This has been shown to be true by a scientific study called the Contact Lenses in Pediatrics (CLIP) Study. The study found that children age 8 to 11 can safely wear contact lenses. The study compared 84 children and 85 teens in how long it took to teach them contact lens to use contacts and if there was any difference in safety. The CLIP study concludes, “neither children nor teens experienced problems related to contact lens wear during the study. Eye care practitioners should consider routinely offering contact lenses as a treatment option, even for children 8 years old.”

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care

From Contact Lens Today, a newsletter of Contact Lens Spectrum.

The Food and Drug Administration (FDA) Ophthalmic Devices Panel of the Medical Devices Advisory Committee met on June 10, 2008 to consider recommendations on contact lens care product development including preclinical testing and clinical performance measures, and labeling for contact lenses and lens care products.

Among the issues reviewed were:

• Changes from “no rub” to “rub and rinse” labeling
• Addition of “discard dates” on contact lenses to indicate when a product should be disposed of after it’s opened
• Expanding preclinical testing protocols to include testing solutions against more types of bacteria and fungi including Acanthamoeba
• Recommendations on frequent replacement of contact lens cases
• Stronger warnings against reuse of contact lens solutions

The panel also considered information offered by companies and others such a joint statement issued by The American Academy of Ophthalmology, the Contact Lens Association of Ophthalmologists, the Cornea Society and the American Society of Cataract and Refractive Surgery. A complete text of their recommendations is available at: http://aao.org/upload/joint_CL_recommendationsL.pdf. Representatives of the American Academy of Optometry Section on Cornea and Contact Lenses and the American Optometric Association Contact Lens and Cornea Section also addressed the panel.

About 30% of my patients wear contact lenses. Some are young children and some are great-grandparents. All of them want their contacts to feel comfortable all of the time. Well, as I tell patients, having comfortable contact lenses is partly my job (to recommend the best contacts and solutions) and partly the patient’s job (to take care of their contacts and their eyes).

Dr. Shelley Cutler, an optometrist practicing in Pennsylvania, has a lot of experience helping patients understand the proper ways to take care of their contacts… and their eyes. In fact, she has written an entire ebook on the subject called, “How To Be A SMARTER / MORE COMFORTABLE Contact Lens Wearer!!” 

After reading Dr. Cutler’s book, I asked her a few questions.

Dr. B: How did you get interested in contact lenses (CLs)? 
Dr: Cutler: I started wearing them myself at the age of15.  This was back in the days when there was ONLY PMMA’s  <gasp>  [Dr. B' s note: PMMA is older material of contact lenses that is almost never used now for health reasons.]

When I had to decide what I wanted to be when I grow up… (and it didnt happen all at once. I went to art school first…<grin>)  I then decided it would be somewhere in the health field as my father and brother were physicians and my mother was a nurse.  I felt that it would take too long to go through medical school.  I didn’t like dentistry or podiatry….  Aha… Optometry it would be!  (I really liked the optometrist that worked for the Ophthalmologist that my father referred to..and had many conversations with him as he took care of my CLs, I sort of fell into the contact lens field as I did my residency after Optometry school. My first position was at Wills Eye Hospital supervising the Contact Lens department.  I taught the Ophthalmology residents their CL education…and saw the clinic patients.   I saw more CL patients in a day than many practices saw in a month…. especially then  (mid 80’s) and all the difficult stuff.  I guess the rest is history.

What prompted you to write an ebook?
A couple of different reasons…….if I said financial wasn’t one of them, I’d be lying.  Researching different ways to accomplish this, it seemed to me that this would be a natural.   I’ve written a lot of articles, lectured, etc. through the years and consider myself an educator.  I seem to say the same thing to most patients throughout the day so why not educate patients via an ebook.  Hopefully it would eliminate some of the problems quickly if patients were better educated and could maximize their time with their docs in the minimal time that is now necessary because of all of the health insurance issues.

With young children and contact lenses, who is usually more nervous: patients or parents?
The parents…by far!   I’ve fit children from 1 week old on up.  (Aphakic lenses – for people who have had a lens removed due to cataract).

What are your thoughts on extended-wear contact lenses, the type that are approved to sleep in?
I dont love them….but there are patients that need this option. I give my patients the riot act…and they understand the rules. 

Your ebook is 60 pages. If you could give contact lens wearers just a little advice, what would it be?
Cleanliness is next to Godliness…  Well, I’m just quoting this phrase because it sounds good…but proper Hygiene and cleaning will solve many of the problems…or more important, prevent them.

1)  CLEAN/wash hands before you handle the lenses both before insertion as well as before removing them

2)  Keep the CL’s clean. definitely rub…. (I recommended this even during the era of “no rub”)

3)  Keep the CL case clean.  Wash it out with soap (be it CL cleaner…or a non moisturizer soap) regularly (2×3x/wk) rinse well with water and dry.  Even if there is some soap residue…(and believe it or not there’s not a whole lot when rinsed to that squeeky clean feel ) this is better than the bacterial biofilm that can harbor germs…in my opinion, especially because most soft lenses are frequent replacement these days.

4)  Keep the ocular environment clean.  Ladies (mostly) remove the make up around your eyes daily…and use my Optimum Lid Hygiene guide.  This will not only remove any make up …but for those who dont wear it, it can minimize oily residue from the lids….keep blepharitis and Meibomian Gland dyfunction, demodex and allergy contaminants to a minimum.

and of course, see your eye care practioner routinely at his/her recommended intervals.

Nate…again…thanks for your interest and support.
Shelley

You can learn more about contact lenses and read about Dr. Cutler’s book at http://www.mycontactsfeelgreat.com/

Note: This is the first post in series about specialized contact lenses that we offer at Bright Eyes.

Very frequently during a comprehensive exam, I will ask patients if they have thought about contact lenses and they will reply something to the effect of: “Oh. I was told that I couldn’t wear contacts.” They’ll say it is because they have astigmatism, or have dry eyes, or need reading glasses, or have had eye surgery in the past, or some other reason.

Well, I’m here to tell you that this is rarely true. Contact lenses are absolutely contraindicated in very few people. This means that almost anyone, if sufficiently motivated, can wear contacts. I have patients that are 5 years old that successfully wear contacts. I have patients that are 70 years old and enjoy contacts as well. And there are lots of people in between of every type and description who use contacts some of the time.

Rather than just saying, “You can’t wear contacts,” I prefer to say, “You probably can wear contacts, but your case is more complex and will require more time and effort for both of us. Because this will require more expertise and specialized contacts lenses, the fee will be higher. But you can be assured that we will proceed with the various options that are open to you until we agree that either (1) you are successful and happy with the vision and comfort of your contacts or (2) we have exhausted all of the options you wish to pursue.”

Dr. Janice Jurkus, one of my Optometry professors who specializes in contact lenses, taught me that the single most important factor in determining success for a given contact lens patient is motivation. If the patient is motivated, contact lenses will likely work, one way or the other. If they aren’t, they likely won’t. It is as true today as when she taught it.

But in addition to motivation, there is another important factor: contact lens technology. Contact lenses have improved so vastly and are now so diverse, that they can meet many needs that we not possible even just a few years ago. From convenient daily disposable lenses, to cosmetic lenses, to high-performance, custom-made lenses, there are contact lenses for every need and lifestyle.

So if you have been told that you can never wear contact lenses, that might be true. Or it might not. If you’d like o find out, schedule an appointment and we can talk about it.

Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care

This new contact lens may mark the arrival of “The 6 Million Dollar Man” to eye care. For years scientists and developers have attempted to combine digital information with normal vision. This can provide a useful combination, like the vision that “The Terminator” employs to navigate and process information from the environment. Imagine, for example, a GPS unit that causes you to see a big arrow right in the middle of the intersection that you are driving toward.

This is currently being done with spectacles. At NextFest I once tried on a pair of glasses connected to a video camera and a backpack. It allowed me to play a real-life version of “PacMan” where I walked around and the digital pellets floated in mid air. It was cool, but primitive.

If that technology could be placed in a contact lens, it would be much less bulky. Although the computerized lens is a long way from being commercially available, research is occuring very quickly, and some people are getting excited. One of them is Babak Parviz, a professor of electrical engineering at the University of Washington in Seattle. “If we’re successful initially, and it takes off, this can get really sophisticated in the next few years,” he says.

Could be interesting!

You can read the article here from Discovery News.

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Be Well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care

In response to patient demand, we’ve added the ability to order contacts directly from the Bright Eyes website. Instead of calling or stopping by, you can just go to the online store and select the brand of contacts we have prescribed for you. We will verify the accuracy of your prescription and check to see if there are any problems with the order. Then, in a few days, you’ll receive the contacts at your home or office by mail. There are options for free shipping and handling.

You can also purchase contact lens cleaning and handling products as well. If you do not see the lenses or products you are looking for, be sure to let us know!

And, remember,  just because you can order online does not mean that you can’t drop in from time to time just to say “Hi.” We like that, too.