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Amblyopia

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.

Sports Vision

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.
 

What’s involved in sports vision training?

Sports vision training refers to a personalized treatment plan that is designed to train the brain to achieve maximum efficiency in the way that it receives, processes, and responds to visual input. Exactly what is involved in your sports vision training will depend on your athletic activity and the visual skills that your eye doctor identifies for improvement after comprehensive sports vision testing. Your treatment program will use a variety of tools, techniques, and exercises. You may also be asked to complete some exercises at home to further enhance your progress. With sports vision training, the ultimiate goal is for athletes to continue to see faster and clearer, giving them a distinct competitive edge. 


For more information about sports vision and how it can benefit amateur and professional athletes, please contact our team.

Types of Daily Contact Lenses

Wearing contact lenses gives patients the flexibility and freedom to live life to the fullest, without some of the difficulties presented by wearing glasses. Many people who choose contact lenses do so because they don’t like the way that glasses look or feel, or because wearing glasses compromises their ability to perform certain tasks or activities, such as sports or jobs that require the use of safety goggles. 

There are lots of different contact lenses to choose from, with two of the most popular being daily disposables and toric lenses. 
 

Disposable Lenses

As their name suggests, these daily contact lenses are disposable. This means that they can and should be discarded at the end of each day rather than re-worn. Disposable lenses do tend to be a little more expensive than some repeat-wear varieties, but the benefits usually outweigh the cost. 

Some of the advantages of choosing daily disposable contact lenses include:

  • You don’t have to clean them, which saves patients a great deal of time and hassle. It also helps save money in terms of the ongoing cost of cleaning solution. 

  • Disposable lenses are also great for people with eye allergies. This is because with ordinary lenses, there’s an opportunity for deposits and microorganisms to build up. With daily disposables, allergens have less chance to attach themselves to the lenses and cause irritation and other allergy symptoms. 

 

  • You don’t need to schedule regular replacements either, which makes wearing contact lenses easier on your schedule. 

  • Disposable contact lenses are particularly good for people who have busy lives and are likely to cut corners when it comes to caring for their eyes or contacts since there is no cleaning or maintenance required.


Daily disposable contact lenses are available in a wide range of prescriptions, including those for patients with nearsightedness and farsightedness. Your eye doctor will be able to advise you if you are a candidate for disposable contact lenses. 
 

Toric Lenses

Toric contact lenses are recommended for patients who have a refractive eye problem called astigmatism. Patients with astigmatism have corneal abnormalities that cause the refraction of the eye to be different between the vertical and horizontal planes, causing blurred vision and difficulty seeing fine details. Toric contact lenses are shaped in a particular way that creates the different focusing powers needed in each part of the lens to correct your vision. For this reason, it’s essential that Toric lenses are placed into the eyes in the correct position. Fortunately, manufacturers design Toric lenses with features that help them to stay in place, including:

  • Thin/thick zones

  • Creating areas of the lens that are thicker or heavier which helps secure it in position 

  • An area where the bottom of the lens is slightly cut off 


To keep them stable, Toric lenses are a little firmer than conventional soft lenses. This means that some patients can find them a little less comfortable, but the superior vision they obtain outweighs this. Your eye doctor will be able to advise you if you are a good candidate for Toric contact lenses and which variety would best suit you. 


To find out more about daily contact lenses, speak to our friendly and knowledgeable team. 

LASIK Surgery

LASIK (laser-assisted in situ keratomileusis), is the most popular refractive surgical procedure. In this procedure, a laser is used to permanently change the shape of the cornea (the clear covering on the front of the eye) to correct common vision problems such as nearsightedness, farsightedness, astigmatism, and presbyopia. This improves vision and reduces a person's need for glasses or contact lenses.

LASIK uses an excimer laser (an ultraviolet laser) to remove a thin layer of corneal tissue, giving the cornea a new shape, so that light rays are focused clearly on the retina. In the case of a nearsighted person, the goal of LASIK is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more normal shape.

LASIK is an outpatient surgical procedure with no need to stay at the surgery center overnight as it will take 10 to 15 minutes to perform for each eye. The procedure is done while the patient is awake, but the patient may request mild sedation. The only anesthetic used is eye drops that numb the surface of the eye. LASIK can be done on one or both eyes during the same session.


How to Prepare for LASIK Eye Surgery?

Before LASIK eye surgery, the eye surgeon will evaluate the patient’s medical history and perform a full eye examination, including measuring corneal thickness, refraction, corneal mapping, eye pressure, and pupil dilation. Afterward, the surgeon will discuss what to expect during and after the procedure.

On the day of the surgery, eat a light meal before going to the doctor and take all prescribed medications, if any. Do not wear eye makeup, creams, perfumes or lotions on the day before and the day of surgery, or have any bulky hair accessories that will interfere with positioning head under the laser.

Contact lenses shouldn't be worn for at least three days prior to the evaluation. In the case of, rigid gas permeable contact lenses, they should not be worn for at least three weeks before. Patients should arrange for a ride home from the place of surgery, as their vision might be blurry.
 

Refraction Test

A refraction test, also called a vision test, is usually performed as a part of a routine eye examination. The purpose of this test is to determine if a person has a refractive error which would then mean the patient would need glasses or contact lenses.
 

What Is The Normal Value for Refraction Test?

A value of 20/20 is normal (optimum) vision. This means that individuals who have 20/20 vision are able to read letters that are 3/8-inch (1 centimeter) tall from 20 feet (6 meters) away. The normal uncorrected vision (without glasses or contact lenses) refractive error is zero (plano). Individuals who don’t have 20/20 vision, have what is called a refractive error. A refractive error means that the light is not bending properly when it passes through the lens of the eye. The refraction test will tell the doctor what prescription lens should be used in order to have 20/20 vision.

For people over age 40 who have normal distance vision but difficulty with near vision, a refraction test with a small type size is used to determine normal near vision and the correct power of reading glasses.
 

How Is The Refraction Test Performed?

The test is performed by having the patient seated in a chair that has a special device (called a phoropter or refractor) attached to it. The patient looks through the device and focuses on an eye chart 20 feet (6 meters) away. The device contains lenses of different strengths that can be moved into the patient’s view. The test is performed one eye at a time. If the patient is wearing contact lenses, they should be removed before the test.

In case the final vision is less than 20/20 even with lenses, then there is probably another non-optical problem with the eye. The vision level achieved during the refraction test is called the best-corrected visual acuity (BCVA).
 

What Are The Causes of Abnormal Refraction Test Results?

  • Abnormal results may be due to:

  • Astigmatism (abnormally curved cornea causing blurred vision)

  • Hyperopia (farsightedness)

  • Myopia (nearsightedness)

  • Presbyopia (inability to focus on near objects that develop with age)
     

Other conditions under which the test may be performed:

  • Corneal ulcers and infections

  • Loss of sharp vision due to macular degeneration

  • Retinal detachment (separation of the light-sensitive membrane (retina) in the back of the eye from its supporting layers)

  • Retinal vessel occlusion (blockage in a small artery that carries blood to the retina)

  • Retinitis pigmentosa (an inherited disorder of the retina)
     

There is an art to refraction and the optometrist will always answer the patient’s questions and as well as discuss their findings. Based on the results of the refraction test, they can determine the amount of myopia, hyperopia or astigmatism.
 

Keratoconus and Your Treatment Options

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.

Optical Coherence Tomography

Optical Coherence Tomography is a non-invasive imaging test that may be performed as a standard part of your regular, comprehensive exams, or you may be able to request this test as an addition to your usual exam.
 

Optical Coherence Tomography uses light waves to take cross-section images of your retina, which is the area of light-sensitive cells at the back of your eye that is responsible for receiving light and transmitting it into messages that are sent up to the brain. The technology behind OCT enables your eye doctor to see each of the different layers that make up the retina. By being able to see these and measure them, they can obtain a much clearer picture of the overall health and condition of your eyes.

Why are Optical Coherence Tomography scans important?

When you choose to have an OCT scan at fairly regular intervals, such as during your normal comprehensive eye exams, your eye doctor can compare newer results to previous ones. This helps them to build up a picture of the health of your eyes, and spot any changes which may be concerning, early, before they cause symptoms or have a permanent effect on your vision. 
 

Anyone can have an OCT scan, but they are particularly recommended for patients over the age of 25 who are concerned about the health of their eyes, or who are at risk of or already have diabetes, glaucoma or a family history of eye disease. This is because they can be used to spot the early signs of a range of eye diseases, including glaucoma, diabetic retinopathy, macular degeneration, disorders of the optic nerve and more – even before you realize that you are affected.

What happens during an Optical Coherence Tomography scan?

An OCT scan is a quick, painless experience. To prepare you, your eye doctor may require you to have eyedrops that will dilate your pupils and make it easier to see your retina. This means that the scanner will get clearer, more concise images. You’ll be asked to sit in front of the OCT machine where you will rest your head against a support to help you sit perfectly still. As you stare ahead, the equipment will perform the scan of your eyes. There is no contact with your eyes whatsoever, you will just need to sit still, with your eyes open as much as possible during the process, which usually takes less than 10 minutes. The images will be sent digitally to your eye doctor for them to assess immediately and stored digitally on your personal record.
 

There’s no downtime after an OCT scan, but if you have had your eyes dilated you may find that you are particularly sensitive to light for a few hours afterwards. This occurs because the pupils remain wider and therefore able to let more light in that usual.
 

If you would like to find out more about Optical Coherence Tomography, don’t hesitate to speak to our professional eyecare team.

Optikam

Eye care professionals use Optikam’s technology to capture more than 3 million eyewear measurements every year. The OptikamPad iPad app is a total dispensing solution that enables eye care professionals to successfully assist patients at all stages of the eyewear dispensing process, providing them with a unique and custom patient experience.

 

Optikam Posture Devise (OPD)

You may be surprised to learn that wearing glasses can and likely will affect your posture. Glasses lenses are most accurate when you look directly through their center. This means if your glasses are sitting too low or have slipped down your nose, you may find that you are subconsciously tilting your head back and this can affect your overall posture.

 

Optikam’s OPD measurement device is a cutting-edge tool that obtains eyewear measurements that take into account how the frame will be worn by patients, enabling the fit to be customized to their individual parameters. The ten measurements taken into account when determining each patient’s position of wear include:

-          Monocular pupillary distance

-          Multifocal seg heights

-          Pantoscopic tilt

-          Rear vertex distance

-          Wrap (face form tilt)

-          Near pupillary distance

 

This results in frames that not only look fantastic, but that also fit perfectly, remaining both comfortable and stable on the face without you needing to adopt an unnatural posture. The measurements obtained by the Optikam OPD measurement tool are immediately visible on your eye doctor’s tablet so that they can recommend which alterations to the frames are needed to ensure that the frames fit with precision and gives you the best visual experience.

 

Benefits of OptikamPad and Optikam OPD

Traditionally, the process of a comprehensive eye exam, choosing frames and fitting glasses requires fairly close contact with your eye doctor or other eye care professionals. However, with social distancing being a new process variable, many patients are looking for more virtual options. Fortunately, OptikamPad makes it possible for optical stores to dispense eyeglasses with minimal human contact. This is because the OptikamPad can take measurements from a further distance or even through plexiglass screens. It can even be placed on a stand and the app operated using a Bluetooth mouse, putting even greater distance between your eye care professional and you. 

If you would like to find out more about Optikam OPD and OptikamPad, our knowledgeable team would be delighted to help. Please contact us with any questions or to schedule an appointment.

Importance of Routine Eye Exams

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

Corneal Refractive Therapy

Corneal refractive therapy, also known as CRT, is a simple, painless treatment for refractive eye errors like myopia and has two core benefits. First, it can be used to help patients see clearly during the day without using glasses or contact lenses, giving them the freedom and flexibility that they need to live life to the fullest. Second, CRT has been shown to help slow the progression of myopia, keeping prescriptions under control and potentially reducing the likelihood of patients developing serious eye health problems associated with high myopia in the future. 

Here’s everything that you need to know about corneal refractive therapy and what it means for you. 


Understanding refractive eye problems

Refractive eye problems like nearsightedness, farsightedness and astigmatism are extremely common, with nearsightedness – also known as myopia – being the most common of all. Patients with myopia can see nearby objects clearly, but those further away become progressively more blurred. Refractive eye errors occur when the shape of the clear dome covering the front part of the eye, called the cornea, impair the light-bending and focusing process in your eyes. This leads to the light ending up in the wrong place inside the eye, and the message that is sent to our brain from our eyes is muddled, causing blurred vision. 
 

What is corneal refractive therapy?

Corneal refractive therapy was initially developed as a treatment to correct and slow the progression of nearsightedness. However, it has also been found to be effective at controlling other refractive errors, including farsightedness, astigmatism and an age-related refractive condition called presbyopia.

CRT is a non-invasive, painless and straightforward method of correcting patient vision so that they don’t need to wear contacts or glasses, and they don’t need laser vision correction surgery to see clearly. CRT uses special contact lenses that are worn overnight and apply light pressure to the cornea in order to reshape it so that light is refracted correctly, and the image sent from the eyes to the brain is clear. The cornea is able to retain this new shape even after the contact lenses are removed the next morning, meaning that you can continue to see clearly for several hours. The more consistently you wear your CRT lenses overnight, the longer your eyes will learn to retain their new shape and eventually, patients can enjoy up to 48 hours of clear vision without using prescription lenses. However, the effects aren’t permanent so if you stop wearing the lenses, your vision will gradually return back to normal over the course of a few days. 


Slowing the progression of myopia with corneal refractive therapy

Another key benefit of CRT is that it can actually help to slow the progression of myopia. Most people who are nearsighted find that their eyesight gets progressively worse as they get older. This deterioration may not be rapid, but it can end in patients requiring high prescriptions. Studies have found that patients who have high myopia are more likely to develop serious eye problems in the future, including glaucoma, macular degeneration, cataracts and a detached retina. Regular use of your corneal refractive therapy lenses could help keep your prescription stable and lower your risk of developing these problems. 


Am I a candidate for corneal refractive therapy?

You may be a candidate for corneal refractive therapy if you:

  • Have a myopia prescription within specific parameters

  • Have a prescription for hyperopia, presbyopia or astigmatism within specific parameters

  • Have stable vision, which means that your prescription hasn’t changed during the last two years

  • Are not a suitable candidate for laser vision correction

  • Have a job that makes it impractical or unsafe to wear glasses or contact lenses

  • Enjoy hobbies that make it impractical or unsafe to wear glasses or contact lenses

  • Have healthy eyes and are generally in good health



For more information, please contact our friendly and knowledgeable team today.  

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