Although this article by the American Optometric Association was released in 2009, its message is still pertinent and important, especially during this time of the year. While parents are getting their kids prepared for a new school year by purchasing supplies and meeting new teachers, it might be easy to overlook their child’s vision. In fact, a shocking 86% of children start school without ever having an eye examination. This is an alarmingly high figure given the strong correlation between vision and learning.

At Bright Eyes, we advise the eye exam schedule that is recommended by the AOA: first eye exam at 6 months,  3 years, and right before school.  This allows your eye doctor to identify and treat any vision related problems before they start to adversely affect your child’s learning and development.

Another important thing to keep in mind is that the screenings used at school are not designed to replace a full, comprehensive eye exam. These screenings offer very little beyond determining clarity of vision. A full eye examination will further test how well the eyes work together in unison at tasks such as reading and computer work, as well as assess the health of the entire eye, inside and out.

The article also suggests signs for parents to look for in their child’s vision between eye exams. The AOA recommends that parents contact their eye doctor if their child frequently:

1. Loses place while reading
2. Avoids close work
3. Tends to rub eyes
4. Has headaches
5. Turns or tilts head
6. Makes frequent reversals when reading or writing
7. Uses finger to maintain place when reading
8. Omits or confuses small words when reading
9. Consistently performs below potential
10. Struggles to complete homework
11. Squints while reading or watching television
12. Has behavioral problems
13. Holds reading material closer than normal

So as the school year begins, if you have any questions or concerns about your child’s vision, do not hesitate to call our office and schedule an appointment.

All the best,

Justin Schoonover

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

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.

I was originally asked these questions by email for an interview about video games and vision.  I was excited because there are a lot of myths and misconceptions about how video games can affect your eyes. Unfortunately,  the interview was not published, so I decided to print them here. If you have questions like this, please let me know. -Dr. Nate

Does playing video games cause more stress to the eyes than watching tv?

Playing video games is considerably more stressful for the eyes than watching TV, but it depends a lot on which form the games take. Games on the TV like Playstation and Xbox are different than games on the computer, such as World of Warcraft, which are different than handheld games like those for Nintendo DS (and soon 3DS).

The visual system is designed for looking at things far away without effort, assuming the eyes are healthy and, if needed, the correct glasses or contacts are being worn. When looking up-close, the eyes have to change focus and position.  The, over time, adds up in a big way. If the visual system is overwhelmed, gamers can have blurry vision, eye strain or headaches. If the eyes are too stressed to move properly, double vision and reduced performance can result. All this is made worse under stressful situations, overall fatigue, and times of extended mental concentration.

As a former gamer (before I had kids), I know that an awesome video game is much more likely to generate stressful situations, require extended mental concentration, and lead to fatigue from sleep deprivation than a random TV show. So gamers are already predisposed to have eye and vision problems.

But here is an additional twist: When we are under stress we have a “fight or flight” response. In this situation, our eyes are evolutionarily adapted to focus in the distance. This was useful when we were hunters and gatherers to help us see what we were hunting and what was hunting us. But it’s counter-productive when at the computer.

Finally, it’s known that people blink much less at the computer than at other times – as much as 60% less. When people don’t blink, the moisture on their eyes evaporates leading to dry, burning, irritated eyes and blurry vision. All of these things together are referred to as Computer Vision Syndrome (CVS.) Although CVS gets more attention in the workplace, it applies to recreational computer users, too.

What’s the best advice for video gamers regarding eye fatigue?

Hands down, the best advice is to take frequent breaks. There is a rule of thumb that eye doctors tell patients called the “20/20/20 Rule.” This means that every 20 minutes, look away from the screen at something specific at least 20 feet away for at least 20 seconds, like a clock or a picture.  When looking away blink your eyes several times and take deep, relaxing breaths.

When looking away, take note if the object you’re looking at in the distance starts off blurry and then slowly gets clear, as this is an indication that your eyes are working too hard and that you should take a longer break. Unfortunately, that is much easier said than done, because video games are extremely engaging. When gamers are “in the zone” they often don’t stop to eat or drink, let alone take a 20/20/20 Rule break. Some people will put post-it notes on the monitors or set alarms to remind them.

Also, set up your gaming environment ergonomically. Make sure that your monitor is approximately two feet away from your eyes and not at an unusual angle. It’s best if there are soft lights on in the room so there’s not a big brightness difference between the screen and the surrounding space.

Remember to talk to your eye doctor during your annual exam about your computer use – both work AND at home. Let him or her know if you experience blurriness, fatigue, double vision, burning or discomfort at the computer. Some people think those things are just “normal” and ignore it, but that isn’t a good idea. Sometimes these symptoms are the sign of more significant underlying problems. Your doctor can do specialized testing to determine the problem. You may be given a prescription for special eyeglasses for the computer, eye drops to use, or a recommendation for therapeutic techniques called vision therapy.

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

Here at Bright Eyes, we are proud to offer unique, high-quality eyewear. We are excited to announce that  Lightec is our newest line of frames. Made by Morel in France, these glasses continue our tradition of offering high quality and good-looking eyewear!

The name LIGHTEC comes from “lightness” and “technology” which allows for maximum comfort. The lightweight stainless steel frames offer flexibility and durability.  The high-tech spring hinges have no screws or internal hinges, meaning they are strong and secure. Lightec frames are available in a variety of eyeglass styles – full metal frame, semi-rimless and fully rimless – for men and women looking for fashion-forward, immediately comfortable frames.

We also feature the Lightec Carbon fiber frames – the temples are made with composite carbon and glass fiber materials for an amazing high-tech look. Take a look:

Stop by Bright Eyes Family Vision Care for our Eyewear Show on February 12 to see the whole Lightec collection, and save 25% off Lightec glasses – frames and lenses! If you buy any 2^nd pair, you will receive 50% off the lesser priced frame. (Prescription or non-prescription sunglasses included!)

And if you bring a friend to the show, you will receive an extra $25 off your purchase.  We would love to show them our optical and give them a chance to meet our optometrist, Dr. Bonilla-Warford.

Cristina Bonilla-Warford
Office Manager
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.

When a book comes out that helps people understand vision and vision therapy I write about it so my patients can find out about it. When an amazing book comes out, I try to interview the authors to not only spread the word, but because I am genuinely interested in their background and the process of writing. Like Fixing My Gaze, Jillian’s Story is one of those books that does a better job of explaining vision therapy than I can. So I am thrilled to be able to present an interview with its authors Robin Benoit and Jillian Benoit. -Dr. Nate

Dr. Nate: Robin,  what made you decide that you wanted to take the time and effort to write the “Jillian’s Story”? Was there one moment, or a gradual realization?

I don’t think a week went by after Jillian started vision therapy that I didn’t say, “Somebody needs to do something to raise awareness about vision therapy.”  My husband would always reply, “You should write a book.”  But, I didn’t really consider it and sort of laughed at the idea.  Then, one day after school as we were driving home in the car, Jillian told me that she suspected a girl in her class needed vision therapy because she had noticed her friend covering one eye with her hand as she read a book.  I mentioned it the next day to Jillian’s teacher.  She said, “You know, Robin, you and Jillian really need to write a book.  I think Jillian’s story could help so many people.”  That night, I started writing “Jillian’s Story.”  I had searched for books to read about vision therapy and couldn’t find very much.  I really wanted to read personal accounts from other parents about how vision therapy had worked for their child.  When faced with the fact that our pediatrician didn’t refer us to vision therapy, our ophthalmologist discredited it and insurance wouldn’t cover it, we went on faith and hope that vision therapy would prove to be helpful to Jillian.  We are so grateful that vision therapy exceeded all of our hopes and expectations.  We hope “Jillian’s Story” will inspire, encourage and lend confidence to others considering vision therapy for themselves or their child.

(Laughing)  Am I famous?  I haven’t noticed!  At first I was kind of nervous, but then I realized how many people, especially kids, I could help just because I have vision problems like they do.  Vision Therapy has made such a huge difference for me.  I love 3D movies now because I can see stuff come out of the screen instead of a bunch of blurry junk.  3D movies used to make me feel sick.  Now they are really fun!  I used to get so frustrated at school.  Now I love it.  It’s so much easier to learn when you can see.  I don’t get frustrated with homework anymore.  Homework that would have taken me an hour to do before vision therapy now takes me just 5 or 10 minutes.  I even love math now and I never thought I’d say that.  I can read any book I want, even a thick one like “Harry Potter.”    Vision therapy really changed my world and I’m so happy to share my story.   I hope our book will help anyone with vision problems to have a happier life.

Robin,  how long it it take to write and get printed?

I wrote the first draft about Jillian’s younger years very quickly, probably in just a few days.  I started the chapters on her vision therapy experience about half way through her 15-month program and wrapped it up a little at a time as she completed vision therapy.  Jillian read what I wrote throughout the writing process and added her suggestions and quotes for each chapter.  It all came together quickly and easily.  I had no idea how to get a book published.  I did a little research on the Internet and bought a very thick book called the Writer’s Market. I went through it page by page and highlighted publishers I thought might be interested in her story.  But, I just didn’t think that mailing in manuscripts and waiting months for a reply (not to mention rejection letters) was the right way to go.  So, before I mailed a single manuscript, I decided to call an old friend for advice.  He had written a book several years ago and I hoped he could give me some tips to follow.  He did more than that!  He suggested I contact a friend of his who owns a publishing company in Dallas and gave me her phone number.  That was in July of 2010.  I signed with Brown Books Publishing Group on August 11th and the book was released on November 12th.  It was a whirlwind and I loved the entire experience!

Jillian: Vision therapy involves a lot different activities. I asked Dr. Barry which was her favorite and she said “Brock String.” Which was your favorite VT activity?

There is more than one.  When I worked with Lindsey in her office, I loved the balance beam and wearing the “googly glasses.”  I looked so silly in those glasses, like a mad scientist from one of those movies.  It made me laugh.  I also liked the big rotator and putting the golf tees in the holes.  At home I liked the ball on the string and, like Dr. Barry, the “Brock String.”

(Robin):  We are really pleased with it.  The cover had to be redesigned rather late in the process.  Our publisher ran across a book published in 1985 that looked too similar in font and coloring.  We actually like the second design and colors even better, so it was a blessing in disguise.  The eye chart is so iconic and the response has been that the second you see the book, you know it is about vision.  We wanted our book to be like sitting down with a friend to talk about a problem.  It’s wonderful to know that anyone looking for an answer or solution to their concerns can read our book in one evening, go to bed and wake up the next morning feeling much better about their situation.  And, that is the response we’re getting.  We’ve received emails from all across the country from people who feel we’ve been living the same life.

(Jillian):  I love the book!  One of the things I like best about it is that it’s quick and easy to read.  Lindsey told us about a family that read it — grandmother, mom and daughter — and they raved about how it answered questions and helped all of them understand vision problems better.  Friends at school have read it and come up to hug me!  That’s awesome!

Have you had any interesting people contact you because of “Jillian’s Story”?

(Jillian):  I had the chance to write a note to a girl in Iowa that just started vision therapy.  I really hope vision therapy helps her like it did me.

(Robin):  Dr. Horning suggested that I contact an optometrist that he admires named Dr. Paul Harris.  Dr. Harris so graciously agreed to read the manuscript early in the process.  He not only endorsed “Jillian’s Story”, but introduced me to many wonderful people including Dr. Sue Barry, who so kindly mentioned “Jillian’s Story” while speaking at the COVD Annual Meeting.  We are finding so many great people willing to lend their support to Jillian’s goal of spreading the word that vision therapy really works.

(Jillian):  Thank you, Dr. Nate, for sharing my story!

(Robin):  Yes, thank you so much.  We hope “Jillian’s Story” will be a strong advocate for vision therapy.  Orders can be made at www.JilliansStory.com.  Please email us your thoughts and comments at robin@jilliansstory.com or jillian@jilliansstory.com.  Anyone wishing to receive a volume discount can have information sent to them on the 50 pack (20% discount) and 100 pack (30% discount) specials by emailing us for the special website ordering link.  You will receive an email response with the link to a PayPal discount pack ordering page.

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!

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

Two very cool things are going on in Tampa Bay during October. The first is my birthday. I will be another year older and, hopefully, wiser. The second (and probably more important) is that thousands of eye doctors and vision specialists are coming to St. Pete and Tampa from all over the world to discuss the most current vision science research and patient care.

These specialists are coming to our community to attend two major meetings. The first one, held at the Vinoy in St. Petersburg, is the annual meeting for the College of Optometrists in Visual Development. This is the premier organization for doctors who treat visual problems in children and provide vision therapy. I have been deeply involved with this organization since Optometry school. It is wonderful because it is made up of energetic doctors and vision therapists who deeply care about their patients.

The other meeting, held at the Tampa convention center, is the annual meeting of the American Academy of Optometry. This huge meeting presents the very latest research in all aspects of visual science: from infant vision to glaucoma management to contact lens advances.

Two of the most exciting areas that I am looking forward to are myopia (nearsightedness) control and orthokeratology (Precise Corneal Reshaping), topics that I have have long had an interest in.

Now, I realize that not everyone is going to get as excited as I am about these two meetings, but consider this: almost every other attendee had to pack a suitcase, fly or drive all day, and stay in a hotel. I, on the other hand, was able to attend committee meetings and lectures during the day and while eating dinner with my family and sleeping in my own bed at night. And, to me, that is a great birthday present!

Be well!

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

You may not know it, but there is a grass-roots effort across the country to improve the vision care that children receive. Because there are many children through out the country that struggle in school due to undetected visual problems, there is a growing trend for individual states to require comprehensive visual evaluations for children before starting school. This is much like early dental visits to ensure that teeth come in correctly.

States such as Kentucky and North Carolina have been the front lines of this effort, with laws designed to make sure children have complete eye and vision examinations before starting school. Illinois has recently joined this growing group.

"Clear and comfortable vision is essential for learning, and 

this new law will help Illinois children succeed and reach 

their full potential," Ed Geppert, Jr., president of the Illinois 

Federation of Teachers, said. "This measure will help 

children read and see chalkboards more clearly. All Illinois 

children deserve the tools they need to fulfill their potential, 

and our students will benefit from this law."

With the exception of a Vision Therapy externship I did in Denver, Colorado, I received all of my Optometric training in Chicago, IL. During my Pediatric Vision residency, I saw many children who were in school who did not have the necessary clarity of vision or visual skills to reach their full academic potential. I enjoyed helping them, either by prescribing their first pair of glasses or making them more comfortable when they read by providing them with vision therapy.  It is my hope that Florida will one day have a similar law in place that will ensure that all children in Florida have proper eyecare before enrolling in school. One major national initiative is the InfantSEE program, that I will write about later, that provides one no-cost visual assessment for any infant between 6 and 12 months old. This will benefit Florida’s children by detecting visual issues before they become problems.

Be well!

Dr. Bonilla-Warford
Bright Eyes Family Vision Care
Westchase, Tampa, FL

Welcome to Bright Eyes Family Vision Care News & Updates! I am very excited about this new project! Most of my patients know that I like to share information This will be new way for me to share news about events and changes at Bright Eyes and discuss new developments about vision care.  I am excited about highlighting new research that pertains to child and adult visual science, discussing new products (such as contact lenses) that may benefit my patients, and providing links to relevant and interesting webpages.

The Bright Eyes staff and I enjoy being a part of the Westchase community, and I am happy about extending this community online. I hope that you find these posts informative. If you have any feedback or questions that you’d like me to address, I would love to hear it.

Be well!

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