The Eye Practice

As computer chips, wireless connections and speeds continue to improve, it is quite conceivable that we will have constant access to the internet through our glasses.

They are convenient, they are light and with voice recognition see the You Tube Video below at what might be possible.

Eye Strain we have discussed in detail in previous posts.  In fact it is so important that we have a website called:

EyeStrain.com.au

Eye Strain can have a number of causes and only a comprehensive examination can reveal what are the contributors to the perception of eye strain.

From next week The Eye Practice will be the first optometrist outlet to trial a new product called Gunnar Technology Eyewear.

This very innovative product can be purchased with or without a customised prescription in glasses.  Even though there might be great value with no prescription, the value of these glasses will excel when it is made up with your own prescription.

Stay tuned for more on this topic soon!  We will trial in house first and if we are convinced that it has a role to play in relieving the Eye Strain epidemic we will start to prescribe it soon.

Eye strain or asthenopia headaches are a big complaint for patients who come to visit us with eye problems. They have dry, weary eyes, and the headaches are sometimes pretty severe. Eye strain headaches are a type of tension headache, and it is felt mostly at the eye area and in the back of the head. Sometimes, the headache can radiate pain into the neck and upper shoulders.

The Role of Glasses in Eye Strain

Luckily, there are some ways that your glasses can help with eye strain headaches – if you come in and get the right prescription.

Some people opt to get their glasses coated with an anti-reflective coating, which helps minimize glare on your lenses. For some of our younger patients, this coating is enough to reduce eyestrain, as long as they continue to do things like frequent eye breaks, exercises, and other preventive measures to ease their eyes.

For those of us who are not so young or not disciplined enough, or have other circumstances that prevent us from taking frequent breaks from our close-up work, there are specialized computer glasses.

With eye strain, the use of glasses – that is, customized glasses that work for the up-close and specific work done with computers – can minimize eye strain, eliminate headaches, and help relieve the symptoms of Computer Vision Syndrome (CVS). CVS is the major cause of eye strain that we see in our office these days...and the use of glasses can help.

There are number of myths:

1. I had better not get glasses as the will make my eyes lazy and then make my eyes worse - WRONG.

2. I had better get glasses as by getting eye strain it will make my eyes worse - WRONG.

Eye strain is related to myopia but it doesn't make your eyes weak.  The link between myopia and near work is a big story and deserves it's own post.

What's so special about computer glasses?

Computer glasses are made to reduce blue light from our monitors. They are yellow tinted and reduce the effect of blue light that contributes to eye strain. Furthermore, computer glasses enhance the “intermediate” viewing area – which is usually 60 to 61cm from worker to screen – so that viewing is more comfortable, and the eyes can relax. Additionally, computer glasses are also curved around the eye, which tends to hold more moisture to the eye – and is corrective for computer related dry eye. While that's not necessarily eye strain...it sure does make sitting at your computer more comfortable (particularly if you wear contact lenses).

But before you go running about to get a pair of these glasses, make sure you have a comprehensive eye exam completed, to make sure that the problem really is eye strain due to computer use. There are a variety of reasons for eye strain and eye strain headaches, and if CVS isn't one of them, then glasses will not likely help. The next problem is that the best glasses that have been designed are called Gunnar - they have yet to come to Australia.  You still can get yellow lenses but the Gunnar have a number of superior qualities.  We will discuss these in a future post.

However, for those of you who have eye strain (also known as asthenopia) from too many hours in front of the computer at work, at home, and too many video games, the use of glasses can make a big change in your eye comfort. Give us a call on 9290 1899, or click here to make an appointment.

Glasses (or Spectacles) are ubiquitous in our visually demanding society.  They are so important that in 3rd world countries the leading cause of blindness is in fact totally correctable by the correct pair of glasses.

We take it for granted that when made, the glasses will be accurately manufactured.  Is this the case though?

There are a few things to consider:

1. Depending on different visual tasks prescriptions often require adjustment, once they have been tested in the real workplace.
2. If adjustment is required, who will be responsible for the remake - the patient or the supplier?
3. A similar analogy can be made when having medical treatment - if the first medication does not achieve the necessary outcome, adjustments are then made to the medications until success is achieved.
4. Possibly the best place to manufacture your glasses is the same place you have them prescribed, as the warranty in this case is guaranteed.
5. There seems to be a trend these days for some patients to take their prescription from the prescribing optometrist and search around for glasses that they perceive are more fashionable or more cost effective elsewhere.
6. This trend also is likely to spill onto the internet, where there are a plethora of online "Spectacle Makers".

A recent study in the USA revealed that around 50% of glasses made online were faulty in the prescription or the safety of the lenses or both.

To make matters worse, it is very unlikely that any glasses bought online will fit properly. So who will adjust your glasses if bought off the internet?

The only conclusion that can be made is that purchasing glasses online is NOT like buying a pair of jeans.  You cannot send the glasses back if they do not fit as your prescription has been put in it.  Not to mention there is a high probability that it will be made incorrectly as well, according to the American study.  It concluded:

"Nearly half of prescription spectacles delivered directly by online vendors did not meet either the optical requirements of the patient’s visual needs or the physical requirements for the patient’s safety"*.

Think about your next spectacle purchase and get them right.  Your prescribing optometrist is by far the best person to make them.  If price is an issue there are always budget options.  The problem is you pay for what you get, but more importantly - they need to be right for your vision needs.

*Safety and compliance of prescription spectacles ordered by the public via the Internet
Karl Citek, O.D., Ph.D., Daniel L. Torgersen, MBA, MS, Jeffrey D. Endres, ABOC, and Robert R. Rosenberg, O.D.

Glasses or Spectacles are relatively simple when you are under 45 years of age.  One lens allows you to see from down the road to as close as reading the small print on a medicine bottle.

The problems start usually after 45 when most of us start to lose the ability to be able to change our focus from down the street to reading a book.  The condition is known as presbyopia.  The lens that is inside the eye, when we are younger is quite supple and an internal eye muscle called the ciliary body is able to squash the lens, which in turn focuses our vision from distance to near.

As time goes on the lens starts to become more rigid so that the eye muscle is not able to change its shape any more.  When this occurs we lose our ability to read.  There are of course solutions to this problem but it will mean either two sets of glasses - one for distance and one for reading, which is inconvenient or multifocals, which have all sorts of problems but mainly a very small reading area, which makes reading a chore sometimes.

Finally in the USA a couple of companies have come up with electronically activated glasses, which automatically change the focus from distance to near just by gently pressing the side arm of the glasses called the temple.

The video below is an advertisement of one of the brands called emPower.  The other brand that has been released is called PixelOptics.  No doubt there will be subtle differences but from what we see they seem to work in similar ways.

The first generation glasses have been just released in the USA.  They are a bit heavy looking and unfashionable but like everything they will evolve very quickly once they establish a market for themselves.  Progressive research requires cash flow from earlier generation products.  Here's hoping the take up is quick, so that the competing companies have incentive to evolve the technology.

At the Eye Practice we will be stocking these unique inventions as soon as they are available in Australia.  Being in the Sydney CBD many of our patients are office workers.  If you ask any office worker that wears multifocals how they feel about their glasses they will tell you that they are a necessary evil.

We believe that the electronically focusing technology will eventually supplant the lenses that we have been using for over 50 years now.  The best analogy we can come up with, is the large cathode ray TV set which has now been fully replaced by Plasma and LCD technology.  Glasses are likely to follow a similar path.

Stay tuned, as soon as the electronic glasses are available in Australia we will start promoting them immediately.

Glasses or Spectacles are used by at least half the population now.  Some people only need to wear them occasionally; others need to wear them from the minute they wake up, to when they go to bed.

Some spectacle prescriptions are simple and some can be very complex.  Getting them just right involves:

• Designing the prescription to work in the environment the patient needs.
• The frame needs to fit properly.
• The lenses need to be as thin and as light as possible.
• The lenses need to be fitted accurately relative to the frame and the pupil centres.
• Explaining normal adaptation issues.
• Recognising that the glasses have been made incorrectly.
• Choosing shapes and colours that complement a persons look.

 

The lens on the left labeled 1.74 is a thinner and a lighter profile than the one on the right labeled 1.50.  These lenses are both the same prescription.  Obviously the thinner lighter lens is the preferred option.  Make sure you are given all options. 

Often patients, once they have had their eyes tested, will ask for their prescription thinking that they will either get the same glasses made elsewhere cheaper or they will have more variety to choose from elsewhere.

Taking your prescription elsewhere is rarely a good option for the following reasons:

1.  Cost is not an issue - complete glasses are available for under $99
2. Glasses can be made for your health fund rebate therefore no out of pocket cost. The same as other optical outlets.
3. When top quality lenses are required from The Eye Practice they will be sourced from Germany, France or Japan NOT China, which is where most of the corporate companies obtain lenses from.
4. If you have trouble getting used to your new glasses, who will be responsible for adjusting the prescription.  If the glasses are made by The Eye Practice we will warranty the lens adjustment 100%.
5. If you are looking for something unique and most importantly fitted precisely to you face this will be difficult to achieve at the corporate entities.  The staff on the floor are usually trained in sales and not the intricacies of spectacle manufacture.
6. The optical industry is slowly being deregulated. This means that untrained people are allowed to not only sell glasses, but also make them, with no concept of accuracy.

Always make your glasses at the same place you have chosen to examine your eyes.  They are by far the best people to advise you about what you need from a functional and a lifestyle perspective.  If you have the perception that they will be expensive, you will be surprised if you just ask to keep to a budget.  Usually the best option will be more expensive, I think we all understand that.  Reasonable glasses can still be made a budget price at The Eye Practice.

 

Eye Strain (or Asthenopia) affects at least 70% of the population.  A recent study completed by Bausch & Lomb in December 2009 revealed through a random survey done in the USA , Europe and Asia that Eye Strain (or Asthenopia) was experienced by most people.

Approximately 20% of the people that reported eye strain described it in the severe category. 

With such a significant incidence of Eye Strain, what can be done to treat it or suppress it?

There are a few options but before considering treatments it is important to workout what is the possible cause of the perceived Eye Strain.  Sometimes there are a combination of factors that contribute and multiple treatments are required.

       

Classifying different types of Eye Strain in laypersons language can be challenging, but let us give it a try:

1. Uncorrected Refractive error is very common - this includes Hyperopia, Myopia, or Astigmatism.  Refractive error means that the eye in it's relaxed state is not focusing properly.  More detail can be found about these conditions by clicking on the highlighted words above.
2. Eye Muscle Imbalance - this condition is medically called Strabismus.  It is quite a complex area
   but a simple explanation can be found by clicking on the highlighted word above.
3. Overuse syndrome - like any muscle of the body, overusing the eye muscles can cause Eye Strain, which possibly will occur without any sign of focusing problems like refractive error or muscle imbalances like Strabismus.  Just like repetitive strain injuries (RSI) can occur, so can Eye Strain just from reading documents, looking at computer screens, smart phones or playing computer games.

Before any complicated treatment is begun for Eye Strain, every patient needs a thorough comprehensive eye exam that measures for refractive error, eye muscle imbalances and very importantly looks for any underlying eye disease.

If no eye disease is present then correcting one problem at a time is the best approach.  Refractive error is quite common and very simple to fix by either glasses or contact lenses.  Assuming there is a clinical relevant refractive error, it is wise to dispense the glasses or contact lenses and allow the patient to re-challenge their eyes and vision in the same environment that they experienced the original eye strain symptoms.

By prescribing glasses or contact lenses we need to be clear about two common myths:

1. By not wearing glasses or contact lenses when there is clinically significant refractive error only means that eye strain symptoms will persist.  It does not mean that your eyes will strengthen because you do not use the glasses or contact lenses. Nor does it mean that your eyes will weaken because you are using them.
2. Some people that are prescribed glasses think that by straining their eyes that somehow this will make them worse - this also is not true. It just means that the eye strain will be relieved and they will feel better and be more productive.

What is true is that over time, eye muscles tend to get weaker like other parts of our body. I think we can all relate to the fact that a physically fit 20 year old will always be stronger and faster than the same individual that has done their best to be physical fit at 50.

In our next Eye Strain post we will discuss other treatment options, which will include those for eye muscle imbalances and just simple repetitive strain relief tactics.

Glasses and Spectacles are very common in a society like ours that relies so much on reading and computer work.  In fact up to 50% of the population need glasses or some form of vision correction like contact lenses to see in the distance as well.

Many patients that we see for eye issues feel that glasses or spectacles are something that have to be used just to see.  This of course is true.  Wearing glasses or spectacles correct a functional disorder like myopia, hyperopia or astigmatism.

Depending on how poor your vision is without glasses, will dictate when and where you will wear them.

Typically there are three mentalities when it comes to glasses:

1. I just need something to see what I need to do.  This attitude normally will get away with the cheapest glasses or spectacles that can be made. This does not mean to see at your best, nor does it mean that the glasses will be comfortable and durable.
2. I need something that I will see at my best possible potential and the glasses will be light, comfortable and durable.  Often this requires technologically advanced frames and lenses, which do come at premium.  There are many analogies we can use here; one of then being cars.  You can buy a car for $15,000 that will get you from A to B or you can buy a car for $50,000 that will be more powerful, be a more comfortable ride and have many more high tech features.
3. I need to look good in glasses.  They typically are the first thing that people will see and if I care about my appearance and presentation then the look and possibly the brand of the glasses is critical.  Typically you would probably want to have the lenses as light and as thin as possible to enhance that look.  Again this also comes at a premium.

   

Glasses or Spectacles at their most basic have Frames and Lenses that are made in China.  This is OK if you are just looking for something just to see.  The best example of this would be a pair of glasses that would only be used to read in bed with.  Assuming they are made accurately, which is another story for another day something in the price range of Frame and Lenses for under $100 can certainly be made.

On the other hand, if you are looking for glasses that will complement your appearance, be super comfortable and make you see at your best, the price can vary - similar to cars or clothes.

Remember that if you spend extra money on a piece of jewellery, or a suit to look great, think carefully about how you will look in your new glasses as it is very likely that they will be the first thing people will look at when they talk to you or approach you.  It is unlikely to be your $500 shoes!

Eye Strain over the years has been on the increase.  Over time people have become more and more educated, which has led to an exponential rise in reading.

In the 80's, the Personal Computer hit the desktop and by the 90's most households had a computer.  Students at high school all have been given a laptop and now most of us carry a smart phone and have access to a digital tablet (like an iPad).  Just recently the Daily Telegraph was been made available for free on your computer or your digital tablet, which eventually will probably lead to the extinction of books and newspapers.

Any form of reading, whether it is from paper or a digital device has the potential to cause Eye Strain but now the roll out of 3D devices is likely to take Eye Strain to a whole new level!  The Salt Lake Tribune in the US recently published an interesting story about 3D TV and 3D Movies.  It goes into great detail about the significant Eye Strain issues that can be caused by this new entertainment medium.  CLICK HERE for the full story.

 

Without getting into the theory of seeing in 3D, the brain requires two slightly different images to be merged into one to allow perception of depth.  By putting on the 3D glasses that we are now all used to, each eye is allowed to see one image and then the eyes have to converge (go cross-eyed) slightly to merge them into one 3D perception.

See a ghost image below that can be merged into a 3D perception of the inside of a car.The image below requires red / green glasses to work, whereas in the movies the glasses are polarised, so that each eye can see a different image.

 

Once the eyes have converged to allow the 3D perception is when the potential for eye strain occurs.  We will normally sit in front a movie screen for a couple of hours keeping the eye muscles strained for the whole time.

The American Optometrists Association has predicted that up to 25% of the population will have eye strain problems when trying to view a 3D movie.  The best analogy we can come up with at The Eye Practice is that it is like trying to walk around in a slightly squatted position. Imagine what your legs would feel like; well that's what your eyes can feel like. 

It is possible to train the eye muscles to perform better with this type of demanding vision.  In a future post we will discuss various types of eye exercises that can be prescribed to relieve eye strain.

Do GLASSES weaken your eyes?

In over 25 years as a practicing optometrist, Dr Jim Kokkinakis says: "this thought is probably the most common fear, that comes up again and again and again".

This fear in his experience is NOT true. Let us explain why.

There are four main periods in ones life that glasses or spectacles might be required. There are a few more but they account for a minority of people, so we will stick to the main ones to keep the explanation simple.

a.    First starting school (4 to 8 years)

b.    Puberty (8 to 16 years)

c.    First few years of a desk job (18 to 22 years)

d.    Over 40 years of age.

The majority of the spectacles that need prescribing occur because of reading difficulties. Whoever designed eyes did not design them to read or look at a computer screen all day. Our eyes and for that matter our body, is designed to look at the trees and plow the land. Unfortunately humans love to turn the world upside down and we now have created a situation (in the Western world) where sitting at desk and reading all day is the norm.

This can fatigue eyes, which in turn causes all sorts of problems called asthenopia. For example: red eyes, eye strain, pain in or around the eyes, blurred vision, headache and occasional double vision are common complaints.

If conservative measures such as taking frequent breaks from reading and computer use fail to alleviate the symptoms, prescribing a weak prescription in glasses invariably helps. This cannot make the eyes lazy as only about 20% of the muscular effort is normally prescribed. Even in these circumstances the eyes are still getting more exercise than they were designed for. What is actually achieved is a feeling of well being and day after day of great productivity.

Asthenopia is just a medical term for Eye Strain.  For a detailed explanation of this, The Eye Practice has created a detailed website called EyeStrain.com.au - CLICK HERE for more information.