Saturday, April 28, 2012

I have another eye infection, can I just use the drops you gave me last time?

Self-medicating can lead to further complications when an infection is present in the eye.  Usually the dosing precedes the visit; patients have already used old medications by the time they arrive the chair.  This can make diagnosing and treating quite challenging for your eye care professional.

Let's discuss that medication sitting in your medicine cabinet.  In most cases it's an expired prescription but let's say it's not, we still worry about contamination.  Droppers have a tendency to pick up lots of bacteria when in use.  Most people fear eye drops and will get the dropper as close to their lashes or eyelids to ensure the drops enters the eye.  I usually instruct patients to hold the dropper at least one inch from the eye and let it drop.  If you miss your eye don't worry there are many drops in those tiny containers.  Once the dropper touches any surface contamination may happen.  Infection gets worse!

Now let's say your drops are totally contamination free, would they help?  It depends if you have the same exact infection as last time.  It might look the same, feel the same and act the same but more often then not it's a completely different bug.  Self-medicating can build a resistance and the infecting agent will become immune to that medication in the future.  In no way is reusing medication ever recommended, call your doctor and make an appointment.

See and Be Seen! at Eyed LA Optometry in Brentwood, West Los Angeles

Thursday, April 26, 2012

Why are there so many prices for thinner lenses? Are they all the same?

Thinner lenses are the lazy way to not explain what products exist in the optical world.  There are a large variety of thinner lenses on the market that perform better than others and deserve higher prices.  Most optical shops will give radically different prices for thin lenses but are you getting the same from each?  Know your questions so that you can better understand your answers.

Plastics have been used for the last handful of decades to replace our glass lenses; safety was the biggest reason this happened.  Glass was used for so long for it's amazing clarity; plastic is very close to mimicking.  The clarity index is the most important topic in optics when choosing your lenses and yet it's never mentioned.  Most times your optician will talk about weight and thinness, great topics but shouldn't be priority in my opinion.  Here is the breakdown on deciding between lenses.

Plastic (CR-39) is the most basic lens material; clarity is about 98% and weight is half of glass.  This is a great, inexpensive lens for most basic prescriptions.  The next one is called Polycarbonate; clarity is about 93%, lighter weight then plastic and impact resistant.  We always recommend children wear this material for safety reasons; adults that are monocular should also consider this option for safety.  This lens also provides strength, extremely useful for semi/full rimless frames.  In our office at Eyed LA we use Trivex which is just as strong as Polycarbonate but much clearer (about 98%), we don't feel anyone should be blurry.  Not all office offer or work with this superior material, so feel free to ask abou it to find out.  Finally we have Hi-index; clarity is about 99%, lightest weight, reduced magnification/minification effects.  I would recommend this lens for moderate to higher prescriptions.  This lens has three distinct levels, the higher the level the thinner the lens; prices will reflect this.

A good optician will be able to guide you through to chose the best option, asking about your daily routines is always helpful.  Personally as an optometrist I address these options with patients when they are sitting in my exam chair, so they have a better education on lens options.  Please make sure you are comparing apples to apples before deciding on the more economical option; know the value of your products.

See and Be Seen! at Eyed LA Optometry in Brentwood, West Los Angeles

Tuesday, April 24, 2012

Is it okay to flush my eye out with water if I feel something in it?

Water is a mysterious instrument of wonderful benefits and horrible consequences all wrapped up in one package.  Let's set the record straight on when to use water for good and when not to use it at all.

Let's say you get something in your eye, maybe a leaf or even a chemical substance.  Immediately run over to a water source, cup some water in your hands and place your eye in the cup and open your eye, repeat for two minutes.  This will sting since the pH of your eye doesn't match that of water.  This is for a naked eye, no contact lenses.  If the eye has a contact lens, it must be removed first before raising, hence the reason most people working with chemicals are instructed to not wear contact.  As you can imagine it's very difficult to remove a contact lens from an eye in pain still it must be done.  The reasoning is that water contains many contaminants that may infect the eye; parasites, fungus, bacteria, added chemicals.  Contact lenses are sponges that absorb all those harmful particles.  You may have flushed the object that entered your eye but now there are microbes latching onto the surface of the contact lens, within hours you could be dealing with a serious infection that may be complicated to treat.  For this exact reason no one should soak contact lenses in water instead of contact lens cleaning solution, ever.

If the water flush makes the eye feel worse or your symptoms have not yet subsided I suggest calling your eye care professional for a consult.  Most medical physician don’t have the proper equipment/microscope to look closely at the eye, I suggest an Optometrist or Ophthalmologist specifically.  You want someone to look first before dispensing medication. 

See and Be Seen! at Eyed LA Optometry in Brentwood, West Los Angeles

Sunday, April 22, 2012

Besides carrots are there any other foods that help the eyes?

A proper diet for your eyes will not only benefit your ocular health but also your systemic health.  The foods that feed your neurological system (brain, spine and eyes) will enable your body to age with more strength, less disease and a happier state of mind.  Nutrition is the fountain of youth.

Antioxidants became very popular a handful of years ago.  These are wonderful foods that not only prevent macular degeneration (leads to blindness) but they also boast your immune system.  You can Google a list of these types of foods.  My favorites are apples, onions, brussel sprouts, all berries, pomegranate, sweet potatoes, mangos, nuts, dark chocolate, red wine, corn, spinach, kale, red meat, beans, eggplant.... you get the point.  The really green and leafy vegetables contain an extra component called Lutein, which functions similarly to antioxidants and promotes healthy retinas.  Think of a spinach salad with nuts, berries and a squeeze of lemon with a glass of red wine and dark chocolate for dessert.  Delicious!  Now I wage caution for patients that are smokers.  Antioxidants can help repair cells all through out your body to keep tissue healthy, but for smokers it actually increases the chances of lung cancer.  Better quit those cigarettes and continue to enjoy your summer mangos.  

Another important component to healthy eyes are omega 3's.  The omega 3's are easy to find in fatty fish and flax seeds (for vegetarians).  Most people usually take supplement vitamins that are rich with omega 3’s; medical journals are stated 2000mg doses to be most effective (two tablets/day).  The last handful of years optometrist have been also recommended omega 3's for dry eye as well, it's extremely effective especially for women over the age of 40 (women dehydrate much more then men as they age).  Now there has been some controversy concerning the omega 3 craze in the last handful of years, specifically dealing with the manufactures of each supplement brand.  Do the research on your brand and ask your medical doctor which they find to be safest.

It's my advice to always consult with your primary care physician before adding any supplements to your diet, especially if you have a pre-existing condition.  We never want drug interactions to occur that may harm your body years in the future. 

See and Be Seen! at Eyed LA Optometry in Brentwood, West Los Angeles 

Friday, April 20, 2012

Can I have my prescription? I want to order my glasses online!

Oh boy here comes trouble.  There are so many steps in making the proper pair of glasses; it’s almost magic.  

Let’s take some moments to explain this wonderful product that results for your viewing pleasure.  The first step is a great eye exam with careful attention paid by the doctor and patient.  Yes the patients are responsible for their own outcome, depending on their responses and physical health.  If patients are pregnant, diabetic, or even tipsy during the exam, outcomes will be varied.  Make sure to be forthcoming with your doctor regarding your state of mind and/or physical health.   

Next crucial step is the measurements needed to assure your optical center (middle of pupil) is perfectly aligned with the optical center of the lenses in your new glasses.  This measurement a computer cannot take, they randomly guess because the frames need to be on your face for this to happen.  The optician (makes your glasses) needs to be certain that all the different levels of prescription in one pair of glasses need to be exactly aligned to get the best results, especially for multifocal prescriptions.  

Next to last step is manufacturing your exact prescription with your exact alignments in your frame.  Occasionally the final product needs to be sent back to the lab for a small 1mm adjustment.  Hence the reasons some glasses take a bit longer then others, don’t yell at your optical staff; they're simply being precise.  The final step is the adjustment of your frames; the optician provides this service.  Online cannot reach out its arms to straighten your glasses let alone shake your hand for your continued loyalty.  So think twice before saving those extra 30 dollars. 

See and Be Seen! at Eyed LA Optometry in Brentwood, West Los Angeles

Thursday, April 19, 2012

Should I get Lasik?

Hmmm it depends!  That’s the best answer you should get from any doctor conducting a good exam on your eyes.  A definite No answer might mean the doctor hasn’t researched the option enough, a definite Yes might mean the doctor is your refractive surgeon and eager to take you on as a patient.  Here’s my advice.

If you’re under 18 years old, forget about it.  Your eyes are still in high flux and will continue to change as you continue to grow.  Once your body stops changing shape (think about height, weight, shoe size) then your eyes will become a bit more predictable.  I’m hoping I’m still getting taller! 

If you can’t seem to wear any contact lenses comfortably (allergy to contact or cleaning solutions) or even get them in your eye; you might be a good candidate.  If you’ve desired to rid yourself of glasses and can’t seem to do it, refractive surgery might be the answer.  Of course there are risk factors involved, including dry eyes years after surgery (new techniques are getting better at reducing this) and decreased best visual acuity (the glasses allowed better vision than surgery).  Those two are most common, but blindness is not even considered because it’s so rare.  Have the surgeon (talk to more than two) explain their expected results and then consider the cost and benefits.

You’re 40+ years old and want to replace your bifocal/progressive lenses with surgery.  I hesitate greatly here because the technology is just taking off for this sort of multifocal correction on the surface of the eye.  Meaning the laser would essentially be creating two point of focus for distance and near on a 10mm corneal surface.  If you haven’t tried contact lenses, I’d give that technology a try first to get an idea of the visual acuity.  It’s a tough surgery for the surgeons, but I have seen some success. 

You love your glasses and are comfortable with contact lenses as your secondary visual option.  Don’t do surgery, you might find yourself underwhelmed and in need of glasses within several years.  However keep in mind, those patients that have extreme corrections (can’t even walk around without their glasses) hardly care if they need to wear a mild prescription 10 years down the line.  So weigh out your pros and cons and decide if refractive surgery is a good match for you. 

See and Be Seen! at Eyed LA Optometry in Brentwood, West Los Angeles

Tuesday, April 17, 2012

I was hiking and I scratched my eye with a branch, I should just wait for it to heal right???

Scratches can be really painful on the surface of the eye; excessive blinking, tearing, photophobia (light sensitive), redness and pain are the key symptoms.  The absolute most common I've seen is the sharp end of a paper/cardboard hitting a patient's unsuspecting eye. Bomb!  Immediate reactions will be closing the eye, palm covers the eye, and you’ll shout a profanity.  If it's a small abrasion the cornea (transparent surface) will repair itself within 9 hours or so.  Sometimes it's not small.   

When a corneal abrasion occurs foreign bodies (bacteria, fungus, viruses, parasites) are immediately introduced into deep, more sensitive tissue.  Fungus/parasites lives on most outdoor vegetation, bacteria lives on most inanimate objects, and viruses can be found just about anywhere.  Bacteria are easily controlled with antibiotic ointments given to you by your eye care professional.  Viruses also have treatments even though they never resolve (ie. ocular herpes); they can be managed.  Fungus and parasites however is another group of monsters that can completely erode your eye within hours. Therefore it's extremely important to know what actually poked your eye.

Most doctors will suggestion medical ointments for these sorts of injuries, for about 1 week.  However the most important healing will occur within two months time after the injury, PAY ATTENTION this is where everyone gets lazy.  The eye care professional will instruct a lubricating ointment (once before bed for two months) to be used once the medicated ointment schedule is done.  The superficial (meaning on the surface) abrasion will heal very quickly once you medicate, usually within 3 days and you start to feel completely healed. You must realize there is reason for some insanity in medicine; the deeper tissue takes much longer to heal.  The non-medicated lubricant will create a barrier between your corneal tissue (still repairing) and eyelid.  Let's say you drank a little extra one night, as you know your body dehydrates and by morning not only is your mouth dry but so are your eyes.  The eyelid can attach to the cornea and re-lift that almost healed abrasion.  There a medical term for it; recurring corneal erosion.  This WILL happen and your eye with the scratch will become a permanent recurring issue within your lifetime.  Take this warning and follow the directions of your doctor to allow full healing, it's really takes about two months. So put that greasy gel in your affected eye and know you are saving yourself some serious pain.  

See and Be Seen! at Eyed LA Optometry in Brentwood, West Los Angeles