Archive for the ‘Ocular Conditions’ Category

Additional Thoughts on Computer Vision Syndrome

Tuesday, April 6th, 2010

There’s the old joke:   A man goes to the doctor and says ‘doc, my arm hurts when I move it like this,’ and the doctor says ‘then don’t move your arm like that.’    If only finding a solution to Computer Vision Syndrome were that easy.   But the computer plays such an integral role in all of  our lives that avoiding it would spell trouble for our careers or our ways of communication.   Since my first post on Computer Vision Syndrome (CVS) was the most popular blog post so far this year, I wanted to add some follow-up ideas.

The most effective solution to CVS is specialized prescription computer glasses.   As mentioned in the first post, computer glasses allow for the correct amount of magnification at computer distance and thus relieve near-focus (accommodation) stress which often causes headache.   These glasses also are treated with anti-glare technology which further comforts the eyes by relieving glare strain produced by the computer screen.

But there are also some ergonomic approaches to CVS, such as:

1.  Take a look at the monitor:    Use an LCD screen with the highest resolution possible.   Most of us are using LCD screens, but some may still be using the older CRT monitors that are not flat-screens.  These older monitors have markedly reduced resolution and this lower resolution tricks the accommodation system into over-working to improve clarity.     Even with a LCD flat screen, it’s important to consider the brightness of the display.   Backgrounds that are too bright inherently create glare and eyestrain over long periods of time.    Consider adjusting the brightness of your monitor to match the brightness of its surroundings.

2.  Don’t forget lighting:  more is not always better.   That holds true with respect to overhead or room lighting when working at the computer for long periods of time.   To reduce strain at the computer, it’s best to avoid very bright lighting.   The eyes will be more comfortable if the environmental lighting is somewhat subdued.   Try to keep the major lighting source to your side, rather than directly in front or back of you while at the computer.

3.  Working distance: the optimal distance to be seated from the computer screen is about 20-24 inches away.   It is also optimal to have the computer screen 10-15 degrees below their eyes.

4.  Take a break, actually take lots of them: I advocate the 20-20-20 rule.  It’s simple and it can help reduced fatigue at the computer.   Every 20 minutes, look at something 20 feet away for at least 20 seconds.   These frequent breaks allow the accommodation (near-focus) muscles to relax and reset.

As always, if you have any questions or comments, please post them here or email us.   Happy computer work!

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Allergy Season Is Arriving

Wednesday, March 24th, 2010

With the snowstorm of 2010 now a distant memory, the arrival of April brings some familiar Hampton Roads sights:   beautiful skies, birds chirping, new leaves on the trees, colorful flowers in bloom, and……POLLEN.    In some areas, the pollen can drop like blankets over driveways and cars.   And if you are like me and many local residents, this brings allergies in the form of red and itchy eyes.

For many individuals, the pollen causes your body to send allergy or mast cells to the surface of the eyes where they release histamines, which cause the itching sensation.   Rubbing the eyes tends to only worsen this biological response and worsen the itching sensation.    But this doesn’t mean you can’t get out there and enjoy one of the truly best times of year in Hampton Roads.

There are some ways to help.    After spending time outdoors, be sure to take a shower and change into new clothes.   Also, artificial tears such as Systane Ultra can help wash allergic material from the surface of the eye and provide temporary soothing of the eyes.    A cool compress may also help calm and sooth the eyes.    Also, and this may be the toughest advice to follow, try not to rub your eyes.   This further exposes your eyes to pollen on your hands and exacerbates the histamine response.

Over-the-counter allergy medicines like claritin or zyrtec may be helpful in relieving nasal symptoms of seasonal allergies but they may not be as effective in controlling the redness and itchiness of the eyes.   In that case, prescription allergy eye drops provide quick and effective relief.    The most effective allergy eye drops are “combination” drops which act to control both the mast cells and the histamines released by those cells.   Also, these allergy eye drops are very safe in most patients and may be used for extended periods of time to get relief from seasonal allergies.

Don’t let allergies stand in your way of enjoying this beautiful spring weather, especially since, after all the snow, I think we’ve earned a great spring this year!

As always, please feel free to post your questions/comments here or email us.

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Computer Vision Syndrome

Monday, March 15th, 2010

It is estimated that nearly 140 million Americans use a computer at work, home, or school on a daily basis.   While computers have dramatically improved our lives over the last 20 years, they haven’t been quite so kind to the eyes viewing them.    Millions of people, using the computer more than 2 hours a day, have experienced Computer Vision Syndrome (CVS).

What is Computer Vision Syndrome?

CVS is a combination of visual and physical symptoms due to the stress placed on the eyes with extended and chronic computer use.     It is most often accompanied by:

  • Headache
  • Loss of focus
  • Burning/tired eyes
  • Blurred vision
  • Shoulder/back aches

What Causes CVS?

In my experience with many CVS patients, there appears to be 3 main contributing factors:

  1. Constant contraction of the near-focus muscles of the eye: this produces fatigue, headaches, fluctuating or decreased focus.
  2. Glare from the computer screen:  interferes with clear vision, producing eye strain and uncomfortable vision.
  3. Decreased blinking of the eyes:   results in greater evaporation of moisture from the eyes which then causes dryness, burning, redness and further blurry vision

Solutions for CVS

The best approach to CVS is a two-pronged treatment plan.   The first step is prescription Computer Glasses, based on careful testing of your visual tendencies when focusing up close.   This will relieve the focusing demand & stress created by chronic computer use.   Computer glasses will also incorporate Anti-Glare Treatment, which will free your eyes from computer glare and will allow for clear AND comfortable vision.   The second aspect of treating CVS is to address the physical symptoms created by reduced blinking.   Careful assessment of your ocular surface will allow for recommendations of artificial tears specific to your situation.   In some cases, complete relief may require prescription eye drops or the installation of tear duct plugs to retain your own natural tears.

If you find yourself in front of the computer on a daily basis, make sure to discuss any of these issues with your optometrist or schedule an appointment to see us.    Your eyes don’t have to suffer from CVS !

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Corneal Topography: Why it’s Important

Thursday, March 4th, 2010

Corneal topography provides the most detailed information possible about the curvature of the cornea.  Using a very sophisticated computer and software, thousands of measurement scans are taken and analyzed in just seconds.  Then, the topographer generates a color map from the data.

The map is interpreted just like any other topography map.  The cool shades of blue and green represent flatter areas of the cornea, while the warmer shades of orange and red represent steeper areas.  This corneal map allows the physician to formulate a “3-D” perspective of the cornea’s shape.    In the following “normal” topography, you can see that the color gradient is very gradual over the whole surface of the cornea.   This patient’s eye is very round, like a basketball, and has very little astigmatism.

Why is topography important?

It helps your optometrist formulate a complete assessment of your astigmatism.   This is important in the fitting of contact lenses.  At Clearview Eye Care, we perform topography on every one of our contact lens patients.   It can aid in the selection of the appropriate contact lenses.

Patients with astigmatism may not be good candidates for certain contact lenses, and they may achieve better vision with special contacts based on the shape indicated in the topography readings.    The following patient has significant astigmatism.  Compare this picture to the “normal” topography above and you’ll see that there is a difference in the curvature of the eye, especially in the 12 o’clock to 6 o’clock meridian:

Corneal topography is also important because it can detetct irregularities in the cornea due to a disease called keratoconus.   This condition is a progressive thinning of the cornea which causes a cone-like steeping on the surface of the eye.     Corneal topography is the best way to help diagnose and map out the severity of keratoconus.  It’s also the best way to monitor progression or worsening of the condition.   Look at the following topography of a patient with keratoconus:

Keratoconus is a whole topic in itself that we’ll get to soon in another blog post, but you can see there is a big difference between this topography map and the “normal” one above.   As always, if you have any questions or comments, feel free to post them or email them our way.

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January is National Glaucoma Awareness Month

Friday, January 15th, 2010

What is Glaucoma?

Wow! That’s a loaded question, and I’m glad to get that question from patients every day.   I’m so glad  because a better public awareness of glaucoma will be key to preventing the blinding effects of the disease.

Statistics and scientific data are a little boring sometimes, but  the one statistic that I would like to share is that glaucoma is the second leading cause of irreversible blindness in the U.S.   And what really speeds up my receding hairline, besides genetics, is that glaucoma is also a preventable source of vision loss.  Ok, one more statistic and then I promise no more–   As many as 4 million people in the U.S. have glaucoma and half of them are not aware of it.

What is glaucoma? Glaucoma is a progressive, irreversible deterioration of the optic nerve which causes blindness.  There are several different types of glaucoma, each having its own unique characteristics, but the common theme is damage to the optic nerve.     Consider these two pictures of optic nerves below.    The one on the left is a healthy optic nerve, and the one on the right has glaucoma.

The parallel lines in each picture are pointing to the edges of the optic “cup.”   The cup in the nerve is basically a hole that allows the blood vessels to enter the back of the eye.   Since it is a hole, there is no nerve tissue there.   Surrounding the cup, you’ll see reddish-pinkish tissue…that is healthy optic nerve tissue sending vision back to the brain.   We need as much of that tissue as possible to maintain a full field of vision.   In the picture on the right, that cup has expanded and the optic nerve has lost a significant amount of optic nerve tissue–which resulted in a severely reduced visual field for the individual.   This loss, unfortunately, is permanent and it never produced any pain symptoms which would have made the individual aware of the damage occurring.

As a result of this, glaucoma is often referred to the “silent thief of sight.”   However, regular eye exams with an optometrist can detect these changes early, and early detection is the key to effective treatment.

Please feel free to email me any questions about this or other eye care related concerns at doctor@clearvieweye.net

Take care,

Dr. Beach

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‘Tis the Season…for Dry Eyes

Thursday, January 7th, 2010

With the holidays now passed, you can finally feel winter weather settling in—especially this past week.     And with this early January weather, you might start asking yourself a few questions:   Why did I eat so many Christmas cookies?   Can I retire my reindeer sweater till next year? … And why do my eyes feels so dry?

Although ocular dryness can be a year round issue for some individuals, for others it can be seasonal.  Several factors help create this problem in the winter:

  • Dry, gusty winds:  it seems this is a trademark of Hampton Roads’ winters.  What we lack in snow, we seem to make up for in wind.   If not wearing eye protection, these winds can disrupt the quality and quantity of the tear film that is needed to cover and comfort your eyes.
  • Home and Automobile Heaters:  these create constant circulations of dry, hot air that can wreak havoc on your eyes
  • Dehydration:  drinking water and keeping hydrated is just as important in the winter as it is in the summer
  • Cold Medicines:  winter weather brings winter sniffles and the use of over-the-counter cold remedies.   Many of these medicines will create varying levels of ocular dryness.

Thankfully, you have many options to treat seasonal Dry Eye Syndrome and get your eyes feeling comfortable again.

The most obvious option is over-the-counter artificial tears, with the warning that not all tear drops are created equal.   In fact, no one tear drop brand is best suited for every individual.   I take the approach of matching the tear brand (based on its preservatives, its thickness, and its chemical composite) to the patient’s individual symptoms, severity of dryness, and associated findings.   One of my most highly recommended brands is Systane Ultra, but there are several others that may be more appropriate based on the individual circumstances.

Yet, the one thing I’d recommend for everyone:   KICK VISINE AND CLEAR EYES TO THE CURB! Drops labeled “gets the red out” are typically constricting the blood vessels on the surface of your eye and creating the risk for more symptoms over the long term.

Often, over-the-counter tear drops may not alleviate all your symptoms.   This is where prescription eye drops earn their keep.  The type and dosing of these prescription drops will depend on the symptoms and findings, but they are often very effective in controlling the ocular dryness and/or stimulating extra tear production.    Yet another option is Punctal Occlusion, whereby the drainage ducts of the eye are temporarily occluded to prevent your tears from leaving the surface of the eye.   This is also quite effective in getting your eyes away from feeling the ‘winter blues.’

As always, I’d love to hear from you with any questions or comments.  Take care.

Dr. Beach

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