Have you ever noticed that when you use a computer in a dark room, a faint blue glow is emitted from the screen?  That blue glow emanates from most electronic devices:  your phone, your computer, your tablet, your TV, and any LED or fluorescent light source.  Blue light is an increasingly large part of our world, but what is it potentially doing to our bodies?

How does your body know when it is time to sleep?  The body's sleep cycle is governed by melatonin; higher levels in your body induce sleep.  Melatonin release is triggered to a large degree by light -- darkness causes an increase in melatonin, and light reduces the amount in circulation.  But different wavelengths of light seem to have different potency.  Blue light (like that emitted from electronic devices) has a more potent effect than other wavelengths, dampening the melatonin response more than longer light wavelengths like red (which you would find in firelight).

What does all this mean to you?  The longer you are exposed to light, and especially blue light levels, the less your body will signal to sleep.  Sleep is important to repair the bodies daily wear and tear, and we don't know all the benefits that really occur for brain function (so much for us to still understand).  But we all know how much a good night's sleep can mean for the next day's performance.  Reduced sleep has been linked to depression, obesity, heart disease, diabetes and even cancer!

Blue light may have an even bigger impact on eye health specifically.  Short wavelength light (like blue) has a higher impact on damage to ocular tissue like the retina and the lens.  This increases the rate of cataract formation, and is associated with higher rates of macular degeneration in studies performed with rats.   We all know the dangers of UV light, and the importance of wearing sunglasses, but are any of us thinking to wear sunglasses while on the computer for long hours?  New studies are showing us it is time to rethink our eyes' health needs and what we can do to protect the eyes from blue light damage.

So what can we do?

f.lux is a free Windows download that changes your computer monitor's color display to match the surrounding light levels of the time of day.  The premise here would be to reset your body to normal melatonin secretion timing by matching your computer to surrounding daylight.  The computer screen will be brighter in morning, and reset to low and more red wavelength light in the evening to encourage melatonin release so that you can get a great night's sleep.

To protect your eyes from potential blue light/short wavelength UV radiation effects, we need a UV protective lens.  Sunglasses are typically much too dark to wear at the computer screen, but even clear lenses can be made with a large degree of UV protection.  Materials like polycarbonate have innate UV protection (and are shatter resistant).  In addition to most quality prescription glasses being made from polycarbonate, more and more electronic devices may be making the switch.  Nokia phones already use polycarbonate screens, and the iPhone 5c is slated to do so as well.

Gunnar Lenses are marketed towards computer and video game users to increase comfort and block out that detrimental blue light!

For maximum blue light protection, yellow tinted lenses are your best choice.  Yellow filters block blue light out of the spectrum and let yellow (lower wavelength light) pass through.  If you have had cataract surgery, you may notice that the implant that they put inside the eye often has a yellow tint for this protective reason.  And yellow tinted lenses also have an added plus of increasing contrast and decreasing glare at your computer screen, making them ideal for computer use!

The new year has started, and that means back to work for everyone.  For many of Americans, that means back to the computer screen, spending 8-12 hours a day with non-stop computer use.  And then, yes, we go home and typically unwind with computer use (or iPad or cell phone).  So what is all of that computer time potentially doing to your eyes?  This month I am devoting multiple posts to computer vision -- how to maximize your computer vision and comfort, and possible solutions for common computer complaints with the eye.

Look for posts in the next few weeks devoted to solutions for these common computer issues:

• Tired eyes, eye strain
• Dull pain behind the eyes
• Double vision
• Eyelid twitching
• Blurry vision, either at the computer screen, or driving home at the end of the day
• Blurry vision that clears between blinks
• Red eyes, burning, stinging, watering, dryness

It's been an exciting (and quickly growing!) year with Eyedolatry, and I just wanted to thank all my regular readers, and those who stumbled upon this blog just wondering what was wrong with their eye. Reading your comments and the search key words that brought you to my blog has been so enlightening and inspiring!  For all of my fellow optometrists (or optometry students) reading this blog, you may be surprised by the topics that most people are searching for.  Here's a review of the most popular search topics from Eyedolatry in 2013:

• Conjunctival Cyst -- That's right, out of all the life and vision threatening conditions that most optometrists would suspect patients are concerned about, conjunctival cyst is the most common medical search word bringing patients to the blog.  In fact, conjunctival cyst, and conjunctival cyst treatment are 2 of the top 10 most frequently searched entries!  Am I the only one that finds this amazing?
• Dailies Total 1 -- Since Ciba launched its revolutionary new water gradient lens material, this contact lens has been a consistent source of inquiry.  In fact, it has surpassed NBA Glasses as my most popular all time post.  People want to know what makes these lenses different, and what exactly are they going to cost them.  Bausch and Lomb's Biotrue One Day was the second most popular contact lens related post of the year.  It is great to see more people interested in dailies, and I hope that trend continues.  Currently only about 12% of Americans are enjoying the advantages of single use contact lenses. I would love for us to see Americans being fit in the safer, healthier, and more comfortable daily modality at the rate that Japan and European countries currently achieve (reported at around 40%)!
• Contact Lens Health and Safety -- Another popular search item is contact lens wear complications.  You don't know how many times I see "Can I sleep in Acuvue 2" pop up in my search item history report.  I am so glad that patients want to ask this, but I am guessing since Acuvue 2 is such an old contact lens (launched by Vistakon in 1999), that patients are searching this because they have been doing it for years, and are just now being told not to.  I wish there was a way I could contact Google and when someone typed that into a search engine, it would just give them an immediate pop-up answer, of "Please, please don't.  Your eye doctor begs you not to."  Congratulations to all those people though who are rethinking the amount of abuse their corneas have been taking for the last 14 years!  
• Enchroma Color Blindness App -- This was a huge surprise to me.  When I first posted about the Enchroma App I figured it would generate basically no interest (that's what I assume about most of my post topics haha).  But people are searching for color blindness testing at a surprising rate.  Maybe its just a fun thing to test out while you are sitting at home watching TV, but I may start pulling out my Ishihara plates more frequently in the exam room.
• Concussions and the Eye -- This is a topic near and dear to my heart, and if you are one of the thousands of people that have clicked on my post about the side effects of concussions, I encourage you to also click over to my colleague's website, See to Play.  Dr. Peters is the optometrist to the Carolina Hurricanes hockey team, and routinely posts about concussion rehabilitation.

As an optometrist, I get a lot of questions.  People ask me about their eyes during their exam (of course), but also when I meet strangers on vacation, at the grocery store, or am just hanging out with friends.  Talking about eyes this much, some of the same questions inevitably get asked over and over. So here is one I know you all want answered:  what are those spots you see in your vision sometimes?

First, we need to break down the kind of spots you are seeing.  Remember, this is just a general guideline, so if you are seeing strange visual changes, you should see your doctor to be sure what you are seeing is normal and not a serious medical problem.

• Floaters: Small dark or outlined shapes
•  move when your eyes move
•  most easily seen in bright or white backgrounds
•  can be normal as the vitreous jelly that fills the eye breaks down during our teenage years
• If you see a swarm of new ones at all once, see your doctor immediately as this could be a retinal tear!
• Click here for more info

• Phosphenes: Balls of light that can be seen even when the eyes are closed
• Ever rub your eyes and seen spots afterwards?  These are phosphones.  Mechanical pressure can also cause the retinal photoreceptors inside the eye to trigger.  Since the retina cells only know how to communicate "light" they will respond the same to mechanical pressure as they do to incoming light!
• Stand up to fast and see spots?  This is a type of phosphene resulting from orthostatic hypotension.  Basically with your quick change in positioning, blood flow to the eye was momentarily minimized, causing the eye to see these spots.  Remember, the retina can only say "light" so when the cells are getting less oxygen and nutrients than they need, they only can communicate that issue with a light signal. When blood flow returns to normal levels, the spots go away.  This can also occur if you are about to faint!

  Want to see some interesting art?  Check out this site for work depicting the artist's ocular migraine symptoms!

• Visual Auras: Changing visual phenomenon
•  Commonly described as waterfall motion, kaleidoscope changes, tunneling of vision, or a light that starts in the center and then expands out.  Medically this is termed scintillating scotomas or ocular migraine
• Visual auras typically last around 15 minutes, but can last as long as 2 hours
• Often followed by a migraine headache, but they don't have to be.  It is possible to just get an ocular migraine where only the visual symptoms occur
• Vision will return 100% to normal within 2 hours.  If it does not, see your doctor immediately!
• What's the cause?  Scientists believe a vascular spasm is the cause of these ocular migraines, and remember, when the eye gets blood flow disruption, it can only communicate by processing light.

Hehehe I could't resist myself.  Optometry jokes are always the best.

Ray Ban RB4171 comes in so many colors!  I love this bright yellow/orange, but they also have a great teal.  If you are interested in more subtle options, of course you can also get black or brown, but where's the fun in that?

Maui Jim just does sunglasses right.  If you are looking for the tops in quality and performance, I can't recommend them more.  Their Hawaiian Time frame is my personal favorite this year -- great for someone who likes the look of aviators but has a small face shape that can be easily dwarfed by common aviator shapes on the market!

Prodesign has really stepped their game up this year, and I am so impressed by their men and women's lines for the season.  For the special man in your life, these wood-inspired frames (Zense 7622) are made from biodegradable materials, so not only is the aesthetic so visually appealing, but you are supporting a company who is putting environmental concerns first too.  A win-win.

Doesn't it seem like everyone in blogland has these Karen Walker Super Duper sunglasses?  Maybe I stalk Atlantic-Pacific too much.  Or maybe they are just that universally good.  They literally go with everything, and would like to personally thank Blair Eadie for being such a great advocate for wearing sun protection because she incorporates it into almost all of her looks!

Is there anything more overwhelming than the artificial tear aisle at your drug store or pharmacy?  Take 10 minutes and stake it out if you are curious.  You will see poor lost souls wander up and down in frustration, comparing bottle labels that could be written in a foreign language for all they tell you, and then landing on the familiar: Visine.  Oh no!  Everyone, please let me help you break this terrible cycle of doom.

This time of year, allergies are typically subsiding so the most likely reason that your eyes are red, irritated, itchy, burning, or watery is that they are DRY.  Dryness is prevalent in winter due to the lower humidity in the air, and the drying action of heaters in homes, offices, and cars.  In mild cases of dryness, usually a good rewetting drop is all you need to get your eyes performing back to their normal standards.  But for more persistent and chronic dryness, your doctor's intervention with more aggressive treatment is often required.

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If you are in the mild category, you need to pick the right drop in order to get successful relief.  To aid in your selection, please ask yourself these simple questions to see which drop works best for you:

1) Are your eyes infrequently dry, red, watery, itchy, burning or irritated?  Usually after certain environment exposures (like going for a run in the cold air) or at the end of your day?

• Best Choice:  Moisturizing or Lubricating Artificial Tears
• Examples:  Systane Ultra, Refresh Optive, Blink Tears, Soothe XP, Theratears
• Dosage:  1 drop in both eyes as needed, up to 4 x a day

You can also use all of these over top of contact lenses.

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2) Do you have the above issues, but eye drops usually sting when they hit your eye, or cause any other discomfort after using them?   Do you need to use drops more than 4 times a day for relief of your symptoms? Have you recently had a surgical eye procedure (like LASIK) causing you to have more frequent dryness issues?

• Best Choice:  Preservative Free Artificial Tears 
• Why? Prevents irritation from unwanted preservatives that are toxic to the eye but found in all bottle-stored eye drops
• Examples: Systane Ultra in Vials, Refresh Optive Sensitive, Retaine MGD in individual vials
• Dosage:  1 drop in both eyes as needed, can use as often as you want

3) Do you have crusting of your eyelid, or see white dome-like growths on your eyelid margins near the lash roots? Do your eyes sometimes feel filmy between or after blinking?

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• Best Choice: Lipid Based Artificial Tears 
• Why?  The questions above are aimed at diagnosing Meibomian Gland Dysfunction, the most common cause of dry eye.  Click the link to learn more.
• Examples: Refresh Advanced, Systane Balance, Retaine MGD
• Dosage:  1 drop in both eyes as needed, up to 4 x a day (or more with Retaine MGD since it is preservative free)

• Best Choice: Gel Artificial Tears or Ointments
• Why?  Gel tear drops are thicker, and will last through the night to rehydrate the eye or protect the eye if your eyelids do not close fully.
• Examples: GenTeal, Systane Gel, Refresh Gel or Celluvisc, Blink Gel, Nighttime ointments
• Dosage:  1 drop in both eyes at bedtime

I always love reviewing retinal photos with patients, because so much can be going on inside the eye without ever causing any vision issues!  Here is one such example: that circular deformity at the optic nerve in this photo is a congenital condition called an optic nerve pit.  When the eye is developing in the womb, a structure called the optic vesicle (the precursor to the optic nerve) turns in upon itself to create a channel through the center of the nerve fiber where all of the blood vessels to the eye will eventually pass through.  This grove or hole is the "cup" we often speak of when determining glaucoma risk.  If the optic vesicle doesn't close completely after this fissure or groove is created, an optic pit is formed.  Basically this is a little hole or excavation in the nerve where the tissue didn't close up properly during development. In and of itself, it is typically asymptomatic and will only be found by a doctor examining the child after birth.

Most of the time, an optic pit is harmless -- you may have an enlarged natural blind spot in your field of vision, but most people are not bothered by this (optic pits are usually only in 1 eye).  There is an association with serous retinal detachment, however.  Since the optic pit it is usually located near the macula (central vision area), a detachment in that area can be devastating to vision. Therefore, a person with an optic pit is watched closely for signs of swelling or fluid leakage inside the eye.  If this occurs, laser treatment can minimize the damage if caught early enough and prevent permanent severe vision loss.

Without someone looking, you would never know if you have an optic nerve pit, so make sure you are seen by an eye doctor for routine health care even if you have no vision complaints!