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I frequently tell people to remember three rules for good visual hygiene: good lighting, good distance, and 20/20/20 rule of rest breaks. Today we’re going to talk about good distance, specifically the Harmon distance.

Tilt reading material to be perpendicular to line of sight (or parallel to head tilt).

Tilt reading material to be perpendicular to line of sight (or parallel to head tilt).


It turns out that when we read there is a specific distance that allows your visual system to be as least stressed as possible. To determine your ideal reading distance (Harmon distance), make a fist and hold it to your cheek. The location of your elbow is now at the Harmon distance.

Allowing reading material to be too close to your eyes, like when hunching over, causes your eyes to overly converge (turn inward) which causes unnecessary strain. Also with the print too close, the eyes have to focus more than they normally would, which causes strain. These sources of strain can cause tiredness, headaches, and even lead to more myopia (nearsightedness) than one would would naturally receive through genetics.

To learn more about why the Harmon distance is really neat, read this and this.

Stay tuned for why good lighting and rest breaks are also important.

Annular-Solar-Eclipse-2005

Annular Solar Eclipse courtesy Wikipedia

On May 20, 2012 at 7:32 PM many of us here in Utah will have the opportunity to see an annular solar eclipse. those in Southern Utah near Kanarraville will get to see the “Ring of Fire” effect. (For more information, see ksl.com.)

What ever you do, don’t look at the sun without proper protection. Using regular sun glasses, even polarized, WILL NOT WORK. You can buy special solar filter glasses at Clark Planetarium. You can also make a pinhole projector. You can also use #14 Welder’s glass.

So please exercise caution, because while I shine bright lights in your eyes during an exam, it’s not nearly the intensity of the sun. The sun will cook your retinas, which causes loss of vision.

For more information, watch the video at ksl.com and visit Clark Planetarium’s website.

Atropine Eye Drops

Atropine 1%. A compounding pharmacist can turn this into 0.01%.

Are you tired of seeing your child’s myopia (nearsightedness) get significantly worse year after year? For a while we’ve had limited options that had significant drawbacks.

One of these options was a strong dilation drop, Atropine 1%, that is applied twice per week. The child would have dilated eyes and an inability to read without reading glasses, so along with the Atropine 1% prescription, we would have to simultaneously prescribe transitions (turn dark outside, clear inside) and progressive lenses (like a no-line trifocal).

Such an extreme treatment wasn’t very palatable or economical for most people. Well, thanks to further research, there is a new treatment we can try for myopia control that involves using Atropine 0.01%.

Yes, we still use Atropine, but at a much smaller concentration which avoids pupil dilation and paralyzing the focusing muscle. Your child can still use their normal glasses instead of expensive ones.

The main catch is that you have to instill the drops every night and this formulation is only available at certain pharmacies called compounding pharmacies, like Spences’s. Also, your insurance will not cover a compounded medicine, so your out of pocket cost for a 15 mL bottle of Atropine 0.01% is going to be about $125 or more. Only one pharmacy in all Cache Valley has a sterile compounding room, and it’s a lot more work, expertise, and equipment to steriley compound an eye drop. All things considered, $125 is really a discount; however, it’s not a negligible charge for you, so you really need to weigh the risks and benefits for your child.

If you are concerned about your child’s myopia progression because of significant, yearly increased myopia or a family history of high myopia, then let’s talk about this treatment at your child’s next eye exam.

Want to know more?

  • Read the abstract of the study cited above.
  • Listen to a podcast of an interview with one of the authors of the study. Go to asseenfromhere.com and scroll down to “Program #235: Low ATOMic Numbers”
  • Please note, the children in the study progressed about a click or two more of myopia each year despite using the treatment, but that’s better than the control which had about 5 clicks of progression. If your child has been having only mild increases in myopia, then trying this treatment may not be indicated. However, if your child has had an increase of one full diopter (4 clicks) of myopia in one year, then we should talk about this treatment option.
  • Also note that the full Atropine 1% might appear to give less progression than the 0.01% concentration, but keep in mind the difference isn’t very significant and it comes at a great cost of undesirable side effects.
  • The scientists still haven’t determined the mechanism of how Atropine is able to reduce myopia progression.
  • Atropine doesn’t seem to cause any change in eye pressure according to this study.

Q: How Many Contacts Come in a Box?

A: Six*

This is one of the more common questions I hear when people are wondering how much their contacts are going to cost. The simple answer is six, but there is a better question to ask: “How much is a year supply of contacts?”

Some brands of contacts are meant to be replaced every two weeks and others are one month. So you have to buy twice as many boxes for a two week lens vs the one month kind. On average, the one month kind are almost twice as much as the two week lenses, but this varies from brand to brand.

In general, the cheaper contacts you see advertised to get you in the door are made from an older, plastic technology that in general is more dry and less breathable on your eyes. The newer contact lens materials cost a little more, but most people notice their eyes feel significantly less dry and red with the newer, breathable contacts.

If you want to find out how much contacts cost per box, check out 1800Contacts.com. If you buy a complete year supply, you can usually get a discount, and having a year supply tends to make it less likely that you will over-wear your contacts and get an eye infection.

 

 

*If you get the daily disposable contacts, they come in packs of 30 or 90.

Optoblog.com cartoon making fun of people who don't know their etymology.

There is a difference between an optometrist and an obstetrician ;)

There is a possibility that if you’ve made an appointment this week that I could be rescheduling if my wife goes into active labor. We’re expecting a baby for Christmas!

Aqua Worx Health Fair

Aqua Worx Health Fair Sponsors

Aqua Worx is sponsoring a health fair on Saturday July 9, 2011 from 10:00am to 3:00pm. I will be there to give simple screenings and answer general questions about eye health.

Planned events are:

  • balance screening
  • hearing screening
  • blood pressure
  • foot soaks
  • massages
  • skin cancer screening
  • fitness, nutrition, and foot care education
  • Door Prizes

So join me there at 209 W 300 N in Logan! Visit aquaworxhealthfair2011.blogspot.com for more information about the health fair.

Ultraviolet Light (a.k.a. UV rays) damages ocular tissues causing all sorts of conditions: photokeratitis and conjunctivitis (snow blindness), premature cataracts (lens cloudiness), and solar retinophathy (retina damage). Eye doctors always recommend that you buy glasses with a material or coating that blocks UV light, but what about contacts?

Because the contact lens doesn’t completely cover your eyes, is it even important for your contacts to have UV blocking? This panel of expert eye doctors concludes that yes, it is. I think it’s especially true if your sunglasses do not have a wrap to stop UV coming in from the side. The UV light on a standard frame will sneak through the side and reflect off the back lens surface and onto/into your eyes. UV blocking contacts filter out these peripheral rays.

These graphs from Acuvue.com illustrate the difference in UV blocking ability between several popular brands of contacts:

UVA blocking ability of select soft contact lens brands

UVA blocking ability of select soft contact lenses

UVB blocking ability of select soft contact lens brands

UVB blocking ability of select soft contact lenses

Most contacts don’t block UV except Johnson & Johnson’s Acuvue brand of lenses. The reason is most soft contacts are created in a solid plastic and then hydrated at the end. Part of their process is to use UV light to cure the lens, so it would be impossible for these manufacturers to create a UV blocking lens. Acuvue, on the other hand, hydrates the lens from the onset, so they can build UV blocking into the material because they don’t need UV light curing for their polymer.

I know a guy who works for Acuvue who told me about a time his daughter went snow skiing and refused to put on sunglasses or goggles. At the end of the day, her eyes were completely red from UV light passing through the clouds, bouncing off the snow, and inflaming her eyes. When she took off the contacts that evening, she had a white ring where the contact lens overlaps from the cornea onto the conjunctiva. Her Acuvue lenses had spared her from getting a photokeratitis! (However, her photo-conjunctivitis was still pretty painful and required some eye drops to treat it.)

My message is, if all things are equal, contact lens wearers should consider getting contacts that block UV light. Also, everyone should wear sunglasses with a side wrap to decrease UV exposure to areas in and around your eyes. Your skin, conjunctiva, and lens will be healthier and look younger for longer. Start your kids out young with sunwear because this is the most important time to prevent UV exposure.

Sources for more information:

(Note: not everyone can wear Acuvue lenses due to fit on their eye or prescription not available in their powers. Ask me during your eye exam if Acuvue lenses are a possibility for your eyes.)

From the News of the American Optometric Association:

AARP, AOA offers free Webinar on the effects of aging vision on driving

AARP’s free Webinar, “Keep Your Safety in Sight: Prepare for the Effects of Aging Vision on Driving,” will be offered Wednesday, May 11 from 3 p.m. to 4 p.m. EDT.

As you age, your vision undergoes certain changes that can affect your driving and may increase your risk of being in an accident. This session, hosted jointly by the AARP Driving Safety Program and the AOA, will explore these changes and provide valuable information to keep you safe on the road. You’ll learn:

  • What changes in vision to expect with aging, including its effect on processing speed, blurred vision, problems seeing in low light or at night and reduced peripheral vision
  • How these changes can affect your driving
  • Practical tips and resources to help you prepare for and cope with vision and environmental driving changes

Presenter: Paul B. Freeman, O.D., AOA

To register go to: http://w.on24.com/r.htm?e=298210&s=1&k=31FAC0CBFB7D907649ECED0AD5548D86.

So for those of us in the Mountain Time zone that is 1:00 PM to 2:00 PM on Wednesday May 11, 2011. Please click on the link above to register your slot.

If you are concerned about you or someone you love and their ability to drive in old age, then please sign them up for the AOA and AARP’s webinar. Or sign yourself up and have them there to watch an interesting presentation with you.

Many people get dryness with soft contact lenses. Sometimes that can be the contact lens material itself, but a lot of times the culprit is the contact lens care regimen they use. Here are my rules of thumb to avoid dryness:

  • Replace your lenses on the approved schedule. (An old lens is a dry lens.)
  • How many hours a day do you wear your lenses? Not all lenses are meant to be worn 14+ hours a day.
  • Ask your eye doctor if he would recommend a certain kind of contact lens brand/material that could help decrease dryness and match your wear time lifestyle.
  • What contact lens care system are you using? Ask your eye doctor for a recommendation considering your eye health and contact lens material.

The contact lens care system you buy is very important because not all contact lens materials are compatible with all contact lens solutions. This has been studied and the researchers publish a grid that helps us predict for most people what solutions they should use. Here is copy I grabbed from their website on January 26, 2011 (click to enlarge):

StainingGrid from 2011-01-26

Match up your solution with your contacts. Is it usually compatible for most people?

My observations are that that Optifree and ClearCare are generally compatible with contact lens materials. (Please don’t just buy the Unisol Saline because it won’t disinfect your lenses.) In general, the Acuvue2, Acuvue Oasys, and Biofinity materials are compatible with most contact lens solutions.

So, in short, if you experience dryness, first start by replacing your contacts according to the recommended schedule which I mark on your prescription paper. If you already do this, then the next step I would take is try changing your contact lens care system.

In your contact lens exam I recommend and mark on your contact lens prescription paper specific contact lens care systems for your eyes based on the lens material, your previous experiences with solutions, and your eye health.

2011 Roadmap Planner with Daily Dats System™

2011 Roadmap Planner with Daily Dats System™

I wanted to make sure everyone know that in addition to eye exam services, I sell the Roadmap Planner with the Daily Dats System™.

More information is available at roadmapplanner.com, but in essence you can calendar, schedule, make goals, and track your goal progress/achievement all in one compact form factor that fits in your pocket. Just add a pen and get your life organized for just $10 (while supplies last).

The 2011 Roadmap Planner is available to buy from the website or pick one up at the office during doctor hours to avoid shipping fees.

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