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Is Eight the New Eighty?

DOES EXCESSIVE USE OF IPADS HURT CHILDREN’S VISION?

Almost daily I have a parent ask me if frequent use of IPADS or other handheld devices will make their children’s vision worse. It’s a consideration because handheld devices are held much closer to a child’s eyes than tv video games or traditional computer video games.

I believe it is likely that excess use of these handheld devices will cause at least some children to require eyeglass prescriptions sooner, and stronger, than they would have otherwise. And we are also starting to hear about possible cumulative internal ocular damage from blue light emanating from hand held and tabletop computer monitors. (more on this topic in a later blog).

But here’s an observation I recently made. We recently had a patient in her 80’s come in for an eye exam. She was reasonably healthy but her posture was somewhat stooped with rounded shoulders and forward neck/head tilt. It was obvious she no longer had good spinal alignment.

My next patient was a mom whose 8 year old was sitting in a chair in my exam room. The youngster was playing video games on a smart phone. The great thing about that is that the child was totally engrossed during the entire eye exam. But as I looked at that young girl’s posture I realized it was identical to the posture of my previous 80 year old patient – rounded shoulders, head tilted forward, spine out of alignment.

If your child is watching a movie on an IPAD, place it on a table with the IPAD at least 2 feet away from the child rather than right in front of the child. This longer distance makes the child’s accommodative/focusing system not have to work as hard. And, placing the IPAD on a table rather than in the child’s hands means that they will likely use better posture.

Excessive use of handheld devices will likely create neck and back problems because of the “slouch” position that is held for long periods of time. Needing glasses to see better is a problem we can easily fix. Neck and back problems? Not such an easy fix.

Remember it’s an IPAD and not an EYE-PAD. It may be good for the I but not good for the EYES.

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik/refractive surgery co-management in the Gainesville-Haymarket area of Virginia.  GH Eye also has a superb collection of frames and high tech lenses.

Un-Puffed

At GH Eye we use ICARE Tonometry and NOT Air Puff Tonometry to measure the pressure in your eyes. (Checking eye pressures is one of the ways we make sure you do not have glaucoma.)

Funny that eye care professionals consider Air Puff Tonometry a “gentle puff of air” while patients remember it as a “blast of air”. In fact, when we seat patients in front of one of our other optical instruments, we see some of them flinch because they think they are going to be puffed. Patients visibly relax when we let them know we are a ‘puff-less’ office.

Prior to the development of the air puff, there was the dreaded Schiotz device. It had something to do with placing weights on the eye. Must have been a big relief to patients and doctors when they could use a puff of air instead.

And in the era before Schitoz Tonometry, doctors could determine if the pressure in the eyes was elevated by digitally pressing on a patient’s eyes. In this case “digitally” refers to a doctor’s fingertips — a very inadequate way to check for pressure elevation.

We’ve come a long way in terms of how to check for ocular pressure. Our patients appreciate that the ICARE Tonometer we use in our office does not require numbing drops or an air puff. We use it on kids and adults. For  some patients, when more detailed analysis is needed, we also use our Goldmann Tonometer, which requires eye drops, but does not puff air.

If you’ve been putting off your annual eye exam because you “hate that puff” now you have no more excuses. At GH Eye, you will never be “puffed”!

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik/refractive surgery co-management in the Gainesville-Haymarket area of Virginia.  GH Eye also has a superb collection of frames and high tech lenses.

Treating Dry Eye at GH Eye

Dry Eyes have been getting a lot of media attention. Even the Wall St. Journal recently published a detailed article “Why There Are More Dry Eyes in the House These Days” in their July 9, 2013 issue! There are probably about ten times the number of articles on dry eye in current eye care journals than there were ten years ago.

Why all the interest? One of the reasons is that how we diagnose and treat Dry Eye has become much more precise. Years ago, treatment was pretty much limited to handing the patient whatever bottle of lubricant eyedrops the last pharmaceutical rep left. That’s all changed because there has been so much more research into the causes and treatments of dry eye.

In addition to much more problem specific lubricating eye drops and ointments, we can also prescribe prescription eyedrops such as Restasis, Topical Steroid eyedrops such as Lotemax, Punctal Occlusion techniques and we even use low dose oral antibiotics such as doxycycline. Several pharmaceutical companies have new treatments for dry eye syndrome in the works.

The person who has dry eye corneal irritation because they sleep with their eyes partially open needs a different dry eye treatment than the patient who has arthritis related dry eye – or allergy related dry eye – or Lasik related dry eye – or corneal surface irregularity dry eye – or ‘meibomian gland dysfunction’ dry eye. We now have the ability to diagnose and treat different types of dry eye.

The most typical complaint we hear from people who have dry eyes is that there is a gritty sensation in their eyes. It may even feel as if there is something in your eye. Many people are surprised to find out that dry eyes can cause vision to be blurry. And, people who have both dry eyes and eye allergies are particularly uncomfortable.

For patients who have dry eye and/or allergic eye symptoms, I recommend an Ocular Surface Evaluation. This examination includes a detailed history and a determination as to whether the cause of your dry eye is excess evaporation of tears, inadequate production of tears, or is related other problems that can affect dry eye symptoms. This type of exam is typically covered by medical insurance (not vision plan insurance).

Whether your dry eyes are mildly annoying or very uncomfortable, we can help.

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik/refractive surgery co-management in the Gainesville-Haymarket area of Virginia.  GH Eye also has a superb collection of   high tech lenses and the latest in fashion frames.


 

Seeing vs. Seeing As Well As You Can

Google Glasses are in the news. These are eyeglasses with a smart pad embedded in the frame. They’re clever, expensive and available to select trendsetters.  But I think that  what should be in the news is that there are millions of Americans who go to school, work or drive with sub-optimal vision.

The saddest moments in my practice occur when I examine people no longer capable of clear vision because of eye disease or injury. The happiest moments occur when a patient picks up new glasses or contact lenses and sees clearer than they have in a long, long time.

But in between the people who may never be able to see clearly again and the people who are thrilled with their amazing  new vision correction, are a whole lot of people who are “seeing” — but not “seeing as well as they can”. This can include people who:

1. Have not had an eye exam in a long time

2. Have their eye exam performed by a doctor who makes minimal effort to fine tune the prescription or discuss current lens technology

3. People who increase the font, purchase over the counter reading glasses, or get bigger tv’s. Seeing magnified images may enable them to do a task like work on a computer or watch tv. But it does not provide the same comfort level as seeing a properly focused image through the best possible vision prescription. It’s amazing how much vision compromise people put up with because they just don’t realize how much clearer their world can be!

4. People who have had Lasik or Cataract Surgery several years ago. Their vision may have gradually changed but they have gotten out of the habit of seeing an eye doctor.

Passing a DMV or school screening means the person simply has MINIMUM required vision. Now wouldn’t you rather share the roads with people who see 20/20 and not just the minimum that DMV requires? And wouldn’t you rather have your doctors, plumbers, accountants, teachers, bus drivers or anyone else whose services you or your family use have perfect vision rather than “minimum” clarity? If an attorney is charging by the hour, I sure hope his or her vision is as efficient as possible. And if a contractor is reading a blueprint, I sure hope he is seeing all that tiny print really well.

I recently had the disconcerting experience of being in a doctor’s office where it was evident the doctor made an error because his vision was not as clear as it should be. When I mentioned he needed an eye exam, he just sort of said that he was ok because he has one eye that sees well at distance and the other eye works for reading and close vision. This doctor was confusing “seeing” with “seeing as well as he can”. He should have known better – but after many years as an eye doctor, I know how often I see people who have spent years not seeing as well as they can.

Vision is precious. Enjoy clear vision by having regular eye exams and utilizing today’s amazing frame, lens and contact lens technology. Be the best that you can be by seeing the best that you can see!

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik/refractive surgery co-management in the Gainesville-Haymarket area of Virginia.  GH Eye also has a superb collection of   high tech lenses and the latest in fashion frames.


 

For The Kale Of It

Kale is popping up everywhere.   It’s even in a new item on Panera’s  menu — Kale and White Bean Soup. Probably a fine choice as long as you don’t take advantage of the 99 cent desert and add a Danish.

One reason for Kale’s popularity is that it’s a tremendous source of lutein and zeaxanthin.  The only part of the body where lutein and zeaxanthin can be found is in the macula. The macula portion of your retina is responsible for the sharpest part of your vision.  Age related damage to the macula results in macula degeneration and there is reason to think that adding lutein and zeaxanthin to your food intake can thicken the  protective pigment of your macula.

Nutritional advice to help prevent macula degeneration includes eating more dark leafy vegetables such as spinach, kale or collard greens.  Unfortunately, most people have no idea what to do with kale or collard greens. (I’m not even sure I heard of kale until just a few years ago!)

The toughest part of preparing dark green leafy vegetables is cleaning them.  But Wegman’s, and other markets, have made it easy.  The Kale I buy comes in a relatively large size bag but as long as I put a rubber band around the bag after I open it, I have found that unused Kale stays good in the fridge for about a week.

Here’s three really easy ways of adding kale to your diet:

1.  If you make shakes or smoothies, just throw a bunch of kale in.  I found it works whether you are making a sweetened smoothie or an unsweetened one.  Even had an 18 month old toddler asking for seconds!  You can drink half the smoothie in the morning and take a  container to drink the remainder during a “coffee” break. You just feel really healthy doing that.

2.  Soups are easy to make, or you can buy canned.  I make a variation of  Weight Watcher’s vegetable soup recipe.  Once your soup is heated up,  just throw in some kale.  You can throw it in at the end for “al dente”  or you can cook it soft.  Either way, it adds color, texture and lots of nutrition to any soup.

3.  If you are microwaving a frozen entree, just add some kale to the top, replace the covering that you had to unfold to put the kale on, and microwave as usual.

Lutein and zeaxanthin are also available as supplements.  But with prepared, cleaned, cut up kale now available, it’s so easy to just add it to your food instead.

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik/refractive surgery co-management in the Gainesville-Haymarket area of Virginia.  She believes that by carefully checking your eye health and offering preventive suggestions, we can prevent small problems from becoming big problems.  GH Eye also has a superb collection of   high tech lenses and the latest in fashion frames.

 

 

 

Hold the Waterline: Eye Make-Up and Dry Eyes

Check an ocular anatomy book and you’ll discover that a “Waterline” does not exist. But check recent articles in women’s magazines — and you will find references to the “Waterline”. Articles on make-up frequently recommend placing eyeliner on the inner rim of your eyelashes. They usually state something to the effect that placing make-up on the waterline makes the whites of your eyes look whiter.

Actually, it can make eyes look more bloodshot because some of the make-up will ultimately flake into the eyes and irritate them.

The inner rim of the eyelash line is where you will find openings to meibomian glands. These delicate glands produce a crucial portion of the tears that bathe the cornea and keep it from drying out. Placing make-up in this area can plug up these important glands. And, make-up in this area is very difficult to remove properly which can mean that the glands are continually blocked.

We have had many patients over the years whose dry eye and other ocular symptoms dramatically improved when they stopped blocking up their meibomian gland openings with make-up and/or the make-up remover they used to try to get the make-up off.

Wearing make-up outside the eyelash line is fine. Wearing make-up inside the eyelash line (or on the “Waterline”) — not a good idea.

It’s funny that while writers in professional eye care journals are frequently writing articles about meibomian gland dysfunction; writers at beauty magazines are writing articles about how to muck up meibomian glands!

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her eye care practice at GH Eye has a superb collection of  basic and high tech lenses and the latest in fashion frames for adults and children.  

 

Contact Lens Acute Red Eye

Meet CLARE. Clare is one of those names that’s coming around again.  It’s not just grandma’s name anymore. There’s Clare Danes, movie star and actress on the popular TV program “Homeland”.  And according to www.babycenter.com , Claire was #31 on the 2012 baby name popularity list.

But the CLARE I am introducing you to is  Contact Lens Acute Red Eye.  It’s about time I make the introduction because too often, and with unfortunate consequences, CLARE is  confused with “pink-eye”.

A pink or red eye could be related to:

  • Bacterial or Viral Eye Infection
  • Allergic Eye Reaction
  • Ocular Inflammation caused by Iritis or Uveitis
  • Foreign Body in the Eye
  • Inflammation from a damaged or dirty Contact Lens
  • Corneal Keratitis or Abrasion,
  • Corneal Infiltrates or Ulcers
  • Reaction to preservatives in Contact Lens Solutions
  • CLARE

 

Treatment for CLARE is different than treatment for other types of pink or red eye. If you are a contact lens wearer, and you have a red or pink eye, you should see your eye doctor.  A phone call to your primary care doctor for “some drops” could result in a severe eye problem if what you actually have is CLARE,  corneal Infiltrates, corneal ulcers, ocular foreign bodies, abrasions or iIritis/uveitis.

If CLARE has found you, we can help.  At GH  Eye we schedule you for a same day appointment for a red eye problem whenever possible.  We hope you don’t meet CLARE, but if you do, we are here for you.

By the way, it’s fitting that  the name  “Clare” is derived from the Latin word for “clear”!

Dr. Ally Stoeger knows CLARE very well!  She provides annual eye examinations, medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her eye care practice at GH Eye has a superb collection of  basic and high tech lenses and the latest in fashion frames for adults and children.   

 

Vision Plan Facts

If you have a Vision Plan, there’s a good chance GH Eye and Dr. Ally Stoeger are providers for your plan. We see patients who have Vision Service Plan (VSP), Eyemed, Davis Vision, Spectera and other vision plans.

One of the benefits for patients who have a Vision Plan is that whether they are examined at an optical store — or whether they are examined at a technologically advanced private practice like GH Eye — fees are determined by their VIsion Plan Benefits.   The bottom line is that patients are pleasantly surprised to find it costs about the same to have their eyes examined at GH Eye as it does to be examined at a big box store optical!

We’re fortunate to have a large number of patients tell us how much they appreciate having a private practice alternative.  

When national retail opticals and big box opticals first appeared on the landscape, the perception was that their prices on exams and glasses were much lower than private practice eye doctors.  But Vision Plans and other changes have leveled the field.   In fact, while private practice doctors have lowered many of their fees, some “discount” opticals have quietly raised theirs.  

If it’s been a while since you’ve had an eye exam by a private practice eye doctor, schedule your next appointment at GH Eye, and see the difference.

If you have a medical eye problem, we accept most medical insurance plans (Anthem, CareFirst BlueCross Blue Shield, Aetna, United Health Care, Medicare).  Vision Plans do not cover medical eye problems, but medical insurance plans do.

If you don’t have a Vision Plan, don’t worry —  just ask us how you can benefit from our GH Eye Club program! 

Dr. Ally Stoeger provides annual eye examinations, medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her eye care practice at GH Eye has a superb collection of  basic and high tech lenses and the latest in fashion frames for adults and children.   

 

 

 

 

 

Eyes, Blood Vessels and Sugar

As an eye doctor, I spend a lot of my day looking at my patients’ retinal blood vessels.  We do this with a Dilated Eye Exam or by using Optomap technology.  An Optomap is an excellent method of assessing blood vessels as this technology provides a panoramic view of the retina.  (www.optos.com)

Allow me to connect some dots:

1.   Eyes have some of the tiniest blood vessels in the human body

2.   Diabetes affects blood vessels.  The blood vessels most affected are the smallest blood vessels.

3.   That’s why Diabetes is a leading cause of permanent vision loss in the United States.

So cutting back on sugar is a good way to protect your eyesight.  From personal experience — the more sugar you eat, the more enticing sweets become.  Gradually decrease how much sugar you eat on a daily basis and you may find overly sweet foods just don’t taste that great anymore.  Really.

You may even end up eating less processed food as  foods that shouldn’t have a sweet taste — like spaghetti sauce, soup, frozen dinners, restaurant meals– start to taste sweet to you.

The easiest way to a healthier diet is to enjoy healthy food.  It’s easy to reduce sugar in your diet when you don’t think it tastes as great as it used to.  Eat less sugar and after a few months you won’t miss it. 

A special dessert to celebrate a special event is a great pleasure for many people.   But making excessive sweets a part of your daily life increases the risk of Diabetes–  and diminishes the the grand wonder of that perfect celebratory dessert on a special day.   Make your every day life healthier and your celebrations more special by eating sweets during celebratory events and not on a daily basis.  

 

Dr. Ally Stoeger provides annual eye examinations for all age groups, medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her practice at GH Eye has a superb collection of  basic and high tech lenses and the latest in fashion frames for adults and children.   


 

How Long Does a Monthly Contact Lens Last?

Sounds like a trick question, right?  So how often should you replace a monthly disposable contact lens?

a.  once a month

b.  when you can’t see out of it anymore

c.  when your eye starts producing odd-looking goop

d.  every 2-3 weeks

The correct answer, for many of our patients, is every 2-3 weeks.  Even though lenses such as Biofinity (CooperVision), Air Optix Aqua (CibaVision)  and Pure Vision (Bausch & Lomb) are marketed as monthly lenses, I find that for many patients the 4th week of wear is noticably less comfortable than the first 2 or 3 weeks.  If a lens is feeling less comfortable there’s a good chance it’s causing irritation to the cornea and inflammation under the upper eye lid–changes that can affect your future ability to comfortably wear contact lenses.

I often suggest to my patients that they replace their contact lenses about 2 days before the lenses typically start to feel less comfortable.  For many patients, that means replacing a monthly disposable contact lenses every 2-3 weeks.

Dr. Ally Stoeger provides annual eye examinations for all age groups, medical eye care, contact lens examinations and Lasik surgery co-management in the Gainesville-Haymarket area of Virginia. Her practice at GH Eye has a superb collection of  basic and high tech lenses and the latest in fashion frames for adults and children.