Macular Degeneration Update
January 23, 2012 | 
Author Probably one of the most frequent diseases that we get questions about is Macular Degeneration.
Age-related macular degeneration (AMD) is a medical condition which usually affects older adults and results in a loss of vision in the center of the visual field (the macula) because of damage to the retina. It occurs in “dry” and “wet” forms. It is a major cause of blindness and visual impairment in older adults (>50 years). Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other activities of daily life.
The macula is the central area of the retina, which provides the most detailed central vision.
In the dry (nonexudative) form, cellular debris called drusen accumulate between the retina and the choroid, and the retina can become damaged. In the wet (exudative) form, which is more severe, blood vessels grow up from the choroid behind the retina, and the retina can also become detached.
Age-related macular degeneration begins with characteristic yellow deposits (drusen) in the macula, between the retinal pigment epithelium and the underlying choroid. Most people with these early changes (referred to as age-related maculopathy) have good vision. People with drusen can go on to develop advanced AMD.
Macular degeneration does have a genetic component, and those with close relatives with the disease are at a greater risk. Also, macular degeneration is much more prevalent in smokers and those with extended UV exposure over a long period of time. Discontinuation of smoking in patients with AMD is 10 times more effective than any other treatment therapy.
New research is exploring a combination of vitamins which may slow or even stop the progression of the disease. Vitamins C, E, Zinc, Lutein, Zeaxanthin, and Omega 3 (fish oil) have been found to be beneficial and are currently recommended for individuals with AMD and those at high risk for the disease. If you have or are at risk for macular degeneration, speak to your eye doctor before starting or changing your medications.
To evaluate your risk for macular degeneration or any other eye condition, contact our office at 336-760-2020 for an appointment.
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Online Prescriptions Eyeglasses
A Warning to our Patients Concerning the Dangers and Risks of Purchasing Online Prescription Eyeglasses
Following up on some of our patients’ requests and complaints, we have been investigating and reviewing the current technologies that allow a shopper to purchase complete pairs of eyeglasses over the internet. While websites may be able to offer frames and lenses to online customers, the reality of the situation is that eyeglasses have to be accurately adjusted and precisely measured on the patient’s face before the order is submitted to the fabricating laboratory to insure that the prescription power, as measured by the doctor during the eye examination, is in the exact place on the lens and that the lens is in the exact place on your face.
What Can Go Wrong?
Eyeglasses have so many variables that it is virtually impossible to be sure that the prescription will work when ordered sight unseen from an unknown website. Even under optimum conditions in a doctor’s office, a small percentage of eyeglasses will not perform as prescribed. Imagine the likelihood of eyeglasses not working when the frame is not correctly adjusted to your face and the measurements, usually measured with a device that can be monocularly accurate to 0.5mm (1/64 of an inch), are simply guessed at.
Frames are the first unknown. The craftsmanship of these discount frames is usually poor, and they are most often made with sub-optimal materials with little or no standard of quality. It is nearly impossible to tell what a frame will look like on your face, and there is no way to tell how it will feel and if it is heavy, uncomfortable, etc. it usually cannot be returned.
The stronger your prescription, whether you are farsighted, nearsighted, have astigmatism and especially if you need a bifocal, the more likely the eyeglasses will not work as prescribed and your vision will be compromised. Prescriptions for the more complex bifocals and progressive lenses have even more critical tolerances than standard single vision lenses.
What Would I Notice if the Eyeglasses Aren’t Working Correctly or if the Prescription is Wrong?
First cover each eye and compare the two images. They should be the same. Next, look far away and then up close. Does everything look clear? Some of the lens fabrication and frame adjustment errors will make you feel a pulling sensation the longer you wear the eyeglasses. After a day of wearing incorrect lenses, it is not unusual to have eyestrain, a little dizziness or a headache, usually located right behind your eyes. Some readers notice that reading makes them very tired and they lose their place often. Some computer users complain that the monitor is not in focus and that the width of the reading area is very narrow. All of these symptoms can be eliminated if the eyeglasses are made correctly, the prescription is verified by the doctor’s office and the frame is precisely adjusted to fit your face. Unfortunately, because the tolerances are so critical, if the lenses are fabricated to the wrong measurements, there is no amount of frame adjusting that will fix the problem and alleviate the symptoms.
Probably the best reason to get your eyeglasses from the Hillcrest Vision is the peace of mind of knowing that we stand behind our eyewear. Our brand name designer frame lines come with 2-year guarantees, meaning that if there is a quality problem with a frame, you get a new replacement at no charge for two years from the date you picked them up. All anti-reflective lenses come with a one year scratch warranty at no additional charge. No online website offers these protections. As a comparison, Lenscrafters, the largest retailer of eyeglasses in the country, offers only a 90 day return policy. Why do we offer such a terrific guarantee? It’s just the way we do things.
Our lenses, which are the most critical part of your eyeglasses, are from the top laboratories in the country that also guarantee the precision and optical quality of the lenses. We stand behind our products unequivocally. Ask an internet site if they have money back guarantees if the glasses don’t work correctly. You may be surprised, or shocked, by the answer, if you speak that language.
Hillcrest Vision offers a one-stop, turnkey solution for eyeglasses. Our doctors, our prescriptions, our products, our guarantees; your peace of mind and the knowledge that you will be able to see clearly out of your eyeglasses and the comfort in knowing that we will always be there to help you should you ever need us.
A recent article in the New York Times describes the terrible experiences of some online purchasers with just one online eyeglass website. There is no way of knowing if one online site is reputable or not. As detailed in the following article, thousands of buyers got ripped off. http://www.nytimes.com/2010/11/28/business/28borker.html?src=me&ref=business The NBC Today Show also reported on this predatory online eyeglass retailer. http://today.msnbc.msn.com/id/26184891/vp/40430545#40430545
Fall Allergies
We all know about Springtime allergies – those runny eyes, sniffly noses, and clogged sinuses that plague so many in North Carolina. What some people may not know is that fall has its own set of allergies and the symptoms can be the same or different from the springtime ones. In the spring, we have tree, grass, and plant pollens in the air. In the fall, we have tree pollens, but they are different from the ones that bloom in the spring.
The good news is that regardless of your specific allergens, there is help available! You probably know about Claritin, Zyrtec, and the like – they are great for nasal allergies. But these oral anti-allergens can actually make eye symptoms worse. Their job is to dry out your mucous membranes, and your eye is a mucous membrane, so it gets dried out too! The problem is that when the eye is too dry, it isn’t able to flush allergens out, so they get stuck in there and irritate even more.
It is much better to use an allergy eye drop, such as Pataday, Optivar, Zaditor, or Alaway, to clear your ocular allergies – separate from your oral meds. Because these eye drops do drain into your nasal passages as well, most people get a bonus relief of nasal symptoms and sometimes, that’s all you need to keep allergies at bay. Most of these drops are only taken 1 or 2 times a day, which is very convenient.
Talk to your eye doctor about your eye allergies – don’t just assume that they are something you have to live with just because you live in a lush, beautiful, green state!
Vision Test Should be the First Exam Students Take This Year
The start of the school year is right around the corner for most kids. To give their children a head start to a successful school year, parents need to educate themselves on the importance of healthy eyesight in relation to classroom performance. Since 80 percent of a child’s learning is visual, a child’s ability to clearly see the blackboard and the words on a page is critical.
Prevent Blindness America, the nation’s oldest volunteer eye health and safety organization, has declared August as Children’s Eye Health and Safety Awareness month in an effort to encourage parents to learn about ways they can help protect their child’s vision. Many children do not know they have a problem because they think how they see is how everyone else sees. Unfortunately, some students who are labeled as having a learning disability or behavioral problems may simply have a vision impairment. “Since one in four school-age children have some form of vision problem, we need to make children’s vision and eye health a priority today, before we begin to see the negative effects,” said Hugh R. Parry, president and CEO of Prevent Blindness America. “A child should not need to start failing in school before we realize there is a problem.”
Prevent Blindness America has recently launched Star Pupils, a program specifically designed to educate parents on what they can do to ensure healthy eyesight for their kids. Parents may simply log on to Starpupils.org and receive free information on everything from common eye conditions in children to tips on how to protect eyes from injury while playing sports. Starpupils.org also houses a unique and easy-to-use comprehensive database for children’s vision care requirements for entering schools.
Another added feature of the Star Pupils website is “The Children and Eye Problems Web Discussion Forum,” which allows parents the opportunity to discuss all subjects ranging from general information on eye conditions such as amblyopia (lazy eye) and its treatment, to shared experiences and emotional support. The online community has grown to be the most active forum on the Prevent Blindness America website with more than 500 active members.
Lastly, Prevent Blindness America offers “The Eye Patch Club,” a program geared towards children with amblyopia and their families. Eye doctors commonly treat amblyopia by having the child wear a patch over the unaffected eye for extended periods of time. But compliance can be difficult and challenging for children and their parents. The Eye Patch Club program is designed to encourage the children to wear their patches as prescribed by their doctor. Among other materials, members of the club receive their own special calendar and stickers. The stickers are placed on the calendar for each day the child wears his or her patch. Once the calendar is complete, the child may send it into Prevent Blindness America to receive a special prize. The Eye Patch Club kit may be purchased for $12.95. Proceeds will go to Prevent Blindness America’s sightsaving programs, including free vision screenings. “We want 2010 to be the best school year ever for your child,” added Parry. “We hope that everyone makes a trip to the eye doctor a part of the back-to-school checklist!” For more information on children’s eye health and safety, amblyopia and other children’s vision issues, or to sign up for The Eye Patch Club, please call Prevent Blindness America at 1-800-331-2020 or visit starpupils.org.
About Prevent Blindness America
Founded in 1908, Prevent Blindness America is the nation’s leading volunteer eye health and safety organization dedicated to fighting blindness and saving sight. Focused on promoting a continuum of vision care, Prevent Blindness America touches the lives of millions of people each year through public and professional education, advocacy, certified vision screening and training, community and patient service programs and research. These services are made possible through the generous support of the American public. Together with a network of affiliates, divisions and chapters, Prevent Blindness America is committed to eliminating preventable blindness in America. For more information, or to make a contribution to the sight-saving fund, call 1-800-331-2020. Or, visit us on the Web at preventblindness.org or facebook.com/preventblindness.
Eye Health in a Digital World
Did you know that on average Americans spend 8.5 hours a day in front of a computer screen? Follow these tips to protect your eyes in our digital world:
In today’s digital world, our eyes are increasingly strained by computer screens, smart phones, e-readers, and digital TV. Our eyes are our most valuable resource to keep up with the digital world, yet we tend to forget to pay close attention to their health. I’ve compiled 11 easy steps to help you navigate the digital world and see it all in clear detail. By making these small adjustments, you can be one step closer to digital eye health.
Here are 11 tips for digital iHealth:
- Get an annual eye exam: The only way to monitor your vision health is through annual exams by an eye care professional. Let your doctor know if you are a “heavy user” of technology.
- Abide by the 20/20 Rule:Take a 20 second break after every 20 minutes of use. Make sure you shift your vision to something in the distance (at least 20 feet away) during this break. If your work area is small, even looking out the window will allow your eyes to relax.[1]
- Screen Placement: Keep your monitor at least 25” away from your eyes, preferably more.[2]
- Monitor Tilt: Tilt your computer screen so that the top is slightly farther away from you than the bottom.[3]
- Lighting: Reduce eye strain by using ceiling-mounted, indirect lighting and control outside light with blinds or shades.[4]
- Font size: Reduce eye strain by enlarging the font. [5] Most hand-held devices and phones have a feature to increase font size when reading emails and text messages.
- Adjust Display settings: Set your screen settings so the background blends easily into your surrounding environment. Adjust the brightness and contrast so that on-screen images and letters are easy to read.[6]
- Minimize Glare: Consider using an anti-glare film on your monitor or hand held devices.[7]
- Upgrade to an LCD: Older CRT monitors are more likely to cause strain on your eyes than a liquid crystal display (LCD). [8]
- Remember to Blink: We tend to blink less often when using a computer, so remember to blink frequently during continuous digital usage. Blinking will keep your eyes moist and prevent you from developing dry eye. [9] [10]
- Find the right vision correction solution: Choosing multifocal contact lenses may help you see near, far, and everything in between. Whether you’re starring at a computer monitor or using your handheld device, multifocal contact lenses provide exceptional vision at any distance.
When wearing progressive spectacles, the area used for near vision is very small. With multifocal contact lenses, you can see clearly in all areas of gaze. For computer users, wearing multifocal contact lenses eliminates the need to raise your head to look through the bottom of your glasses to view the screen. By looking straight ahead, you can also reduce neck strain. For more information on digital iHealth, check out www.coopervision.com/clearchoice.
CooperVision – On Eye | iHealth in a Digital World.
[1] Computer vision syndrome. (n.d.). American Optometric Association, Retrieved from <http://www.aoa.org/x5253.xml>. Accessed on March 12, 2010.
[2] Eyestrain. (2008, July 12). Mayo Clinic, Retrieved from <http://www.mayoclinic.com/health/eyestrain/DS01084/DSECTION=lifestyle-and-home-remedies>. Accessed on March 12, 2010.
[3] Ankrum, D. (1999). Visual ergonomics in the office. Retrieved from <http://www.office-ergo.com/setting.htm>. Accessed on March 12, 2010.
[4] Ankrum, D. (1999). Visual ergonomics in the office. Retrieved from <http://www.office-ergo.com/setting.htm>. Accessed on March 12, 2010.
[5] Eyestrain. (2008, July 12). Mayo Clinic, Retrieved from <http://www.mayoclinic.com/health/eyestrain/DS01084/DSECTION=lifestyle-and-home-remedies>. Accessed on March 12, 2010.
[6] Eyestrain. (2008, July 12). Mayo Clinic, Retrieved from <http://www.mayoclinic.com/health/eyestrain/DS01084/DSECTION=lifestyle-and-home-remedies>. Accessed on March 12, 2010.
[7] Computer vision syndrome. (n.d.). American Optometric Association, Retrieved from <http://www.aoa.org/x5253.xml>. Accessed on March 12, 2010.
[8] Tips for selecting a monitor. (n.d.). UCLA Ergonomics, Retrieved from <http://www.ergonomics.ucla.edu/Howto_Monitor.html>. Accessed on March 12, 2010.
[9] Computer vision syndrome. (n.d.). American Optometric Association, Retrieved from <http://www.aoa.org/x5253.xml>. Accessed on March 12, 2010.
[10] Eyestrain. (2008, July 12). Mayo Clinic, Retrieved from <http://www.mayoclinic.com/health/eyestrain/DS01084/DSECTION=prevention>. Accessed on March 12, 2010.
