Ask the Vision Expert
May 2012 Article
A guide to selecting sunglasses.
There are more options and variations to sunglass lenses than you might think. The majority of the options available are more a question of personal preference as opposed to prescribed needs. This article is meant to guide you through the decision making process of selecting the appropriate sunglass lenses.
Polarized vs. Unpolarized lenses
A polarized lens is extremely valuable in reducing the amount of glare coming through the lens. When light travels, the orientation of oncoming light is scattered in all directions. However, after light bounces off a relatively reflective surface such as water, snow or even a windshield, the orientation of the light changes to be mostly parallel to the surface it bounced off of.
A polarized lens is a filter that only allows light of a certain orientation to pass through the lens. This greatly reduces glare and makes vision more comfortable. Polarized sunglasses are far superior to unpolarized lenses and are especially useful for people who spend lots of time around water or snow, or people who spend a lot of time driving.
If you are not sure if your sunglasses are polarized, one way to check is to put your sunglasses on and look at an LCD screen such as a computer monitor or cell phone. These type of screens emit polarized light. If you look at the screen through polarized lenses and tilt your head from shoulder to shoulder there should be a point where the screen darkens or completely disappears. If not, your lenses are not polarized.
Grey vs. Brown lenses
The choice between grey and brown lenses depends on personal preference. Grey lenses are designed to achieve true colour contrast, which means that the spectrum of colours is not skewed when looking through a grey lens.
A brown lens on the other hand gives greater contrast between certain colours and makes greens and yellows stand out a bit more. For this reason, golfers will often opt for a brown lens in order to make the green grass appear more bright.
UV protection
Not all sunglasses protect against ultraviolet (UV) rays. UV rays have been shown to increase the risk of cataracts and even macular degeneration to some extent. There are also different categories of UV rays, so even though glasses may say they are UV protecting, they may not protect against all types of UV rays.
There are 3 major UV ray categories: UVA, UVB and UVC. UVA rays penetrate further into the eye and are the ones that can lead to cataract formation. UVB rays are mostly absorbed by the cornea (clear front part of the eye) and excess exposure can be harmful to the cornea as well as the sclera (white part of the eye). UVC rays are far less common and are mostly absorbed by the earth’s atmosphere. When they do make their way through, they are absorbed by the cornea as well, but are much more damaging. Of interest, UVC rays are also emitted by welder’s arcs and are the ones responsible for giving people welder’s flash.
As a general rule, if sunglasses say they are UV protecting, they are referring to UVA and UVB rays.
Lens quality
As a final comment, it is important to realize that lens quality also plays a role in the vision. Drug store sunglasses for instance are stamped out of thin plastic and are not great from an optical perspective. Sunglasses with higher quality lenses on the other hand, will provide clearer and more comfortable vision.
April 2012 Article
Myth: Seeing 20/20 vision means you have healthy eyes
Needing glasses to see well has very little to do with the health of the eye’s tissues. Instead, it has to do with the optics of the eye. Eye health and needing glasses are very different things. It’s important to remember that 20/20 vision does not always mean healthy eyes. This is why regular eye exams with an optometrist is very important.
FACT: Children who spend more time outdoors have a reduced risk for developing nearsightedness
Recent studies show that this is actually true. Spending time outdoors is healthy on many levels and is true for the eyes as well. It is important to remember however, that having your child spend more time outdoors does not guarantee that they will not need glasses, but it reduces the risk by a small amount.
Myth: Reading in dim light will make your eyes worse
This is a very common belief, but there is no evidence for this. However, reading in dim lighting makes it more difficult for us to focus on what we are reading. This can lead to excess focusing and eye strain. The eye strain we feel when this happens is like the muscle aching we may feel after visiting the gym. The strain is in the eye muscles, but it will not change your glasses prescription or make your eyes less healthy…it only makes it harder to read comfortably. For this reason, more light is better.
FACT: Eye exams for children, teens and seniors are free through Alberta Health
Alberta Health care allows for one full eye exam every year for children under the age of 19. All you need is the health card number. Alberta Health also covers annual eye exams for seniors starting at age 65. Alberta Health does not cover the cost of glasses, but it does cover the cost of the exam. In addition, Alberta Health covers all medical eye problems that you may encounter such as eye infections, metal in the eye, or any other eye health related problems. This eye emergency coverage is for all ages.
Myth: Children are born with perfect vision
At birth, vision is actually quite bad and over a period of a few years the vision improves by 30 times! Having said this, it is still recommended that children get their first eye exam at 6 months of age to ensure that the eyes are aligned, that they are healthy and that their prescription is within the normal range for their age.
FACT: Children in kindergarten are entitled to a free pair of glasses
Through a program called “Eye See Eye Learn”, children in kindergarten are eligible to receive one free pair of glasses if they are needed. This program is only available in Alberta for those who have an Alberta Health Care number.
Myth: 3-D TV is worse for your eyes than regular TV
Although more people have trouble watching 3-D television than regular TV, this is not an indication that it is worse for our eyes. 3-D TV makes us use more areas of our brain responsible for sight and encourages the use of both eyes equally and together. If people have an eye teaming or an eye coordination problem, they will feel eye strain while watching prolonged 3-D TV, but will not feel this way with a regular TV. If you or your child are experiencing eye strain while watching 3-D TV, this may be an indication of an eye teaming or coordination problem.
Myth: Wearing glasses weakens the eyes
People who have always seen well without glasses may find it difficult to read as they get older (past 40). When they see that the power of their reading glasses starts to be stronger and stronger they sometimes think that glasses have “ruined” their eyes. In reality, they are gradually going through a very normal process called presbyopia – the inability to focus the eyes for near objects.
As for nearsighted children and adults, sometimes people will feel that because their glasses prescription is changing and getting stronger over time, that their eyes are becoming weaker because of the glasses. The reality is that nearsightedness will increase whether glasses are worn or not. Nearsightedness tends to increase gradually and usually plateaus between the late teens and early 20’s.
Myth: Sitting too close to the TV wrecks your eyes
Sitting close to a TV is no different from looking at a computer screen. The truth is, children have a better ability to focus up close without eye strain than adults. However, sitting close to the TV may be a sign of nearsightedness. So, if your child is always sitting close to the TV and has difficulty seeing it clearly from a distance it would be wise to get their eyes checked. This myth probably developed because sitting close to the TV is a habit that nearsighted children have. Sometimes when the parents discover their child needs glasses they feel that the TV made their child’s eyes nearsighted; in reality, sitting close to the TV was just the child’s adjustment to their nearsightedness.
E-Mail: landon.halmrast@westernfg.ca
March 2012 Article
Glaucoma
Vision loss caused by glaucoma is progressive, painless and permanent. Those are three very scary words when it comes to vision loss. However, if caught in it’s early stages, vision loss can be prevented.
Glaucoma is a disease that slowly damages tissues in the back of the eye that are crucial for sending information about our vision to our brain (the optic nerve). The most common reason for this damage is from increased pressure in the eyes, but it can even be found in people with normal eye pressure.
Glaucoma is more common in people over the age of 40, but can even be found in infancy and early adulthood.
A Dangerous Misconception
The most common misconception about glaucoma is that patients think that they will actually notice something wrong with their vision early in the disease. They cannot. When glaucoma starts to cause vision loss, patients don’t notice it. This is because the vision loss starts in the periphery.
With very few exceptions, glaucoma, in its early stages, has no symptoms at all. There is no redness, pain or any noticeable vision loss early on. By the time vision loss is noticed by the patient, it is often too late.
Prevention
The best thing you can do for your eyes is to have regular eye exams. When an eye care professional examines your eyes, they will look for glaucoma risk factors such as high pressures in the eyes , optic nerve appearance, family history, and a few others.
There are a few ways your eye care professional can measure the pressure in your eyes. One way to measure eye pressure is with that dreaded air puff test at the optometrist’s office. Although this test is not liked by many, it is important for assessing your risk for glaucoma.
Because glaucoma causes progressive, painless and permanent vision loss, if you have any risk factors for glaucoma, your eye care provider will very likely have you do additional testing and make sure to check your eyes on a regular basis to ensure that no damage is happening.
If your risk is above a certain threshold, or if you have any signs that glaucoma has already begun, appropriate action will be taken.
Management
The way that glaucoma is managed is first through medicated eye drops that lower the pressure in the eyes. These drops are taken on a daily basis and this is normally an extremely effective way to prevent damage.
In some circumstances, these eye drops are not enough and some surgical procedures are available that decrease the eye pressure as well.
In every case, if glaucoma is caught in it’s early stages, vision loss can be delayed or prevented all together.
If you would like more information about glaucoma, or have any other questions about the health of your eyes please don’t hesitate to call our office.
February 2012 Article
Cataracts
40 years ago, the word cataract instilled a lot more fear than it does now. This all changed because of advancements in surgical procedures; in 40 years we have gone from traumatic eye surgeries with uncertain results, to simple 20 minute inpatient surgeries that have few complications. Today, cataract surgery is the most common inpatient surgery worldwide.
A cataract develops in the natural lens of our eye that is located directly behind the coloured part of our eye (iris). Normally, this lens is clear like a window, but over time this lens can begin to become more yellow and cloudy. If this happens, we call it a cataract.
There are varying degrees of severity and types of cataracts, but not all cataracts need to be removed. Certain types of cataracts progress quickly over a period of months and are often removed quickly in order to restore clear vision. Other types of cataracts are so slowly progressing that it may take decades before they start to cause blur and may not ever need to be removed.
Who are at risk?
Cataracts are most often seen in people over the age of 60. They are so common that everyone gets some degree of cataract formation if they live long enough.
Aside from increasing age, certain conditions increase the likelihood of cataract formation. Diabetes for instance, can cause cataracts at an earlier age. Long term steroid use can also cause early cataracts. Myotonic dystrophy, atopic dermatitis and eye injuries are also on the list of conditions that can cause early cataracts. In addition, studies have shown that increased UV exposure can increase the risk for cataract formation.
What are the symptoms of cataracts?
Symptoms of cataracts include: blurred vision, halos and glare. Cataracts develop without pain or redness. They can also cause small shifts in glasses prescriptions.
What can be done?
If the cataracts begin to affect the quality of one’s vision, cataract surgery is how cataracts are treated.
As mentioned earlier however, not all cataracts need to be removed.
The decision about getting cataract surgery is completely between yourself and your eye doctor. For instance, if your eye care provider tells you that your cataracts are becoming increasingly cloudy, but you are content with your vision, surgery will not be performed. By the same token, if your eye care provider does not see dense cataracts, but your cataracts are making your ability to do every day tasks difficult, surgery is considered.
What is a secondary cataract?
Sometimes after cataracts are removed, a secondary cataract can develop. This type of cataract is much different because it is a cloudiness to the bag or capsule that the new artificial lens sits in. If a secondary cataract forms, it is easily removed with a laser.
Prevention
Because exposure to UV light can increase the chances of cataracts, a good pair of sunglasses can help to prolong cataract formation. Of course wearing sunglasses will not guarantee having no cataracts in your lifetime, but it may prolong their emergence.
If you have any questions or are unsure about your eye health, please feel free to contact our office at 403-526-2020.
January 2012 Article
How to avoid contact lens related eye problems
Infections and eye problems that stem from contact lens wear are quite common. If you have ever experienced an infection or problem because of contact lens wear you will know that it is not pleasant to say the least. Often, patients need to use medicated eye drops and stay out of contacts for two weeks or more.
How can you avoid infections and eye problems with contacts? The single most contributing factor to these problems is sleeping in your lenses. In fact, studies show that if you sleep in your contact lenses you are four times more likely to get an eye infection than your friends who don’t!
Another important finding to these studies is that even if your contacts are APPROVED for overnight wear, you are STILL four times more likely to get an infection.
Of course, sleeping in contact lenses is not forbidden and sometimes your optometrist will tell you that it’s OK to do so. Keeping this in mind, at your next eye appointment when they ask “How often do you sleep in your contacts?”, don’t be ashamed to tell the truth if you do sleep in your lenses. Your optometrist simply wants to know your risk of potential problems that may arise down the road.
Besides not sleeping in lenses, how else can we avoid infections/problems?
Here are some very important pieces of advice that could save you from potential problems.
1) If it hurts to wear your contacts, TAKE THEM OUT.
2) Always make sure you have a pair of glasses to use in case your contacts start giving you problems.
3) Don’t extend the life of your lenses (throw them out when you are supposed to).
4) Follow your optometrist’s recommendations for how to clean and care for the lenses.
These pieces of advice are key. I can’t tell you how many times in my career that a person comes in with a contact lens related problem or infection because one or more of these points were not followed.
Unfortunately, there are still times when people follow all these rules and they still get infections. These instances are rare, but they still happen.
If you have had a problem before, ask your optometrist about different types of contact lenses that would be safer for your eyes. If you wear daily disposable lenses for instance (ones that last 1 day and you throw out at the end of the day), you are at a much lower risk for complications.
How do I know if I have a problem/infection?
If you have a problem or infection, you’ll know about it. Common symptoms are pain, sensitivity to light and redness. Even if you are suspecting a problem but are not certain, it is better to get it checked than to leave it.
What to do if a contact lens related eye problem arises?
If a problem arises, see your optometrist as soon as possible. These types of visits are medically necessary and are covered by Alberta Health.
If you have any concerns or questions about contact lenses and your eyes, we are here to help. Call us at 403-526-2020.
December 2011 Article
Macular Degeneration
These two words can cause a great deal of worry to anybody who knows about the disease.
Facts
Age-related Macular degeneration (AMD) is the leading cause of untreatable vision loss and legal blindness in people over the age of 50 in North America.
Over 2 million people in Canada have AMD. As the population ages, the number of cases of AMD in Canada are expected to triple over the next 20 years. Right now, 1 in 4 Canadians over the age of 75 have some signs of AMD.
AMD affects central vision and leaves the peripheral vision in tact. So, someone with advanced AMD can be legally blind, but can still walk around without the use of a cane by using their peripheral vision.
Macular degeneration has two forms: a dry form and a wet form. The dry form accounts for 90% of all AMD cases and is far less threatening to vision than the wet form. However, about 10% of people with the dry form can progress to the wet form, which can be visually devastating.
There is currently no cure or treatment available for the dry form, but things can be done to help prevent it from progressing. There are surgical treatments for the wet form (not the dry form) and are directed at treating the fluid/bleeding in the macular area in the back of the eye. This treatment often needs to be done on a long term basis.
Risk Factors
The biggest risk factor for macular degeneration (AMD) is age. In addition, being female, Caucasian, or having a family history of AMD are also known risk factors. Unfortunately, these risk factors cannot be changed or altered.
The number one modifiable risk factor for AMD is SMOKING. If you smoke, you are 2-6 times more likely to develop AMD. Diet is another way to prevent AMD.
Prevention
In short: Say NO to smoking and YES to leafy greens. Eating a healthy diet of fruits, vegetables and fish has been proven to help prevent AMD. Special vitamin supplements are useful if AMD is already in its early stages. These have been proven to delay the progression of AMD. If you smoke, there are different types of multivitamins that are taken.
If you in this category and have any questions about which vitamin supplements to take, or if you have any other AMD enquiries, please don’t hesitate to ask us here at 20/20 Vision Care.
November 2011 Article
This month I will answer some common questions that people ask in eye exams. Because of space, my answers must be simple and brief. If you would like further clarification on any of these answers, don’t hesitate to contact our office.
What age is recommended for a child’s first eye exam?
The Canadian Association of Optometrists recommends that a child’s first eye exam happen at 6 months of age. Then again every year. You may be thinking, “What can you tell at 6 months of age or even at age 1 or 2?”. Surprisingly, quite a bit can be determined.
The optometrist will check that the eyes are aligned and that no subtle eye turns are present. We also check the health of the eyes both inside and out. Many optometrists require that the children have their eyes dilated so that the health of the eyes can be fully assessed. Lastly, the child’s prescription will be determined. Surprisingly, even if a child cannot communicate, their prescription can still be accurately determined. It is then compared to age related norms.
The chances that your child will need glasses or have eye health problems at that age is uncommon, BUT if people postpone getting their children’s eyes checked because statistics are in their favour, they may be making a big mistake. I for one would know.
My first eye exam was at age 5. My parents had no concerns at all with my vision. They were shocked to discover that one of my eyes could not see and that it could not be corrected with glasses. My parents were devastated to say the least. This could have been avoided with an earlier eye exam.
Does Alberta Health cover eye exams for children?
YES! Alberta Health covers an annual full eye exam for children under the age of 19! Even if you have no concerns with your children’s eyes, an annual eye exam is still recommended.
Other things Alberta Health covers:
– Medical eye problems/emergencies
– Annual eye exams for seniors (65 and older)
– Annual eye health checks for patients with diabetes (excludes glasses prescription checks)
– Getting a prescription for glasses right after cataract surgery
Why am I having trouble seeing fine print?
If you happen to be in your 40s or older, having trouble seeing clearly at near is very normal. This is not a disease, but can be very bothersome to many people.
Each time we look at something up close, the lens inside our eye needs to change shape to make objects appear clear. Over time, the lens becomes more rigid, making it harder for the lens to change for near tasks. The early to mid 40s is normally when people start noticing these changes. At this point, two different prescriptions are needed: one for distance, and one for near.
There are many options to help with this. For some, simple over-the-counter reading glasses does the trick. Others who are slightly near sighted may just remove their glasses to read. Most people prefer wearing a progressive lens that has both prescriptions in the same lens (these lenses have no visible line). Also, multifocal contact lenses are becoming increasingly popular and work quite well for some people.
October 2011 Article
Why do I have dry eyes and what can be done about it?
If you’ve ever experienced dry eyes, you’ll know that it can be more than just a nuisance. Having dry eyes can cause things like: a burning sensation, an overall redness to the white part of the eyes, fluctuations in the quality of vision and all these symptoms are usually worse at the end of the day. Not only this, but if you happen to be a contact lens wearer, dry eyes can make your contact lens wearing experience an uncomfortable and sometimes painful experience.
If you have dry eyes you may be asking yourself, why me? The truth is, there are many causes and reasons your eyes could be feeling dry. First of all, the fact that southern Alberta is one of the driest parts of Canada doesn’t help. In addition to that, the list of other contributing factors is quite extensive.
Whatever the source of dry eyes, the result is the same: poor quality of tears. Having a healthy tear film is essential not only for ocular comfort, but for ocular health and clear vision. There are many components and layers to the tear film, and dryness can be felt when any part of the tears is compromised.
Factors that may put you into a higher risk for dry eyes includes: smoking, certain medications (acne medication, beta blockers, antihistamines, birth control pill, etc…), rheumatoid arthritis, thyroid conditions, aging (especially menopause), rosacea, and even LASIK surgery.
In addition to this, sometimes bacteria can collect on our lashes that can affect our tear composition. Other times, when people do not completely close their eyes during sleep or during simple blinking, dryness can occur. Some people’s work environments create dry conditions, such as air conditioning blowing towards the face. Even extended computer use can cause dryness because our blink frequency decreases as we look at screens for long periods of time. And if that list isn’t enough, any time we add contact lenses to the mix, it can make the eyes feel even more dry.
What to do about it:
How we manage dry eyes is very different depending on the source. There is a ladder that we climb with patients as far as treatment options go. Artificial tears, for instance, can be very helpful in some cases, but they are simply giving relief rather than fixing the problem. Sometimes cleaning the eyelashes on a daily basis can help with dryness. Also, hot compresses over the closed eyelids can help restore function to an important oil layer on the tears, if done on a daily basis. In stubborn cases of dryness, we can actually block the tear drainage system in our eyes which helps keep the tears in our eyes longer. Other times, medicated prescription eye drops help to restore the quality of tears. If people are contact lens wearers, changing the type of contact lenses can sometimes help and even altering the contact lens solution can improve dryness symptoms.
The absolute best way to combat dry eyes is to manage it with the expertise of your local optometrist. They will be able to identify the reasons for your particular dryness and begin treating or managing the dryness according to the source. It is important to realize that not everyone will find 100% relief from dryness, but in almost every patient we can improve the symptoms and reduce the discomfort associated with it.
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