We're launching a new feature on the blog today, bringing you advice on the top trends and technology in eyewear straight from the people who know it best, your optometrists!  If you are active on Instagram you'll definitely recognize our first featured OD; with over 2,000 followers, Dr. Fartash posts daily as @glamoptometrist about her favorite eyewear and eye-themed fashion.  She is a 2nd generation optometrist, born and raised in Orange County, California.  A graduate of SCCO (Southern California College of Optometry), she practices in both optical and private practice settings, as well as doing bedside exams at nursing facilities.  "What drove me to start a blog and Instagram was my passion for fashion.  Luckily, in optometry we are able to have both worlds collide."



Current Eyewear: As I am writing this I am wearing my Dolce & Gabbana horned rimmed ophthalmic glasses.  I have recently been more daring in the frames I wear and choose to live in color! So most of the newer frames I wear have lots of personality, like my pink Cartier [above] and red SEE glasses [below]. 

Dolce & Gabbana frames (left) and SEE frames (right)

Tom Ford Sunglasses

Cipro is commonly prescribed for bacterial infections of the sinus and GI tract via

Last month oral fluoroquinolones, which include the popular antibiotics Levaquin (levofloxacin) and Cipro (ciprofloxacin), made news in Canada as new legislation passed requiring a warning label about the increased risk for retinal detachment with these medications. Health Canada (the country's version of our FDA) cited a 2012 study by Dr. Mayhar Etminan that reviewed 4,383 cases of retinal detachments in British Columbia from 2000 to 2007.  The study found a 4.5 x greater risk of retinal detachment for patients taking oral fluoroquinolones.  The mean number of days before starting a prescription for a fluorquinolone to retinal detachment occurrence was 4.8 days.  The study author could only theorize how these antibiotics could be related to retinal detachment risk; previous investigation has shown oral fluoroquinolones disrupt collagen synthesis and can cause tendon weakness.  Theories arose that a similar effect on the eye's collagen tissue could potentially cause a risk for retinal detachment.

But Canada's ruling to put warning labels on these antibiotics is not without controversy.  The FDA and the American Medical Association have not come to the same conclusion that oral fluoroquinolones pose an increased risk. Several review studies have reported no correlation between the two; a 2013 study and most recently a 2016 meta-analysis showed no statistically significant association between fluoroquinolone usage and retinal detachment occurrence. 

Retinal Detachment via

What does increase the risk?
Retinal detachments are a serious medical condition, requiring prompt treatment.  Even with quick repair, vision loss can be permanent, so recognizing the signs and symptoms of a detachment is essential to saving sight.  Retinal detachments are painless, but they do cause sudden changes to vision like flashing lights, new floaters, or blacking out or shadowing of vision.  Check this article for more.

You are at an increased risk for retinal detachment, whether you are taking oral fluoroquinolones are not, if you are:

• highly myopic (near-sighted)
• had recent ocular surgery or injection of ocular medication
• had recent trauma
• are diagnosed with glaucoma, diabetes, AIDS, or malignant hypertension
• are diagnosed with a collagen tissue disorder like Marfan's Syndrome or Ehlers-Danlos
• have a family history of retinal detachment

With fashion weeks across New York, Paris, and Milan winding down this week, we've been swamped with fantastic style inspiration! This season I was especially feeling the street style eyewear captured by photographers like Phil Oh and on random Instagram accounts of the fashionable and famous.  Wondering what's in for spring?  Look no further than these street style mavens!

Round  - Thought that 70s vibe would be over this season?  Think again.  Round eyewear, tinted lenses, and lots and lots of fringe were having the streets outside fashion runways look like an extras call for Vinyl.

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Shop the Look:

When I first switched to a Daytona Optos imaging system for retinal photography, I'm not gonna lie -- I was a little hesitant.  I had gotten so comfortable with traditional imaging systems, and I felt like the posterior pole looked sort of warped in the Optos picture.  Within just a few weeks I was completely sold, though.  The images I was seeing were totally changing the way I talked about ocular health with my patients.  We could see tiny peripheral retinal hemorrhages.  We could see peripheral drusen that might increase their risk for macular degeneration later in life, or even the risk of Alzheimer's disease.  And the filter system allows for spectacular contrast views, even auto-fluorescent imaging.

A large rhegamatogenous retinal detachment

If you are considering upgrading to Optos imaging, or have a camera and want to share your fantastic photos, you need to check out What the Fundus?, a website dedicated to fascinating images taken with Optos cameras.  The founder Dr. M created "What the Fundus?" after a discussion with fellow eye doctors at a Optos training session. "We wanted a place where we could post interesting or just cool looking pictures that have been taken in our practices.  A place free from internet trolls and malcontents where we share what we are passionate about.  Hence, whatthefundus.com was born."

Asteroid Hyalosis

One (or a few) retinal tears going on in the periphery of an asymptomatic patient.

Have images of your own you want to share?  Email Dr. M at michael@whatthefundus.com to be featured on the site!  He adds new photographs regularly, so keep checking back to see what interesting cases walk through the door.

You know that feeling -- the ache behind your eyes, the heavy feeling of your eyelids, the redness and under eye circles you see looking in the mirror, and that intense sensitivity you get when you look at bright lights or step outside of your workplace and venture outdoors.  This feeling of light sensitivity and tired eyes has a name -- digital eye strain.  For 65% of Americans digital eye strain is wreaking serious havoc on work performance, and how your eyes feel when you're not logging those long hours at your computer and cell phone screen.  The average American spends nearly 6 hours a day using mobile digital devices and almost 11 hours daily when you include time on desktop computers, laptops, and watching TV!  Our eyes struggle adapting to light after logging long hours in a digital environment for two big reasons:

Lot's of announcements with the start of 2016 at CooperVision, including the impending nationwide launch of the lens we've been waiting (and waiting, and waiting) for -- Biofinity Toric XR.  For patients with high amounts of astigmatism, CooperVision has been the only company providing soft contact lens options that aren't custom order for this community for years. But Frequency 55 Toric XR is limited by its' low oxygen permeability (Dk/t is 15.7 in this lens -- other monthly disposable lenses on the market typically have numbers over 100), and the more updated extended power range option Proclear Toric XR isn't much better at 30.9 Dk/t.  Proclear Toric XR has also been notorious for easy ripping, a headache for patients and your doctors!  Biofinity Toric XR will be the first lens that isn't custom order that is made in a highly breathable silicone hydrogel material (Dk/t for Biofinity is 116).  This higher breathability is a needed improvement for patients that have suffered scarring or corneal health changes from the lower oxygen materials they've been stuck with due to their high prescriptions in the past.  The lens has been launched on a very limited initial roll-out already (about 400 offices nationwide), but is slated to be released nationwide between April and June/July.  Here are the details:

A flap of the cornea is removed during LASIK that is reapplied to act as a natural bandage via

With so many options, the best way to select the right surgery for you is to talk with a doctor you trust.  Refractive surgeons are well-versed in the options available today, and based on your personal and family medical history, your prescription, and your eye’s anatomy, they’ll be able to recommend the best option for you.  Just remember, any refractive surgery may not be able to achieve perfect, 20/20 vision in all lighting conditions.   Today’s refractive surgery may not mean no glasses ever again for every patient, but it will definitely significantly reduce your dependence on corrective eyewear and the freedom to see clearly without the constant hassle of bulky frames or contact lenses.  And what’s more, the technology just keeps getting better.  Even people with high prescriptions can now enjoy refractive surgery, even if you’ve been told you weren’t a candidate for LASIK in the past.  Better versions of LASIK and now the mainstream use of phakic IOLs means that there is a surgery option for nearly everyone.  


This post also  appears on the CIA Medical Insights Blog as free content donation by Dr. L to help promote discussion of ocular health on their website

A new white-colored, painless bump appears on your eyelid margin.  You've rubbed at it, and now there are more.  What could it be?

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After a few years ruled by thick zyl frames in black and tortoise, eyewear is poised for a complete 180 -- lightweight metals and barely there plastics are dominating the marketplace.  And the color palate of choice? Think the soft pastels that received dual honors as Pantone's Color of the Year 2016: a blushy dust pink called Rose Quartz and an icy grey-blue called Serenity.

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MODO Eyewear's Paper Thin frame line is composed of ultra-lightweight titanium.

MODO Eyewear 4078

Celebrity favorite Oliver Peoples Annetta frame via

Olivia Palermo's latest collab with Westward Leaning is the Rose Gold Collection, featuring blush tinted lenses in a range of frame styles.  Our favorite is a combo made in Pantone heaven, the Flower 14 (below).

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There are a few things in life that are inevitable.  As a colleague of mine likes to phrase it, "If you live long enough, you will get a cataract."  But developing cataracts is not a diagnosis of doom and gloom.  Today's cataract surgery is as much a refractive procedure to bring you back to clear vision (maybe even without glasses!) as it is a medical one.  Some of my patients are actively hoping for that cataract diagnosis from year to year so we can correct their high nearsightedness or reduce their dependence on reading glasses.  And cataract surgery itself has changed so much, even in the last decade.  Now there are ways to reduce healing time, and achieve more precise vision refinement. There are implants that can correct even high amounts of astigmatism, and that can help you read again free from those OTC readers.  If you are about to undergo cataract surgery, here are the two questions you need to ask yourself to prepare for the best procedure for your needs:

In fall 2015 Alcon very quietly discontinued their preservative free saline solution for contact lens rinsing and filling, the well-regarded Unisol 4.  Most local pharmacies and box stores are now out of the product, and patients that have used the product loyally for years are scrambling for a replacement.  If you don't think the panic is real, just check out the price gauging on ebay -- $50 for a 3 pack that would have run you under $10 just a few months ago.  I've spoken with a rep from Alcon, and there was no official statement released as to why the product was discontinued, and there is no plan for reinstating the product in future.  If you are in need of preservative free saline, here are a few doctor recommended solutions that can take it's place.

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