Eyedolatry

Think About Your Eyes

160 dental check-ups just 16 eye exams 10:16 AM

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Valentine's Day Gifts for the Optometrist in Your Life

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The Patient's Guide to Pink Eye

Red, watery, matted shut in the morning, and just uncomfortable. "Pink Eye" as we so affectionately label an infection or inflammation the eye is so common this type of year, I am averaging a few cases a week. But for such a common ocular ailment, it is surprising how little the average person really knows about it. For curious minds, here is what you are really dealing with:

A classic viral conjunctivitis (or pink eye) appearance via

Pink Eye is a slang designation typically used to refer to any type of conjunctivitis (an inflammation of the conjunctiva which is the clear vascular layer that lies on top of the white of the eye). Far and away the most common culprit is a virus, but bacterial and allergic conjunctivitis are also differentials that a trained eye care specialist will be able to detect. Viral conjunctivitis typically has a tell-tale symptom pathway, so here's what we are looking for:

Red eye with watery discharge (thick mucus discharge is more typically bacterial)
Starts in one eye and spreads to the other within a few days
May have swollen lymph nodes, a recent cold, or recent interaction with someone who was sick
Typically seen in children or people who are around children in their daily life

Here's the thing about viral conjunctivitis: there is NO treatment that is curative. That's right, when you go to the doctor and they prescribe you sulfacetamide or polytrim, those are antibiotics. And you have a virus. Do you know what an antibiotic does against a virus? Nothing.

Most of my patients that go to a walk-in clinic, or even their primary care provider get prescribed a low-strength generic antibiotic for their viral conjunctivitis, and they aren't really educated as to why the doctor is writing this Rx. The antibiotic won't kill the viral infection. But your doctor doesn't have any medicine they can give you anyway, and antibiotics are cheap. The best they can hope to do with an antibiotic is to prevent a secondary bacterial infection (unlikely) but really, it is typically prescribed as just a "that's all I can do" mentality. It can't really hurt, and they don't have anything that can really help. This idea of "not hurting" though is debatable with all the recent data of antibiotic resistance, but I digress.

Personally, I think this borders on false advertising,
but if you read the fine print they never promise any
more than just "symptom relief". Most people
just see "pink eye" on the box and think they are
getting some sort of medicinal treatment incorrectly.
It's really our job as the doctor to educate
the limits of these OTC drops.
via

If you see an eye care specialist for viral conjunctivitis, you won't be getting an antibiotic prescription alone. What would really work better is a steroid eye drop at relieving the symptoms, and this is what I typically prescribe if my patients want an Rx to feel better faster. Steroids won't get rid of the virus either, but at least it lessens the redness and crusting so your eyes feel more normal. You will still be infected, and still be contagious (just as you are if you use an antibiotic drop), but your eye will feel better because it is less inflamed.

Rewetting drops are a more non-aggressive treatment option, used to simply flush viral cells off the eye. You can use any over the counter moisturizing drop, but I especially like preservative free tears due to their lack of toxic preservatives that could further irritate the eye. Are you thinking of buying an OTC "pink eye" drop like Similasan? It's just a lubricating effect with a small amount of vasoconstrictor action (shrinks the appearance of blood vessels temporarily) achieved with a belladonna extract. Yes, belladonna, so that means if you get an enlarged pupil while using this stuff you used enough to actually dilate your eye. Again, it will not treat the virus. It just moisturizes your irritated eye and superficially makes your redness decrease (temporarily) by shrinking the diameter of the blood vessels on the eye's surface. I personally like preservative free artificial tears better than these "red eye relief" drops that are misleadingly packaged with a "pink eye" label as if they were some sort of treatment, because at least with preservative free lubricants there are no irritants or dilators on board that could make your eye feel worse.

If you have a viral conjunctivitis, the most important thing you can do is wash your hands. You are contagious for about 7 days from the onset of your symptoms, so try to avoid infecting others and re-infecting yourself. That means frequent hand washing, avoid eye rubbing, and wash your pillowcase every morning if your eye was weepy overnight. In 1-2 weeks your body will fight off the virus even without treatment, and you will be back to normal.

If you are a contact lens wearer, it is best to avoid lens wear while you are infected, not just for your own comfort but because bathing the contact lens in viral cells all day long, which in turn just locks those viral cells against your eye's surface with nowhere to go, is just going to keep you infected longer.

In some severe cases of virus, a betadine treatment in office has been shown to greatly reduce the viral load in the eye. But again, this is not something that you can be prescribed to use at home, and it can be very irritating and toxic to the eye to use a betadine flush. Your eye doctor will be able to discuss pros and cons with you if you are in need of this more aggressive treatment.

Remember, only a trained doctor with the correct equipment to examine the eye can differentiate your conjunctivitis from viral, bacterial, or allergic. The treatments for these different types of "pink eye" are vastly different, so I can't encourage you enough to be seen by a professional who can get your eyes back to normal and healthy as fast as possible.

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Spring 2014 Eyewear Inspirations: Round is In

2014 glasses fashion 11:24 AM

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VSP to provide coverage for Google Glass

cost google glass 8:43 PM

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?

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Computer Vision Syndrome in the News

50% less blink rate at the computer 10:23 AM

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.

More and more of us are spending long hours on the computer, and the topic of computer vision syndrome is only gaining more attention nationally. As optometrists we are leading the discussion, so as new ergonomic approaches, dry eye therapies, and computer-friendly glasses options come to market, your eye doctor will be your source for help! No one has to suffer through the computer day -- tell your friends and family if they are long-hour computer users there are ways that their eye doctor can make their day better.

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