Archive for the ‘Ocular Conditions’ Category

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Eyes may be the key to accurate ADHD diagnosis

Monday, May 20th, 2013

While ADHD is not my area of clinical expertise, I do know there seems to be conflicting points of view on ADHD in pediatric care.    Some feel ADHD is under diagnosed and proper identification of the condition could lead to ADHD 1 300x207 Eyes may be the key to accurate ADHD diagnosisbetter social and academic outcomes in children.   Others feel it may be over-diagnosed, and thus over-medicated.      But a new study indicates the eyes may play a role in giving clinicians a more objective test for properly diagnosing ADHD.

Researchers in Germany found that Pattern Electroretinogram (PERG), which is like a electrocardiogram of the retina, shows an increased “noise” pattern in patients with ADHD when compared to non-ADHD patients.     This noise in retinal nerve cells may help explain the inattentiveness found in ADHD.

PERG is a relatively easy and completely painless test, although it’s not a particularly common test.    Further research is needed across larger populations, but if the correlation holds up in further testing it could establish a more objective method for diagnosing ADHD.    This could help assuage both sides of the ADHD debate by allowing for accurate diagnosis and treatment.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

 

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“Do I need glasses to drive?”

Tuesday, April 9th, 2013

I think when many people ask this question, they are really asking “does the DMV require me to wear glasses or contacts while I drive?”     Each state has different requirements, but let’s take a look at the requirements for Doc7 300x195 Do I need glasses to drive?the Commonwealth of Virginia.

The DMV in Virginia states that you must wear vision correction if your natural vision is 20/40 or worse with both eyes open.   In fact, if you took your vision test at the DMV and didn’t pass, they would require your eye doctor to fill out the appropriate form.   Or, if you used your glasses/contacts to pass the vision test at the DMV, the requirement to wear vision correction is now on your license.

But,  I also like to let patients know while 20/40 vision means the DMV feels you can drive without glasses, 20/40 vision is still not very good vision.    20/40 vision means it will take a person longer to recognize important road signs.    20/40 vision could cause you to squint or focus more attention to recognizing important road signs and thus distract you from other vital tasks involved in driving.   A second or two longer spent to see something could be enough of a distraction to cause you to miss dangerous events  around you on the road.

So, even if the DMV may say your vision isn’t bad enough to require glasses for driving, I often recommend driving glasses to anyone with less than 20/20 vision.   Improving 20/25 or 20/30 vision back to 20/20 with glasses can only serve to improve your visual function while driving and only enhance your chances for safe arrival at your intended destination.    Not to mention, additional treatments  like polarization for daytime driving or anti-glare lenses for nighttime, can also improve driver safety.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

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Why do we check blood pressure as part of your eye exam?

Tuesday, February 26th, 2013

You may have noticed, at our office, the patient care technician checks your blood pressure as part of your testing during the eye exam.    But why?    What does blood pressure have to do with your eyes or your vision?    The upimg6 Wrist Blood Pressure Monitor 28996 300x267 Why do we check blood pressure as part of your eye exam?answer:  a lot!

Almost everyone—the news, our doctors, Dr. Oz’ talk show, our neighbors, and our spouses— tell us having high blood pressure can leave you at risk for a heart attack.    But, high blood pressure can also cause changes in the eye that may lead to permanent vision loss.      The reason is that the eye is a highly vascularized tissue.     The retina and optic nerve need a lot of blood supply to function perfectly.   And where there’s blood vessels, there’s the risk for malfunction due to high blood pressure.

If you’ve had your eye exam at our office, you may have undergone retinal photos and may remember me pointing out your arteries and veins in the retina.    If a person has chronic high blood pressure, something called Hypertensive Retinopathy may result in these vessels.    When this happens, blood flow is disrupted.   There may be leakage of blood and other fluids into the retina, and other portions of the retina may be cut off from blood flow and the influx of oxygen.    These events carry the risk for permanent damage to the retina.   Depending on the severity and location of this damage, vision loss will be the end result.

In addition, high blood pressure can also lead to a Retinal Vein Occlusion, where the pressure in an artery clamps down on a nearby retinal vein.   The result is that blood already used by the retina can’t be recirculated back down to heart.   Instead, it leaks from capillaries and pools in the retina.    Again, the result could be permanent vision loss.    The optic nerve may also be susceptible to chronic high blood pressure, and damage at this part of the eye is just as threatening as the retina.

But, there is an even more valuable reason to check blood pressure.  I firmly believe the optometrist plays an important role in the overall health of an individual.   Sometimes, people may see us every 12 months for their annual eye exam but only see their primary care physician every three years.   If I can let a patient know that her blood pressure is elevated, and she isn’t being followed for high blood pressure, then the eye exam has now served as an entry point for this person to take charge of their overall health.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

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Study Says Dry Eye Disease Slows a Person’s Reading Speed

Monday, February 18th, 2013

I’ve posted a lot over the past few years on Dry Eye Disease.    It affects millions of people every day and I’ve seen, in my practice, the effects and symptoms of dry eye ranging from mild to severe.   Dry Eye Disease can cause

punctate keratitis1 Study Says Dry Eye Disease Slows a Persons Reading Speed

staining of damaged surface cells in Dry Eye Disease

physical symptoms, as well as functional issues.  It can cause blurry and fluctuating vision.   But, a recent study was able to take it a step further and identify a more tangible functional loss due to dry eyes.

In the January 2013 issue of “Optometry and Vision Science,” researchers were able to demonstrate that patients with Dry Eye Disease had a slower rate or speed of reading than individuals without dry eye.    And, the difference in reading speed was pretty significant.    Further, they found that the worse the dry eye condition, the slower the reading speed.

This study truly  points to how dry eyes can affect our everyday lives.     As our eyes become dry, we’ll lose productivity that is tied to reading efficiency and efficacy.   The good news there are many treatments available to address Dry Eye Disease.    Click here to see previous posts about treating dry eyes.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

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Tanning Beds Can Damage Your Eyes

Thursday, February 7th, 2013

There’s no doubt artificial tanning through the use of “tanning beds” is a big business in the United States–especially in states like Virginia where the colder months prevent sunbathers from venturing outside to catch their sunbed 300x143 Tanning Beds Can Damage Your Eyesrays.    We know that tanning beds provide significantly more UV (ultra-violet) light than the sun.   And we know that UV light can lead to melanomas and other skin cancers.    But, the eyes are probably even more susceptible to tanning bed UV light damage than the skin.

Some sources estimate that the UV concentration reaching the eyes is 100 times greater in a tanning bed than from normal sun exposure.    Simply closing your eyes or wearing traditional UV blocking sunglasses will do little do block this amount of UV light.   The “tanning eyeglasses” provided by the tanning facility will provide a higher level of protection, but the best bet is not to tan at all, given the harmful effects.

One of the most common eye problems caused by tanning bed exposure is photokeratitis.   This is akin to a sunburn on the cornea, which is a delicate but extremely important part of the eye’s front surface.    Symptoms of photokeratitis include sensitivity to light, eye pain, swelling of the eyelids, hazy or blurry vision, redness and a sandy feeling.     Thankfully, this condition is temporary.

However, UV light is also linked to the development of cataracts, which causes vision loss only reversible with surgery.     Even more detrimental, UV light is linked with macular degeneration and melanomas of the eye.   These carry serious complications for long term eye health and vision.     So before you use a tanning bed, know all of the risks.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

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Sleep Apnea Can Affect Your Ocular Health

Saturday, November 3rd, 2012

Most of my blog post ideas come from real life patient care issues that we see here in the office.   But, this topic is a little more personal.   I was recently diagnosed with sleep apnea and my first thought was “I can’t believe I haven’t yet posted about the ocular effects of sleep apnea!”

First, what is sleep apnea?   Sleep apnea is a breathing disorder characterized by brief interruptions of breathing during sleep.   According to the EVMS Sleep sleeping Sleep Apnea Can Affect Your Ocular HealthMedicine website, “in a given night, the number of involuntary breathing pauses or “apnea events” may be as high as 20 to 30 or more per hour. These breathing pauses are almost always accompanied by snoring between apnea episodes, although not everyone who snores has this condition.”

The cause of obstructive sleep apnea is related to the structures of the mouth, throat and airway.   As muscles and tissues relax during sleep, the airway becomes partially blocked.   The result is less oxygen in and less carbon dioxide out.    Possible symptoms of sleep apnea include:  loud and chronic snoring, gasping or choking episodes during sleeping, excessive daytime sleepiness, personality/cognitive changes related to fatigue, and increase in workplace or automobile accidents.

Sleep apnea is typically diagnosed through a sleep study which measures body functions during sleep, such as the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow, and blood oxygen levels.    Treatments for sleep apnea include dental devices, weight and behavioral adjustments,  nighttime air masks, and select surgeries depending on the severity of the condition.

Sleep apnea has taken on greater importance recently as further research shows that sleep apnea is more than just a cause of fatigue.   It may contribute to the development of high blood pressure, stroke, heart failure and irregular heart beats, diabetes and depression.

Sleep apnea can also affect eye health.   There is growing evidence that sleep apnea plays a significant role in the development and progression of glaucoma.     More specifically, there is a high association between sleep apnea and “normal tension” glaucoma.    In this type of glaucoma,  the eye pressures may not be elevated beyond the “normal range,” but there occurs glaucoma-like damage to the optic nerve fibers.    The belief is the low oxygen levels that occur during sleep apnea are leaving the optic nerve susceptible to damage from even “normal” levels of eye pressure.    (see our earlier posts on glaucoma)  The association between normal tension glaucoma and sleep apnea is so high that any person with signs of one condition should be fully evaluated for the other.     Because glaucoma’s damage is permanent and produces no symptoms in the early stages, the best defense is annual eye exams along with updating your eye doctor on medical conditions such as sleep apnea.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

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When can an eye exam save your life? In the case of retinal emboli.

Monday, October 8th, 2012

Not too many people think of their annual visit to their optometrist as an opportunity to save their life, but when a dilated retinal exam is performed there is the possibility of finding warning signs for potentially life-threatening health issues.    This is the case when an optometrist finds a retinal embolism or plaque within one of the arteries in the retina.

To the right is a picture of a person’s retina.   As you can see, there is vast array of arteries and veins in the retina.    The optometrist is in the unique position of being able 1218567931960 low When can an eye exam save your life? In the case of retinal emboli.to physically see the quality of the local blood vessels without  surgery or complex imaging tests.   In the picture, you can see a yellow waxy-like object within the artery.    This is a retinal embolism called a Hollenhorst plaque.     It’s made mostly of cholesterol and it’s origins are from blood vessels somewhere else in the body.

Sometimes the plaque can disrupt blood flow to parts of the retina.  In that case, temporary or permanent vision loss may occur.   But this is not always the case.     Many times, a person can have this plaque in their retinal artery and have absolutely no visual symptoms.

However, the bigger concern may be where this plaque came from.    There is a risk that cholesterol deposits are collecting and blocking the carotid artery, which is the main lifeline of blood flow to the head region.   If plaques have broken off from here and entered the eye, there is a significant risk for similar plaques to break off and enter small but crucial arteries surrounding the brain.  This could cause stroke or even death.

If a retinal plaque or embolism is seen during a dilated eye exam, the next step is notifying the primary care physician to rule out carotid artery occlusion as well as other potential sources of the plaque.     Such steps, which may include carotid artery ultrasound,  could be instrumental in identifying and treating issues which have potentially life-threatening complications.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

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“Go Play Outside!” Study says that may cut kids’ risks for nearsightedness in half.

Sunday, August 19th, 2012
random summer 2012 025 300x225 Go Play Outside! Study says that may cut kids risks for nearsightedness in half.

7-month Parker Beach playing outdoors & decreasing his risk for myopia

With increases in childhood obesity and diabetes, there has been a big public awareness effort to get kids outdoors.    A little less time playing video games or watching television and a little more time exercising can help keep children healthy through their important developmental years.   But a recent study says that being outdoors may also provide a huge benefit to a child’s vision.

Well over 10,000 children were followed in a study that concluded being outdoors could significantly reduce a child’s likelihood of developing myopia, or nearsightedness.   Children who spent a “high” amount of time outdoors were up to 50% less likely to develop nearsightedness over time. A “high” amount of time was defined as at least 3 hours outdoors a day during the summer and 1 hour a day in the winter.

The interesting aspect of the study is that it may actually be the outdoor light, rather than the specific activity, which reduces the risk of nearsightedness.   While further study is needed, researchers theorize that the increased duration of outdoor light may stimulate dopamine production in the eye  to reduce the development of nearsightedness.

Given this was such a large study with a very significant conclusion, it’s clear that your child’s vision could benefit by playing outdoors.   The risk for nearsightedness could be greatly reduced, as well as the likelihood they would need glasses or contact lenses.    But don’t forget UV-blocking sunglasses when outdoors!

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach.

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Does Caffiene Help with Dry Eye Syndrome? Maybe.

Monday, June 11th, 2012

An interesting study out of Japan this year examined tear production and related dry eye symptoms in two groups of patients: the first group was given caffeine and the second group was not.caffeine 300x225 Does Caffiene Help with Dry Eye Syndrome? Maybe.

Researchers found that the group taking 400 mg of caffeine (almost the equivalent of 4 cups of coffee) show significantly greater volume of ocular surface moisture than the group not taking the caffeine. While researchers proposed caffeine could be responsible for stimulating tear glands the same way it stimulates saliva and digestive juices, they were quick to point out further study is indicated before doctors start prescribing caffeine pills to their patients who suffer from dry eyes.

Of course, it’s no surprise the caffeine group also indicated greater side effects such as increased heart rate, sweating, and nervousness. Although, some of these responses may be due to genetic variations that cause some patients to respond differently to caffeine intake.

While more research is indicated to understand the exact causes and the minimal amount needed to benefit ocular dryness, the bottom line is that morning cup of Joe may be helping to reduce the level of ocular surface dryness.

As always, I’d love to hear your comments or questions. Give us a shout over on Facebook or on Google+. And, remember, you can now request your annual eye exam appointment at our office by clicking here.

Dr. Beach

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Friday the 13th? Don’t be Scared. No more Air Puff!

Friday, April 13th, 2012

When you think of Friday the 13th, no doubt images of the scary movie series may pop into your head. And for some people, the “air puff” at the eye friday 13th 150x150 Friday the 13th? Dont be Scared. No more Air Puff!doctor’s office has become just as frightening. Whether it’s the anticipation of the air puff or the actual puff itself, there are not too many people who enjoy this aspect of their visit to the eye doctor.

We are pleased to announce this week, we ditched the “air puff.” While it gave us the very important readings of intraocular pressure to screen for glaucoma, we knew that this was an aspect of the patient experience that needed to be improved. Not to mention we couldn’t help but overhear comments such as “we put a man on the moon 50 years ago but we can’t come up with something to replace the air puff?”

From now on, we’ll be using the Icare Tonometer to check eye pressures. The Icare uses brand new technology which doesn’t need the “air puff” and does not cause any discomfort to the patient. It’s great technology and it’s keeping in line with our mission statement to bring our patients the best in eye care and vision correction.

So this Friday the 13th, don’t be scared to come to the eye doctor—NO MORE AIR PUFF! icon smile Friday the 13th? Dont be Scared. No more Air Puff!

Best Wishes,
Dr. Beach

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