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Mind Your P's and Q's – A Look At The Eye Chart

For more than 100 years, Optometrists have used a typical eye chart in order to test your vision and find your most accurate prescription. To the patient, all eye charts must look about the same, but to me, there are vast differences.

A brief history of the eye chart: the typical “Snellen Chart” is named after a Dutch Ophthalmologist who designed the chart in 1862 and is comprised of block letters. These letters have a standard and specific geometry, with each black line being the same thickness as each space within the letter, and the height being five times the size of each block. Originally, only the letters C, D, E, F, L, N, O, P, T, Z were used. These are the wall mounted charts that we see in all doctors offices, school nurse stations and and health clinics across America.

Newer charts have a slightly different arrangement, and range from perfect block letters to fonts that even an eagle-eye couldn’t differentiate. The whole idea of the eye chart is to make it confusing and difficult to discern if your vision is blurry, but crisp if you can see clearly.

For instance, an F and a P look very similar if there is any slight blur. This is also true for a C or an O. Only the small openings at the far right differentiate these letters. It’s much easier to tell an A from a V even if your vision is a little blurry because of the letter form and the point facing either up or down.

One curiosity to me as an eye doctor is how many people guess Q during the exam. The only difference between an O and a Q is the ‘descender’ (the downward vertical tail, I looked it up!). It’s actually funny to me that mostly adults guess Q– a child will never guess the letter. I figure that kids don’t expect such trickery during their exam and don’t over-analyze.

In my exam room, I have three different letter configurations for each line vision. I still hear the same guesses and mistakes, and the same letters differentiate good vision with a particular lens versus blurry vision. The only advice I can give my patients is to never guess Q.

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Tags: eye care, Eye care professional, Eye chart, optometry, Snellen Chart, vision

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Just In Time For the Holidays!

On this day in December, it’s apropro that a patient presented with what can only be called a grinch – stealing vision from patients both good and bad.

I’m referring to a “christmas tree cataract.”

A christmas tree cataract gets its name from the red and green irridescent refractile crystals that form inside of the natural lens in the eye. These crystals are only visible with the high-powered microscopes your eye doctor uses.

This type of cataract occurs with aging but is very common in patients with myotonic dystrophy. Surgery is required soon after onset to restore vision.

The name of this cataract is a reminder this holiday season about the importance of regular eye exams. My patient today didn’t have any visual symptoms, but I was able to educate her on her eyes and the future course of her condition.

This information is brought to you by Clarin Eye Care, a family Optometry practice in Palmetto Bay, Florida. Please call or contact our office for more information.

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Tags: cataract, eye care, Eye care professional, eye doctor, Eye examination, optometrist, optometry, vision loss

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McDonalds Worker Serves As a Warning to Us All

Fast food giant McDonalds recently had to pay a former employee who became partially blind while working at one of their restaurants. The employee attempted to unclog a drain in the restaurant, but when the first attempt at using a sulfuric acid-based cleaner did not work, he poured a second bottle into the pipe.

The contents of the second bottle blew back into the employee’s face and into both of his eyes. Following treatment, he regained almost all of the vision in his right eye but only about 55% in his left eye.

This serves as a warning about household cleaners and chemicals and the possible effects in your eyes. Some substances only burn or sting, but are relatively harmless, while others can potentially cause serious long-term injuries.

If you do get a splash of a chemical in your eye, immediately wash your eye under a steady stream of water for 15 minutes. Allow the water to run into your open eye to wash out as much of the chemical as you can. Next, call your eye doctor or go to an emergency room. Remember to tell the doctor exactly what substance got into your eye and what you’ve done about it.

Chemical burns can cause blindness, so anytime you get a foreign substance in your eye it’s important to take it seriously. The most important step is washing out your eye, then calling your eye doctor.

This information is brought to you by Clarin Eye Care. Please call or contact our office for more information.

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Tags: chemical burn, clarin eye care, Eye care professional, eye doctor, vision loss

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How I Use Intuition to Prescribe Eye Glasses

$An optical refractor (phoropter) in use.$: Image via Wikipedia

When you think about an Optometrist, it conjures up images of someone standing next to you flipping lenses in those ‘big glasses’ to find your prescription. And that certainly sums up a lot of my day, but there is much more than meets the proverbial eye.

It’s my belief that intuition as well as understanding the psychology of a patient’s response to either ‘#1 or #2′ is what makes a prescription good or bad, and what makes one Optometrist more successful in prescribing glasses versus another.

Slight hesitations or common letter mix ups tell me a lot about what you are, or are not, seeing. When I flip a lens and have my patient re-read a line on the chart, I’m watching facial expressions and body language to gauge how much that lens might have helped or if I’m headed in the wrong direction.

To me, understanding a patient’s wants and needs along with their response to the vision test is what leads me to prescribing certain glasses. No one part on its own is enough, but if I had to err, I’d rather see the body language and response time rather hearing the actual answer to “which is better, one or two?”

So if it seems like your eye doctor is going too fast or not listening to your response, often we do know what we’re doing. I know I’m trying to ‘see’ everything in order to prescribe your best vision!

This information is brought to you by Clarin Eye Care Center. Please call or contact our office for more information.

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Refraction test – All Information (umm.edu)
Two Presentations on Why Undetected Vision Problems Significantly Impact Learning (prweb.com)

Tags: contact lens, Eye care professional, Eye examination, glasses, Health, optometrist, optometry, United States

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When Should Your Child Have Their First Eye Exam?

When I ask most parents about their children’s eyes, almost all of them tell me they had an eye exam at their pediatrician‘s office. I’m here to tell you that that is far from a comprehensive eye exam.

Pediatrician’s offices are good at screening for large distance vision problems, but there is more to vision than just reading the 20/20 line. On the same note, I’ve seen a lot of kids who passed a ‘school screening,’ but get to my office and absolutely need glasses. In fact, if you just do an eye chart you miss 50% of eye problems.

Nearly all farsighted children will pass a vision screening, and most in fact won’t require glasses. But as an Optometrist with you child’s best interest in mind, I want to know their exact prescription and make sure we’re not missing any problems.

Vision is responsible for 80% of what kids learn, so it’s important to make sure they can see clearly and comfortably. That’s why I recommend every child has a comprehensive eye exam before they start kindergarten. It’s so vital to make sure your youngster starts school seeing their best, to ensure they get off on the right foot and have every advantage to excel at school.

When I do a pediatric exam, of course I test distance vision. I also test your child’s ability to use both eyes together and focus at near. I look for symptoms of headaches, trouble reading, or subtle eye turns.

Our office is very kid friendly and we work closely with many pediatricians. And even though taking your child to yet one more doctor’s appointment may seem like a chore for both of you, just know that visiting the eye doctor is not likely to be as upsetting for a youngster as visiting the pediatrician. As I tell all of the kids to put them at ease, we don’t have shots, only letters and a flashlight.

Pediatric exams are fun and rewarding for us, knowing that we are integral in your child’s overall eye and health care.

This information is brought to you by Clarin Eye Care Center. Please call or contact our office for more information.

Tags: Child, children, clarin eye care, eye care, Eye care professional, eye doctor, eye exam, Eye examination, optometrist, optometry, Pediatrics, vision, vision care

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Eye Care Is More Than Just Blurry Vision

The fear of going blind is a scary thought in most people’s minds. However, Lighthouse International conducted a new survey showing six out of seven people that are at risk for, or who currently have, eye disease do not get annual eye exams.

Some of the reasons people may forgo eye care is the cost, the fear of hearing a worst case scenario from the doctor or because they don’t experience any trouble with their vision. Of course if you wait until you experience a change in your vision, you can miss an early diagnosis of a possibly treatable or manageable disease.

For example, glaucoma and macular degeneration are two of the most common eye diseases. Both of these have almost no symptoms early on — but can cause partial blindness and a loss of function in your life. Both are also manageable, especially if they are discovered early.

These conditions are also much more likely to occur if there is a family history, so talking to your relatives and being proactive in your eye care are the two greatest things you can do. You should see an eye doctor annually if someone in your family has been diagnosed with glaucoma or macular degeneration.

Vision loss, however, isn’t the only issue. A routine eye exam can also detect many other diseases in their early stages, including diabetes, autoimmune disorders, neurofibromatosis and even brain tumors.

Routine eye exams should be performed every year for those 40 and older, not just to check for blurry vision but to make sure your eyes, and body, are healthy. Call our office today to schedule the next step in your preventative medical care.

This information is brought to you by Clarin Eye Care Center. Please call or contact our office for more information.

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Tags: Blurred vision, clarin eye care, Eye care professional, Eye disease, eye doctor, eye exam, Eye examination, eyecare, glaucoma, Macular degeneration, optometrist, optometry, retina, vision, vision care, vision loss

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Contact Lenses Can Be A Safe Option When Used Properly

In the United States, 40 million people use contact lenses to improve their vision. While most of these contact lens wearers adhere to the guidelines set out by their doctors, many do not. According to the American Optometric Association‘s annual American Eye-Q® survey, many people are putting their health and vision at risk by not following the recommendations of their eye care professionals.

According to the study, a majority of contact lens wearers overwear their lenses. This comes as no surprise to me, as a clear majority of my patients tell me they don’t follow the recommended replacement schedule. Even more alarming, more than twenty-five percent of respondents reported sleeping in their contact lenses, a major risk factor that increases complications by 15 times.

“It’s easy for patients to forget that contact lenses are medical devices and as such, should be handled with an appropriate level of caution,” said Dr. Christine Sindt, OD, FAAO, chair of the AOA’s Contact Lens and Cornea Section and Associate Professor of Clinical Ophthalmology, Department of Ophthalmology and Visual Sciences, University of Iowa. “Clean and safe handling of contacts is one of the most important measures wearers can take to protect their sight.”

According to the press release, “the AOA’s survey shows that although a majority of contact lens wearers (58 percent) clean and disinfect them with an appropriate solution, another 23 percent of respondents soak or clean lenses in water, and 12 percent store their contacts in something other than a typical storage case. Cleaning and rinsing lenses are necessary to remove mucus, secretions, films or deposits which may have accumulated during wearing, while disinfecting is required to destroy harmful germs. Water does not disinfect lenses; in fact it can actually contaminate contacts. Using something other than an appropriate case for storing lenses can allow bacteria to grow on or near contacts.”

This information is brought to you by Clarin Eye Care Center. Please call or contact our office for more information.

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Tags: clarin eye care, contact, contact lens, Contact Lenses, dr. clarin, eye, Eye care professional, eye doctor, eyecare, lenses, optometrist, optometry, vision, vision care

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The Solution to Contact Lens Trouble

At Clarin Eye Care Center, we often recommend multipurpose contact lens solutions such as Alcon’s OPTI-FREE RepleniSH, AMO Complete or the new BioTrue from Bausch + Lomb. However, according to a study in the Archives of Ophthalmology, the incidence of complications from wearing contact lenses was lowest with a hydrogen peroxide based solution, such as Clear Care.

Clear Care is our go-to solution for contact lens troubleshooting. The hydrogen peroxide liquid completely cleans your lens and is the only true no-rub/no-rinse solution on the market. When you take your lenses out of the solution, they are as close to a fresh lens as you can get, allowing you to wear them more comfortably for more hours in the day.

There is, however, a reason hydrogen peroxide solutions haven’t become commonplace in the market. The actual hydrogen peroxide will burn if you get it in your eyes. Therefore a bit more care has to be taken when taking out and putting in your lenses. The solution needs to sit in the lens holder to create a chemical reaction and turn the hydrogen peroxide into water and oxygen. This process take six hours (overnight), and afterwards the lenses and remaining solution can go directly into your eyes. This is different from the multipurpose solutions most people are used to. You cannot store your lenses in a standard lens case with the hydrogen peroxide, it must go in the vile that comes with the solution. But again, it’s worth it. Your lenses will be cleaner and more comfortable afterwards.

If you wish your lenses were more comfortable, if you can’t wear lenses all day or if you have repeated complications with contact lens wear, talk to your doctor about switching your solution to find the solution.

This information is brought to you by Clarin Eye Care Center. Please call or contact our office for more information.

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Tags: clarin eye care, contact lens, Contact Lenses, contacts, cornea, dr. clarin, eye, eye care, Eye care professional, eye exam, eyecare, infection, optometrist, solution, vision, vision care

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Parents: Top Tips For Infant Eye Health

You can never take for granted the health of an infant. It’s imperative for parents to understand some preventive measures that can be taken to keep their babies healthy. In some cases failure to identify early eye symptoms can result in vision loss and even blindness. That’s why a new Pediatric Cataract Initiative has been formed to identify, fund and promote innovative methods of overcoming pediatric cataracts for the long-term benefit of children, their families and their communities.

“Dr. Joseph Barr is a world-renowned optometrist and a member of the global advisory council for the Pediatric Cataract Initiative, a new initiative from the Bausch + Lomb Early Vision Institute and Lions Clubs International Foundation. He shares the following tips to help parents identify vision problems during those first critical months of life:

Dr. Barr recommends that children be given an eye exam before their first birthday; if there is a significant family history of eye problems, then he recommends an eye exam during the first six months. He points out that, “Eye care professionals offer different recommendations on when that first eye exam should take place for a child. While opticians, ophthalmologists and pediatricians may differ in their point of view, I personally like to see my grandchildren get their eyes checked within the first 12 months. An infant’s visual system is developing so rapidly in the first year that any abnormalities in vision can have long-term effects if not identified and corrected quickly.”

During the first few months of life, many babies appear to have misaligned eyes – but this is not usually the case. It’s often an illusion caused by the relatively large size of their eyes. However, there can be conditions that result in misalignment. Crossed eyes occur at a rate of about four percent in the general population. Another approximately three percent of children are eventually diagnosed with amblyopia. Sometimes referred to as “lazy eye,” amblyopia prevents both eyes from working together to produce consistently aligned binocular vision, thus hindering the development of a normal visual pathway. Signs to look for are children covering up or closing their eye or tilting or turning their head to favor one eye. If a child is showing these signs, they should visit an eye care practitioner right away, since amblyopia and crossed eyes can result in certain problems such as distorted depth perception. Early diagnosis and correction is important to prevent long-term vision problems.

At birth or soon thereafter, a doctor will examine infants for a “white pupil” instead of the normal black pupil in both eyes; this often identifies a pediatric cataract. If your baby does show signs of cataract, removal of the cataract and follow up care in the first weeks and months of life is important; failure to act or delay in treatment can lead to loss of vision or functional blindness. In the United States, incidence of pediatric cataract is relatively rare, although it is a more common problem in developing countries.”

For more information on Dr. Barr and the Pediatric Cataract Initiative, visit www.PediatricCataract.org.

This information is brought to you by Clarin Eye Care Center. Please call or contact our office for more information.

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Tags: amblyopia, cataract, clarin, clarin eye care, dr. clarin, eye, eye care, Eye care professional, eye exam, Eye examination, eyecare, infant, optometrist, pediatric, vision, vision loss

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Lower Your Risks

Did you know that sleeping in your contact lenses is the single biggest risk factor for contact lens-related complications? Everyday I see patients with red, painful eyes due to over wearing their contact lenses. Some mistakenly think they just need a fresh lens, but what is going on is potentially blinding.

Your eyes only receive oxygen from the air. When you wear a contact lens, the amount of oxygen getting through is reduced. And although advances in contact lens materials have allowed more oxygen to pass than ever before, any lens lowers the ultimate amount. And when your eye is closed, that amount drops to almost zero. Your body tries to bring more oxygen to your cornea in the form of growing new blood vessels, which is why people who sleep in their lenses generally have redder eyes. But theses new vessels are weak and can ultimately threaten your eyesite.

Another potential and more serious complication is a bacterial infection, called microbial keratitis. This infection is most commonly caused by a bacteria such as pseudomonas, which can live and grow on your lens. Pseudomonas, for instance, can make a hole through your cornea within 24 hours. If these infections are not treated seriously, scarring can permanently affect your vision and may even lead to a corneal transplant.

Anytime a contact lens patient, especially someone who sleeps in their lenses, has any redness or discomfort they need to see their eye doctor immediately. With the potential for serious complications, contact lens wearers need to be responsible and alert. The best predictor of good outcomes in these cases is early treatment and intervention. If your eye is red or doesn’t feel right, do not put in your contact lenses, call your Optometrist promptly.

This information is brought to you by www.clarineyecare.com. Please call or contact us for more information.

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Tags: contact, contact lens, Contact Lenses, cornea, eye, eye care, Eye care professional, lens, optometrist, optometry, vision

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