Cleaning your glasses is just a normal part of your daily routine when you are a glasses wearer.  I know I have to clean mine 2-3 times a day due to the normal smudges and finger prints that my lenses will accumulate as I go through a normal work day.  But if you don't always have the right tools available, cleaning your glasses can not only be tedious but also expensive -- use a tissue or a harsh fabric, and  the scratches you create could mean you need to buy new lenses to see clearly again!  I always have a bottle of spray and lens cloth in my purse, but not everyone carries around a little Mary Poppins bag of wonders with them all day.  Enter the new Peeps cleaner from LensPen.

Peeps is a small hand held device that uses carbon to attract and remove the oils that can smudge and smear the surface of your lenses.  The other end of the product has a goat hair brush designed to prevent scratching to the delicate surface coatings of your glasses.  No spray or external cloths are needed -- the company recommends just breathing gently on the surface of your lens if a smudge persists and then slide the Peeps cleaner over them again in a circular motion.

The circular area is made to run over your lenses in a gentle, rotating motion, and utilizes carbon molecules to lift oils up and away.  The other end of the product has a goat hair brush to gentle remove surface debris. via

Pocket-sized so that you can keep them anywhere! via

The important thing to remember about your glasses is that the surface is very delicate.  Yes, you should have a scratch coating on your lenses to help prevent surface issues, but if you are using the wrong products no scratch coating in the world can withstand that kind of daily abuse.  Where the LensPen product prevails is that the carbon particles draw oils up and away from your lenses without relying on any rubbing or mechanical action.  It's all in the ionic attraction.  The goat hair brush on the other end are just there to gently remove any physical debris, but you aren't really rubbing your glasses clean with either side.  This type of product is designed to delicately protect your glasses lenses the same way you treat those expensive camera lenses.  The result should be clear, lasting lenses with no surface scratches!

Because the Peeps cleaner relies on an ionic charge attraction, there is a limit to how long it can last. Per the company's website, every time you close the Peeps cleaner back into its case it is recharged, up to 500 uses.

You can pick these up from Amazon for under $18.  Stocking stuffer for the glasses wearer in your life, perhaps?

Have you used the LensPen product?  If so, I would love to hear your personal reviews!

Seen the latest issue of Contact Lens Spectrum?  It was hard to miss that most of the articles were discussing study results about contact lens performance and where Ultra ranks against today's most popular lenses.  Bausch and Lomb's new monthly disposal Ultra contact lens has taken the market by storm since its full launch earlier this year, and there are plenty of things to like about the lens.  Here's a breakdown of the study results published in the CLS supplement.  Disclaimer: I want to add that the studies featured were all reported on by doctors with Bausch and Lomb and its parent company Valeant Pharmaceuticals.  I myself am not affiliated with any contact lens company or pharmaceutical company and am just presenting a summary of the findings from this report.  I have cited all tables included to their origin source of Contact Lens Spectrum, but at this time I have not found that they are available online.  I will update things here when they do become available for you to direct link to.

LogMAR units are used here to demonstrate visual clarity as perceived by the wearer.  20/20 is the perfect vision we all try to achieve during the eye exam and is shown above.  20/40 is legal driving vision.  Image from Contact Lens Spectrum Special Edition Volume 14, "Preventing Dehyrdation Blur"

Based on the study performed, image quality can vary greatly between blinks across different lens types.  30 seconds would be an incredibly long time to go without blinking, but many of us as computer users do go longer than 20 seconds without blinking, and you can see the blur that accompanies this. The Ultra lens in this simulation performs far and away better at keeping clarity even as the lens material is kept without moisture for 30 seconds. Image from Contact Lens Spectrum Special Edition Volume 14, "Preventing Dehyrdation Blur"

Who doesn't want longer, fuller eyelashes?  Latisse is a prescription medication that can give you just that when applied daily to your lash line over the course of three to four months.  The amount of lash growth that you achieve may vary, and these pictures from the Latisse website give you a great overview of the kind of success you may achieve:

BEFORE:


BEFORE:
As you can see, results are going to vary based on your individual eyelash make-up.  But with daily use for the given time period, you should be seeing longer and fuller lashes from your baseline.

How Does it Work?
Latisse is the trade name for 0.03% bimatoprost, chemically a prostaglandin analogue. Prostaglandins are naturally found in our body as part of the inflammatory cascade, and bimatoprost increases the action of these mediators.  Originally bimatoprost was used as a topical eye drop for glaucoma, but a surprising side effect occurred -- users of the drop were experiencing an abundance of eyelash growth. Bimatropost had a secondary effect of stimulating anagen phase eyelash growth, resulting in users experiencing this eyelash explosion. After this secondary effect was tested and confirmed for safety, the original glaucoma eye drop was reformulated for the specific purpose of eyelash growth and that was the birth of Latisse.

What Are the Side Effects?

Latisse comes with applicators to help minimize exposure to skin and ocular tissue and target your eyelashes themselves! via

Because of its chemical make-up, Latisse can cause inflammation around the eyelid skin (remember, it increases the action of prostaglandins, which are part of our body's inflammatory pathway).  Because of this, I always recommend using the applicator carefully -- try to apply just on the eyelashes and avoid putting too much on the eyelid area.  Some people may be allergic to Latisse, and you would experience red and swollen eyelids within a few applications.  If the product comes into contact with the white of your eye itself, you may also notice redness and irritation on the white of the eye due to this inflammatory function of the drop.  If you apply the drop at night, it is common to wake up with red and irritated eyes in the morning if Latisse got in contact with your eyes.

Other side effects include increased pigmentation around the eyelid and even iris.  Latisse can cause an increased expression of our body's melanin (pigment).  This means a darker color to your skin along the lid line, but many times you will hear this marketed as a natural "eyeliner" effect.  More significant in issue is the chance that your iris will be darkened by Latisse use.  If you have light brown, hazel, or green eyes, Latisse can cause more melanin to be expressed, and thus darken your iris color.  Blue eyes are generally not affected since they have an absence of melanin to begin with.  If you have light brown or hazel eyes you should take this potential darkening effect into consideration, because it may not be reversible even if you stop using Latisse.

Take Home
Latisse is a very effective prescription for eyelash growth with minimal side effect risks.  I recommend trying to avoid too much contact with your eyelid when applying with the wand, and avoid exposing the drop to the surface of your eye if you are concerned with the risk of red and irritated eyes or darkened iris pigmentation.  If you stop using the drop, your eyelashes will eventually return to their normal state, so you would have to continue with the drop long term if you want long term effects.  Also, there is no generic version of Latisse, so depending on your medical insurance there may be a large price involved (in the same range as high end wrinkle cream products).  On average a single prescription of Latisse costs $120 without insurance coverage.

Have you used Latisse and want to share your before and after photos, or your experience?  Please comment or post your link below!

Wondering what the top trend for eyewear is this fall?  Look no further than Raf Simmon's sunglasses for Dior for a trend that the most fashion forward celebrities are embracing.  Dior's So Real sunglasses are an architectural rethinking of the clubmaster, a look that is incredibly futuristic in appearance despite its retro inspiration.  Celebrities like Olivia Palermo and Rihanna have embraced the look for recent fashion week appearances around the globe.

Rihanna via

Olivia Palermo via

The color options are just as inspiring as the unique frame shape.  Just check out this black version with the bright blue nosepads.  This is a trend I can really see taking off.  Neon nosepads with a more basic frame in a solid black or brown could be great.
Not convinced yet?  Supermodel Karina Kurkova sported a great pair of Dior So Real sunglasses for a recent spread in Vogue Spain.

via

 And you know that they are seriously trending in the eyeworld if Dr. Glover at Eye See Euphoria is posting about it.

Dior So Real Sunglasses via Eye See Euphoria

Not sure your pocket book can support this trend?  Look for similar options at your local high end optical by embracing the mix of plastic and metal.  Architectural details like browbars or oversized metal bracketing can elicit this same retro turned futuristic feel.  And if you can find frames with colored nosepads, then take a risk.  This touch of detailing can elevate your frame selection into what is styling into 2015!

Shop the Style (images are clickable!)

When checking someone's dilation, there can be a number of findings in the outer periphery of the eye that have no affect on the person's vision.  That's why dilation or fundus photography like Optos are so important to the ocular examination -- changes in the eye don't necessarily cause changes in vision.  Today we explore a relatively common ocular finding, congenital hypertrophy of the retinal pigment epithelium (or CHRPE for short).

An impressive Optos image of CHRPE just outside of the posterior pole via

CHRPE as viewed by off-axis fundus photography.  This picture was taken by me which explains why it is not that great. All of the white spots are artifact.

If you are going to buy one pair of glasses, please buy tortoise shell, black, or a a blendable neutral. But if you are going to buy two (or more) pair of glasses, then this post is for you.  I wear glasses at least 5 days a week, so having a few fun pair in my rotation is essential.  I honestly don't think you can make a better choice on your second pair of glasses than to go bold on color -- and red glasses are my statement of choice for fall and winter 2014.

Prodesign 1705 via

Red eye? Time to see your eye doctor via

It's that time of year again -- red eye time of year.  For every red eye patient that comes through the door I have a differential list going of 3 most likely suspects.

1) Do they wear multiple wear contact lenses?  Corneal ulcer is my first thought until I see otherwise

2) Do they itch?  Allergies and itching are almost always hand in hand

3) Is there crusting?  Viral conjunctivitis or pink eye as it is commonly called is so prevalent this time of year because of the number of viral colds going around.  Plus with back to school time, being around children is a really common infection source.  That means parents and teachers are at higher risk of coming to my office with a viral infection.

The reason that it is so important to see an eye doctor for a red eye is that your primary care doctor does not have the equipment to differentiate any of the above.  And the treatments for each of the above issues are vastly different!  You need a high powered ocular microscope to find a corneal ulcer (unless it is visible just looking at the person, in which case we are in a very emergent situation where there will almost certainly be permanent vision loss).  But the most important thing that is necessary when determining is this virus, allergies, or bacteria is a close microscopic evaluation of the under eyelid (tarsal) conjunctiva. Viruses typically have a follicular reaction in the conjunctiva, and bacteria and allergies classically have papillary reactions. Without a microscope, seeing this subtle difference is impossible.

Differentiating Papillae from Follicles

Papillary Reaction

A great example of papillae via

Giant Papillary Conjunctivitis -- Due the the chronic nature of inflammation, the papillary reaction is larger as the areas of irritation expand into each other.

Bacterial infections are very rare by comparison, so the most likely culprit when I see papillae under the eyelid is allergies.  Papillae are signs of chronic irritation, where the conjunctival tissue has become elevated and swollen due to repeated exposure to an irritant.  There are two important distinctions that are hallmark signs of papillae:

1. Red Center =  Papillae are elevations of the vascular conjuncitval tissue so there will be a red central vascular core to the lesions
2. Distinct Elvations = The conjucntival tissue has fibrous connections that limit the size and expanse of swelling.  This means distinct, well separated bumps in the papillary reaction.  The only time this logic doesn't fully apply is when the inflammation has been around for so long that the bumps begin to coalesce, creating the large cobblestone appearance we associate with giant papillary conjunctivitis.

Follicular Reactions

Follicular reaction via

While papillae are consistent with a local irritation, follicles are a sign of an immune reaction in the area.  This finding is almost always an indication of a viral infection of the eye.  Follicles have a larger appearance than papillae, and have a white central core since they are really accumulations of cellular level inflammatory agents -- lymphocytes, lymphoblasts, and macrophages if you remember your microbiology.   The big tell-tale sign of follicles are:

1. White Center = look for that inflammatory matter filling the center of the bump

Take Home

Having a hard time seeing the difference?  That's understandable because it takes doctors that are trained in this numerous patient encounters to develop a quick sense of which is which, and there are still some reactions that have questionable appearances with characteristics of both.  My real take home for any non-OD readers of this post is that a red eye takes a specialist to properly diagnose. The tell-tale anatomy is so nuanced, it is impossible to see without the proper equipment.  So please, see your eye care provider for any eye care needs so that you get the proper treatment without delay.