Vision in contact lenses can be a challenge for many people -- do you have astigmatism?  a high prescription? need correction for both distance and near work?  If you answer yes to any or all of these questions, finding a soft contact lens that solves all of your needs could be challenging, or down right impossible.  That is where specialty contact lenses like Synergeyes come into play.  Wouldn't it be great to have the comfort of a soft contact lens, with the vision of a gas permeable contact lens?  That is the design that Synergeyes is built on, and it is a lens that can provide that next level of contact lens success for patients where soft lenses have been disappointing.

The concept is a simple recipe for success -- why do you have to sacrifice vision for comfort? Or comfort for vision? If you are an RGP or soft contact lens wearer and feel like you are sacrificing, then maybe this is your answer.  via

Simultaneous Vision is just a nicer way to say ghosting, but putting a positive spin on the struggle of seeing in multifocal contact lenses is fighting the good fight.   You need to prepare the patient that they likely aren't going to like how they see at first.  Probably for several days.  Give the brain time to practice and learn, and things should start getting better!  It is 100% expected for your reading vision to look like the paragraph above if you are a first time multifocal contact lens wearer via

White glasses and sunglasses were all over multiple designer's collections for the spring and summer, but I don't see white leaving us when Memorial Day hits our calendars.  White glasses are so bold and graphic in a world where colorful plastics have dominated eye wear for the past several years. We traditionally associate whites with spring and summer, but making a bold statement is in style every month of the year.  Here are a few good reasons to bring white into your wardrobe, even if you are looking ahead into fall fashion.

Mixing white with gold is always a winning choice.  Gold metal accents always transition well into fall and winter because of the warm color palate that we typically associate with these seasons.  If you break down the color theory, by pairing white (a cool color) with gold (a warm color) you are achieving a look that should be great with any outfit, any skin tone, and any season.  via

I know they are rather avant garde, but I have been a huge fan of Prada's collection this year featuring oversized plastics with large gemstones.  Where the loud color combos used in other sunglasses in this collection can look almost juvenile (bright yellow sunglasses and cobalt blue bedazzles anyone?), the white on white look is much more sophisticated.  It could look great even with a white wool coat, scarf and hat in the middle of winter.  via

I would wear these glasses every day if I owned them.  Literally every day.  When I saw them on Eye See Euphoria, it was just love at first sight. The art deco-inspired detailing over the browline is a nod to another major trend in eyewear, making this pair of glasses really fashion forward for the moment. via

Round is not leaving us any time soon, and as the trend sticks around more and more people are beginning to dare to try it.  If you want a younger and more fun look, then you need to go big with this trend.  Oversized plastics in round shapes are almost cartoon-like, but there is no denying that you are making a statement.Wildfox Round White Sunglasses via

If you like the idea of white round sunglasses, but want a more mature and sophisticated route, look for a frame that is more delicate in size.  Round glasses are always going to look very graphic because you are creating a new shape on your face, so keeping the size smaller and the color more subdued can make round glasses actually wearable for the average person.  These Rochas frames are a really understated take on the trend, and therefore much more wearable than your average round pair of glasses via

Pseudopapilledema: The patient above has Buried Optic Nerve Head Drusen, causing elevation of the nerve and an appearance that is suspicious for edema

True Papilledema needing a prompt referral

Vision or Ocular Symptoms

It would be easy to think that if the person has normal vision and no complaints, then they likely don't have papilledema.  That is not the case, however.  In fact, acute papilledema is typically associated with only minimal loss of function of the optic nerve.  The average patient with acute optic nerve edema has normal vision, normal color vision, and normal pupil reaction.  Longstanding edema associated with ischemic syndromes like NAION are very likely, however, to have significant vision side effects.

Just because your patient doesn't have any symptoms -- no headaches, no vision changes, no visual auras or disruptions, they could still have papilledema needing prompt referral for imaging.



Sources: "Differential Diagnosis of Optic Disc Edema" A. Arnold, MD. American Academy of Ophthalmology. Volume 17 Issue 2.  March 1999

I don't know that there is a medical marketplace so oversaturated and underperforming as artificial tears. Just ask 10 people who complain that their eyes are red or burning or dry what eye drops they are using and the variety of answers is astounding.  Depending on the OTC drops you purchase, you may be experiencing really poor relief of your dry eye symptoms, and could even be making your symptoms worse! (Please, please, don't buy those red eye drops.  They are full of preservatives that are making your eyes much worse!)

Your tear film is made of 3 layers.  The lipid layer (surface coating) is usually the one that is compromised in dry eye, so the best artificial tear drops will help replace or stabilize this lipid layer.  via

I have had quite a few emails and posts wondering about the status of Ciba Vision's other color contact lens options since their launch of the new Air Optix Colors.  As of July 2014, this is the memo that Ciba Vision has circulated to doctors and contact lens distributors for the future availability of their older color products:

Freshlook Toric Handling Tint Single Trials:   Discontinued July 31st, 2014
Freshlook Colorblends Toric Boxes:   Discontinued October 31st, 2014
Focus Softcolor Single Trials:   Discontinued Immediately
Focus Softcolor Boxes:    Discontinued March 31st, 2015 (or as supplies last)

There is no plan at this time for another color toric (or astigmatism) contact lens to be on the market from the Ciba Vision company.  I am uncertain of the future option of an Air Optix for Astigmatism Color lens, but I imagine it would be several years away at the earliest.

The recommended replacement for Focus Softcolor lenses are Air Optix Colors or Freshlook Dimensions.

What to do if your lens has or is being discontinued?

Orion BioColor and BioColor Torics are a customizable soft contact lens made by Alden Optical.  These are special order contact lenses requiring more sophisticated contact lens evaluation and fitting process. At this time BioColor is one of very few color contact lenses that are available in astigmatism correction.

If you wear Freshlook Coloblends Toric, it appears that you should be able to continue to purchase boxes until October 31st.  Certain distributors may no longer have the lens in stock, so you may need to call around if your vendor or doctor's office is unable to secure the lens for you.  Your best bet is to order through a doctor if you are having trouble because they can order personally and directly from their Ciba company representative if there are any boxes left in your power or color to be had.  After October 31st, if you would like to continue to wear color contact lenses with astigmatism, there will no longer be a readily available option.  Ask your doctor if they offer custom contact lens fitting and the prices for this service.  Custom contact lenses like Orion BioColor Toric come in a range of astigmatism and color options, but these lenses are specialized, made to order contact lenses.  That means a more time consuming ordering and evaluation process, and typically a higher cost of goods and service.  If you are interested in exploring custom astigmatism color contact lenses, your doctor will be able to tell you if it is a service they can provide, and the cost that this process and the lenses would require.

It is always frustrating when your favorite contact lens gets discontinued.  Remember when they stopped making Durasoft colors?  Remember when Acuvue discontinued all of their color contact lens options?  In the future we may have more color options available again for people with high prescriptions or astigmatism, but it may take some time for new lenses that meet the FDA's safety protocols to get tested and approved to bring to market.  Your doctor will work with you to find a lens that provides the health and comfort and vision that you need, but color options may be limited to the world of custom order for those in more specialized prescriptions for the time being.

Sometimes I can't tell if eyes are just getting more popular, or if I just notice them more since I think about eyes pretty much the entirety of every day.  I have been seeing a multitude of designers for both fashion and home featuring eyes in their newest designs and collections.  From over the top statements to subtle embellishments, eyes are a source of inspiration not just for eye doctors, it seems.

Fashion:

• 1) Dip +1.00 in front of the patient while they are reading.  Did you see with or against?
• If you saw with, then you know they have a higher than normal lag (at least +1.25 or higher)
• If you saw against, then do a quick retinopscopy sweep of the eye without any lens in place
• If you saw with, then you know they are normal
• If you saw no motion or against, you know they have a lead in accommodation

Exact quantification is not necessary on this test, bracketing is really your best friend to make MEM retinopscopy both efficient and informative.  Remember, when assessing accommodation with this method you are just trying to assess if the accommodation to the target is normal, and if it is abnormal, is it a lag or a lead?  This information tells you if the visual system is compensating for another problem that you need to uncover and explore, and is not an end point to your investigation.