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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
  
   

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. 
 

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.
 

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

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.

There are many different elements that make up our eyes. One of these is the macula. This is part of the retina, which is found at the back of the eye. The macula contains a high concentration of light-sensitive cells. As they detect light that passes through the eyes, these cells send signals to the brain which then interprets them as images.

The macula contains three pigments. These are: lutein, zeaxanthin and meso-zeaxanthin. To preserve the health of the macula it’s necessary to maintain a deep layer of macular pigment. This will help to protect the cone cells from oxidative stress, keeping them healthy and functioning optimally for longer. The best way to achieve this is to find ways to replenish the macular pigment so that it remains thick and offers the greatest protection from the type of damage that characterizes eye diseases such as macular degeneration.

It’s true that lutein and zeaxanthin can be found in certain foods such as dark, leafy vegetables and citrus fruits, but you would need to consume large amounts to give the level of these nutrients an effective boost. Meanwhile, meso-zeaxanthin is much harder to increase through consumption alone. Fortunately, there is another option – supplements. Studies have shown that taking supplements that contain all three macular pigments can slow the progression of conditions like macular degeneration and keep vision optimized for longer.
 

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.
 

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 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.
 

Both optometrists and ophthalmologists treat many common types of ocular disease. However, for the best outcome, it’s important to see an eye doctor regularly. They can identify any issues before they become serious problems.

Fortunately, they can treat all of the diseases mentioned below, and in some cases, you can do certain things to prevent them from developing. Look at the most recent statistics, and you’ll see why good eye health care matters.

Currently, more than 4.2 million people in the U.S. alone over the age of 40 are partially blind or have poor visual acuity. Although a lot of things cause these problems, the ocular diseases listed below are the most common.

Macular Degeneration

This is commonly referred to as “age-related macular degeneration” because it affects seniors. Not only does it cause blurriness and distortion but left untreated, individuals lose their central vision. In other words, they are unable to see anything through the center portion of the eye.

Two types of this ocular disease exist. First, wet macular degeneration means that abnormal blood vessels that are located behind the retina grow under the macular. Along with leaking blood and fluid, this leads to scarring and, sometimes, permanent damage. Second, dry macular degeneration progresses slowly as part of the natural aging process. Typically, it affects both eyes at some point.

Cataracts

Roughly 20 million people in the U.S. over the age of 40 have cataracts in either one or both eyes. While they can develop in children, teens, and young adults, cataracts are most often associated with age. With this, a film covers the eye, which, in turn, makes everything appear blurry.

Of all the different kinds of ocular diseases that lead to blindness worldwide, cataracts rank number two. Fortunately, an eye doctor can remove the damaged lens, followed by implanting an artificial one. After recovery, patients see amazingly well.

Diabetic Retinopathy

If you have diabetes, then you’re at risk of developing this ocular disease. This particular disease causes progressive damage to the retina’s blood vessels. The first stage consists of mild non-proliferative retinopathy and then moderate non-proliferative retinopathy, which blocks some of the vessels.

Then, it moves into stage three or severe non-proliferative retinopathy, which means more blood vessels become blocked. The fourth and final state, proliferative retinopathy, is the most advanced. Although Diabetic Retinopathy does affect just one eye on occasion, it typically involves both eyes.

Start by improving your overall health. Eat balanced meals, keep your blood pressure and cholesterol levels down, and take insulin. In addition, regular exercise, losing weight, and giving up smoking all make a huge difference. From there, a qualified eye doctor can provide you with treatment options to reduce the risk of losing your vision.

Glaucoma

Many people think glaucoma is one type of ocular disease. However, it’s a group of diseases that cause damage to the optic nerve. When that happens, people face the risk of losing their sight completely. With glaucoma, the fluid pressure inside the eyes gradually rises.

There are also two categories of glaucoma: open-angle and closed-angle. Not only is open-angle glaucoma chronic, but it also progresses slowly. Often, a person can have this type without knowing it. Unfortunately, they don’t realize there’s an issue until they have a comprehensive eye exam performed.

As for closed-angle glaucoma, it’s usually painful and it comes on suddenly. In addition, an individual can lose their vision much faster with this kind of glaucoma compared to the open-angle kind. Because this happens fast and involves pain, it’s diagnosed much quicker as well.

For these common types of ocular diseases, it’s important to have your vision checked. If an ocular disease is diagnosed, your optometrist will be able to determine the best treatment plan for optimal eye health and vision.