Are school vision screenings good enough?

The screenings that are done at schools or at the pediatrician's office are usually very basic, and a lot of the essential tests that an optometrist performs are not done during a screening. Without any assessment of ocular alignment, binocular function, accommodation and convergence, these screenings are providing no info as to how a child is performing with reading and tracking. I have seen children "pass" their school screening, but fail their comprehensive eye exam. And vice versa. One of my favorite things about being an optometrist is pediatrics, as it is incredible how much a child's academics, attention, and headaches can start to improve once the proper glasses Rx is prescribed, if necessary.

"Why do I need to have a contact lens exam EVERY year?"

Great question! The short answer is because I need to make sure your eyes are still healthy enough to continue to wear contact lenses, and that you are okay to stay with the brand/material/base curve you're in currently. Now, time for my long answer! :) There are several things that can go wrong when wearing contact lenses, with one of the more common being that your eyes could be starving for oxygen with your current contact lenses, and you wouldn't even know it. You see, the cornea is the only tissue in the body that does not contain blood vessels. Well, at least it's not supposed to contain blood vessels. If a person regularly sleeps in his/her contact lenses or always pushes his/her monthly contacts to two months of wear time, the cornea will eventually start starving for oxygen. To cope with this, the body sends blood vessels to the cornea so that oxygen can be pushed that way. If this continues for a long time, scarring and permanent vision loss can result. These blood vessels, in their early stages, can only be viewed with a microscope and there would actually be no symptoms. This can also occur if a contact lens is fitting too tight or if a person is in a very old, non-breathable material. Unfortunately, I see this almost every week. Fortunately, though, with a change in habits or change in contact lens brand, this vessel formation can be reversed. There are other things that need to be checked for every year as well on contact lens patients, including a check for corneal infiltrates and a check for giant papillary conjunctivitis. I won't go into details on these 2 diagnoses in this blog, but let's just say that if these things were to occur, they could lead to potential problems as well, and need to be treated right away. So, please, don't try to save money by letting your 6 month supply of contact lenses last for an entire year! And take them out at night!
 

"I was never able to adapt to my progressive lenses that I got online for $100." Of course not!

Have you ever had progressive lenses ("no-line trifocals") in the past and just could not get used to them? Think you are stuck wearing lined bifocals or stuck wearing 2-3 separate pairs of glasses for different needs? We may be able to help! Believe it or not, there are actually hundreds of different brands/types of progressive lenses. Recent technology has brought about the advent of "digital" progressives, which give you the sharpest, most natural vision possible at distance, computer, and near. The cheapest progressives on the market (commonly found at places that offer "2 pairs of glasses for $99") are not digitally surfaced, may cause even more eyestrain than you had before, and will not give you as wide a range of peripheral vision through the lens. You DO get what you pay for when it comes to your eyeglasses!

Why does my eye doctor need to know what medications I'm taking?

Certain medications have been known to cause some unusual ocular side effects. Therefore, it's important that we know what medications you take, as it may help guide the testing that we perform during your exam. I will give you 3 examples:

1) Plaquenil, commonly used to treat arthritis, lupus, and malaria, can cause "bulls eye maculopathy," a condition affecting the retina that can lead to central vision loss.
2) Amiodarone, used to treat arrhythmia, can cause "whorl keratopathy," affecting the cornea.
3) Prednisone can cause early-onset cataracts (see pic below) and/or glaucoma.

Baby photos may be first sign of eye cancer

"Leukocoria" is the term used to describe a pupil that appears white. Generally, this occurs because there is a white reflection from something inside the eyeball that isn't supposed to be there. Sometimes this is more noticeable when looking at photographs, as one eye may appear to have the normal "red reflex" in the photo, while the other eye appears to have a white reflex. Please, if you feel your child may have this sort of white reflection in one pupil, do not hesitate to have him/her examined by an eye doctor. This could be the first sign of a retinoblastoma (a very serious intraocular tumor) or a congenital cataract, both of which are rare but need to be treated ASAP.

For EYE pain, see an EYE doctor!

If you're having eye pain/redness, I strongly discourage going to the ER or your primary care doctor. Let me tell you a little story. When I first started practicing, I saw a patient with severe pain in one eye. She had gone to the ER one week prior to seeing me. The ER doctor gave her a bottle of Atropine dilating drops. By the time she came in to see me, she had a corneal ulcer so large that she could barely see. Luckily, with a heavy course of antibiotics, I was able to restore most of the vision she had lost. Had she been given antibiotic eye drops to begin with, she likely would have not lost any vision in that eye. Is this a one-time case? Unfortunately, no. I see this type of thing several times a year. It makes sense, though! If I didn't have a slit lamp microscope in my office, I wouldn't be able diagnose a corneal ulcer either! Case in point: If your EYES hurt, see an EYE doctor!