Posts Tagged ‘Strabismus’

Your Eyes Age as You Grow Older so Don’t Take Yours For Granted!

Wednesday, March 9th, 2011


Your eyes change as you age, and there are things that you can do at every age to help your eyes gracefully, and see your best. Don’t wait until you can’t see before you visit your optometrist. By then, the problem is probably advanced, and may be irreversible. Most eye diseases have no warning signs because you don’t have pain receptors in the retina in the back of your eyes.

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.

Computer Vision Syndrome: Does Using the Computer Make You Tired?

Saturday, July 17th, 2010

Using the computer more than 2 hours a day is hard on your eyes. Your eye muscles have to stay in focus, track across thousands and thousands of words, and work like a synchronized swim team, or you will see blurry or double. If you have astigmatism, are farsighted, or your eye prescription is different in each eye, this adds more strain to the focusing system. Also, if your eyes don’t work well together (the eyes drift apart due to poor eye muscle coordination from strabismus, convergence insufficiency or excess, and tracking problems), this can cause eyestrain and diminish your productivity also. To see my latest TV interview about CVS, go to: http://www.videowired.com/video/2674864358/

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

Do I Have a Vision Problem if I Can’t See 3D Movies?

Sunday, February 7th, 2010

3D Movie  Audience

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. Fusion

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.


[i] Montes-Mico R. Prevalence of general dysfunctions in binocular vision. Annals of Ophthalmology. 2001; Volume 33, 3: 205-208.

What options besides surgery do I have for strabismus (esotropia or exotropia)?

Thursday, December 24th, 2009

This is the number one question I receive regarding strabismus. Most surgeons or ophthalmologists will recommend eye muscle surgery, but cannot guarantee their results.

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.

Does My Child Need to Have an Eye Exam?

Thursday, July 23rd, 2009

This is the number one question that I receive from parents. The answer is YES, by 6 months old, and yearly thereafter. The reason is because 80% of the information taken in while reading and writing is through the visual system, so vision problems can interfere significantly with learning. Early vision problems can also delay development in areas such as eye hand and eye body coordination which affect walking, reaching, crawling, and balance for infants and toddlers.
The vision exam needs to evaluate more than the need for glasses and eye health. Developmental or Behavioral Optometrists, such as myself, evaluate for age-appropriate visual motor and visual perceptual skills that affect learning and sports. Visual motor skills that important to learning include eye tracking, teaming and focusing. Visual Perceptual skills include visual memory, visual sequential memory, visual closure, and visual motor integration.

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.