Anyone else just sick of winter?  Time to daydream about the eyewear you need when we can finally get outdoors and enjoy some natural Vitamin D.  The runway trend for Spring 2014 was rather consistent across designers:  round is the shape of the season.  Round can be a very difficult and unflattering shape to wear, so I personally have avoided it.  But for most oval or square-shaped faces, round frames can be a visually interesting and still flattering alternative for the season.  Here's a preview:

The original Google Glass design via. Note the dumb looking nosepads and absence of lenses in the mount frame.

If you haven't heard by now, Google Glass has taken the next step in entering the homes (or faces?) of main stream consumers.  The New York Times released an article today announcing that Google has partnered with vision insurance VSP to offer health insurance benefits towards the purchasing of Google Glass spectacles.  Google Glass previously had been designed with a rather odd-looking frame (see this post) that apparently drew a lot of negative attention in the test-wearers.  Back to the drawing board for the Google design team, and their next-gen edition features the same computer mounted device but on more "normal" looking spectacle frames.  This helps make the Google Glass wearer blend in better in a crowd, but also has the luxury of being able to be combined with prescription lenses for all those people that actually need to wear glasses.

The new Titanium Collection of Google Glass frame-mounts look like regular glasses, and you can actually wear prescription lenses in the frame!  Via

By partnering with VSP, Google Glass wearers can get a portion of their spectacle mount frames and their prescription lenses covered with insurance benefits.  VSP will not be reimbursing or covering any part of the actual Google Glass computer device (which is currently retailing for $1500 in its test phase).  Your doctor would utilize your best distance spectacle Rx (or bifocal or progressive if you are over 40 and desire reading area in the glasses as well), and then help position the mounting of the Google Glass device so that it would not disturb or limit regular vision.  The Glass device needs to be mounted at eyelid level to avoid blocking vision, so finding the correct size frames for each patient's face shape will be of utmost importance.

Currently the offered Google Glass frames are available in 4 style options and 2 sunglass options, and will retail for $225. VSP will only cover the purchase of frames or lenses if you have a valid prescription (less than 1 year old), so you would need to make a trip to your eye doctor to take advantage of this coverage.  No news yet if they will cover non-prescription glasses to mount the Glass computer device upon, but it sounds unlikely.

So what does this mean to the future of optometry?  Are we all really going to be using wearable computers in the next few years?  Google Glass is not some distant idea out of  Brave New World; it is launching for full retail availability this calendar year.  The fact that they are planning ahead by teaming with health care, and specifically the optometric industry (since VSP is an insurance for optometrists) shows the foresight of Google developers.  What better way to reach your audience than by utilizing their healthcare coverage?  I am all for Google Glass utilizing the great minds of optometrists to make their product both practical and visually pleasing, and maybe we will all be fitting our first Glass Rxes this year.

I'd love to hear your feedback as to how you think Glass will change our industry in the next few years.  Do you foresee people wearing it in large numbers?

Apparently a lot of people want to get in on the conversation of computer-induced eye discomfort this month.  For more reading material, check out this article in the Washington Post.  Another article out this week from USA Today reports 70% of Americans complain of ocular issues with computer and digital device user.  With so many people affected, computer vision syndrome or "digital eye strain" which is a new term for the same symptoms that is being used more recently is a growing topic of conversation. Leaders from both the optometry and ophthalmology communities are featured with their perspectives on why our eyes feel so strained and tired after continuous computer use.

Take Home Points:

• Computer Vision Syndrome is defined as the eye fatigue, strain, discomfort, and dryness that results from prolonged computer use.  Typically it is associated with 2 hours of continuous screen time or longer.

• Why do our eyes hate computers so much?  We blink about 50% less frequently at the computer screen than when in natural conversation.  Even compared to blink rates when reading paper materials, reading on an LCD screen is much lower.  Blinking is how your tear film coats and protects the eyes, so the less you blink, the drier your eyes will become.

• Why do our eyes feel so tired?  They are working to focus at near.  Move your screen back to at least 18 inches from your face for improved comfort.  I have many of my patients use 26 to 30 inch distance between themselves and the computer (especially for large monitor or 2 screen set ups).  The further distance between yourself and the screen, the less your eyes will have to work to focus.

I'm trying to collect my best images from patients seen in clinic this month to share with optometry students or curious patients.  Here's a photographic review of January at the office:

Conjunctival Cyst

Typically these resolve on their own, often with encouragement from frequent artificial tears and or steroid drops or ointments.  For more information, see this post.

Herpes Simplex Keratitis
This virus typically presents (in my experience) as a dull persistent irritation.  Your eye has been mildly red, mildly uncomfortable, and vision seems a little off.  Often I am seeing it after you have been bothered for a few weeks.  With an incubation of that long, herpes simplex's tell-tale corneal disruption (called dendrites) is easily visible.  If your doctor sees the virus too early in its life span, these dendrites may not have yet formed, making it harder to diagnosis.  It is also true that if it incubates too long, the cornea is just a complete mess and the dendrites will have merged into something that can look like a bacterial or fungal ulcer.  The point here is, if you have an irritated eye that just isn't healing or responding to your doctor's treatment, you need to be seen again!  Sometimes herpes will reveal itself only after an initial misdiagnosis.

Herpes Simplex Dendrites with NaFL staining

Herpes Simplex Dendriteis with Rose Bengal staining

Peripheral Corneal Infiltrate; Marginal Ulcer
See that white spot near the pupil of this image?  It is actually located on the superficial cornea, and is a small infiltrate or ulcer.  Technically this particular patient had an infiltrate since the overlying epithelial defect was much smaller than the size of the stromal opacity.  But I have heard these called marginal ulcers just as often as peripheral infiltrates. The real treatment for a sterile infiltrate is steroids, but I usually just do a antibiotic combo with Zylet or Tobradex.  Kill the inflammation and any bacteria in just 1 drop!  A small stromal scar will often remain after treatment, so that is why getting these diagnosed and treated quickly is important.  They are most commonly associated with blepharitis and meibomian gland dysfunction, and not necessarily in just contact lens wearers where the cornea is more susceptible to infection.

Posterior Blepharitis
It wouldn't be January without a lot of meibomian gland issues.  This time of year the cold weather constricts the meibomian glands in the upper and lower eyelids, limiting the amount of tear film leaving the gland opening with every blink.  As those tears get backed up inside the gland, they harden and become even more difficult to blink out normally!  The result: a thick, milky tear film that leaves the eyes dry and blurry between blinks.  Your best relief is to get those tear glands working again, encouraging the glands to open and express with daily warm massage.  Aim for the eyelash line with a gentle circular motion, and you will see results in the way your eyes are feeling within a week or two (depending on how long your glands have been clogged for).  Sometimes medication is needed to get the glands working again at their best level, so steroid ointments and oral minocycline are common treatments.

Don't you just want to get all that thick, milky, hardened tear film junk out of those glands?  If you do, you will make a very happy optometrist because I do this all day long for a living.

All-day computer users are typically unhappy in my experience via

Let me first preface this by saying, this particular post may be overwhelming.  It certainly was when I was writing it.  If you have any of the common computer-related complaints listed below, this post is just meant to help show you that your eye doctor is the BEST way to figure out what is causing your complaint and how to solve it.  With that being said, let's take a look at the most common ocular complaints in the world of computer users, and what may be causing those problems!

Tired eyes, eye strain, dull pain behind the eyes

When your eyes are looking at the computer, for most people their eyes have to work to see.  Most people who have perfect distance vision (or have their distance vision made perfect by wearing glasses or contact lenses) have a natural focus point at 20 feet (distance vision).  That means that when they look in the distance, their eyes have to do no work to focus.   When you shift your vision to a near task (like the computer), your eyes will have to use their focusing ability.  This "work" or focusing ability for the eyes to see up close is called accommodation.  I like to compare it to lifting weights:  when you look at the computer, your eye is "lifting weights"; when you look in the distance, it is as if you are putting the weight down.  No surprise, looking at the computer screen all day long is tiring!

BEST RELIEF: 

 20/20/20 rule - this is a popular ergonomic strategy for taking breaks to let your eyes refocus.  Every 20 minutes, look 20 feet away (down the hall or out a window), and break to blink for 20 seconds.

Computer Glasses - Your doctor can prescribe a pair of glasses to help your eyes focus at your computer distance.  Some people benefit from a low amount of plus power (typically less powerful than you would find with over-the-counter reading glasses).  Think of these glasses as aids to let your eyes do less work when they are at the screen

Anti-reflective coating or yellow tint - if your screen or workplace has a ton of glare, your eyes could be suffering from that excess reflecting light.  Coatings can help minimize that light bounce-back.  A yellow tint in your glasses increases contrast on the screen and cuts even more glare.

Double Vision

If you experience double vision (or diplopia as it is called in the medical world), it is likely because your eyes are having a hard time working together.Your eyes may not naturally focus together equally.  This does not necessarily mean you have an eye turn, but many people's eyes over or under focus.  These conditions are typically termed convergence insufficiency (eyes underfocus) or convergence excess (eyes over focus).  Either can lean to strain, ache behind the eyes, and potentially double vision.  Only your eye doctor can determine if your eye muscles are working together properly.  Treatments include glasses, prism (to move the image to your eye's natural focal spot), and vision therapy.

• uncorrected astigmatism:  A lot of my patients have astigmatism (curvature of the eye) that they have never needed glasses for before, but due to their long hours of eye work, their eyes can no longer compensate for their natural imperfect eye shape.  If you have astigmatism, it is just the shape of your eye -- it typically is present from early childhood. But if it is a low amount, your eyes can "squint" or focus, and see clearly without you needing glasses.   At the computer, your eyes are being asked to squint and focus more than ever, and sometimes they will finally give up.  Blurry vision results.  
• 
  
• uncorrected hyperopia:  Hyperopia means that the eyes have to work harder to see up close than they do to see in the distance (far-sighted is the other word for this).  Most people that are far sighted do not need any glasses until after 40 when the normal aging change of the eyes kicks in.  But computer users sometimes need help earlier in life because their eyes are doing so much more work!
• 
  
• uncorrected myopia:  Sometimes years of near work, either computer use, studying, or both, can result in late-onset myopia (typically in our 20s).  In the optometry world, we call this graduate school creep -- your eyes typically stop changing in college, but for people doing long near work hours later into life, it may keep changing! Myopia or near sightedness means that is it easier to see up close than it is in the distance.  For these patients, a pair of night driving glasses can be beneficial for driving home after a long day.  Since their eyes are made to see better at near, computer glasses wouldn't be beneficial in this case (unless they also have astigmatism of course).

Take Home Point:  Your eyes may be blurry driving home because they were working too hard at the computer, or because they need glasses to see at the distance.  Either of these conditions have night driving blur as a complaint!  Your eye doctor will be able to determine which of these conditions is your culprit, and prescribe what you need depending on the underlying issue.

I usually don't bombard you with so many fashion posts, but there was such a great showing for eyewear at this year's Globe awards Sunday night, I have to post about it.

via

via

via

via

via

Thursday night's Project Runway All-Star finale had all a girl could want:  lots of clothes, at least one of Elena's high pitched panic-squeals, and a polarizing winner.  And it had a lot of glasses too:

via

Seth Aaron's winning collection above was inspired by the drama of Spain, but obviously the designer's personal appearance as well.  Seth has been no stranger to a bold pair of oversized black zyl frames.

Seth Aaron in center sporting his trademark look of the season via

 While the look may not be suited for everyone, you have to admit it makes a bold statement.  And that's what glasses are all about looking at 2014.  This is not the tame to have your glasses fade into the background.  Color, proportions, details -- they are all about "too be noticed" this season.  I look forward to featuring some of the best looks of 2014 with features from fashion bloggers, and fashion forward optometrists over the coming months. In 2014 there is only one rule in glasses -- embrace your glasses; make them bold and make them you!

Interested in finding a similar look?  Tom Ford's collection offers several stand-out options:

via

via Eye See Euphoria