If you are seeing the 3 F's, you might have a retinal tear or detachment and you should have an eye exam quickly.

The 3 F's are:

• Flashes - flashing lights.
• Floaters - dozens of dark spots that persist in the center of your vision.
• Field cut – a curtain or shadow that usually starts in peripheral vision that may move to involve the center of vision.

The retina is the nerve tissue that lines the inside back wall of the eye and if there is a break in the retina, fluid can track underneath the retina and separate it from the eye wall. Depending on the location and degree of retinal detachment, there can be very serious vision loss.

If you have a new onset of any of the three symptoms above, you need to get in for an appointment fairly quickly (very quickly if there are two or more symptoms).

If you have just new flashes or new floaters you should be seen in the next few days. If you have both new flashes and new floaters or any field cut, you should be seen in the next 24 hours.

When you go to the office for an exam, your eyes will be dilated. A dilated eye exam is needed to examine the retina and the periphery. This may entail a scleral depression exam where gentle pressure is applied to the outside of the eye to examine the peripheral retina. Some people have a hard time driving after dilation--since the dilating drops may last up to 6 hours, you may want to have someone drive you to and from your appointment.

If the exam shows a retina tear, treatment would be a laser procedure to encircle the tear.

If a retinal tear is not treated in a timely manner, then it will progress into a retinal detachment. There are four treatment options for retinal detachment:

• Laser.  A small retinal detachment can be walled off with a barrier laser to prevent further spread of the fluid and the retinal detachment. 
• Pneumatic retinopexy. This is an office-based procedure that requires injecting a gas bubble inside the eye.  The patient then needs to position his or her head for the gas bubble to reposition the retina back along the inside wall of the eye. A freezing or laser procedure is then performed around the retinal break. This procedure has about 70% to 80% success rate, but not everyone is a good candidate for a pneumatic retinopexy.
• Scleral buckle.  This is a surgery that needs to be performed in the operating room. This procedure involves placing a silicone band around the outside of the eye to bring the eye wall closer to the retina. The retinal tear is then treated with a freezing procedure. 
• Vitrectomy. In this surgery, the gel - the vitreous inside the eye - is removed and the fluid underneath the retina is drained. The retinal tear is then treated with either a laser or freezing procedure. At the completion of the surgery, a gas bubble fills the eye to hold the retina in place.  The gas bubble will slowly dissipate over several weeks.  Sometimes a scleral buckle is combined with a vitrectomy surgery.

Prognosis

The final vision after retinal detachment repair is usually dependent on whether the center of the retina - called the macula - is involved. If the macula is detached, then there is usually some decrease in final vision after reattachment. Therefore, a good predictor is initial presenting vision. We recommend that anyone with symptoms of retinal detachments (flashes, floaters, or field cuts) have a dilated eye exam. The sooner the diagnosis is made, the better the treatment outcome.

Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Fall brings a lot of fun, with Halloween bringing loads of it.

But did you know that some Halloween practices could harm your vision? Take Halloween contacts, for instance. They vary widely, with everything from monster eyes to goblin eyes to cat eyes to sci-fi or  glamour looks. They can be just the added touch you need for that perfect costume. However, some people do not realize that the FDA classifies contact lenses as medical devices that can alter cells of the eye and that damage can occur if they are not fit properly.

Infection, redness, corneal ulcers, hypoxia (lack of oxygen to the eye) and permanent blindness can occur if the proper fit is not ensured. The ICE, FTC, and FDA are concerned about costume contacts from the illegal black market because they are often unsafe and unsanitary. Proper safety regulations are strictly adhered to by conventional contact lens companies to ensure that the contact lenses are sterile and packaged properly and accurately.

Health concerns arise whenever unregulated black-market contacts come into the US market and are sold at flea markets, thrift shops, beauty shops, malls, and convenience stores. These contacts are sold without a prescriber's prescription, and are illegal in the US. There have also been reports of damage to eyes because Halloween spook houses sometimes ask employees to share the same pair of Halloween contact lenses as they dress up for their roles.

So the take home message is, have a great time at Halloween, and enjoy the flare that decorative contacts can bring to your costume, but get them from a reputable venue and be fit by an eye care professional with a proper legal prescription. Don't gamble with your eyes for a night of Halloween fun!

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

The eye holds a unique place in medicine. Your eye doctor can see almost every part of your eye from an exterior view. Other than your skin, almost every other part of your body cannot be fully examined without either entering the body (with a scope) or scanning your body with an imaging device (such as a CAT scan, MRI, or ultrasound).

This gives your eye doctor the ability to find many eye problems just by looking in your eye. Even though that makes diagnosing most problems more straightforward than in other medical specialties, there are still many things you can do to get the most out of your eye exams. Here are the top 7 things you can do to get as much as possible out of your exam.

1) Bring your corrective eyewear with you. Have glasses? Bring them. Have separate pairs for distance and reading? Bring them both. Have contacts? Bring them with you and not just the lenses themselves but the lenses prescription, which is on the box they came in. What we most want to know is the brand, the base curve (BC) and the prescription. If you have both contacts and glasses bring BOTH--even if you hate them.  Knowing what you like and hate, can help us prescribe something that you will love.

2) Know your family history of eye diseases. There are several eye diseases that run in families. The big ones are glaucoma, macular degeneration, and retinal detachments.  If you have a family history of one of these, it may change a doctor’s recommendations for intervention compared to someone without a family history.

3) Know your medical problems. There are several medical problems that correlate with certain diseases of the eye. Diabetes, hypertension, thyroid disease, multiple sclerosis, and autoimmune diseases all correlate with particular eye problems.  Knowing your medical history greatly increases the likelihood of more accurately dealing with your eye problem.

4) Know your medications. Several medications are known to produce specific eye problems. Drugs like steroids, Plaquenil, Gleevac, amiodarone, fingolamide, diuretics and Topamax, to name a few, can create problems in your eye. Knowing you are on certain medications may make it much easier for the doctor to arrive at a diagnosis of your eye condition.

5) Be calm and do your best. There are several tests we do that require your participation. The two tests that make people most anxious are the refraction (which determines glasses or contacts prescriptions) and a visual field test (which tests your peripheral vision.)  Stay calm and give your best answers. There are no perfect answers. You are not going to get shocked for a wrong answer, so don’t ramp up the anxiety.  Just give it your best try.

6) Bring someone with you when possible. There are two reasons for this. One is that it is better to not drive home if you are having your eyes dilated. Many people can do it comfortably, but some can’t. If you are not sure you can drive comfortably with your eyes dilated it is better to have someone with you who can drive home. The second reason is that is always better to have a second pair of ears to hear what the doctor is telling you - especially if the problem is significant. There are many studies that show a person often mishears or misremembers what they have been told, especially if they are anxious. Two pairs of ears are better than one.

7) Write down any questions. It’s very easy to forget to ask something you really wanted to know. You will get your questions answered much better if you have written them down prior to your appointment.

Follow these tips and you will have your best experience possible at your next exam.

Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Oftentimes, contact lens wearers will skimp on their lens care because some of the solutions are costly and it seems like a good way to save some hard-earned cash. But this is not a good idea.

Cutting corners can result in infections or irritations, and after one or two copays to your eye doctor's office you probably will have spent more than what you saved in a year by cutting corners--plus you have to deal with your discomfort and inability to wear your contact lenses while you are being treated.

The reasons you clean your contacts is to give increased lens comfort, prolong lens oxygen permeability, and to protect your eyes from infection. The reason you have to disinfect your contact lenses is - as nasty as it may sound - that your eyeball and eyelids are covered in essential bacteria that are kept in check by your body’s immune system. When you remove your contact lens at night it is covered in these essential bacteria. If you don't kill them overnight this will allow the bacteria to grow unchecked and then, instead of inserting a freshly cleaned lens, you are inserting a lens covered in more bacteria than your eye is used to and you end up getting an infection.

Let’s talk about the most widely used type of solution - the multipurpose solution. While this is often the most incorrectly used solution, multipurpose solution is a very safe and effective disinfection method when used properly.

Many multipurpose solutions advertise themselves as “No Rub.” Just put it in the case and you are done. This is OK to do, but a quick rub with the no-rub solution in the palm of your hand and the opposite hand’s middle or ring finger provide an even better cleaning option. Just the slight roughness of your fingerprint adds a light scrubbing effect that helps improve the removal of surface debris, protein, and mucous better than just letting the lens soak overnight. This rubbing of the lens is especially important for women to remove any cosmetics that are rarely removed by just soaking alone. These few seconds of extra cleaning will make your lenses stay more comfortable longer during their wearing cycle, and help to keep the pores of the lenses open, allowing more oxygen to contact your cornea.

Many name brands and store/warehouse brands of multipurpose solutions exist. All are FDA approved to do the same thing: clean/disinfect/rinse/store your contact lenses. You can't really mess them up unless you try. Remove the lenses, lightly rub them with the multipurpose solution, place your lens into a CLEAN and DRY lens case, and cover the lens with solution to disinfect it. Then let it sit for the number of hours recommended by the manufacturer, generally between 4 to 8 hours, or overnight. Remove the lenses in the morning, rinse with the same multipurpose solution and rinse the lens case out and leave it open to air dry in an area away from your sink and toilet to prevent airborne contaminants from getting into your case as it dries.

The biggest misuse of the multipurpose solution is not changing your case’s solution nightly and just adding more solution to the case each night. We call this “topping off the case.” This is NOT safe because it will lose disinfection power since the old/used solution was busy killing the bacteria and organisms from the night before. Just adding a little fresh solution will eventually allow for the bacteria to take over and you may be adding more bacteria into your eyes than if you never disinfected the lenses to begin with.

Multipurpose solution companies oftentimes will give you a new case when you buy bigger bottles of solution. You should start using the new case with the new bottle of solution. Dont's just stash the case away. There are fungi and other organisms that have been demonstrated to grow from very old lens cases so USE the new case and don't keep it for when you break the old one.

There are many different multipurpose solutions on the market. They aren't cheap and it is tempting to purchase “what is on sale” to save a few dollars. If it does the same thing as the expensive one, then why bother spending the extra? But remember, your contacts are like little sponges that soak up your lens solution. The lens companies don't care if brand A’s solution is compatible with brand B’s or C’s. So over time you can develop a sensitivity to one particular brand of solution, or mixing solutions with the same lens can cause a chemical reaction that occurs because the solutions are not compatible. If you are using the same brand regularly and start having issues your doctor may recommend a solution change to another company that you haven't tried and this may potentially solve your problem. But if you have used several different ones in a few weeks prior to your visit it makes it much harder to determine the cause of your irritation.

The generic/store brands are usually fine products but a grocery store or discount chain doesn’t have a factory that makes their solution for them--they purchase it from a larger supplier. These third-party suppliers can alter their recipe for their multipurpose lens solution and you as the consumer would never know. You could just start finding your contacts are not as comfortable as they used to be and it is actually the unknown generic solution change that is bothering you. Brand name companies like Bausch and Lomb, AMO, and Alcon will rarely make product changes without making consumers aware that they've reformulated the product so if something changes with the reformulated product you have a better chance of knowing it than with a generic solution manufacturer.

Finally, there is a product called saline solution. Saline is extremely inexpensive, generally half to a third the price of multipurpose solutions. This is a product made by many different companies and was the first lens solution ever used. Saline solution was initially used in a heat disinfection system where the lenses were boiled nightly. The boiling of the lens provided the disinfection, not the saline solution. The solution was to just to prevent the lens from drying out while you cooked it. You should NEVER use saline solution as a replacement for multipurpose solution. Saline solution is NOT a disinfectant for your lenses. It doesn’t contain an agent that will prevent bacteria and organisms from growing in the case overnight. However, it’s totally acceptable if you want to rinse your lenses in the morning with saline prior to inserting them after they were disinfected with your multipurpose solution.

Oftentimes, a practitioner will recommend a certain type of solution to help with things like dryness, environmental allergies, or allergies to specific solutions. I always recommend to check with your practitioner before making any changes to your lens care solution or lens care routine. The best advice for saving money on your preferred solution is buy extra when it is on sale, buy in bulk, and buy what is most comfortable in a multipurpose solution for you. Then stick with it and use it correctly for many years of happy lens wear.

Article contributed by Dr. Jonathan Gerard

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

After cataract surgery, there are two main issues we try to control: preventing infection and controlling inflammation.  Traditionally, we prescribed antibiotic eye drops to prevent infection, as well as steroid eye drops to control post-operative inflammation. But eye drops can be hard for some patients to put into their eyes. Now we have some alternatives to using drops after surgery.   

There are some antibiotic solutions we can place inside the eye at the end of the cataract surgery that have been shown in most studies to do as good or better a job preventing infection as using antibiotic eye drops before and after surgery.

The FDA approved two new steroid delivery methods to reduce post-operative inflammation that have the potential to eliminate post-op steroid eye drops in most (but not all) patients who are undergoing cataract surgery. Those two products are called Dexycu and Dextenza.

Dexycu is a white bolus of steroid medication that is injected inside the eye after cataract surgery. It will not be visible in most patients because it is injected behind the iris, or the colored part of the eye.  It sometimes doesn’t stay behind the iris and you might see a small white dot in the eye initially after surgery.  It is a sustained-released medication, which is absorbed over a couple of weeks and replaces the need for post-operative steroid drops.  

Dextenza is a white pellet that is inserted into the lower punctum of the lid, which is the small opening for the drainage of tears. This insert is designed to deliver medication for up to 30 days.  It is slowly absorbed and doesn't need to be removed. Similarly, it is usually not visible and does not cause any discomfort.

If you have either a Dexycu or Dextenza implant placed and an antibiotic medication is injected inside the eye after surgery, then you may be drop free after surgery. The main difference between the two steroid injections is that Dexycu is injected inside the eye while Dextenza is deposited outside the eye.  For each of these newer options there is a chance that in your particular case there may still be too much inflammation and you might need to take eye drops for a while, but the majority of the time you would not need drops.

If you are going to have cataract surgery and would like to be drop free after the procedure, then ask your surgeon if you would be a candidate for either the Dexycu or Dextenza implant.

Article contributed by Dr. Jane Pan.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Choosing a new pair of eyeglasses can be a daunting task.

Making a decision on what style glasses you will be wearing for the next year until your vision is checked again can be stressful. This is one of the many reasons opticians are here for you. In many ways, this may be the most important task for the optician, because keeping you happy with the way you look motivates you to wear your glasses daily.

Most people’s reaction is to play it safe with new glasses and stick with something relatively similar to what they are currently wearing.

While not necessarily a bad decision, this isn’t something opticians try to promote. Opticians often spend time meeting with frame representatives and browsing the Internet to keep up with the ever-changing trends in the world of eyeglass frames. And it’s a great feeling to successfully “update” your image with a new set of frames. Many patients are amazed at the difference a well-fit and -styled pair of glasses makes on their overall look.

There are many simple tips and tricks to consider when starting to browse for your next pair of frames.

The goal of this article is to improve your starting point when beginning to choose frames. That way, once the optician gets involved, the process is already well under way. Keep in mind that these are guidelines and “outside the box” thinking can be good as long as it fits within the required parameters of your prescription.

The first step is successfully identifying what face shape category you seem to fit into.

This image shows the most common face-shape categories. The following is a general guideline to help decide which frames will most likely appear to fit the best.

Oval - Oval faces are considered to be the “most versatile” because most frame styles and sizes fit well on this face type. As a general rule, and especially for oval faces, avoid choosing frames that extend past the widest part of your face. Stick with moderate-sized frames.

Upside Down Triangle - To even out the proportions of this face shape, choosing semi-rimless frames is always a positive. Less attention to the bottom half of the frame helps enhance the natural curves of this face shape. Frames that stay wide at the bottom and do not taper inward will also help even out this face.

Oblong - Being longer than it is wide, this face shape enjoys having larger frames on it. A lower bridge will help shorten the nose, and solid dark colors are a positive as well.

Square - A strong jaw line is the focus of this face shape, so to work with that, choosing smaller, narrow frames is a positive. Ovals and rounds work better than squares.

Diamond - Broad cheekbones are the focal point of this face shape. Being quite rare, the best style of frames to put on these faces are in the cat eye family. Following the face’s contours, flare-top frames, semi-rimless frames, and fun colors tend to work well with this shape.

Round - Rectangular frames work best on round faces. Wide bridges help separate the eyes and bring symmetry to the face. Make sure the frames are wider than they are deep.

Triangle - Cat eye frames work exceptionally well with this face shape also. Frames that have a lot of style and accents to the upper part of the frames and temples are a plus as this brings attention to the naturally narrow forehead.

Along with shapes and styles, some believe that certain colors work best with certain faces.

All people are considered to have either cool (blue) or warm (yellow) skin tones. Some people feel customers should stick within their family of coloring. Again this is only a recommendation since you should wear what you like. This is just strictly a guideline for those struggling to choose a frame for themselves. Based on experience, eye color can make a difference as well. People with lighter eyes tend to prefer lighter frame colors, and vice versa for people with darker eyes. Also, hair color can be considered. Patients with lighter or grey hair tend to shy away from darker frames unless looking to make a statement.

At the end of the day you have to choose what is most comfortable for you. Opticians’ suggestions and educated opinions can help steer you in the right direction. There is much to consider, but always keep in mind that comfort and functionality are the priorities.

Some people believe plastic or zyl frames are more comfortable than metal or semi-rimless. Having nose pads, metal frames feel “heavy” to some. Others cannot wear plastic due to oily skin. Plastic frames may slide as the day progresses so metal may be better suited.

Don’t be overwhelmed. Follow some simple guidelines, and remember to enjoy the process. There are infinite styles and options to get you seeing well and looking great. And while you’re considering lenses for your regular lenses, don’t forget to look for sunglasses frames!

Article contributed by Richard Striffolino Jr.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Don't be one of the thousands of parents every year who think, "I wish I had realized sooner that my child coudn't see properly!"

Did you know that early intervention in children's vision is the key to success?

• 80% of learning comes through vision.
• During the first year of life, and then again by age 3 or 4, each child needs a comprehensive eye exam.
• 6 months old is not too early.

Even though a school vision screening, nurse evaluation, or pediatrician screening is important, it doesn't take the place of a comprehensive eye exam by an eyecare professional. Some symptoms of an undetected vision problem include: decreased performance in school, aversion to reading, excessive blinking, eye rubbing, headache, or inability to see 3-D movies properly.

This could indicate conditions such as amblyopia (lazy eye), nearsightedness (myopia), astigmatism, or farsightedness (hyperopia) that can be corrected with glasses.

Surger might even be required for more serious conditions, such as esotropia, where the eye turns in, or exotropia where the eye turns out.

Although school screenings, nurses, and pediatricians are extremely valuable, they don't take the place of a comprehensive eye exam by an optometrist or ophthalmologist.

In fact, school screenings can give a false sense of security. There are visual skills necessary for reading that aren't diagnosed easily just by reading an eye chart. If a child frequently lose his or her place while reading, he or she may benefit from glasses, vision exercises, or therapy.

Vision Therapy involved training the eyes and brain to help alleviate issues that glasses alone can not.

A comprehensive exam can also reveal more serious threats to vision and health in children. A more rare, but life threatening condition is a fast growing eye tumor called retinoblastoma. The proximity of the eye to the brain makes fast intervention critical. This is a condition that parents might notice by looking at pictures and noticing a "white pupil."

Here are some resources to find out more information on children's vision--

• Your local eye care provider.
• Websites such as American Optometric Association.
• The InfantSEE program. It is a no cost public health program for early detection of optical issues in the first year of life.
• Don't Shake is the National center on Shaken Baby Syndrome
• American Academy of Pediatrics

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Knowing the difference between the various specialties in the eye care industry can be confusing, especially given the fact that they all start with the same letter and in many ways sound alike.

So, here’s a breakdown of the different monikers to make life a little less confusing for those wanting to get an eye exam.

Ophthalmologists

Ophthalmologists (pronounced “OFF-thal-mologists”) are eye doctors who went to four years of undergraduate university, four years of medical school and four to five years of ophthalmic residency training in the medical and surgical treatment of eye disease.

Many ophthalmologists then go on to pursue sub-specialty fellowships that can be an additional one to three years of education in areas such as cataract and refractive surgery, cornea and external disease, retina, oculoplastic surgery, pediatrics, and neuro-ophthalmology.

Ophthalmologists are licensed to perform eye surgery, treat eye diseases with eye drops or oral medications, and prescribe glasses and contact lenses.

Optometrists

Optometrists are eye doctors who went to undergraduate university for four years, then went on to optometry school for four years.

Many optometrists choose to pursue an additional year of residency after optometry school, though this is not a requirement for licensure. Optometrists are licensed in the medical treatment and management of eye disease, and prescribing glasses and contact lenses. The ability to prescribe varies by state law.

In some states, optometrists can perform certain minimally invasive laser surgical procedures, but on the whole, optometrists do not perform eye surgery. In addition, optometrists usually have different sub-specialties from ophthalmologists, including vision therapy, specialty contact lenses, and low vision.

The analogy I use most often in comparing optometrists to ophthalmologists is that of a dentist and oral surgeon. Many people choose to have optometrists as their primary eye care provider doctor for medical treatment of eye disease, but when surgery is needed, they are referred to the proper ophthalmologist.

Opticians

Opticians specialize in the fitting, adjustment, and measuring of eye glasses. Some states require that opticians are licensed, and others do not.

If you have any questions about which professional is the right fit for your needs, check with your eye-care professional’s office and they’ll be happy to answer them for you.

Article contributed by Dr. Jonathan Gerard

This blog provides general information and discussion about eye health and related subjects. The words and other content provided on this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Who is Charles Bonnet?  He was a Swiss naturalist, philosopher, and biologist (1720-1793) who first described the hallucinatory experiences of his 89-year-old grandfather, who was nearly blind in both eyes from cataracts.  Charles Bonnet Syndrome is now the term used to describe simple or complex hallucinations in people who have impaired vision.  

Symptoms

People who experience these hallucinations know they aren't real.  These hallucinations are only visual, and they don't involve any other senses. These images can be simple patterns or more complex, like faces or cartoons.  They are more common in people who have retinal conditions that impair their vision, like macular degeneration, but they can occur with any condition that damages the visual pathway.  The prevalence of Charles Bonnet Syndrome among adults 65 years and older with significant vision loss is reported to be between 10% and 40%.  This condition is probably under reported because people may be worried about being labeled as having a psychiatric condition. 

Causes

The causes of these hallucinations are controversial, but the most supported theory is deafferentation, which in this case is the loss of signals from the eye to the brain; then, in turn, the visual areas of the brain discharge neural signals to create images to fill the void.  This is similar to the phantom limb syndrome, when a person feels pain where a limb was once present.  In general, the images that are produced by the brain are usually pleasant and non-threatening.

Treatment and prognosis

If there is a reversible cause of decreased vision, such as significant cataract, then once the decreased vision is treated, the hallucinations should stop.

There is no proven treatment for the hallucinations as a result of permanent vision loss but there are some techniques to manage the condition.  Give these a try if you have Charles Bonnet Syndrome.

• Talking about the hallucinations and understanding that it is not due to mental illness can be reassuring.
• Changing the environment or lighting conditions.  If you are in a dimly lit area, then switch on the light and vice versa. 
• Blinking and moving your eyes to the left and right and looking around without moving your head have been reported as helpful.
• Resting and relaxing.  The hallucinations may be worse if you are tired or sick.
• Taking antidepressants and anticonvulsants have been used but have questionable efficacy. 

Over time, the hallucinations become more manageable and can decrease or even stop after a couple of years.

If you experience any of these symptoms, please get evaluated by your eye doctor to make sure there is not a treatable eye condition.  Don’t be embarrassed or ashamed—your issue is likely caused by a physical disturbance and we are here to help!

Article contributed by Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

We commonly see patients who come in saying that their eyes are bleeding.

The patient is usually referring to the white part of their eye, which has turned bright red. The conjunctiva is the outermost layer of the eye and contains very fine blood vessels.  If one of these blood vessels breaks, then the blood spreads out underneath the conjunctiva. This is called a subconjunctival hemorrhage.

A subconjunctival hemorrhage doesn't cause any eye pain or affect your vision in any way. Most of the time, a subconjunctival hemorrhage is asymptomatic.  It is only noticed when looking at the mirror or when someone else notices the redness of the eye.  There should not be any discharge or crusting of your lashes.  If any of these symptoms are present, then you may have another eye condition that may need treatment.  

What causes a subconjunctival hemorrhage?  The most common cause is a spontaneous rupture of a blood vessel.  Sometimes vigorous coughing, sneezing, or bearing down can break a blood vessel.  Eye trauma and eye surgery are other causes of subconjunctival hemorrhage.  Aspirin and anticoagulant medication may make patients more susceptible to a subconjunctival hemorrhage but there is usually no need to stop these medications.  

There is no treatment needed for subconjunctival hemorrhage.  Sometimes there may be mild irritation and artificial tears can be used.  The redness usually increases in size in the first 24 hours and then will slowly get smaller and fade in color.  It often takes one to two weeks for the subconjunctival hemorrhage to be absorbed.  The larger the size of the hemorrhage, the longer it takes for it to fade.

Having a subconjunctival hemorrhage may be scary initially but it will get better in a couple of weeks without any treatment. However, redness in the eye can have other causes, and you should call your eye doctor, particularly if you have discharge from the eye.

Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

YOUR EYES.......You only have two of them so treat them well and learn how to keep them safe from harm. Here is a list of five vital ways to prevent injuries to one of your most precious assets, your vision.

1. Wear Safety Glasses. Failure to wear protective eye wear is one of the main causes of job related injuries to the eye according to OSHA (Occupational Safety & Health Administration). Well-made safety glasses are made from a polycarbonate material which can withstand the impact of a .22 caliber bullet. Safety glasses at work protect you from foreign bodies and chemical exposure to the eye area. Wearing protective eyewear for yard work, weed eating, and cutting wood keeps injury from high velocity foreign bodies to a minimum.
2. Wear Sunglasses with UVA and UVB protection. Doing so protects the thin skin around the eyes from sunburn, and also helps protect your ocular system. It has long been stated that excessive exposure to sunlight causes cataracts, so using ultraviolet (UV) protection in your sunglasses is vital. Many sunglasses, especially for children, do not contain adequate UV filters. These inferior sunglasses can actually harm your eyes more than not wearing any, since the dark lenses cause the pupil to dilate, thereby letting in more of the harmful rays. Buyer beware: not all sunglasses are created equally.
3. Make sure children’s glasses are made of polycarbonate material and have UV protection. This ensures a minimum exposure of ultraviolet rays which will pay off when they are older by helping prevent cataracts. The polycarbonate lens material gives maximum protection against breakage.
4. Don’t obstruct vision with a child’s costume. During Halloween, opt for face paint instead of a mask that could occlude or obstruct vision.  Bulky masks that accompany halloween costumes can be a deterrent to the child seeing out of the mask. During Halloween or costume parties, keep it fun and safe by “seeing and being seen.”
5. Use the wisdom of preventative maintenance. Get yearly eye examinations where the entire retina is evaluated with a a dilated exam. Routine check ups, sunglasses, vitamins, and smoking cessation will keep those peepers healthy and clear.

Applying these pointers can keep your eyes healthy and safe.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

1. Vision is so important to humans that almost half of your brain’s capacity is dedicated to visual perception.

2. The most active muscles in your body are the muscles that move your eyes.

3. The surface tissue of your cornea (the epithelium) is one of the quickest-healing tissues in your body. The entire corneal surface can turn over every 7 days.

4. Your eyes can get sunburned. It is called photokeratitis and it can make the corneal epithelium slough off just like your skin peels after a sunburn.

5. Ommatophobia is the fear of eyes.

6. You blink on average about 15 to 20 times per minute. That blink rate may decrease by 50% when you are doing a visually demanding task like reading or working on a computer – and that’s one reason those tasks can lead to more dry-eye symptoms.

7. Your retinas see the world upside down, but your brain flips the image around for you.

8. If you are farsighted (hyperopia) your eye is short, and if you are shortsighted (myopia) your eye is long.

9. An eyelash has a lifespan of about 5 months. If an eyelash falls out it takes about 6 weeks to fully grow back.

10. One in every 12 males has some degree of “color blindness.”

What do amblyopia, strabismus, and convergence insufficiency all have in common? These are all serious and relatively common eye conditions that children can have.

Did you know that 80% of learning comes through vision? The proverb that states ”A picture is worth a thousand words” is true!  If a child has a hard time seeing, it stand to reason that she will have a hard time learning.

Let’s explore amblyopia, or “lazy eye.” It affects 3-5% of the population, enough that the federal government funded children’s yearly eye exams through the Accountable Care Act or ObamaCare health initiative. Amblyopia occurs when the anatomical structure of the eye is normal but the “brain-eye connection” is malfunctioning. In other words, it is like plugging your computer into the outlet but the power cord is faulty.

Amblyopia need to be caught early in life--in fact if it is not caught and treated early (before age 8) it can lead to permanent vision impairment. Correction with glasses or contacts and patching the good eye are ways it is treated. Most eye doctors agree that the first exam should take place in the first year of life. Early detection is a key.

Strabismus is a condition that causes an eye to turn in (esotropia), out (exotropia), or vertically. It can be treated with glasses or contacts, and surgery, if needed. Vision therapy or strategic eye exercises prescribed by a doctor can also improve this condition.

When we read, our brain tells our eyes to turn in to a comfortable reading posture. In convergence insufficiency, the brain tells the eyes to turn in, but they instead turn out, causing tremendous strain on that child’s eyes while reading. Another tell tale sign of this condition is the inability to cross one's eyes when a target approaches. The practitioner will see instead, that one of the eyes kicks out as the near target approaches. This condition can be treated with reading glasses or contacts, and eye exercises that teach the muscles of the eye to align properly during reading. Vision therapy is the treatment of choice for convergence insufficiency.

It is important to understand the pediatric eye and all the treatments that can be implemented to augment the learning process. Preventative care in the form of early eye examinations can mean the difference between learning normally or struggling badly. Remember, a young child can’t tell you if he has a vision impairment. For the success of the child, be proactive by scheduling an early vision exam.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Is making an appointment for a comprehensive eye exam for your children on your back-to-school checklist? It needs to be.

No amount of new clothes, backpacks, or supplies will allow your child to reach their potential in school if they have an undetected vision problem. 

The difference between eye exams and vision screenings

An annual exam done by an eye doctor is more focused than a visual screening done at school. School screenings are simply "pass-fail tests" that are often limited to measuring a child’s sight clarity and visual acuity up to a distance of 20 feet. But this can provide a false sense of security.

There are important differences between a screening and a comprehensive eye exam.

Where a screening tests only for visual acuity, comprehensive exams will test for acuity, chronic diseases, color vision and eye tracking. This means a child may pass a vision screening at school because they are able to see the board, but they may not be able to see the words in the textbook in front of them.

Why back-to-school eye exams matter

Did you know that 1 out of 4 children has an undiagnosed vision problem because changes in their eyesight go unrecognized? 

Myopia, or nearsightedness, is a common condition in children and often develops around the ages of 6 or 7. And nearsightedness can change very quickly, especially between the ages of 11 and 13, which means that an eye prescription can change rapidly over a short period of time. That’s why annual checkups are important.

Comprehensive eye exams can detect other eye conditions. Some children may have good distance vision but may struggle when reading up close. This is known as hyperopia or farsightedness. Other eye issues such as strabismus (misaligned eyes), astigmatism, or amblyopia (lazy eye) are also detectable. 

Kids may not tell you they're having visions issues because they might not even realize it. They may simply think everyone sees the same way they do. Kids often give indirect clues, such as holding books or device screens close to their face, having problems recalling what they've read, or avoiding reading altogether. Other signs could include a short attention span, frequent headaches, seeing double, rubbing their eyes or tilting their head to the side.

What to expect at your child's eye exam

Before the exam, explain that eye exams aren’t scary, and can be fun. A kid-friendly eye exam is quick for your child. After we test how he or she sees colors and letters using charts with pictures, shapes, and patterns, we will give you our assessment of your child’s eyes. 

If your child needs to wear glasses, we can even recommend frames and lenses that would be best for their needs.

Set your child up for success

Staying consistent with eye exams is important because it can help your kids see their best in the classroom and when playing sports. Better vision can also mean better confidence because they are able to see well. 

Because learning is so visual, making an eye examination a priority every year is an important investment you can make in your child's education. You should also be aware that your health insurance might cover pediatric eye exams.

Set your child up for success and schedule an exam today!

What's one of the most common questions people ask when a baby is born? "WHAT COLOR ARE HIS EYES?” is usually right up there.

What makes the color of our eyes appear as they do? What role do genetics play? What if you don’t like your eye color--can you change it? Are there any medications that can change eye color? Get ready to explore the science behind eye color by starting at the beginning.......

Baby’s eye color can change. A baby can start out with blue eyes, for example, that change to brown as she ages. It’s all dependent on a brown pigment called melanin which develops as a child grows. The more melanin present, the darker the eye color. Brown eyes have the most pigment saturation, green/hazel eyes have less melanin, and blue eyes have the least pigment. The color of eyes is dependent upon genetics. Genetics are complicated, but generally speaking brown trumps blue if there is a brown-eyed parent. This is because darker pigment is the dominant trait in genetics. This isn’t to say that two brown-eyed parents could not have a blue-eyed child......it's just not very common.  In recent years, scientists have found many genes that play a role in determining eye color.  For example, in March 2021, researchers announced that they had discovered 50 new genes that play a role.  So yeah...it's more complicated than was thought.

So what if you don’t like your eye color? Can you change it? Yes, you can. The most common way is through cosmetic colored contact lenses. It’s possible to change almost any eye color, even changing brown to blue. A special colored dye is injected into the contact lens material, creating magnificent colors. There are also surgical methods for changing iris color but the risks far outweigh the benefits, so it is not recommended. Furthermore, contact lenses are medical devices that alter cellular tissue, which makes it really important to get your color contacts by obtaining a prescription for a legitimate brand from an eyecare practitioner.

Some medications can change eye color. A class of medication called prostaglandins, used to treat glaucoma, has a side effect of darkening the iris color. This same class, in a weaker strength, is used to lengthen eyelashes. Studies have shown that in a certain percentage of patients, light blue and green eyes have turned brown.

So maybe Crystal Gayle was looking into a crystal ball when she sang "Don’t It Make My Brown Eyes Blue," predicting eye color changing medications to come.

Only future science holds the key to permanent eye color change. But in the meantime, genetics, medication, and cosmetic colored contact lenses can enhance and change the color of your eyes. 

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

The retina is the nerve tissue that lines the inside back wall of your eye. Light travels through the pupil and lens and is focused on the retina, where it is converted into a neural impulse and transmitted to the brain. If there is a break in the retina, fluid can track underneath the retina and separate it from the eye wall. Depending on the location and degree of retinal detachment, there can be very serious vision loss.

Symptoms

The three 3 F’s are the most common symptoms of a retinal detachment:

• Flashes: Flashing lights that are usually seen in peripheral (side) vision.

• Floaters: Hundreds of dark spots that persist in the center of vision.

• Field cut: Curtain or shadow that usually starts in peripheral vision that may move to involve the center of vision.

Causes

Retinal detachments can be broadly divided into three categories depending on the cause of the detachment:

1. Rhegmatogenous retinal detachments: Rhegmatogenous means “arising from a rupture,” so these detachments are due to a break in the retina that allows fluid to collect underneath the retina. A retinal tear can develop when the vitreous (the gel-like substance that fills the back cavity of the eye) separates from the retina as part of the normal aging process.

The risk factors associated with this type of retinal detachment:

• Lattice degeneration – thinning of the retina.

• High myopia (nearsighted) - can result in thinning of the retina.

• History of a previous retinal break or detachment in the other eye.

• Trauma.

• Family history of retinal detachment.

2. Tractional retinal detachments: These are caused by scar tissue that grows on the surface of the retina and contraction of the scar tissue pulls the retina off the back of the eye. The most common cause of scar tissue formation is due to uncontrolled diabetes.

3. Exudative retinal detachments: These types of detachments form when fluid accumulates underneath the retina. This is due to inflammation inside the eye that results in leaking blood vessels. The visual changes can vary depending on your head position because the fluid will shift as you move your head. There is no associated retinal hole or break in this type detachment. Of the three types of retinal detachments, exudative is the least common.

Diagnostic tests

• A dilated eye exam is needed to examine the retina and the periphery. This may entail a scleral depression exam where gentle pressure is applied to the eye to examine the peripheral retina.

• A scan of the retina (optical coherence tomography) may be performed to detect any subtle fluid that may accumulate under the retina.

• If there is significant blood or if a clear view of the retina is not possible for some other reason, then an ultrasound of the eye may be performed.

Treatment

The goal of treatment is to re-attach the retina to the eye wall and to treat the retinal tears or holes.

In general, there are four treatment options:

• Laser: A small retinal detachment can be walled off with a barrier laser to prevent further spread of the fluid and the retinal detachment.

• Pneumatic Retinopexy: This is an office-based procedure that requires injecting a gas bubble inside the eye. After this procedure, you need to position your head in a certain direction for the gas bubble to reposition the retina back along the inside wall of the eye. A freezing or laser procedure is performed around the retinal break. This procedure has about 70% to 80% success rate but not everyone is a good candidate for a pneumatic retinopexy.

• Scleral buckle: This is a surgery that needs to be performed in the operating room. This procedure involves placing a silicone band around the outside of the eye to bring the eye wall closer to the retina. The retinal tear is then treated with a freezing procedure.

• Vitrectomy: In this surgery, the vitreous inside the eye is removed and the fluid underneath the retina is drained. The retinal tear is then treated with either a laser or freezing procedure. At the completion of the surgery, a gas bubble fills the eye to hold the retina in place. The gas bubble will slowly dissipate over several weeks. Sometimes a scleral buckle is combined with a vitrectomy surgery.

Prognosis

Final vision after retinal detachment repair is usually dependent on whether the macula (central part of the retina that you use for fine vision) is involved. If the macula is detached, then there is usually some decrease in final vision after reattachment. Therefore, a good predictor is initial presenting vision. We recommend that patients with symptoms of retinal detachments (flashes, floaters, or field cuts) have a dilated eye exam. The sooner the diagnosis is made, the better the treatment outcome tends to be.

Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

The sun does some amazing things.  It plays a role in big helping our bodies to naturally produce Vitamin D. In fact, many people who work indoors are directed to take Vitamin D supplements because of lack of exposure to the sunshine. 

But being in the sun has risks, as well...

If sunglasses are not worn, there is a greater risk for cataracts or skin cancers of the eyelids. It is important to know that not all sunglasses are made alike. UVA,UVB, and UVC rays are the harmful rays that sunglasses need to protect us from.

However, many over the counter sunglasses do not have UV protection built into the lenses, which can actually cause more damage than not wearing sunglasses, especially in children. 80% of sun exposure in our lives comes in childhood. Without UV protection in sunglasses, when the pupil automatically dilates more behind a darker lens, more of the sun's harmful rays are let in.

The whole point is that consumers should be aware that it is vital to buy sunwear that has UV protection built into the lenses.

Polarization is another option to add to sunglasses to protect the eyes from glare from the road and water. Fisherman love polarized lenses because you can see the fish right through the water. People who boat also claim their vision is better because glare off the water is reduced.

There are so many reasons to wear good sunglasses!  Plus, they just look fabulous!

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Fireworks Eye Injuries Have Skyrocketed in Recent Years

Fireworks sales will be blazing across the country from now through the Fourth of July. As retailers begin their promotions, we and the AAO are shining a light on this explosive fact: The number of eye injuries caused by fireworks has exploded in recent years.

Fireworks injuries caused approximately 15,600 emergency room visits each year, according to data from the U.S. Consumer Product Safety Commission. The injuries largely occurred in the weeks before and after the Fourth of July. The CPSC’s fireworks report showed that about 2,340 eye injuries related to fireworks were treated in U.S. emergency rooms in 2020, up from 600 reported in 2011.

To help prevent these injuries, the Academy is addressing four important things about consumer fireworks risks:

1. Small doesn’t equal safe. A common culprit of injuries are the fireworks often handed to small children – the classic sparkler. Many people mistakenly believe sparklers are harmless due to their size and the fact they don’t explode. However, they can reach temperatures of up to 2,000 degrees – hot enough to melt certain metals. 
2. Even though it looks like a dud, it may not act like one. At age 16, Jameson Lamb was hit square in the eye with a Roman candle that he thought had been extinguished. By age 20, Lamb had gone through multiple surgeries, including a corneal transplant and a stem cell transplant to try to restore partial vision to the eye. 
3. Just because you’re not lighting or throwing it doesn’t mean you’re out of the firing line. An international study of fireworks-related eye injuries showed that half of those hurt were bystanders. The researchers also found that one in six of these injuries caused severe vision loss. 
4. The Fourth can be complete without using consumer fireworks. The Academy advises that the safest way to view fireworks is to watch a professional show where experts are controlling the displays.

If you experience a fireworks eye injury:

• Seek medical attention immediately.
• Avoid rubbing or rinsing the eyes or applying pressure.
• Do not remove any object from the eye, apply ointments, or take any pain medications before seeking medical help.

Watch the AAO’s animated public service announcement titled “Fireworks: The Blinding Truth.”

Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

There are many things that can cause your eye to turn red.

The eye looks red when the blood vessels that are in the conjunctiva (the mucous membrane that covers the white of your eye and the backside of your eyelids) becomes dilated.

Those blood vessels often dilate when the eye gets irritated. This irritation can originate from a problem occurring inside the eye or factors from outside the eye.

The most common external factors that can cause the eye to become red are exposure to infectious organisms (mostly viruses and bacteria), environmental irritants (smoke, chemicals, sunlight), or allergens.

Infectious organisms can cause infectious conjunctivitis, or what is more commonly referred to as “pink eye.” This condition often presents with the eye being red and a mucous discharge being produced, often to such a degree that the eyelids are crusted over upon awaking in the morning. Infectious conjunctivitis can be extremely contagious and it is often advised that you severely limit your exposure to others while the problem is active. Infectious conjunctivitis caused by bacteria can be treated with antibiotic eye drops but viral conjunctivitis currently has no treatment and must run its course like the common cold.

Environmental irritants can make the eye look red for a short period of time during and immediately after exposure. The irritation is usually self-limited but may resolve more quickly with the use of over-the-counter lubricating drops or artificial tears. It is very important to understand exactly which irritant you were exposed to because there are some chemicals (acids and bases) that can cause extreme damage to the eye. So if you’re exposed to a caustic chemical you need to immediately rinse your eye out with water and seek emergency medical attention.

Allergens can cause allergic conjunctivitis, which can look very similar to pink eye but usually has significantly less mucous discharge and is usually accompanied by fairly severe itching. Allergic conjunctivitis is not contagious and can usually be treated with anti-allergy eye drops.

Infectious and allergic conjunctivitis can cause mild discomfort and itching but they rarely cause significant pain or loss of vision. A red eye with significant pain, especially when accompanied by severe light sensitivity and vision loss, often indicates more significant problems such as iritis, angle closure glaucoma or a corneal ulcer, all of which require immediate medical attention. If your eye is red and there is significant pain do not assume you have pink eye--see your eye doctor immediately!

Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Ready or not...here are 13 more jokes to make you groan!

1. Patient: "What’s that floater doing in my eye, doctor?"  Doctor: “The sidestroke.”

2. Doctor: “Have your eyes ever been checked before?”  Patient: “No, they’ve always been hazel.”

3. Why did the cyclops have to close his school?  He had only one pupil!

4. Why wouldn’t the optometrist learn any jokes?  He had heard that a joke can help break the eyes.

5. What is it called when you poke your eye with safety glasses?  Eye-rony!

6. Did you here about the new website for people with chronic eye pain?  It’s a site for sore eyes.

7. When are your eyes not eyes?  When an onion makes them water!

8. Why do beekeepers have such beautiful eyes?  Because beauty is in the eye of the bee holder!

9. Why were the teacher’s eyes crossed?  Because she couldn’t control her pupils.

10. What's your eye doctor's favorite treat?  Candy cornea!

11. What has four eyes and a mouth?  The Mississippi.

12. Did you know that your left eye isn't real?  It's just in your head.

13. What did the optometrist say when the patient complained he made too many jokes?  “Bad puns are how eye roll.”