Brother #1 noticed some “gnats” moving around in his vision like he was looking through a snow globe. After they didn’t go away for a few days he called his older brother, the eye doctor, who told him he needed to be seen immediately. Long story short he had a large retinal detachment. Same day major surgery with significant recovery no doubt saved his eye but vision is now 20/100.
Brother #2 texted me: “What are you doing today?” “Running like crazy. Full schedule of patients. What’s going on?” “I have some new floaters.” “Alright dilate yourself (brother #2 is the eye doctor after all) and stop in during your lunch break.” It’s always an extra honor when an eye doctor trusts me with such a serious condition.
My staff was not impressed when I told them I was squeezing in yet another patient. I assured them that he will dilate himself so we don’t have to wait the 20 minutes for the drops to work and I don’t have to explain what’s going on–he already knows. All to well.
Turns out brother #2 had a retinal tear in his right eye. Fortunately no fluid had accumulated underneath causing a retinal detachment. A 10 minute laser procedure to “spot weld” the area around the tear and he was back to work.
Quick action meant his vision was saved.
If you experience new floaters or flashes of light, you have to come in immediately.
Because they don’t work as well as a highly skilled optician with years of experience.
Listen: we love gadgets, gizmos, and technology more than anyone and love implementing it into our office. However, there is a huge difference between flashy computerized whatchamadoodles to look cool vs. useful high tech.
If I were running an optical business online, or with hundreds of locations around the world, I would absolutely implement the measuring by computer image only. Why? I could bring someone in off the street and within 5 minutes teach them how to run the computer. It is difficult and expensive to train opticians on all the subtleties of frame selection, adjustment and measurements.
Our product is caring, and we care about achieving the perfect fit. Every time.
Most folks’ eyes are near identical twins of each other and if not twins at least similar enough to be siblings. If you’re someone who has different prescriptions between the two eyes, this post is for you. How do you know? Well your lenses may be different thicknesses or you may notice a significant difference in power written on your contact lens boxes. You may be bored or get headaches when trying to watch 3D movies.
The problem that this difference creates is called aniseikonia. The problem with aniseikonia is more than just how do you spell it or say it. The problem is that one eye sees an image of one size and the other eye sees an image of a different size. When your brain tries to put these two images together, it gets confused and mad leading to eyestrain, double vision, and headaches.
Enter the SHAW lens.
Eyeglasses made with the SHAW lens are the only spectacles available that correct aniseikonia. Enough flowery prose; let me tell you about a few of our patients.
Annie (not her real name) was a sweet 10 year old when I first saw her as a patient. Her father, a local general surgeon, had chatted with me about her over the past few years. She has amblyopia or “lazy eye” due to a big difference in prescription between the two eyes. She would never wear her glasses and no amount of patching or drops or visits to specialists over the past 4 years could get her seeing better. Long story short: we put her in SHAW lenses and every time I see her around town, she’s smiling and wearing her glasses. Her vision is improved and she’s starting to use both eyes together.
Bob is a retired Californian in his early 70s. He’s worn glasses since the 3rd grade and never goes a waking moment without his specs. He is very far sighted with lots of astigmatism and a moderate difference in prescription between the two eyes. Three days after picking up his glasses, I received this email:
“You need to know this is the first time in some 50 years or so of wearing glasses that I have not suffered from what was thought to be irritable bowel syndrome, some levels of nausea and other tension related issues. It is like a whole new world for me emotionally. You can use that statement plus my name and reference if you want to do so.”
Above is a printout for Bob’s glasses using the SHAW software. On the left is a standard set of progressives and the right is his SHAW optimized lenses. This shows that we have doubled the field of vision Bob can use with both eyes together. On the bottom, the red dots moving to green show him going from double vision to clear, comfortable and single vision.
With a money back guarantee (which we have never had a patient take us up on because they all love their lenses) we love ’em. Learn more at www.shawlens.com
It’s always fun when my buddies come and see me at the office. They always put stuff on their history form like they’re pregnant or allergic to bullets just to see if I pay attention.
I’ve also noticed a pattern. They ask how I’m doing and I go: check this out and pull out the iPad to show them cool eyeballs that I just saw. Of course there is nothing to identify the patient in the photo so if you’re looking to hit the HIPAA whistleblower lottery, you’re gonna have to keep looking.
Without further ado I present a short collection of cool eyeballs where most everyone simply came in complaining that their eyes were irritated.
[fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]Bullseye! I love this patient. He thought his eye had been hurting for four days because he had a stye. Nope-chunk of metal dead center of your cornea my friend.
[/fusion_builder_column][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]We often use cobalt blue light and sodium fluorescein dye to highlight irregularities on the ocular surface. See that faint line yellow line running behind the eyelashes? It’s called the Line of Marx (different guy – save the Obama comments). This buildup of dead cells works like a dam blocking beautiful olive oil consistency tears from lubricating your peepers.
[/fusion_builder_column][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]This 6 year old was sent over from the pediatrician. No it’s not melanoma – just a little flat rock that was really suctioned on.
[/fusion_builder_column][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]“Got some metal in my eye, waited three days, went to ER, they took it out, but a week later and it still hurts.” Yep-gotta get the rust out and that ain’t happening at the ER, Urgent Care, Primary Care doc, etc.
[/fusion_builder_column][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]Uhmm. Ouch. You know how your lips get chapped? Yeah your cornea can sort of do that too when it gets really dry. This one was sad because this lady was in her 70s with long term Diabetes damage so her nerves are jacked up preventing the eye from helping heal itself.
[/fusion_builder_column][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]Lard, butter, crisco take your pick for the analogy. Once again, those glands along the eyelid are supposed to secrete olive oil (vegetable oil, Wesson oil, etc.) consistency tears. If the glands ain’t happy-ain’t nobody happy.
So what’s the point of all this? Eyeballs are neato and irritated eyes can be caused by lots of different things.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
Wow. We’ve had a handful of patients today asking us about this and it’s not even 11 am. The short answers are: this is not quite ready for prime time and no doctor can simply look in your eye and tell you Alzheimer’s yes or no.
The study out of Australia being cited only had 40 patients. For something this large and important, we need thousands of patients to be studied.
On to the good news:
Just a few years ago researchers were excited and publishing results in postmortem eyes and mice eyes. So to move to results in real live humans so quickly is very encouraging.
[fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”]Much easier and less invasive than traditional PET scans
The patient gets a retinal photograph using a specialized camera developed by NeuroVision Imaging LLC and software developed at Cedars-Sinai Medical Center in Los Angeles. They then take a dietary supplement containing curcumin. The next photograph is compared to baseline and the curcumin stains the beta amyloid plaques which are the hallmarks of Alzheimer’s.
Because the retina is an extension of the brain, the plaques are present in retinal tissue as well as the brain. Doctors have been using these plaques to diagnose Alzheimer’s for years using PET scans which are expensive and much less friendly. The other exciting aspect is the thought of detection 15-20 years sooner using this device compared to a PET scan.
Now whether or not patients want to know they are in the early stages of Alzheimer’s is a Pandora’s box beyond the scope of this post.[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
I’m not much of a traveler but I’ve flown 24+ hour trips at least a half dozen times and will embark on the next ones in late January when we head back to Cambodia.
The internet is full of advice on how to make long haul flights more enjoyable (ie: drink heavily before boarding and chase with NyQuil) but I figured I’d throw out some pointers specifically relating to the eyes.
1. Take out your contacts. The humidity in most planes is below 10%. Even compared to mile high Prescott, that’s dry.
2. Use lubricating drops before you need them. In much the same way it is better to use lotion before your hands are cracked and bleeding, it is better to use eye drops before your eyes feel like a campfire in the middle of the Sahara. My favorite brand is Systane. A drop in each eye before boarding, after eating, and after waking up works great.
3. Bring along your computer glasses. If you don’t have computer glasses then you’re working your eyes harder than you have to while reading this….but that’s for another post. Most long haul flights have personal TVs (AVOD: audio and visual on demand) and those are about the same distance as your computer monitor.
4. Drink water. I know you don’t want to have to try to maneuver inside those tiny lavatories (who in the world calls ‘em lavatories outside the airplane world anyway?) or bother your seatmates but this is more important than those annoyances. Oh and for some more lavatory laughs, check out Mike Rowe’s (from Dirty Jobs fame) Facebook post.
Drink water the day before travel and the day of. If you start out well hydrated, then you don’t have to try and make up for it on the plane (bad idea). This is especially important as caffeinated beverages and alcohol are diuretics and dry you out.
5. Take a nap and use your eyeshades. These will help prevent further drying of the eyes (notice a theme?). Along with super dry air, the cabin has air constantly flowing through it. You might not feel this breeze but your eyes do.
6. Buy a first class seat. Your eyes will feel much better I’m sure.
It seems so simple yet most of us can’t seem to get it right so a refresher course is in order.
Below are some helpful tips from our website but let me add some “blog extras.”
*Do NOT reuse solution* Let me reiterate that: do not “top off” the solution in your case. Each time you take your contacts out of your case, you should dump the solution out and let the case air dry. Here’s how I recommend leaving your case:
That lets the case air dry. If you just lay it face down on the counter, all the solution won’t evaporate. If you lay it face up, your wife’s hair spray will probably land in the case.
Run your case through the dishwasher every few weeks to clean it.
Wear one day contacts and you don’t have to keep up with how old your contacts are or worry with solution.
Helpful tips for contact lens wear
Always wash and dry your hands before handling contact lenses. Non-moisturizing soaps are preferred as they do not leave a film on the contacts.
Use only the products recommended by our doctors. We have selected the best cleaner/storage solution for you based on your prescription, type of contacts and health of your eyes. Saline and rewetting drops are not designed to disinfect lenses.
Use only fresh solution. NEVER re-use solution.
Clean the storage case after each use, and keep it open and dry between cleanings.
Always follow the recommended lens replacement schedule prescribed by our doctors. Waiting until lenses feel irritated means microscopic damage has already occured to the lens and your eyes.
It is always best to not sleep in your contacts. If you must, inform our doctors so they can work with you to find the best options available.
Put on lenses before makeup, lotions or creams to limit the chance of getting those in your eyes or on your contacts. Take lenses out before removing makeup.
On the rare chance your eyes become red, irritated, painful or your vision becomes blurry, remove the lenses and call our office.
What gets me up on a Monday morning? Beautiful sunrise, smiling kids, gorgeous wife, coffee? All of the above help but what really gets me moving is knowing I get to ask people, “Which is better one or two?” And knowing that the best answer is, “About the same.” Pure torture 🙂
So what’s really going on when we’re doing the lens monster dance?
Well we’re trying to adjust light rays such that once they are refracted by the cornea and crystalline lens they are converged onto the fovea. Then we reduce the Interval of Sturm to correct any astigmatism. You asked.
“Oh no. I said 3 when I really meant 4 was clearer.” Don’t worry. It’s not only what you say behind the lens monster that goes into your prescription that I’m developing. I use your old Rx, what my instruments tell me, plus what you tell me to determine your prescription. Technicians, nurses, and doctors who can’t Rx glasses and contacts worth a darn only use what you tell them.
“Why is my contact lens prescription different than my glasses prescription?” For one contacts must be fit to your eye as they are a medical device. Different brands, different base curves, etc. all factor in. For the difference in power it is simple optics. As the lens (eyeglass or contact lens) is moved closer to the retina, it needs less minus power. You’ll notice that your contact lens prescription will be less minus or more plus power than your eyeglasses prescription.
So when I think I’m funny and use big technical words to describe eyeglasses prescription determination, then this happens:
I love being a Lion. Lions Clubs International is made up of over 1.3 million individuals around the world who live the motto “We Serve.” Maybe you’ve seen us around town wearing bright gold vests while collecting food for the food bank, money for the visually impaired or hosting a dinner for outstanding high school students.
Please join us in one of our biggest worldwide projects: eyeglasses recycling. It’s very simple. You have glasses and millions of people around the world don’t. We work alongside Lions Sight & Hearing Foundation in Phoenix and ALERT in Tucson.
Glasses simply need to be usable. They can be used, but broken and destroyed can’t be reinvigorated. Even non prescription sunglasses and over the counter reading glasses are highly valuable.
Here’s just one example of a pair of glasses traveling from Prescott, AZ to Banlung, Cambodia. This seamstress was using broken glasses since that was all she had. Living in the middle of no where she couldn’t get glasses and even if she did they would cost her about two weeks worth of wages.
Simply bring your eyeglasses (and hearing aids) into our office and we will get them to where they need to go. In fact Dr. Sullivan or I may hand deliver them to someone on the far side of the globe.
-JB
Oh and if you ever want to be my guest at a meeting of the Prescott Sunrise Lions Club, let me know. Thursdays 7am at Waffles N More on Iron Springs Road. Breakfast is on me 🙂
Our new Optovue iVue is a Spectral Domain Optical Coherence Tomographer or SD-OCT if you prefer. If you want to know how it works you’ll probably need to get a PhD in electrical engineering and applied physics. Fortunately much like you don’t have to understand internal combustion to drive a car, you can think of the SD-OCT as working like magic.
Measurements are painless and take only a moment. 26,000 measurements per second means we get much more detail than even the highest sensitivity MRI. Dr. Sullivan are able to show you each of the 10 layers of your retina. Not impressed? The entire thickness of your retina is around one fourth of a millimeter.
Who cares? Different layers are affected by different problems: glaucoma vs. macular degeneration vs. diabetes to name a few.
So here’s a patient we saw recently. She was sent over from her rheumatologist because she is taking medications which are known to potentially cause eye problems.
Unrelated to her rheumatoid arthritis and high risk medications, she was found to have normal tension (low pressure) glaucoma. These are tough because patients say “How can I have glaucoma? My eye pressure has always been good and I’m seeing fine.” High eye pressure is only one risk factor for developing glaucoma and peripheral vision loss is very insidious. We now have her on treatment to halt her vision loss.
This new scanning laser is one more piece of equipment that we have invested in because you’re worth it. Fortunately no instrument can substitute for a knowledgeable and caring doctor, but it sure is nice to have them help us out.
