New Study: Store Contact Lens Cases with Care

June 1st, 2010

Where and how do you store your contact lens cases when not in use?

So much time and effort is spent by doctors and patients regarding the proper care of contact lenses themselves that the importance of contact lens cases may get overlooked.    However, overlooking the risks associated with contact lens cases could be damaging to your eyes.

A new study from the University of New South Wales in Australia looked at the effect of air-drying contact lens cases in different locations and positions.     The results of the study were very interesting and should be considered by every contact lens patient in order to reduce their risk for contact lens case contamination and subsequent eye infection.

The researchers looked at the contamination rates for air-drying contact lens cases face up and face down in four different locations:  toilet, bathroom, bedroom, and office.    They found that the microbial contamination rate of lens cases air-dried face up was 6 times higher than cases dried face down.   Nearly 73% of cases positioned face up were contaminated by bacteria and/or fungi.     That contamination would greatly increase a patients risk for serious eye infections and permanent vision loss.

The study also found that when cases were positioned face up, the contamination rate was higher when the cases were located in humid environments (toilet/bathroom) than in drier environments (bedroom/office).   Although, when the cases were positioned face down, there was little difference between humid and dry environments.

The big take home message:   contact lens cases stored face up pose serious health risks and those risks can be significantly reduced by air drying the cases face down.     The bigger take home message:   better public awareness is needed regarding the importance of contact lens case hygiene.

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CEC Welcomes a new Team Member

May 28th, 2010

CEC Welcomes Marisa Stassi, optician, to the practice

As our part of our commitment to continually improve our level of service and patient care, we are pleased to announce the addition of a new CEC team member, Marisa Stassi.      Marisa is an exceptionally trained optician, and her nearly 15 years experience in the optical industry will be of great benefit to the patients of Clearview Eye Care.     We pulled Marisa away from her busy schedule of assisting CEC’s wonderful patients to ask her a few questions about her philosophy as an optician.

Dr. B:   What do you like best about being an optician?

MS:  I love being able to assist people in selecting eyewear that is absolutely the best fit possible. I take a lot of pride in the special process of eyewear selection which considers the patient’s prescription, visual needs, and personal preferences and style .  It is extremely gratifying when a patient puts a pair of glasses on for the first time and immediately falls in love with them.

Dr. B:  Many people have not experienced a proper fitting of eyewear. What is your approach to customized fitting of eyewear?

MS:  Eyewear selection is so much more than just style.  There are several aspects to selecting eyewear of which many patients are unaware.  When selecting the size and style of the frame, it’s important to educate patients as to why certain frames may or may not work well with their Rx.  For example, people who are moderately to severely myopic (nearsighted) should choose a frame that is not too large and that centers the eye well. People who are moderately to severely hyperopic (farsighted) should try to avoid semi rimless frames because this can add to the thickness and weight of the lenses.

Dr. B: What are some of the prescription lens technologies you are excited to share with patients?

MS:  Since I first learned about polarized lenses, when I was in Opticianry school, I have been a fan of polarized lenses.  Those who surf, fish, boat or swim, should know the benefits polarized lenses give, such as eliminating glare off of highly reflective surfaces (such as water) having polarized lenses is like seeing things in Hi-definition!!  Having so much water near us in the tidewater area, I feel that polarized lenses are a must for sunglasses!

I have been in the optical industry for many years now and the advancements that have been made to anti reflective lens treatments have improved the durability as well as overall wear ability of anti reflective lenses.  No longer will coatings flake off and craze, and they are much easier to keep clean and smudge free.

Dr. B:  What are some of the patient care benefits that you see given by CEC that you feel set us apart from the average optometry practice?

MS:  After many years in the optical profession,  one of the most impressive things I have seen at CEC is the 3 year warranty on frames and lenses.   We also go the extra mile by sending thank you’s and welcome letters to patients; not many eye care professionals take this extra step to show that they really appreciate their patients.   We also have some of the latest technology available to our patients and go the extra mile to even print out digital photos so that our patients can take them home with them.

I’ve also been impressed by the way CEC invites patients to stop by at any time for an adjustment to their current glasses, regardless of where they were purchased, and enjoy a cup of freshly-ground coffee in the process.   CEC is truly a unique practice centered on great service and genuine customer appreciation.  I am glad to now be a part of the CEC team.

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Facebook Fan Submitted Topic # 5: What causes cataracts?

May 26th, 2010

We asked for suggestions from our Facebook fans for blog posts and we got some great responses.   This is the fifth of  5 posts on Dr.  Beach’s blog  to be based on these topics/questions.

Michael, a CEC Facebook fan, asks:    “What causes cataracts because I know my grandparent had it.”

Hey Michael.   Cataracts are the number one cause of reversible blindness in the world, so it’s a pretty important topic.   I say reversible blindness, because cataract surgery is used to remove the cataract to restore vision, which I’ll touch on in a minute.

Before we get into what causes a cataract, it’s important to answer the question,  “What is a cataract?”   A cataract is a cloudiness that occurs within the crystalline lens inside the eye.   The crystalline lens is made entirely of proteins.  It’s the arrangement of these proteins during embryonic development that gives the lens its clarity and focusing properties.   Over time, these proteins may start to clump together or alter their arrangement.   Once that arrangement of proteins changes, clarity is lost and haziness develops within the crystalline lens.  The result is cloudy vision, almost like looking out a foggy windshield.   There are different types of cataracts based on where within the lens they develop.

So, what causes cataracts?    The number one cause is age.   As the lens ages, the proteins start to change and the lens becomes cloudy.  There is no specific age for cataract development.   In the clinic, I have seen age-related cataracts develop in patients in their 50’s and I’ve seen other patients in their 80’s with hardly any signs of cataracts.

Another factor in cataract development may be UV light exposure (sun bathing without sunglasses).   Also, nutrition and diet may influence cataracts and much discussion is being made regarding anti-oxidants in the prevention of cataract progression.   Trauma is yet another cause of cataract development.   Certain medications, such as oral prednisone or other corticosteroids, can cause cataracts.    Medical conditions, especially diabetes, can result in an earlier onset of cataracts as well.

While there have been false claims that certain eye drops can be  used to treat cataracts, the only cure is cataract surgery.   This outpatient procedure has seen great advances in recent years  in it’s efficiency, reduction of potential complications, and final vision results.   In essence, the cataract surgeon makes a small incision on the front surface of the eye, removes the natural crystalline lens containing the cataract, and a customized lens implant is put back in place.

Michael, thanks for the question.    It’s been a lot of fun answering questions from our Facebook fans these past two weeks.   It’s great to see such an interest in eye care!

Dr. Beach.

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Facebook Fan Submitted Topic # 4: Vision Changes with Age

May 24th, 2010

We asked for suggestions from our Facebook fans for blog posts and we got some great responses.   This is the fourth of  5 posts on Dr.  Beach’s blog  to be based on these topics/questions.

David, a CEC Facebook fan, asks:    “What do I do? As I age, my eyesight is getting worse and I never wore glasses before.”

Thanks David for the question!    Vision changes with age can be frustrating to a lot of people, especially those who’ve been able to live their entire lives free of glasses or contact lenses.    There are some naturally occurring changes within the eye, though, that are creating these visual challenges.   But of course, there are some medical conditions of the eye that also can causes changes in vision and that is why I encourage every patient to see their optometrist for a comprehensive exam annually—–regardless of how well they see!

The most common development over time is Presbyopia, which results in blurry vision while reading up close.    Presbyopia is the result of physical changes that occur within the eye.   The cornea, on the front surface of the eye, provides the majority of the eye’s focusing power but it is a fixed amount of focus.   The crystalline lens, within the eye, provides an adjustable focus which allows the eye to clearly focus on objects up close.    Somewhere between 35 and 45 years, this crystalline lens starts to lose its ability to focus up close.   The loss may be due to thickening within in the lens itself or stiffening of the muscle fibers responsible for flexing the lens, but either way once the process starts it typically worsens over a long period of time.

The change can be addressed by either glasses or contact lenses.   While Lasik doesn’t directly address Presbyopia, other surgical options are being used to treat Presbyopia.  One such option is the Restor lens, which is a modified cataract surgery in which the crystalline lens is removed and replaced with a multifocal implant, allowing for distance and reading vision to be restored.

The best course of action is a comprehensive examination in which the optometrist can evaluate your vision, your complete ocular health to rule out ocular disease, and an assessment and recommendation for possible treatments.

Thanks for the question, David.

Dr. Beach.

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Facebook Fan Submitted Topic #3: Nearsightedness vs. Farsightedness

May 20th, 2010

We asked for suggestions from our Facebook fans for blog posts and we got some great responses.   This is the third of  5 posts on Dr.  Beach’s blog  to be based on these topics/questions.

Jessica, a CEC Facebook fan, asks:    “What is the difference between near/far sighted and whats the difference physically that makes a person one or the other?“

Great question.

Nearsightedness, also called Myopia, is when a person experiences blurred vision for far away distances and clear vision while reading up close.

Farsightedness, also called Hyperopia, is when a person experiences clear vision for far away distances and blurred vision while reading up close.  (some exceptions apply to hyperopia though)

I like to think about the visual system like a projector system at the movie theater.  In order for your vision to be clear, it needs to be focused directly on the retina which would be equivalent to the screen at the movie theater.   If the projector system overfocused, the image would be blurry.  If the projector system underfocused it would also be blurry.   The focus has to be just right.    People who don’t need glasses or contacts have visual systems which accurately focus images on the retina.

People with myopia, or farsightedness, essentially have a vision system that is overfocussed or too strong.   The image focus before the retina.    Why does this happen?    One possible reason is the the cornea on the front surface of the eye is too steep in curvature which makes it too strong.   Imagine someone sneaks into the projector room at the movie theater and turns the focussing knob to a much stronger setting.   The movie on the screen is now blurry.   Another reason for myopia is the eye may be too long.   Sounds strange, but the visual system of the eye is designed to focus at a certain distance between the cornea and the retina.   Imagine that same movie theater in which the engineers have designed a projector system focussed on a screen with a set distance.   But what if someone knocked out the back wall of the movie theater and moved the screen back 10 feet?   It would be blurry because now the projector is over-focused for this new longer screen distance.

Hyperopia, or farsightedness, is the exact opposite.    The visual system is essentially too weak and focuses images somewhere behind the retina instead of directly on the retina.    This may happen if the cornea curvature is too flat (too weak) or if the eye is too short.     Just to muddy the waters, if someone has a lot of hyperopia their far away vision can also be blurry….we’ll save that one for another blog post!

Jessica, thanks for the great question.   The human visual system is essentially physics in motion, which is pretty cool….of course I’m a little biased.

Dr. Beach.

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Facebook Fan Submitted topic #2: How do Smart Phones affect our Vision?

May 18th, 2010

We asked for suggestions from our Facebook fans for blog posts and we got some great responses.   This is the second of  5 posts on Dr.  Beach’s blog  to be based on these topics/questions.

Wanda, a CEC Facebook fan, asks:    “With more phones being smart phones allowing us to spend more time on Facebook, ect how does this effect our vision versus time spent on computers?”

Wanda, I have to admit that I am addicted to my Blackberry Storm (and still pondering the Google droid) so I can relate to this question as a patient and an optometrist.   This is a great topic as more and more people buy smart phones and spend more time using applications on those phones.

Some of the potential visual issues of using smart phones are very similar to those experienced with heavy computer use.    I made some pretty interesting posts regarding Computer Vision Syndrome (CVS) about a month ago.     Be sure to check them out if you get a chance, but potential issues that could be experienced with smart phone and computer use include headache, loss of focus, burning/tired feeling, and blurred vision.

One effect of smart phones that may be more severe than with computer use is the need for “accommodation”, or the contraction of near focusing muscles.   This is for two reasons.    First, most of us hold our smart phones at a distance much closer than we view our computers.  The closer the distance, the greater the contraction of near focus.   Secondly, the print or text on smart phones is typically much smaller than that found on computers.  The smaller the print, the greater the contraction of near focus.

It is this overuse of accommodation when using smart phones that may create problems for some individuals.   Overuse can result in headaches, eye strain, and blurry vision.   Sometimes, the contraction of accommodation is such that it may not relax when looking far away which would actually result in blurry distance vision.

Whether it be computers or smart phones, the key is to take breaks.    On the Computer Vision Syndrome post I advocated the 20-20-20 Rule:   every 20 minutes, take a 20 second break by looking at something 20 feet away.  This would relax accommodation.   Given the increased demand on the near focusing muscles created by smart phones, perhaps that rule should be adapted to 10-20-20:  every 10 minutes, take a break and look at something 20 feet away for 20 seconds.

Wanda, thank you for submitting such a great topic.


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Facebook Fan Submitted topic #1: Diabetes

May 13th, 2010

We asked for suggestions from our Facebook fans for blog posts and we got some great responses.   This is the first of  5 posts on Dr.  Beach’s blog  to be based on these topics/questions.

Christie, a CEC Facebook fan, asks:    “What about eye problems that diabetics may face and how to potentially avoid them?”

Awesome topic suggestion, Christie!   This one is so important because diabetic retinopathy is one of the leading causes of blindness in America.

There is a very large range of potential issues that the eyes may develop as a result of diabetes.

One of the most common, and fortunately reversible, issues is prescription fluctuations.   Changes in the blood sugar levels of diabetics will very likely change their glasses or contact lens prescriptions.   For instance, if a patient’s blood sugar runs near 120 for a few weeks and then sees their doctor right after thanksgiving with a blood sugar near 200, this person has most likely experienced some changes in their prescription.   If a diabetic patient has highly fluctuating blood sugar levels from day to day or week to week, it is usually beneficial to wait for stabilized levels before finalizing glasses or contact lens prescriptions.

The best way to avoid these fluctuations is to check blood sugar regularly and to work closely with the primary care physician to help stabilize the blood sugar levels.   If a person isn’t regularly checking their blood sugar levels, these fluctuations are being missed and might lead to glasses prescriptions that will need to be changed frequently.

There are a number of other issues diabetics face, including cataracts and increased risk for glaucoma—-just to name a few.    However, it’s diabetic retinopathy that is the most serious complication and is currently one of the leading causes of blindness in America.    Diabetes tends to make blood vessels more prone to leakage.   When this happens in the retinal vasculature, it can potentially be devastating to the retinal tissue.   The severity of the damage and the resulting affect on vision depends on the location of the leakage within the retina and the response of the retina to the problem.   The damage done by diabetic retinopathy may be permanent, and retinal laser surgery may be required to prevent that damage from worsening.

Monitoring and keeping control over blood sugar is extremely important.  But when it comes to diabetic retinopathy, annual dilated eye exams with an optometrist are crucial to detecting early indications of diabetic retinopathy.   It is an absolute necessity for every diabetic patient to get a dilated retinal evaluation every 12 months, even if the diabetes is well controlled.  If I wasn’t such a horrible driver, I would personally drive diabetics to get their annual exam—–it really is that important.

Thanks Christie for suggesting this great topic.   It is definitely one that I am personally passionate about and one that I’d like to revisit in more detail soon.

Dr. Beach.

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Vitamin & Nutrition Corner: Omega-3 Fatty Acids

May 11th, 2010

Omega-3 Fatty Acids

Fatty acids are a group of nutrients that are extremely important in the function of cells, muscles, nerves and organs.  They also influence blood pressure and other cardiovascular functions through their ability to interact with hormone controls.   An “essential” fatty acid is one that our bodies can’t make naturally and must be obtained by consuming food.   Two such categories of  “essential” fatty acids are Omega-3 and Omega-6.

Omega-3 fatty acids are found in high proportions within the cell membranes in the retina and they play an important role in regenerating pigments within the retinal cells responsible for vision.   A deficiency of Omega-3’s could lead to decreased visual performance in certain situations.   Omega-3’s have also been identified as an important factor in Age-related Macular Degeneration (AMD), which is a leading cause of permanent blindness in America.   Two recent articles, highlighting studies in Australia, showed that higher consumption of Omega-3 fatty acids were correlated with significantly lower risk for AMD.

Omega-3 fatty acids have also demonstrated significant anti-inflammatory properties in the treatment of Dry Eye Syndrome.  A 2005 study at Brigham and Women’s Hopsital of Boston showed that increased consumption of omega-3 significantly reduced symptoms associated with Dry Eye Syndrome.   The study also showed that patients who consumed tuna 5-6 times a week had almost a 70% reduction in symptoms compared to those who only consumed tuna once a week.

With respect to general health, Omega-3’s have been found to lower triglycerides and the American Diabetes Association now recommends diabetics increase their fatty acid intake by consuming 3 oz. of fish 2 to 3 times a week.

In general, the American diet shows a significant deficiency in Omega-3 fatty acids.   However, there are some easy ways to change that.   One of the greatest sources is the consumption of cold water fish.   Salmon, tuna, herring, mackerel, and halibut show the greatest levels of omega-3 fatty acids, while other types of fish have much lower amounts.    Fish oil supplements have recently become popular and may serve as an alternative to consuming fish.   Flax seed may even be a better source of certain Omega-3’s, and may be found through Flax seed oil supplements.   In a future post, I will touch on how Omega-6 fatty acid and its ratio to Omega-3 is also important in maintaining ocular health.

How Much Omega-3 fatty acids?

  • 1-2 grams per day
  • or 4-5 servings of fish per week, depending on the type of fish

Where to get Omega-3 fatty acids?

  • Cold water fish:   salmon, herring, mackerel, tuna, halibut
  • Fish oil supplements
  • Flax seed oil supplements

What are the Benefits of Omega-3 fatty acids?

Reduced triglycerides

Possible reduction of blood pressure or other cardiovascular disease risks

Lowered risk for ischemic stroke

Lowered risks for Age-related Macular Degeneration

Improvement of Dry Eye Syndrome

Possible improvement of retinal function in vision

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A Glimpse at Coach

May 5th, 2010

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May 4th is National Teacher Appreciation Day

May 3rd, 2010

National Teacher Appreciation Day is May 4th.   While we all should be appreciative of the hard work and positive influence of our local educators every day, this is a special opportunity to say thanks and let them know we appreciate everything they put into the development of our youth.

If you are a teacher and reading this, please know that Clearview Eye Care greatly appreciates the positive role you play and all the hard work that goes into that role.

If you are reading this and know a teacher or have a child in school, please take a moment to write a note of thanks.    Often, it is the most important things in life we take for granted.

Again, thank you teachers!

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