A recent investigation done by David Elliott and Alison Green, and published in the Optometry and Vision Science journal of the American Academy of Optometry found that 48% of the 322 reading glasses that they tested were wrong. That means 1 out of every 2 pairs sold over-the-counter is wrong and can hurt your eyes.

The main problems with these readers are:

• Wrong power, or different power between the eyes. Some lenses were not even near the power they claimed to be

• Poor optical quality (like a disposable camera lens compared to a good quality camera lens)

• Induced prism, meaning that the lens may move the image up, down, or sideways

It is safest for your eyes to wear optical-quality prescription lenses that have been custom made for you. Otherwise, you are looking through a slightly distorted lens, that most likely isn’t the right power for you, and the optical center isn’t right for the distance between your eyes (so you’ll have to turn your eyes inwards and look cross-eyed, or outwards to look through the readers). Most people have a small amount of astigmatism, or an imbalance between their eyes, so to see your clearest, and have your eyes focusing on the same plane while you study or work on the computer or at your desk, you need a pair that is made from an eye exam where the doctor has measured your eyes.

Wearing the wrong prescription, or poor quality lenses affects your productivity and comfort while reading.

Eyestrain during prolonged and visually demanding computer work taxes the orbicularis oculi muscle. It’s like doing physical labor for a prolonged period. When you use the same eye muscles for hours, even half an hour, your eyes get tired. There is increased blood flow to the muscles 6 extra-ocular muscles around your eyes. These muscles are “exercising” as they precisely coordinate and move the eyes across thousands of words and lines of print. Simultaneously, the accommodative muscles must focus very rapidly to fill in the gaps so that the rapidly flickering screen appears stable, even though an electron beam is sweeping across the computer screen to refresh the pixels to form words and images.

It is easier on the eyes to read printed matter, or even a Kindle type device, because the print is stable, and not flickering.

The eyes also dry out more while working on the computer because blink rate slows down to minimize disruption of the image to the brain. The less you blink. the less interruption to your concentration, and therefore comprehension and processing of what you are doing. Beware of using over-the-counter artificial tears that only replace tears. Your eyes tend to feel good for 15-20 minutes, then more dry and sticky after the artificial tears drain out of your eyes. I recommend homeopathic drops that not only replace tears, but also stimulate tear production.

Take visual breaks every 20 minutes to decrease eye strain, make sure you are wearing a prescription that is less than a year old to correct for astigmatism and refractive or optical problems, and use homeopathic tear drops to stimulate tear production.

First of all, mommies & daddies: start checking your baby’s vision at 6 months old, since vision guides development, and prevents vision loss from a lazy eye. Have your children’s eyes checked every year since there is a strong relationship between learning and vision. If your child isn’t seeing correctly, or they have a tracking or eye teaming problem, this will interfere with their academic and athletic performance. Please do not avoid bringing your children in for an exam at an early age because you are worried about them wearing glasses. You can do a lot more harm by allowing a vision problem to go uncorrected, and we can fit children as young as 8 years old with contact lenses. Check out the CLIP and ACHIEVE studies which show how contact lenses in young children can improve their quality of life. Regarding infants, we can fit them with special contact lenses and teach you how to care for your child’s eyes.

In your 20’s and 30’s many of us feel like we are invincible, but we aren’t. Now is a good time to make sure you are doing the right things for your eyes and your overall health. Be sure to eat healthy foods, stop smoking, wear sunglasses to protect your eyes from sun damage, and find out if a prescription can help you see better at the computer, driving, or playing ball. I know this for a fact since I was the Team OD for the Mighty Ducks of Anaheim. The better you see, the better you’ll be!

In your 40’s you start losing the ability to see close up: this is called presbyopia. See your Optometrist about doing eye exercises to keep your eyes flexible so they can zoom in and out between close and near objects. There are even homeopathic remedies you can use to slow down aging in your eyes. And then of course, keep getting your eyes checked EVERY YEAR! 1 of 4 over 40 have some level of vision loss so don’t just sit there – do something about it.

60+ years old: Your eyeballs have been around for a long time, and they start degenerating, just like the skin on your face is aging. Health problems like hypertension and diabetes affects your eyes. Half of us will develop cataracts, and the risk for glaucoma and macular degeneration increases significantly. But you don’t have to take it lying down: eat healthy, have your eyes checked yearly, BEFORE you start to lose vision. There are so many ways your OD can help you keep your eyes healthy, so you can keep enjoying life, and watch your grandchildren, and grandpets (!) grow up.

Let me tell you what to look for:
• Gradual loss of central or peripheral vision
• Distorted vision or loss of color vision
• Dim, blurry, cloudy or foggy vision

Most people spend more time buying shoes or watches than they do caring for their eyes. People look at your EYES when they talk to you, and your shoes don’t help you see how beautiful life is! Your eyes are your most important sense: RESPECT your eyes, and have your eyes checked every year!

I’m a firm believer in wellness and preventive care. Like going to the dentist: don’t wait until a tooth falls out, or like eating right, and exercising keeps your body healthy. It keeps your eyes healthy also, as well as annual eye exams to catch and treat problems before they harm your vision. Your eyes are one part of your body where it’s important to have them checked before you notice vision changes because by then, it may be impossible to reverse any loss.

Presbyopia makes reading more difficult because of a decreased ability to change focus, especially from far to near. As you age, the lens in your eyes becomes more rigid, and the muscles gradually lose their ability to focus at near.

The signs of presbyopia are:
• Small print is difficult to read
• You need to hold things further away to read
• You need more light to read
• Reading is easier without glasses or contact lenses if you are nearsighted

You can slow down the progression of presbyopia by doing several things:
1. Accommodative exercises: focus between a distant and very close target as fast as you can for 5-10 minutes every day. This increases your eye’s focus flexibility, strength and stamina.
2. Homeopathic remedies: This can slow down, and even reverse the aging process of presbyopia and cataracts. We can prescribe these for you after examining your eyes.
3. Wear sunglasses or glasses with an ultraviolet filter to slow down the aging effects of the sun on your eyes, and to minimize wrinkles around your eyes.
4. Taking anti-oxidant supplements to minimize lens oxidation, which can increase the rigidity of your eyes’ focusing lens. Green leafy vegetables, and orange-colored fruits and vegetables are also good sources of anti-oxidants.

Inevitably, you will need a special prescription, or bifocal lens for reading, even if you had refractive surgery. Options to help you read include:
• Progressive lenses (no-line bifocals)
• Reading glasses
• Adjustable computer glasses
• Bifocal contact lenses
• Mono-vision contact lenses or refractive surgery

We practice in a holistic manner, and are always looking for ways to help our patients age gracefully through diet and exercise, not only for your body, but also for your eyes.

Lady Gaga’s fans are putting their vision at risk by attempting to copy her huge, anime-style eyes as seen in the Bad Romance video. Although Gaga’s gigantic peepers were computer generated, fans are copying the look with illegal Circle contact lenses obtained without a prescription on foreign websites.

These contacts are larger than normal lenses and cover more of the sclera or white part of the eye to create an exaggerated appearance of the eyes. They can cause significant, permanent damage to the eye if they do not fit your eyes properly. This requires a contact lens evaluation by an Optometrist. Potential problems include impaired vision, conjunctivitis (pink eye), swelling, redness, corneal abrasion, scarring, and insufficient oxygen due to the larger, tighter contact lenses that allow less tear exchange and oxygen to the eye. No beauty fad is worth damaging your eyes or causing an infection.

There are safe and legal soft contact lenses with the dark limbal ring, but these lenses are going to be discontinued by the manufacturer as of 10/31/10. You do need a prescription for these lenses, and yes, they look fabulous on your eyes!

This You Tube video describing how to create the “big eyes” from Lady Gaga’s video has received more than 9 million views. Many girls who obtain these Illegal Contact lenses do not care for them properly, and use them for longer than they should be worn for which can also hurt your eyes. Remember, contact lenses are medical devices, not make up.

Here’s a recent interview on the KTLA Morning News about this and other related topics.

It is more tiring to read from a computer screen than a printed book because the pixels that form the letters are not stable, and have less contrast & definition than books. There is an electron beam that scans the monitor and recharges the illumination of each pixel frequently. Your eyes have to continuously “fill in the gaps” to keep the words in focus which causes fatigue and eyestrain. Printed books are easier on the eyes because the characters are dense and have well-defined edges.

Studies suggest that most computer users experience some level of eye discomfort from computer work; therefore, most people who work on a computer more than a couple hours daily could benefit from prescription computer glasses.

Symptoms of CVS include:
•    Overall fatigue
•    Headaches or eyestrain
•    Dry, burning eyes
•    Double vision
•    Blurred vision
•    Neck and shoulder pain

Treatment:

•    Get your eyes checked because even a small, uncorrected prescription can cause eyestrain and decrease productivity. Glasses prescribed for computers balance the eyes and eliminate the constant refocusing effort. This increases comfort, accuracy and productivity. Computer glasses are not the same prescription as reading glasses which are prescribed for a closer working distance of 14-16”. Most computer screens are set at 20-24” away. Computer glasses may keep your eyes from getting worse (more nearsighted) by reducing excessive focusing strain on the eyes, especially for children and teens whose eyes are still developing.

•    To avoid visible flickering, the Refresh Rate should be set at a minimum of 75Hz

•    Vision Therapy to correct eye muscle problems computer glasses eliminate the constant refocusing effort that your eyes go through when viewing the screen. Vision problems that affect productivity include: Strabismus (esotropia, exotropia), Amblyopia, Convergence problems (convergence insufficiency or excess), Oculomotor Dysfunction (tracking problems), Fusional Instability (impaired ability to fuse the images from both eyes together).

•    Take a 20/20 “eye break”. Every 20 minutes, rest your focusing muscles by taking a 20 second break. Look into the distance, away from your desk and computer for 20 seconds.

•    Correct computer set up: do not have a window in front of, or behind, your computer screen. Overhead lights should be perpendicular to you. Dim the room lights to decrease glare and avoid washing out the computer screen and causing glare. Use a light on paperwork or your desk if necessary, but make sure it’s not pointed at the screen.

•    Use artificial tears to moisturize your eyes if they are dry. Your doctor can also recommend homeopathic remedies and nutrition tips to increase tear production

Technically speaking, if your eyes are tired, or you are tired, have your eyes examined to see if a prescription for Computer Glasses can help you, or if you have an eye muscle or focusing problem, or dry eye problem that is treatable. This will help you be more comfortable and more productive at work, school, and while tweeting on your iPhone or Blackberry!

Dr. Elise Brisco, OD, FAAO, FCOVD
www.HollywoodVision.com
Los Angeles, California (323)954-5800

When the cornea, the transparent and sensitive outside window to the eye, is not adequately lubricated, corneal cells are damaged which exposes its nerve endings. This causes the typical dry eye symptoms of pain and reflex tearing.  If the nerves become severely damaged, they may get to the point where you unable to feel or transmit pain which means there will be few, or no symptoms. This is dangerous because without a warning system,  it is like your hand not being able to feel pain if you put it into a fire, which would alert you to avoid the dangerous situation.

Dry Eye Symptoms

Symptoms of dry eyes include:

• burning, scratchy sensation
• eyes feel tired
• red or bloodshot eyes
• rubs eyes frequently
• sensitive to light
• teary eyes (reflex tearing)

Health problems associated with dry eyes include inflammatory, nutritional and endocrinological causes.

Inflammatory Causes

Inflammatory causes such as Sjogren’s syndrome, juvenile arthritis, and graft-versus-host disease (GVHD, i.e. after bone marrow transplantation) can decrease tear production which causes dry eyes.

Sjogren’s is an autoimmune  disease characterized by excessive antibodies directed against various tissues in the body. The dry eye condition, called keratoconjunctivitis is also usually accompanied by dry mouth (xerostomia). Other symptoms include: chapped lips, arthralgia, morning stiffness, nonerosive arthritis, myalgia, muscle weakness, fatigue, depression, dry cough, and achalasia (difficulty swallowing, chest pain, regurgitation).

Juvenile arthritis (JRA) is another autoimmune disease. In autoimmune diseases, the white blood cells (WBC) lose the ability to differentiate between the body’s own healthy cells, and harmful invaders such as bacteria or viruses. The WBCs start attacking healthy tissues which causes inflammation and pain. JRA first manifests between 6  months and 16 years of age. Symptoms include swelling and pain in the joints, high fever, and enlarged lymph nodes or spleen.

Congenital Disorders

Riley Day Syndrome or Family Dysautonomia is a condition that occurs almost exclusively among people of Ashkenazi Jewish descent. Roughly 1 in 3,600 people in this population have this disease. The hallmark of this disease is alacrimia which is deficiency or absence of tear production. Other symptoms include hypoesthesia (decreased sensitivity of the cornea to trauma or pain), and corneal erosions. Systemic effects include progressive impairment of motor sensory and peripheral functions.

Cystic Fibrosis affects all secretory epithelia and can lead to dry eyes also.

Diabetes can lead to insufficient tear production due to autonomic neuropathy. This is the same process that causes peripheral neuropathy in diabetes which causes tingling and burning in the hands and feet. It also impairs the mechanism that allows the nerves on the cornea to sense dryness on the eyes, which triggers a message to the brain to produce moisture to moisturize and lubricate the eyes moist and lubricated.

Poor Nutrition

Undernutrition, diets low in iron or animal sources providing vitamin A, cystic fibrosis and other causes that interfere with nutrient absorption, can lead to Vitamin A deficiency which can cause dry eyes and even blindness. Approximately 250,000 to 500,000 vitamin A-deficient children worldwide become blind each year.

Miscellaneous Factors

Medications such as antihistamines for allergies and retinoids taken for acne vulgaris can decrease tear production.

Blink rate is reduced during computer use and video game play due to intense visual concentration. Blinking interferes with concentration by breaking up the image, so the brain slows down the blink rate to nearly one-quarter of a normal resting blink rate. This dries out the eyes.

Borderline dry eye symptoms can be exacerbated with contact lens wear, although newer generation contact lenses have moisture release agents embedded within the lens that help moisturize the eyes during contact lens wear, rather than wick away moisture from the eye’s surface.

Treating Dry Eyes

In my practice, we measure  tear quality and production, and consider your health history to customize the best dry eye management program for you or your child.

If the cause is a health problem, this should be treated first. If it is related to a medication, an alternative can be explored.

Temporary relief can be achieved with over-the-counter drops and ointments, but these last only a short while, and  flush away the body’s own tears, which are more effective than artificial tears (AT). If AT are necessary for short-term relief, I prefer non-preserved artificial tears because repeated use of artificial tears with preservatives can be chemically toxic to the eyes. There are also more effective prescription strength artificial tears, such as Fresh Kote, which mimic all three layers of tears and can promote corneal surface healing.

Other treatment options include nutritional supplementation with Omega 3 fatty acids to promote natural tear production, eating more moisture-promoting foods, anti-inflammatory prescription drops such as Restasis or prednisone, and moisture chamber glasses. Since I practice holistically, I use more natural treatment options first, then medications second.

A dry eye problem in children and adults is uncomfortable, and ultimately unhealthy for the eyes. Finding the root of the problem, and the best treatment options are important to keep your child’s eyes healthy, comfortable, and looking their best.

Elise Brisco, OD, FAAO, FCOVD

www.HollywoodVision.com

WHAT IS GLAUCOMA?

Glaucoma results from damage to the optic nerve which can impair vision. Glaucoma is the second leading cause of blindness, and is commonly referred to as the “Silent Thief of Sight” because it damages vision so gradually that you do not notice it until the advanced stages.

It is usually associated with elevated intraocular pressure or reduced blood supply – circulation to the optic nerve. Another mechanism is when the microscopic drainage system in the eye is partially obstructed, the intraocular pressure increases causing damage to the optic nerve. However, even people with normal eye pressures can have glaucoma.

HOW CAN I TELL IF I HAVE GLAUCOMA?

Unfortunately there are usually no symptoms until you have lost vision. Early diagnosis and treatment are the best way to minimize or prevent optic nerve damage, and limit glaucoma-related vision loss which is why we recommend annual eye exams.

Normal Vision without Glaucoma

Loss of Peripheral Vision with Glaucoma

HOW DO YOU TREAT GLAUCOMA?

There is no cure for glaucoma, but continuing treatment can preserve eyesight. Eye drops are usually the first line of treatment followed by laser procedures, surgery, and oral medications. A glaucoma specialist will prescribe the best treatment for your type of glaucoma.

RISK FACTORS FOR GLAUCOMA include:

-    Family history (10X greater risk)
-    African-American descent (6-8X higher risk than Caucasians)
-    Age (although infants can have glaucoma)
-    Thin cornea (front surface of eye)
-    Diabetes, high blood pressure, heart disease, hypothyroidism
-    Severe eye injuries
-    Nearsightedness
-    Prolonged corticosteroid use
-    Elevated intraocular pressure (although people with low pressures can develop glaucoma also)

HOW CAN I REDUCE MY RISK FOR GLAUCOMA, and KEEP MY OPTIC NERVE HEALTHY?

There are several ways to keep your body healthy and help reduce your risk for glaucoma:
-    Regular exercise (40 minutes of brisk walking 3x/week for 3 months can reduce intraocular pressure by 20%)
-    Quit smoking (smoking increases risk of glaucoma 2.9X)
-    Limit caffeine intake
-    Limit YOGA inversion techniques which can increase intraocular pressure
-    Ginkgo biloba (antioxidant that can increase blood flow and promote optic nerve health)
-    Acupuncture
-    Bilberry
-    Green leafy vegetables (i.e. spinach, collard greens, broccoli)
-    Consume other antioxidants such as Vitamin E, C, B12
-    Foods high in magnesium (Ex. Fish, apples, avocados, bananas, dairy)
-    Eat less refined foods (i.e. white bread, pasta, sugar)
-    Eat mainly vegetarian including cold-water fish, and eggs
-    Chrysanthemum tea
-    Chinese herbs (Wu Ling San Teapills, Huang Lian Yang Gin)

Dr. Elise Brisco, OD, FAAO, FCOVD

(323)954-5800

www.HollywoodVision.com

Sources: Glaucoma.org, healingtheye.com, medicalhealthguide.com