What Are The Benefits Of A Comprehensive Eye Exam?

Comprehensive eye exams evaluate all aspects of your vision and eye health.

• Internal Exam – This is an evaluation of the retina and optic nerve while your eyes are dilated.

• Visual Function and Eye Health – This includes testing depth perception, color vision, peripheral vision and response of the pupils to light, as well as an evaluation of eye focusing, eye teaming and eye movement abilities.

• Glaucoma Testing – This is a test of fluid pressure within your eyes to check for the possibility of glaucoma.

• Visual Acuity – Your doctor will test your vision with different lenses to determine if glasses or contact lenses can improve your vision.
  
  

Comprehensive eye exams look at your total health history.

Even though you visit a separate office for your eye health, that doesn’t mean your eyes shouldn’t be treated holistically. Your eye doctor will discuss your overall health and that of your immediate family, any medications you’re taking and whether you have high blood pressure or diabetes. They’ll also want to know if you smoke and how much sun exposure you get. All these factors help the eye doctor properly assess your eye health.

Comprehensive eye exams are performed by eye professionals.

Eye doctors are highly trained. Optometrists examine the eyes for visual defects, diagnose problems or impairments, and prescribe corrective lenses. After a bachelor's degree, optometrists complete a four-year program to obtain their Doctor of Optometry degree.

Regular eye exams are important for children because their eyes can change significantly in as little as a year as the muscles and tissue development. Good eyesight is critical for a child’s life and achievements; success in school is closely tied to eye health. School demands intense visual involvement, including reading, writing, using computers, and blackboard/smartboard work. Even physical activities and sports require a strong vision. If their eyes aren’t up to the task, a child may feel tired, have trouble concentrating, have problems in school, and have difficulty playing their favorite games which may affect their quality of life.

When To Perform A Pediatric Eye Exam?

According to the recommendations of the American Academy of Ophthalmology and the American Association for Pediatric Ophthalmology and Strabismus, a child should have initial screening between 6 and 12 months of age, and then routine eye health and vision screenings throughout childhood to help detect any abnormalities as their eyes develop and unless otherwise recommended, every two years thereafter until the age of 18.

For a newborn, an optometrist should examine the baby’s eyes and perform a test called the “red reflex test” which is a basic indicator that the eyes are normal. In case that, the baby is premature or at high risk for medical problems for other reasons, has signs of abnormalities, or has a family history of serious vision disorders in childhood, the optometrist should perform a comprehensive exam.

A second eye health examination should be done on infants between six months and the first birthday. This examination includes tests of pupil responses to evaluate whether the eyes pupil opens and closes properly in the presence or absence of light, fixate and follow test, to determine whether the baby can fixate on an object; such as light, and follow it as it moves.

And a preferential-looking test, by using cards that are blank on one side with stripes on another side to attract the gaze of an infant to the stripes thus, vision capabilities can be assessed. Infants should be able to perform this task well by the time they are 3 months old.

For a Preschooler, between the ages of 3 and 3½, a child’s visual acuity and eye alignment should be assessed. If the child is diagnosed with misaligned eyes (strabismus), "lazy eye” (amblyopia), refractive errors (astigmatism, myopia, hyperopia), or any other focusing problems, it’s important to begin treatment as soon as possible to ensure successful vision correction and life-long benefits.

At School age or upon entering school, the child’s eyes should be screened for visual acuity and alignment. In this age group, nearsightedness (myopia) is the most common refractive error and can be corrected with eyeglasses.

There are some signs that parents can tell if their child has a vision problem, for example, the child may squint, hold reading material very close to their face, or complain about things appearing blurry. However, there are some less obvious signs that may indicate vision problems, such as having a short attention span, quickly losing interest in games, projects, or activities that require using their eyes for an extended period of time, or losing their place when reading. Also, choosing to avoid reading, drawing, playing games, or doing other projects that require focusing up close. Another sign is that a child may turn his or her head to the side when looking at something in front of them. This may be a sign of a refractive error, including astigmatism, so turning their head helps the child see better.

That’s why it is so important for kids to have regular eye screenings. The earlier a vision problem is found and treated, the better off your child will be in and out of school.

You have almost certainly heard of diabetes, which is one of the most common chronic health conditions in the United States with an estimated 100 million adults currently living with diabetes or pre-diabetes. This metabolic disorder occurs when the body is no longer able to regulate its own blood sugar levels and requires intervention to keep them stable. Most people are aware that diabetes can have serious consequences for our health. However, you may be surprised to learn that it can also influence our vision. This is because patients who are diabetic can go on to develop a complication that is known as diabetic retinopathy. Without prompt treatment, diabetic retinopathy can cause permanent vision loss. It is for this reason that patients who suffer from diabetes are asked to attend regular diabetic-related eye exams.

What is diabetic retinopathy?

For us to be able to see clearly, our eyes need to be healthy and functioning perfectly. The most important component of our eyes are the retina. Found at the very back of the eye, the retina is a patch of light-sensitive cells that have the job of converting the light that passes into the eye into messages that are passed up the optic nerve and into our brain. Our brain then receives them and tells us what we can see and how clearly we can see it.

The retina relies on a continuous supply of blood, which is delivered using a network of tiny blood vessels. Over time, having continuously high blood vessels can damage these blood vessels causing a leak of blood and other fluids onto the retina. If this happens, scarring may occur which could compromise the quality of your vision.

Am I at risk of diabetic retinopathy?

Technically, anyone who suffers from diabetes, whether it be Type 1 or Type 2, could be at risk of developing diabetic retinopathy. However, the condition is more likely in certain situations. These include if:

• your blood sugar levels are uncontrolled or poorly controlled

• you have a long history of diabetes

• you have high blood pressure (hypertension)

• you suffer from high cholesterol

• you are pregnant

Regular diabetic-related eye exams will enable your eye doctor to monitor your condition and ensure that any signs of diabetic retinopathy are detected and acted upon immediately.

What to expect from diabetic-related eye exams?

The process of a diabetic eye exam is very simple and straightforward. In fact, in most instances, it is included within the other elements of a comprehensive eye exam and you may not even realize that you have had a specific test to check for diabetes-related complications.

Diabetic eye screening is non-invasive. You will be given eyedrops which will blur your vision. These may sting a little when they are administered, but this will pass within just a few moments. Once your vision is blurred, you will be asked to rest your head on a device and stare down a lens. This leads to a camera that will take images of the backs of your eyes so that your eye doctor can assess the structures, which include the retina, for any abnormalities. You will see a flash when each image is taken, but at no point should you be in any pain.

In addition to the images of the back of your eye being taken, you will also be given a visual acuity test. This is where you will be asked to read letters off a chart a short distance away, as well as reading from a card held in front of you.

The information that your eye doctor will obtain from your examination will be able to tell them if you are experiencing any of the signs of diabetic retinopathy. If so, they will discuss the best way to get your condition under control. This could involve a combination of elements, including controlling your diabetes more effectively, taking medications or more invasive treatment to preserve your vision. Your eye doctor will give you more specific information based on your individual circumstances.

If you have further questions about diabetic-related eye exams, please contact our knowledgeable eye care team.

Macular degeneration, commonly referred to as age-related macular degeneration (AMD), is the single largest cause of sight loss in the developed world and affects more than 10 million Americans. It usually affects people over the age of 60, but has been known to affect those who are younger. It is a painless condition that usually affects both eyes with the loss being experienced in the central vision. It does not affect the peripheral vision, meaning that it does not cause total blindness.

What is the macula?

The macula is the most sensitive part of the retina and is responsible for our central vision and what allows us to see fine details with clarity.

Varieties of AMD

Wet AMD

Wet AMD is one variety of condition in which abnormal blood vessels grow into the macula, leaking blood or fluid which then causes scarring and a rapid loss of central vision. Wet AMD can develop suddenly and rapid referral to a specialist is essential as it can be treated if caught quickly.

Dry AMD

Dry AMD is the most common variety of age-related macular degeneration and is a gradual deterioration of the retina as the cells die off over time and are not regenerated. Up to 15% of people with dry AMD go on to develop wet AMD, and so any sudden changes in your vision should be followed up with your optometrist as soon as possible.

Symptoms of macular degeneration

Macular degeneration affects each person differently, which means that it can sometimes be difficult to diagnose, particularly as you may not notice any change in your vision early on in the condition. However, as the cells deteriorate, you will start to see an increasing range of symptoms, including:

• Distortion or bends in what should be straight lines (such as lampposts or door frames)

• Dark spots in your central vision

• Fading colors

• Difficulty adapting from dark to light environments

• Blurred vision

• Objects may appear to change shape, size or color, or may move or disappear

• Bright lights may be difficult to tolerate

• Words may disappear while you are reading

Is there any way I can reduce my risk of developing AMD?

Unfortunately, there is no clear reason as to what triggers the process that causes macular degeneration. However, you are at an increased risk if you have a family history of the condition, or if you are over 60.

Experts suggest that the best thing you can do to minimize any potential risk is to ensure that you live a healthy, active lifestyle. You can do this by:

• Stopping smoking

• Eating a healthy, balanced diet with plenty of fruit and vegetables

• Moderating your alcohol consumption

• Maintaining a healthy weight

• Getting regular exercise

There is also some limited research that suggests that eating leafy, green vegetables can slow the deterioration of vision in cases of dry AMD.

Treatment for AMD

Sadly, there is currently no cure for either variety of AMD. In the case of dry AMD, the treatments suggested are done so with the aim of aiding the patient to make the most of their remaining vision. This can include things such as using magnifying glasses to help with reading.

Wet AMD can be treated with anti-vascular endothelial growth factor medication. This should stop additional blood vessels from developing and stop your vision from deteriorating further.

Occasionally, laser therapy is suggested as a possible treatment for destroying abnormal blood cells, but this is only suitable for cases of wet AMD and usually only around 1 in 7 sufferers may be potential candidates for this procedure.

If you have any questions or concerns regarding macular degeneration, we highly recommend that you speak with your optometrist who will be happy to assist you.

If you’ve been diagnosed with glaucoma, you’re probably already familiar with the typical options in glaucoma treatment – eye drops, laser treatment or traditional surgery. While these are certainly effective, especially when glaucoma is diagnosed early, researchers have been working hard to offer new glaucoma treatments. Their goal is not only to improve outcomes but also reduce the treatment’s side effects and frequency of use.

What is the Goal of Glaucoma Treatment?

Before we dive into the new options, it’s important to understand the goal of any glaucoma treatment. At present, glaucoma is not curable. However, treatment can significantly slow the progression of the disease. Glaucoma damages your eye's optic nerve. Extra fluid builds up in the front part of your eye (cornea), which increases the pressure in your eye. Reducing this pressure is the primary objective of any glaucoma treatment. This is often referred to as intraocular pressure or IOP.

What are the Limitations of Standard Glaucoma Treatments?

Eye drops for glaucoma treatment seem like an easy option but there are several challenges that can reduce its effectiveness. It can be difficult to get all the medicine in the eye, especially for older adults with less of a steady hand. In addition, since it must be applied daily, individuals may forget. Since the drops have no perceivable benefit because early stages of glaucoma have no symptoms, patients might make it a lower priority which is understandable since it may also have unpleasant side effects like burning, red eyes.

Beyond eye drops, laser surgery is a less invasive option. The laser opens clogged tubes and drains fluid. It can take a few weeks to see the full results. If laser surgery or drugs don’t relieve your eye pressure, you may need a more traditional operation. You would have to go into the hospital and will need a few weeks to heal and recover. Although usually effective, glaucoma surgery can make you more likely to get cataracts later on. It can also cause eye pain or redness, infection, inflammation, or bleeding in your eye.
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What are Recent Advances in Glaucoma Treatment?

Alternatives or Improvements to Eye Drops
The Glaucoma Research Foundation reported several new developments on the horizon. These technologies focus on reducing patient error in applying eye drops which would make the medication more effective and improve the quality of life for the patient. Here are some of the products underway:

• A polymer, like a contact lens, would contain the drug; it would sit under the eyelid and release the medication over several months

• Microneedles would inject medication into a specific spot to be most effective

• Implantable extended-release devices using engineered highly precise microparticles and nanoparticles

• Polymer-based intraocular delivery technologies that would allow customizable sustained release

• Drops that allow the medication to get into the eye more easily

• Tear duct plugs that release medication

In addition, people with glaucoma who take more than one eye drop per day are beginning to see those medications available as a single, combined eye drop. New products include Cosopt (timolol and dorzolamide), Combigan (timolol and brimonidine) and Simbrinza (brinzolamide and brimonidine).

Eye emergencies cover a range of incidents and conditions such as; trauma, cuts, scratches, foreign objects in the eye, burns, chemical exposure, photic retinopathy, and blunt injuries to the eye or eyelid. Since the eye is easily damaged, serious complications can occur from an eye injury thus, any of these conditions without proper treatment can lead to a partial loss of vision or even permanent blindness. Likewise, certain eye infections, other medical conditions, such as blood clots or glaucoma, and eye problems such as a painful red eye or vision loss that are not due to injury also need urgent medical attention.

Depending on the type of injury, any of the following symptoms may be present:

• Bleeding or other discharge from or around the eye

• Bruising

• Decreased vision

• Double vision

• Loss of vision, total or partial, in one eye or both

• Pupils of unequal size

• Eye pain

• New or severe headaches

• Itchy eyes

• Redness or bloodshot appearance

• A sensation of something in the eye

• Sensitivity to light

• Stinging or burning in the eye

• One eye is not moving like the other

• One eye is sticking out or bulging

• Nausea or headache occurs with eye pain (this may be a symptom of glaucoma or stroke).

A black eye is usually caused by direct trauma to the eye or face, causing a bruise resulting from bleeding under the skin. The skin around the eye turns black and blue, gradually becoming purple, green, and yellow over several days. Swelling of the eyelid and tissues around the eye may also occur. The abnormal color usually disappears within 2 weeks.

A blow to the eye can potentially damage the inside of the eye. Trauma is also a common cause of hyphemia, which is blood inside the front of the eye and is often due to a direct hit to the eye from a ball. Besides, certain types of skull fractures can cause bruising around the eyes, even without direct injury to the eye.

A chemical injury to the eye can be caused by a work-related accident, common household products such as cleaning solutions, garden chemicals, solvents, or other types of chemicals. Fumes and aerosols can also cause chemical burns. With acid burns, the haze on the cornea often clears and there is a good chance of recovery. However, alkaline substances such as lime, lye, drain cleaners, and sodium hydroxide found in refrigeration equipment may cause permanent damage to the cornea. It is important to flush out the eye with large amounts of clean water or salt water (saline).

Photic retinopathy, also known as foveomacular retinitis or solar retinopathy, is damage to the eye's retina, particularly the macula, from prolonged exposure to solar radiation or other bright light, e.g., lasers or arc welders. It usually occurs due to staring at the sun, watching a solar eclipse, or viewing an ultraviolet, Illuminant D65, or other bright light. Immediate evaluation by your doctor is advised.

In case of an eye injury, cut or trauma, gently apply a clean cold compress to the eye to reduce swelling and help stop the bleeding. Do not, however, apply pressure to control bleeding. If blood is pooling in the eye, cover both eyes with a clean cloth or sterile dressing. And, call your doctor immediately.

In case of eye injury be sure NOT to:

• rub or apply pressure to your eye

• try to remove foreign objects that are stuck in any part of your eye

• use tweezers or any other tools in your eye (cotton swabs can be used, but only on the eyelid)

• put medications or ointments in the eye
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As for contact lenses wearers, attempting to remove your contacts can make the injury worse. The only exceptions to this rule are in situations where there is a chemical injury and the lenses didn’t flush out with water, or where immediate medical help cannot be received.

How to prevent eye injuries

Eye injuries can happen anywhere. Accidents can happen during high-risk activities, but also in places where you least expect them. There are things that can be done to decrease the risk of eye injuries, including wearing protective eyewear when using power tools or engaging in high-risk sporting events, following the directions carefully when working with chemicals or cleaning supplies, keeping scissors, knives, and other sharp instruments away from young children, and keeping a distance from amateur fireworks.

To decrease the chances of developing permanent eye damage, immediate medical evaluation is necessary in the event of an eye injury.

Complete contact lens services including all specialty lens products (astigmatism correcting toric contacts, multifocal contacts, monovision contacts, color enhancing contacts, daily contacts, disposable contacts, gas permeable contacts, bandage contacts, etc.)

While dry eye isn’t a serious condition, it can have a major impact on your quality of life. You may find your eyes get tired faster or you have difficulty reading. Not to mention the discomfort of a burning sensation or blurry vision. Let’s take a look at dry eye treatments – from simple self-care to innovative prescriptions and therapies – to help you see clearly and comfortably.

What is Dry Eye?

Understanding dry eye will help you determine the best treatment option. Dry eye occurs when a person doesn't have enough quality tears to lubricate and nourish the eye. Tears reduce eye infections, wash away foreign matter, and keep the eye’s surface smooth and clear. People with dry eyes either do not produce enough tears or their tears are poor quality. It’s a common and often chronic problem, especially in older adults.

Preventive Self-Care

Before we delve into more serious dry eye treatment options, here are a few simple self-care options that can manage minor cases of dry eye.

• Blink regularly when reading or staring at a computer screen for a long time.

• Make sure there’s adequate humidity in the air at work and at home.

• Wear sunglasses outside to reduce sun and wind exposure. Wraparound glasses are best.

• Take supplements with essential fatty acids as these may decrease dry eye symptoms.

• Drink 8 to 10 glasses of water each day to avoid dehydration.

• Find out if any of your prescriptions have dry eye as a side effect and if so, see if you can take an alternative.
  
  

Artificial Tears

For mild cases of dry eyes, the best option is over-the-counter eye drops. Here are a few tips for selecting the right one:

• Low viscosity – These artificial tears are watery. They often provide quick relief with little or no blurring of your vision, but their effect can be brief, and sometimes you must use these drops frequently to get adequate relief.

• High viscosity – These are more gel-like and provide longer-lasting lubrication. However, these drops can cause significant blurring of your vision for several minutes. For this reason, high-viscosity artificial tears are recommended at bedtime.
  
  

Prescription Dry Eye Treatments

There are several prescriptions that treat dry eye differently. Your eye doctor can advise the best option for your situation.

• Contact Lenses – There are specialty contact lenses that deliver moisture to the surface of the eye. They’re called scleral lenses or bandage lenses.

• Antibiotics– If your eyelids are inflamed, this can prevent oil glands from secreting oil into your tears. Your doctor may recommend antibiotics to reduce inflammation.

• Anti-inflammatory drugs – These are eye drops to control inflammation on the surface of your eyes (cornea) using the immune-suppressing medication cyclosporine (Restasis) or corticosteroids.

• Eye Inserts – If artificial tears don't help, another option may be a tiny eye insert. Once a day, you place the hydroxypropyl cellulose (Lacrisert) insert between your lower eyelid and your eyeball. It dissolves slowly, releasing a substance to lubricate your eye.

• Tear-stimulating drugs – Available as pills, gel or eye drops, cholinergic (pilocarpine, cevimeline), these help to increase tear production.

• Autologous blood serum drops – For serious dry eye that’s not responding to other treatment, these eyedrops are made with a sample of your blood. It’s processed to remove the red blood cells and then mixed with a salt solution.
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Dry Eye Procedures

• Punctal Plugs – Tear ducts can be plugged with tiny silicone plugs to reduce tear loss. By partially or completely closing your tear ducts, it can keep your tears from leaving your eye too quickly.

• LipiFlow Thermal Pulsation – This treatment helps to unblock oil glands. Placed over your eye, the device delivers a gentle, warm massage to the lower eyelid over about 15 minutes.

• Intense-Pulsed Therapy – This utilizes pulses of light to liquefy and release hardened oils that have clogged glands in the eyelids.

• You don’t have to suffer from the symptoms of dry eye. Talk to your optometrist about dry eye treatment options designed to address the underlying cause of your condition.

The Optos Optomap has revolutionized how retinal examinations are performed by providing a digital image of the back of your eye without having to have your eyes dilated. A quarter of a second scan captures the digital image of your retina, optic nerve, and blood vessels in the back of your eye. We can see retinal findings that can indicate diseases in other parts of the body such as hypertension, diabetes, melanoma, and intracranial hypertension.

​By picking up these findings early we cannot only help prevent problems in the eye, but problems in the rest of the body.

Dr. Patterson will be able to show you the inside of your eye, zoom in on possible problem areas, and show you what is normal vs. abnormal. Ideally, this examination is performed annually so we can catch changes in the early stages as many eye diseases have no symptoms until more advanced stages. Our patients are willing to pay extra for this technology knowing it will save them time, reduce their discomfort, and provide permanent documentation. The doctors in our practice recommend an Optomap Retinal Exam for all of our patients during comprehensive examinations and retinal evaluations.

If you’ve been diagnosed with cataracts, you may wonder if cataract surgery is right around the corner. Not to worry. There are many preventive steps you can take to slow the progression of cataracts and preserve your vision. That doesn’t mean you won’t eventually need surgery, but you can at least delay the need for quite a while.

Protect Your Eyes from the Sun

The National Eye Institute recommends protecting your eyes from the sun's harmful ultraviolet (UV) and high-energy visible (HEV) rays by always wearing good quality sunglasses while outdoors. Look for sunglasses that block 100 percent of UV rays and absorb most HEV rays with large lenses or a close-fitting wraparound style. Remember that the peak hours for sun exposure are between 10 am and 3 pm or 11 am and 4 pm during daylight savings time and that the sun’s rays are strong enough to pass through clouds, so you need your sunglasses every day.

Avoid Steroid Eye Drops

Steroid eye drops are routinely prescribed to treat dry eyes or an arthritic flare-up in the eyes. Unfortunately, they can also speed up the progression of cataracts. Talk to your Optometrist about how you can manage both conditions without inadvertently making your cataracts worse – and hastening the need for surgery.

Check Your Medications

There are over 300 commonly prescribed medications with side effects that may impact cataract progression. Since your primary care physician may not have access to your eye doctor’s medical records, be sure to ask your doctor if your current medications will affect your cataracts. If you must stay on the medication, it’s even more important to avoid sunlight during peak hours and to wear sunglasses.
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Quit Smoking

If you haven’t quit already, here’s another good reason to do it: over time, the damage from smoking can double or triple an individual's risk of developing cataracts. If you’ve been a smoker, your habit was probably a big contributor to the diagnosis. The good news is – by quitting smoking now, you can slow the progression of cataracts.

Follow Eye Health Diet Guidelines

Studies have shown that certain vitamins and nutrients may reduce age-related decline in eye health, particularly antioxidants. If you’ve already been diagnosed with cataracts, adding foods rich in antioxidants to your diet will help slow the progression. This list isn’t exhaustive, but here are some examples to get you started: dark chocolate, blueberries, strawberries, pecans, carrots, sweet potatoes, artichokes, kale, red cabbage, beans, beets, spinach, apples, and plums.

Doctors also recommend eating more fish high in omega-3 fatty acids. This has been linked to a potentially reduced risk of cataracts or their progression. You may also consider taking a multivitamin that contains Vitamin C and E. Talk to your doctor or nutritionist about how you might adopt a healthy eating plan that’s designed to prevent cataracts.

Fortunately, making these healthy modifications to your diet can prevent many other lifestyle diseases such as diabetes. Studies have shown that a diet rich in processed carbohydrates can increase your risk of both developing cataracts and speeding up its progression. It’s important to develop a plan that works for you and supports your holistic health.

Take control of your cataract diagnosis by getting regular eye exams, communicating with your doctor, and putting these tips into practice. You’ll have better vision and prevent the need for cataract surgery in the near future.