1. Bring an extra pair of contact lenses or glasses in case you lose, tear or break yours. It is often difficult to find an eye doctor quickly while away from home.
2. Wear glasses, instead of contact lenses, while flying. The dry air in the plane’s cabin air can make your eyes feel dry and scratchy.
3. Put your name and address on your eyeglass case so it can be returned to you if you misplace your glasses.
4. Bring ophthalmic antibiotic drops if you are traveling to a remote area in case your eyes become infected while camping, hiking, swimming in the ocean, etc. Schedule an appointment with Dr. Brisco before your trip for a pre-trip eye health evaluation, to prescribe antibiotics for your medical emergency kit.
5. Bring wetting drops for moisturizing your eyes while on the plane (especially on long flights). The drops will also be useful if you are in a dusty environment, such as while on safari or on dirt roads.

Pink Eye

There are many possible causes of red eyes; therefore, it is important to have an Optometrist examine your eyes to determine the cause and best treatment. Here are some of the most common causes:

• Allergies: Dust, pollen, mold, environmental (smog, pollution, etc.)
• Infections: bacterial (may have mucopurulent discharge and crusting), viral (may have runny nose, sinus congestion, swollen eyelids). Both are very contagious.
• Sexually transmitted: Herpes Simplex, Chlamydia
• Dry Eye: insufficient tear production, hormonal, age, systemic health problems
• Excessive UV/sun exposure: tanning beds, sports: skiing, surfing, etc.
• Environmental: smog, chemicals, wind, blowing dust
• Eye strain: prolonged computer work or visual tasks decreases blink rate
• Lack of sleep
• Contact Lens wear: wearing contact lenses too long, or not replacing lenses as prescribed
• Uveitis: is an inflammation of the middle layer of the eye where most of the blood vessels are. Symptoms include redness, pain, blurry vision, floaters and light sensitivity. Uveitis can be caused by health problems such as autoimmune disorders such as rheumatoid arthritis or ankylosing spondylitis. Uveitis can also be associated with AIDS, psoriasis, ulcerative colitis, herpes zoster, and syphilis. Uveitis should be treated quickly because other complications, such as glaucoma, cataracts, or retinal and choroidal scarring, may occur if it left untreated.
• Blepharitis: a chronic infection and inflammation of the eyelids
• Lid Lice (Pthiriasis Palpebrarum)
• Smoking marijuana, drinking alcohol
• Acute Angle-Closure Glaucoma: Acute angle-closure glaucoma is a serious medical emergency and must be treated immediately.
• Subconjunctival Hemmorage: It can be caused by a Valsalva maneuver such as hard sneezing, coughing, intense straining, vomiting, trauma, high blood pressure, diabetes and sometimes from certain blood disorder problems
• Injury:Corneal abrasion, ocular trauma, sports injury
• Corneal Ulcer or Infection: The cornea has no blood vessels of its own. When the cornea becomes infected, surrounding blood vessels enlarge to bring immune system-related cells to help fight the infection.
• Frequent Use of Eye Drops: Constant use of one of the “get the red out” eye drops can cause over dilation of the eyes’ blood vessels. A rebound hyperemia effect can occur when you stop using the drops because the body becomes accustomed to being chemical constricted by the eye drops. After the effect of the eye drop wears off, the blood vessels sometimes dilate larger, causing the eyes to appear even more bloodshot

If you have a red or pink eye, see your Optometrist immediately. In case your red eye is contagious, be careful not to spread the infection. Wash your hands often, do not share linens, do not share make up, and do not go swimming. Discard any liquid make up that you are using, and soft contact lenses.

Do not use medications prescribed for someone else, or leftover from an old infection. The medication may not be appropriate for your current condition, and the bottle may be infected from touching the eye during previous use.

If you, or your child, are experiencing other symptoms such as coughing, runny nose, earache, the symptoms may be caused by the same bacteria, and you may need an oral antibiotic in addition to the treatment for your eyes.

The bottom line is that pink or red eyes can be caused by many reasons. Make an appointment immediately with your Optometrist to determine the cause and best treatment for you or your child.

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

The procedure is relatively painless and takes approximately 20-45 minutes per eye to perform. There is little downtime, so you may return to work the next day. You will need to avoid swimming for 2 weeks and refrain from strenuous exercise and heavy lifting for 3-4 days. Your eyes will have increased redness for the first few weeks, but once the new tissue regenerates, your eyes will become whiter and brighter! You will use eye drops for several weeks during the recovery period to aid the healing process, as well as artificial tears to help with temporary dryness. It is recommended to use artificial tears at least 4 times daily for 2 months after your procedure. You may also have temporary light sensitivity while healing, so it is recommended to wear sunglasses with a UV400 filter to protect your eyes from sun damage and aging.

The procedure is has a high success rate, so it is unlikely that you would need a second treatment except for the following cases:

• Pterygium: 7% may need a second treatment

• Excessive brown pigments/freckles: 3% may need a second treatment

To make sure that you are a good candidate for I –Brite, we will examine the health of your eyes before surgery. You must be at least 16 years old, and neither pregnant nor breastfeeding to have the procedure performed. The procedure may not be recommended if you have certain auto-immune diseases, so you would need to speak with your surgeon regarding this.

After the procedure, we will see you at 1 month, 3 months, and 1 year after your procedure to monitor your healing.

The proof is in the before and after pictures. Please call our office if you are interested in determining if you are a good candidate for the I-Brite Eye Whitening procedure.

]]> http://www.hollywoodvision.com/blog/2010/can-i-make-my-eyes-whiter/feed/ 2 http://www.hollywoodvision.com/blog/2010/do-i-have-a-vision-problem-if-i-can%e2%80%99t-see-3d-movies/ http://www.hollywoodvision.com/blog/2010/do-i-have-a-vision-problem-if-i-can%e2%80%99t-see-3d-movies/#comments Sun, 07 Feb 2010 17:49:42 +0000 admin http://www.hollywoodvision.com/blog/?p=19

Research has shown that up to 56% of those 18 to 38 years of age have one or more problems with binocular vision and therefore could have difficulty seeing 3-D.[i] In addition, about five percent of the population have amblyopia (lazy eye) and/or strabismus (eye turn) which makes 3-D viewing impossible. See my interviews nationally on NBC  and on KTLA:

http://www.ktla.com/videobeta/?watchId=801f6ab5-cbfe-401e-9608-6bc4bddeb8c3

http://www.ktla.com/health/3d-movies-health-vision,0,4561218.story

http://www.youtube.com/user/pkandapr#p/u/6/YIvK5gHw9sc

Unfortunately, not all people are able to see 3 dimensional images (stereovision, stereopsis), or 3D. Many people see a 2 dimensional, or flat world, and don’t know it because they have never experienced the pleasure of seeing in 3D. Vision problems such as strabismus (eye turn), amblyopia (lazy eye), or poor binocular skills (eyes drift apart) can interfere with the ability to see true 3D. In order to see in 3D, your eyes need to work together as a team to align the images from each eye, then the brain fuses the images into a 3 dimensional image.

For example, the 3-D version of the movie Avatar has two images projected on the screen, each image seen by one eye. The images are then merged into one by your brain. If your eyes don’t work together, it will be very difficult to merge or fuse the images into 3-D. The technology behind the Avatar 3-D effects is based on the premise that the viewer has the ability to see 3-D. If you have poor eye coordination, or a lazy eye, 3D television will also look flat to you (2 dimensional), and objects will not “pop off the screen”.

These vision problems affect more than just your ability to see 3D movies. They also impair depth perception, your ability to know where objects are located in space, eye hand and eye body coordination for driving and sports, and reading efficiency and comfort. Over time, if the eyes do not coordinate and work together, the brain ignores one image to avoid seeing double vision. This results in seeing a flat or 2D world.

But there is hope. Thanks to Optometric Vision Therapy, people who previously could not see 3-D are enjoying every special effect that 3-D movies such as Avatar, and 3-D TV have to offer. There are methods to teach people to see in 3D. Using Vision Therapy and physical aids (lenses and prisms) as “training wheels,” you can eventually learn how to point both eyes to focus on the same space. Visual skills are definitely trainable, so you can learn better eye control and coordination through special Vision Therapy techniques.

Most optometrists will recommend Vision Therapy or a type of physical therapy to work on eye muscle coordination and control.

The truth is that there are several options depending on how much you, or your child’s eye is deviating, which direction, how often it drifts, and the age of onset. It’s also important to consider if there are any co-existing neurological factors such as a traumatic brain injury, or acquired brain injury (such as stroke or craniotomy) to determine the potential for improvement.

Surgery alone is never the best option. If you cut the eye muscle, but the brain doesn’t learn how to coordinate the eyes and use them together, the eyes will drift apart again, and another surgery will be necessary. The brain needs to be trained to function as a two eyed system and use the eyes as a team. This will minimize the likelihood of the eyes drifting apart after surgery, and will maximize cosmetic alignment as well as visual function (such as depth perception/stereopsis).

Doing nothing is also not a good option. A patient with strabismus has little to no depth perception which will affect their ability to judge depth and distances such as while driving a car or catching a ball. It will also diminish your reading skills because the brain must ignore or suppress the eye that is deviating to prevent from seeing double vision. This wastes energy and attention is drawn away from the task at hand. Also, when one visual pathway is not stimulated and developed, that side of the brain doesn’t develop, and amblyopia usually occurs where the eye is not correctable to 20/20 vision, even with glasses, contact lenses or LASIK.

Usually the best option is Vision Therapy if the amount of eye drift is small, or intermittent. A combination of surgery and Vision Therapy is best if the deviation is larger.

That having been said, LASIK is still surgery, and we need to do a pre-operative exam to make sure that your eyes are healthy and suitable for LASIK.
Before you see the surgeon, we evaluate the following aspects of your eyes such as:
* Ultrasound to measure the thickness of your cornea for creation of the flap
* Tear analysis
* Cycloplegic refraction (prescription analysis under dilation)
* Topography (map of corneal surface)
* Pupil measurement
* Lifestyle analysis (to determine the target post surgical prescription goal i.e. monovision, under correction, full distance correction, etc.)

If everything looks good, you’ll meet the surgeon and schedule your procedure.

We will see you after surgery over the next several months to make sure that your eyes have healed properly.

LASIK or refractive surgery can be life changing for some patients as they wake up every morning seeing clearly. It is important to do it correctly, and choose the best surgeon after we’ve determined that your eyes are suited for LASIK.

I did a post-doctorate Fellowship in Developmental Optometry or Pediatric Optometry, and serve as a consultant to over 40 schools in Los Angeles. I evaluated my own son at 6 months old, and often play games with him to develop his visual motor and visual perceptual skills since vision is the dominant sense and extremely important to learning and sports.