Eye Care Articles

Children's Vision

Are Contact Lenses a Good Choice for Kids?

Are Contact Lenses a Good Choice for Kids?

Are Contact Lenses a Good Choice for Kids?

Contact lenses can offer several benefits over other forms of vision correction for kids. But a common question many parents have is: "When is my child old enough to wear contact lenses?"

Physically, your child's eyes can tolerate contact lenses at a very young age. In fact, some babies are fitted with contact lenses due to eye conditions present at birth. And in a recent study that involved fitting nearsighted children ages 8-11 with one-day disposable contact lenses, 90% had no trouble applying or removing the contacts without assistance from their parents.

A Matter of Maturity

The important question to ask yourself is whether your child is mature enough to insert, remove and take care of their contact lenses. How they handle other responsibilities at home will give you a clue. If your child has poor grooming habits and needs frequent reminders to perform everyday chores, they may not be ready for the responsibility of wearing and caring for contact lenses. But if they are conscientious and handle these things well, they may be excellent candidates for contact lens wear, regardless of their age.

Contact Lenses for Sports

Many kids are active in sports. Contact lenses offer several advantages over glasses for these activities. Contacts don't fog up, get streaked with perspiration or get knocked off like glasses can. They also provide better peripheral vision than glasses, which is important for nearly every sport. There are even contact lenses with special tints to help your child see the ball easier.

For sports, soft contact lenses are usually the best choice. They are larger and fit closer to the eye than rigid gas permeable (GP) lenses, so there's virtually no chance they will dislodge or get knocked off during competition.

Controlling Nearsightedness

If your young son or daughter is nearsighted, rigid gas permeable (GP) contacts may be a good choice. GP lenses are more durable and often provide sharper vision than soft contacts.

A modified technique of fitting gas permeable lenses — called orthokeratology or "ortho-k" — can reverse myopia temporarily. Kids put their ortho-K lenses in at night and wear them while they're sleeping. In the morning, when the lenses are removed, nearsighted kids should be able to see clearly without lenses of any kind.

Researchers also are finding that multifocal soft contact lenses may be effective for myopia control. Multifocal contacts are special lenses that have different powers in different zones of the lens.

Building Self-Esteem with Contact Lenses

Contact lenses can do wonders for some children's self-esteem. Many kids don't like the way they look in glasses and become overly self-conscious about their appearance because of them. Wearing contact lenses can often elevate how they feel about themselves and improve their self-confidence. Sometimes, even school performance and participation in social activities improve after kids switch to contact lenses.

Glasses Are Still Required

If your child chooses to wear contact lenses, they still need an up-to-date pair of eyeglasses. Contact lenses worn on a daily basis should be removed at least an hour before bedtime to allow the eyes to breathe. Also, there will be times when your child may want to wear their glasses instead of contact lenses. And contact lenses should be removed immediately anytime they cause discomfort or eye redness.

Don't Push Contacts on Your Kids

Motivation is often the most important factor in determining whether your son or daughter will be a successful contact lens wearer. If you wear contact lenses yourself and love them, that still doesn't mean they are the right choice for your child. Some children like wearing glasses and have no desire to wear contact lenses.

Sometimes it's just a matter of timing. Often, a child may feel they don't want contacts, but a year or two later, they do.

Children's Vision FAQs

Children's Vision FAQs

How often should children have their eyes examined?

According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. After that, kids should have routine eye exams at age 3 and again at age 5 or 6 (just before they enter kindergarten or the first grade).

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is needed. Children who need eyeglasses or contact lenses should be examined annually.

My 5-year-old daughter just had a vision screening at school and she passed. Does she still need an eye exam?

Yes. School vision screenings are designed to detect gross vision problems. But kids can pass a screening at school and still have vision problems that can affect their learning and school performance. In fact, studies have found that up to 11 percent of children who pass a vision screening actually have a vision problem that needs treatment. A comprehensive eye exam by an optometrist can detect vision problems that a school screening may miss. Also, a comprehensive eye exam includes an evaluation of your child's eye health, which is not part of a school vision screening.

What is vision therapy?

Vision therapy (also called vision training) is like physical therapy for the visual system. It involves an individualized program of eye exercises designed to correct vision problems, such as amblyopia ("lazy eye"), eye movement and alignment problems, focusing problems, and certain visual-perceptual disorders. Vision therapy is not designed to treat nearsightedness, farsightedness and astigmatism. Vision therapy is usually performed in an optometrist's office, but most treatment plans also include daily vision exercises to be performed at home.

Can vision therapy cure learning disabilities?

No, vision therapy cannot correct learning disabilities. However, children with learning disabilities often have vision problems as well. Vision therapy can correct underlying vision problems that may be contributing to a child's learning problems.

Our active 1-year-old boy needs glasses to correct his farsightedness and the tendency for his eyes to cross. But he pulls them off the second they go on. We've tried an elastic band, holding his arms, tape... He just struggles and cries. How do we get him to wear his glasses?

In most cases, it just takes awhile for a toddler to get used to the sensation of wearing glasses. So persistence is the key. Also, you may want to put his glasses on as soon as he wakes up - this will usually help him adapt to the glasses easier.

But it's also a good idea to recheck the prescription and make sure his glasses were made correctly and are fitting properly. Today, there are many styles of frames for young children, including some that come with an integrated elastic band to help keep them comfortably on the child's head. Bring your son and the eyewear to our office. Even if you didn't purchase the glasses from us, we will be happy to give you our opinion about why your son is having a tough time wearing them and what you can do about it.

Our 3-year-old daughter was just diagnosed with strabismus and amblyopia. What is the likelihood of a cure at this age?

With proper treatment, the odds are very good. Many researchers believe the visual system can still develop better visual acuity up to about age 8 to 10. If your daughter's eye turn (strabismus) is constant, it's likely surgery will be necessary to straighten her eyes in order for her therapy for amblyopia (or "lazy eye") to be successful. Strabismus surgery often is followed by eye patching and vision therapy (also called orthoptics) to help both eyes work together as a team. See a pediatric ophthalmologist who specializes in strabismus surgery for more information.

My daughter (age 10) is farsighted and has been wearing glasses since age 2. We think she may have problems with depth perception. How can she be tested for this, and if there is a problem, can it be treated?

We can perform a very simple stereopsis test to determine if your daughter has normal depth perception. In this test, she wears "3-D glasses" and looks at a number of objects in a special book or on a chart across the room. If she has reduced stereopsis, a program of vision therapy may help improve her depth perception.

We have an 11-year-old son who first became nearsighted when he was 7. Every year, his eyes get worse. Is there anything that can be done to prevent this?

A number of recent studies suggest it may be possible to slow myopia progression, or even reverse it, during childhood. Currently, four types of treatment are showing promise for controlling myopia: atropine eye drops, multifocal contact lenses, orthokeratology ("ortho-k") and multifocal eyeglasses. A comprehensive examination will help determine which of these options might help the individual needs of your son.

My 7-year-old son's teacher thinks he has "convergence insufficiency." What is this, and what can I do about it?

Convergence insufficiency (CI) is a common learning-related vision problem where a person's eyes don't stay comfortably aligned when they are reading or doing close work. For reading and other close-up tasks, our eyes need to be pointed slightly inward (converged). A person with convergence insufficiency has a tough time doing this, which leads to eyestrain, headaches, fatigue, blurred vision and reading problems. Usually, a program of vision therapy can effectively treat CI and reduce or eliminate these problems. Sometimes, special reading glasses can also help.

My son is 5 years old and has 20/40 vision in both eyes. Should I be concerned, or could this improve with time?

Usually, 5-year-olds can see 20/25 or better. But keep in mind that visual acuity testing is a subjective matter - during the test, your child is being asked to read smaller and smaller letters on a wall chart. Sometimes, kids give up at a certain line on the chart when they can actually read smaller letters. Other times, they may say they can't read smaller letters because they want glasses. (Yes, this happens!) Also, if your son had his vision tested at a school screening (where there can be plenty of distractions), it's a good idea to schedule a comprehensive eye exam to rule out nearsightedness, astigmatism or an eye health problem that may be keeping him from having better visual acuity.

My daughter has been diagnosed with refractive amblyopia due to severe farsightedness in one eye. She just got her glasses, and the lens for her bad eye is much thicker than the other lens. She complains that the glasses make her dizzy, and she refuses to wear them. Can anything be done about this?

In situations like this, where one eye needs a much stronger correction than the other, contact lenses are a better option. With glasses, the unequal lens powers cause an unequal magnification effect, so the two eyes form images in the brain that are different in size. This can cause nausea and dizziness because the brain may not be able to blend the two separate images into a single, three-dimensional one. And, of course, the glasses will be unattractive because one lens will be much thicker than the other.

Even if your child is quite young, she can probably handle contact lens wear. Contact lenses don't cause the differences in image magnification that glasses do. Continuous wear lenses (worn day and night for up to 30 days, then discarded) or one-day disposable lenses may be good options.

Keep in mind that amblyopia is a condition where one eye doesn't see as well as the other, even with the best possible correction lens in place. Simply wearing the contacts may not improve the vision in her weak eye. Usually a program of vision therapy will also be needed.

Controlling Nearsightedness in Children

Controlling Nearsightedness in Children

Myopia (nearsightedness) is a common vision problem affecting children who can see well up close, while distant objects are blurred. Nearsighted children tend to squint to see distant objects such as the board at school. They also tend to sit closer to the television to see it more clearly.

Sometimes, childhood myopia can worsen year after year. This change can be disconcerting to both children and their parents, prompting the question: "Will it ever stop? Or, will this get so bad that, someday, glasses won't help?"

Myopia that develops in childhood nearly always stabilizes by age 20. But by then, some kids have become very nearsighted, leading scientists to search for ways to slow down the progression of myopia in children. Four possible treatments that show promise include orthokeratology ("ortho-k"), atropine eye drops, multifocal eyeglasses, and soft multifocal contact lenses.

Orthokeratology

Orthokeratology, or "ortho-k," is the use of specially designed gas permeable contact lenses to flatten the shape of the cornea and thereby reduce or correct mild to moderate amounts of nearsightedness. The lenses are worn during sleep and removed in the morning. Though temporary eyeglasses may be required during the early stages of ortho-k, many people with low to moderate amounts of myopia can see well without glasses or contact lenses during the day after wearing the corneal reshaping lenses at night.

Recent research suggests ortho-k may also reduce the lengthening of the eye itself, indicating that wearing ortho-k lenses during childhood may actually cause a permanent reduction in myopia, even if the lenses are discontinued in adulthood.

Atropine

Topical atropine is a medicine used to dilate the pupil and temporarily paralyze accommodation and completely relax the eyes' focusing mechanism. Because research has suggested nearsightedness in children may be linked to focusing fatigue, investigators have looked into using atropine to disable the eye's focusing mechanism to control myopia.

The results of these studies have been impressive. However, additional research has shown that the myopia control effect from atropine does not continue after the first year of treatment, and that short-term use of atropine may not control nearsightedness significantly in the long run.

Multifocal Eyeglasses

Some evidence suggests wearing eyeglasses with bifocal or progressive multifocal lenses may slow the progression of nearsightedness in some children. The mechanism here appears to be that the added magnifying power in these lenses reduces focusing fatigue during reading and other close work, a problem that may contribute to increasing myopia.

A five-year study published in Investigative Ophthalmology & Visual Science produced an interesting result involving nearsighted children whose mother and father were also nearsighted. These children, who wore eyeglasses with progressive multifocal lenses during the course of the study, had less progression of their myopia than similar children who wore eyeglasses with regular, single vision lenses.

Soft Multifocal Contact Lenses

New research shows that multifocal contact lenses also may be an effective myopia control treatment, potentially more so than multifocal eyeglasses. A recent study by researchers at Ohio State University found that wearing multifocal contact lenses reduces the rate of progression of myopia in children by 50%.

One potential reason why multifocal contact lenses may limit progression is that these lenses appear to reduce the lengthening of the eye, which leads to increasing myopia over time.

Learning-Related Vision Problems

Learning-Related Vision Problems

There's no question that good vision is important for learning. Experts say more than 80% of what your child is taught in school is presented to them visually.

To make sure your child has the visual skills they need for school, the first step is to make sure your child has 20/20 eyesight and that any nearsightedness, farsightedness and/or astigmatism is fully corrected with glasses or contact lenses. But there are other, less obvious learning-related vision problems you should know about as well.

Good Vision Is More Than 20/20 Visual Acuity

Your child can have "20/20" eyesight and still have vision problems that can affect their learning and classroom performance. Visual acuity (how well your child can see letters on a wall chart) is just one aspect of good vision, and it's not even the most important one. Many nearsighted kids may have trouble seeing the board in class, but they read exceptionally well and excel in school.

Other important visual skills needed for learning include:

Eye movement skills - How smoothly and accurately your child can move their eyes across a printed page in a textbook.
Eye focusing abilities - How well your child can change focus from far to near and back again (for copying information from the board, for example).
Eye teaming skills - How well your child's eyes work together as a synchronized team (to converge for proper eye alignment for reading, for example).
Binocular vision skills - How well your child's eyes can blend visual images from both eyes into a single, three-dimensional image.
Visual perceptual skills - How well your child can identify and understand what he sees, judge its importance, and associate it with previous visual information stored in his brain.
Visual-motor integration - The quality of your child's eye-hand coordination, which is important not only for sports, but also for legible handwriting and the ability to efficiently copy written information from a book or chalkboard.

Deficiencies in any of these areas can significantly affect your child's learning ability and school performance.

Many Kids Have Vision Problems That Affect Learning

Many kids have undetected learning-related vision problems. In fact, children are often misdiagnosed with learning problems or ADD/ADHD when, in fact, they have a vision problem.

According to the College of Optometrists in Vision Development (COVD), one study indicates 13% of children between the ages of 9 and 13 suffer from moderate to severe convergence insufficiency (an eye teaming problem that can affect reading performance), and as many as one in four school-age children may have at least one learning-related vision problem.

Signs and Symptoms of Learning-Related Vision Problems

There are many signs and symptoms of learning-related vision disorders, including:

Blurred distance or near vision, particularly after reading or other close work
Frequent headaches or eye strain
Difficulty changing focus from distance to near and back
Double vision, especially during or after reading
Avoidance of reading
Easily distracted when reading
Poor reading comprehension
Loss of place, repetition, and/or omission of words while reading
Letter and word reversals
Poor handwriting
Hyperactivity or impulsiveness during class
Poor overall school performance

If your child exhibits one or more of these signs or symptoms and is having problems in school, call us to schedule a comprehensive children's vision exam.

Comprehensive Children's Vision Exam

A comprehensive children's vision exam includes tests performed in a routine eye exam, plus additional tests to detect learning-related vision problems. These extra tests may include an assessment of eye focusing, eye teaming, and eye movement abilities (also called accommodation, binocular vision, and ocular motility testing). Also, depending on the type of problems your child is having, we may recommend other testing, either in our office or with a children's vision and/or vision development specialist.

Vision Therapy

If it turns out your child has a learning-related vision problem that cannot be corrected with regular glasses or contact lenses, then special reading glasses or vision therapy may help. Vision therapy is a program of eye exercises and other activities specifically tailored for each patient to improve vision skills.

Vision and Learning Disabilities

A child who is struggling in school could have a learning-related vision problem, a learning disability or both. Vision therapy is a treatment for vision problems; it does not correct a learning disability. However, children with learning disabilities may also have vision problems that are contributing to their difficulties in the classroom.

Vision Therapy for Children

Vision Therapy for Children

Many children have vision problems other than simple refractive errors such as nearsightedness, farsightedness and astigmatism. These "other" vision problems include amblyopia ("lazy eye"), eye alignment or eye teaming problems, focusing problems, and visual perceptual disorders. Left untreated, these non-refractive vision problems can cause eyestrain, fatigue, headaches, and learning problems.

What Is Vision Therapy?

Vision therapy (also called orthoptics or vision training) is an individualized program of eye exercises and other methods to treat non-refractive vision problems. The therapy is usually performed in an optometrist's office, but most treatment plans also include daily visual tasks and eye exercises to be performed at home.

Optometrists who specialize in vision therapy and the treatment of learning-related vision problems are sometimes called behavioral optometrists or developmental optometrists.

Can Vision Therapy Eliminate the Need for Glasses?

Vision therapy is NOT the same as self-help programs that claim to reduce refractive errors and the need for glasses. There is no scientific evidence that these "throw away your glasses" programs work, and most eye care specialists agree they are a hoax.

In contrast, vision therapy is approved by the American Optometric Association (AOA) for the treatment of non-refractive vision problems, and there are many studies that demonstrate its effectiveness.

The degree of success achieved with vision therapy, however, depends on a number of factors, including the type and severity of the vision problem, the patient's age and motivation, and whether the patient performs all eye exercises and visual tasks as directed. Not every vision problem can be resolved with vision therapy.

Vision Therapy Is Customized and Specific

The activities and eye exercises prescribed as part of a vision therapy program are tailored to the specific vision problem (or problems) a child has. For example, if a child has amblyopia, the therapy usually includes patching the strong eye, coupled with visual tasks or other stimulation techniques to develop better visual acuity in the weak eye. Once visual acuity is improved in the amblyopic eye, the treatment plan may then include eye teaming exercises to foster the development of clear, comfortable binocular vision to improve depth perception and reading comfort.

Vision Therapy and Learning Disabilities

Vision therapy does not correct learning disabilities. However, children with learning disabilities often have vision problems as well. Vision therapy can correct underlying vision problems that may be contributing to a child's learning problems.

Be sure to tell us if your child has been diagnosed with a learning disability. If we find vision problems that may be contributing to learning problems, we can communicate with your child's teachers and other specialists to explain our findings. Often, vision therapy can be a helpful component of a multidisciplinary approach to remediating learning problems.

Schedule a Comprehensive Eye Exam

If you suspect your child has a vision problem that may be affecting their performance in school, the first step is to schedule a comprehensive eye exam so we can determine if such a problem exists. If learning-related vision problems are discovered, we can then discuss with you whether a program of vision therapy would be helpful.

Your Infant's Visual Development

Your Infant's Visual Development

One of the greatest moments after the birth of your baby is the first time your newborn daughter or son opens their eyes and makes eye contact with you. But don't be concerned if that doesn't happen right away.

The visual system of a newborn infant takes some time to develop. In the first week of life, your newborn's vision is blurry and lacks detail. In fact, newborns see only in shades of gray. It takes several months for your child's vision to develop fully.

Knowing the expected milestones of your baby's vision development during their first year of life can insure your child is seeing properly and enjoying their world to the fullest.

During Your Pregnancy

Your child's vision development begins before birth. How you care for your own body during your pregnancy is extremely important for the development of your baby's body and mind, including their eyes and the vision centers in the brain.

Be sure to follow the instructions that your obstetrician (OB/GYN doctor) gives you regarding proper nutrition and the proper amount of rest during your pregnancy. And of course, avoid smoking and consuming alcohol or drugs during pregnancy, as these toxins can cause multiple problems for your baby, including serious vision problems.

At Birth

At birth, your baby sees only in black and white. Nerve cells in the retina and brain that control vision are not yet fully developed. Also, newborn eyes don't have the ability to accommodate or focus on near objects. So don't be concerned if your baby doesn't seem to be focusing on your face or other objects right away. It just takes time. It may also assure you to know that, despite these limitations, studies show that within a few days after birth, infants prefer looking at an image of their mother's face over anyone else's.

The First Month

Color vision develops in the first few weeks of life, so your baby is starting to see the world in full color. But visual acuity and eye teaming take a bit longer - so if your infant's eyes occasionally look unfocused or misaligned, don't worry.

The eyes of infants are not as sensitive to visible light as adult eyes are, but they need protection from the sun's harmful UV rays. Keep your baby's eyes shaded outdoors with a brimmed cap or some other means.

Months 2 and 3

Your baby's vision is improving, and their two eyes are beginning to move better as a team. They should be following moving objects at this stage, and starting to reach for things they see. Also, infants at this stage are learning how to shift their gaze from one object to another without having to move their head.

Months 4 to 6

By 6 months of age, significant advances take place in the vision centers of the brain, allowing your infant to see more distinctly, and move his eyes faster and more accurately to follow moving objects. Six months of age also is an important milestone because this is when your child should have his first eye exam.

Visual acuity develops rapidly, improving from about 20/400 at birth to about 20/25 at six months of age. Your child's color vision should be nearly fully developed at age six months as well, enabling them to see all the colors of the rainbow with ease.

Children also develop better eye-hand coordination at 4 to 6 months of age. They're able to quickly locate and pick up objects, and accurately direct a bottle (and many other things) to their mouth.

Months 7 to 12

Your child is now mobile, crawling about and covering more distances than you might have expected. At this age, babies are also better at judging distances and are more skilled at locating, grasping and throwing objects, too.

During months 7 to 12, children are developing a better awareness of their overall body and learning how to coordinate their vision with their body movements. At this time, watch them closely to keep them from harm as they explore their environment. Keep cabinets that contain cleaning supplies locked, and put a barrier in front of stairwells.

When It's Time for an Eye Exam

If you suspect something is seriously wrong with your baby's eyes in their first few months of life (a bulging eye, a red eye, excessive tearing, or a constant misalignment of the eyes, for example) take your child to a pediatric ophthalmologist or other eye doctor immediately.

For routine eye care, the American Optometric Association (AOA) recommends you schedule your baby's first eye exam when they are six months old. Though your baby can't yet read letters on a wall chart, your optometrist can perform non-verbal testing to determine visual acuity, detect excessive or unequal amounts of nearsightedness, farsightedness and astigmatism, and evaluate eye teaming and alignment. At this exam, your doctor will also check the health of your baby's eyes, looking for anything that might interfere with normal and continuing vision development.

Computer Vision Syndrome

Children and Computer Vision Syndrome

Children and Computer Vision Syndrome

Computer use has become a routine part of kids' lives. About 90% of school-aged children in the U.S. have access to a computer. And kids are starting to use computers at a younger age. Among college students who were interviewed, 20% said they began using a computer before they were 9 years old.

In fact, the use of computers and other digital devices has become so common during childhood that a 2015 report by The Vision Council revealed that nearly one in four kids spend more than three hours a day using digital devices.

A Connection Between Computer Use and Myopia?

So how is all this computer use at a young age affecting kids' eyes?

Many eye doctors who specialize in children's vision say sustained computer use puts kids at higher risk for childhood myopia (nearsightedness). They point out that, though myopia affects approximately 25% of the U.S. population, nearly 50% of adult computer users with a college education are nearsighted. Computer use, especially among youngsters whose eyes are still changing, may be the reason for this disparity.

Research seems to support this theory. A study of 253 children between the ages of 6 and 10 at the University of California at Berkeley School of Optometry found a strong correlation between the amount of time young children spend on the computer and their development of nearsightedness.

Why Computers Can Be Hard on Kids' Eyes

Sitting for hours in front of a computer screen stresses a child's eyes because the computer forces the child's vision system to focus and strain a lot more than during any other task. This can put children at an even greater risk than adults for developing symptoms of computer vision syndrome. Computer use stresses the eyes more than reading a book or magazine because it's harder to maintain focus on computer-generated images than on printed images. This is especially true for young children, whose visual system is not fully developed.

Doctors are also concerned about the long-term effects of exposure to the blue light that is emitted by digital devices. Blue light, also known as high-energy visible, or HEV, light penetrates deeper into the eye than ultraviolet light and may damage kids' retinas.

According to the American Optometric Association, children may be especially vulnerable to computer-related vision problems because:

Children have a limited degree of self-awareness. They may perform a task on the computer for hours with few breaks. This prolonged activity can cause focusing and eyestrain problems.
Children assume that what they see and how they see is normal - even if their vision is impaired or slowly deteriorating.
Children are smaller than adults. Because computer workstations are often arranged for adult use, this can increase the risk of children sitting too near the screen or adopting unusual postures that can lead to eyestrain and neck, shoulder and back pain.

Tips for Preventing Computer Vision Syndrome in Children

To prevent your child from developing eyestrain and other CVS symptoms (including increasing myopia), follow these tips:

Before they start school, make sure your kids have a comprehensive eye exam - including an assessment of their near-point (computer and reading) vision skills.
Make sure your child's computer workstation is arranged to suit body size. For children, the recommended distance between the monitor and the eye is 18 to 28 inches to avoid risk of eyestrain with closer viewing. Also, the screen should be a few inches below the child's eyes. The chair should be adjusted so your child's arms are parallel with the desk surface and his feet rest comfortably on the floor. These adjustments help avoid posture problems and strained muscles.
Be aware of the signs and symptoms of vision problems, such as eye redness, frequent rubbing of the eyes, head turns and other unusual postures or complaints of blurriness or eye fatigue. Avoidance of the computer or school work may also indicate a vision problem.

If you suspect your child may be developing a vision problem related to computer use, be sure to mention this when you make an appointment for an eye exam. Your doctor may want to set aside extra time to perform tests specifically designed to detect computer vision problems.

Computer Eyestrain: 10 Steps for Relief

Computer Eyestrain: 10 Steps for Relief

With so many people using computers at work, eyestrain has become one of the leading office-related health complaints.

Experts estimate 50% to 90% of computer users experience some degree of eyestrain or other symptoms of computer vision syndrome (CVS) during their work day. Studies show eyestrain and CVS often cause fatigue, decreased productivity and more work errors.

So what can you do about it? Here are steps you (and your employer) can take to reduce computer eyestrain and the other common symptoms of computer vision syndrome (CVS):

1. Get a computer eye exam. This is the most important thing you can do to prevent computer vision problems. According to the National Institute of Occupational Safety and Health (NIOSH), computer users should have an eye exam before they start working on a computer and once yearly thereafter. Be sure to tell your eye doctor how often you use a computer at work and at home.

2. Use proper lighting. Computer eyestrain is often caused by excessively bright ambient lighting — either from outdoor sunlight coming in through a window or from harsh interior lighting. For the most comfortable computer use, ambient lighting should be about half as bright as that found in most offices.

If possible, reduce the brightness of interior lighting by using fewer fluorescent tubes in overhead light fixtures, or use lower intensity bulbs. Also try to position your monitor so that windows are to the side of it, instead of in front or back. You can also close curtains, shades and blinds to reduce the amount of sunlight at your workstation.

3. Minimize glare. Glare on walls and finished surfaces, as well as reflections on the computer screen, can also cause computer eyestrain. You may want to install an anti-glare screen on your monitor and, if possible, paint bright white walls a darker color with a matte finish.

Again, cover the windows. When outside light cannot be reduced, consider using a computer hood.

If you wear glasses, have an anti-reflective (AR) coating applied to your lenses. AR coating reduces glare by minimizing the amount of light reflecting off the front and back surfaces of your eyeglass lenses.

4. Upgrade your display. If you've not already done so, replace your old tube-style monitor (called a cathode ray tube or CRT) with a flat-panel liquid crystal display (LCD), like those on laptop computers.

LCD screens are easier on the eyes and usually have an anti-reflective surface. Old-fashioned CRT screens can cause a "flicker" of images on the screen. Even if this flicker is imperceptible, it can still contribute to eyestrain and fatigue during computer work.

If you still use a CRT, you can decrease eyestrain from flicker by increasing the refresh rate of your screen to 75 hertz (Hz) or higher. You can access this setting in the Control Panel of your computer.

When choosing a new flat panel display, select a screen with the highest resolution possible. Resolution is related to the "dot pitch" of the display. Generally, displays with a lower dot pitch have sharper images. Choose a display with a dot pitch of .28 mm or smaller.

Finally, choose a relatively large display. For a desktop computer, select a display that has a diagonal screen size of at least 19 inches.

5. Adjust the brightness and contrast of your computer screen. For more comfortable viewing, adjust the display settings on your computer so the brightness of the screen is about the same as that of your work environment.

As a test, try looking at the white background of this web page. If it looks like a light source, it's too bright. If it seems dull and gray, it may be too dark.

Also, adjust your screen settings to make sure the contrast between the screen background and the on-screen characters is high. And make sure that the text size and color are optimized for the most comfort. Usually, black text on a white background is the best color combination. But other high-contrast, dark-on-light combinations may also be acceptable.

Finally, adjust your computer's color temperature. Reducing the color temperature of your display lowers the amount of blue light emitted by a color display. Blue light is short-wavelength visible light that is associated with more eyestrain than longer wavelength hues, such as orange and red.

6. Blink more often. Blinking is very important — it rewets your eyes to keep them moist, comfortable and clear.

Studies show that, during computer use, people blink less frequently — about one-third as often as they normally do. And, according to studies, many blinks performed during computer work are only partial lid closures. This greatly increases the risk for dry eyes, blurred vision, eye irritation and fatigue.

To keep your eyes comfortable and seeing well during computer use, try this exercise: Every 20 minutes, blink 10 times by closing your eyes as if falling asleep (very slowly). This will help rewet your eyes.

Also, keep a bottle of artificial tears at your workplace and use them to moisten your eyes often during prolonged computer use. Ask your eye doctor to recommend the best brands for your needs.

7. Exercise your eyes. Another cause of computer eyestrain is focusing fatigue. Research shows that it's harder for our eyes to maintain focus on computer-generated images than on printed images in a book or magazine.

To reduce your risk of focusing fatigue during computer use, look away from your screen or monitor every 20 minutes and gaze at a distant object across the room. Looking far away relaxes the focusing muscles inside your eyes, reducing focusing fatigue.

Another exercise is to look far away at an object for 10-15 seconds, then gaze at something up close for 10-15 seconds, and then look back at the distant object again. Do this 10 times. This exercise reduces the risk of your eyes' focusing system "locking up" (a condition called accommodative spasm) during prolonged computer work.

8. Take frequent breaks. Take frequent, short breaks from your computer work throughout the day. Stand up, walk away from your work station and stretch your arms, legs, back, neck and shoulders. These activities will reduce your risk for computer vision syndrome and neck, back and shoulder pain.

Many workers take only two 15-minute breaks from their computer during their work day. According to a recent NIOSH study, computer workers experienced significantly less discomfort and eyestrain if they took four additional 5-minute "mini-breaks" during the day.

Interestingly, these supplementary breaks did not reduce productivity. Data entry speed was significantly faster as a result of the extra breaks, so work output was maintained even though the workers had 20 extra minutes of break time each day.

9. Modify your workstation. Looking back and forth between a printed page and your computer screen (as during data entry tasks), can also cause eyestrain. To improve comfort during these tasks, place the print material on a copy stand adjacent to your screen or monitor. If necessary, use a desk lamp to illuminate the print material - but make sure it doesn't shine into your eyes or onto the computer screen.

Improper posture during computer work also contributes to computer vision syndrome. Adjust your workstation and chair to a comfortable height so your feet are flat on the floor in front of you.

Adjust your chair and computer so your screen is approximately 20 to 24 inches from your eyes and slightly below eye level so you can view it comfortably with your head and neck in a natural position.

10. Consider computer eyewear. For the greatest comfort at your computer, you may benefit from having a customized eyeglasses prescription for your computer work. This is especially true if you normally wear contact lenses that can become dry and uncomfortable during sustained computer work.

Computer glasses are also a good choice if you normally wear eyeglasses with bifocal or progressive lenses. Though these lenses provide excellent vision for most tasks, they don't provide an adequate viewing zone for prolonged computer work.

Your eye doctor can prescribe specially designed computer eyewear to give you the best possible vision at your computer screen. Keep in mind that computer glasses are a specific type of eyewear and typically should not be worn when driving.

Computer Glasses

Computer Glasses

When you work at a computer for any length of time, it's common to experience eyestrain, blurred vision and other symptoms of computer vision syndrome (CVS). Viewing computer-generated print and images on a screen or monitor for prolonged periods is harder on the eyes than viewing a similar amount of material on the printed pages of a book or magazine.

If you're under age 40, blurred vision during computer use may be due to your eyes being unable to remain accurately focused on your screen for sustained periods. Or you may have a hard time quickly and accurately changing focus, such as when you shift your gaze from your monitor to your keyboard and back again. This problem, called lag of accommodation, can cause eyestrain and headaches — two common symptoms of CVS.

If you're over age 40, the onset of presbyopia — the normal age-related loss of near focusing ability — can make focusing on a computer screen even more difficult, further increasing the risk of eyestrain, headaches and eye fatigue.

So what can you do to make your eyes more comfortable and function more efficiently during computer use? Have your eye doctor prescribe specially designed computer glasses.

Customized computer glasses can make a world of difference. These special-purpose glasses are prescribed specifically to reduce eyestrain and give you the most comfortable vision at your computer.

I Already Wear Glasses. Do I Really Need Computer Glasses?

If you already wear prescription eyeglasses or reading glasses, you may be tempted to dismiss the idea of computer glasses. But eyeglasses prescribed for general-purpose wearing are often not well-suited for prolonged computer work.

Why? When working at a computer, your eyes are generally 20 to 26 inches from your computer screen. This distance is considered the intermediate zone of vision — closer than driving (distance) vision, but farther away than reading (near) vision.

Most young people wear eyeglasses to correct their distance vision. Reading glasses are prescribed to correct near vision only. And bifocals prescribed for those over age 40 with presbyopia correct only near and far. None of these eyeglasses are optimized for the intermediate zone of vision used during computer work.

Even trifocals and progressive lenses, which do include the correct power for intermediate vision, have only a small portion of the lens dedicated to this area — not nearly a large enough area for comfortable prolonged computer work.

Without the appropriate eyewear, computer users can often end up with blurred vision, eyestrain, and headaches — the hallmark symptoms of computer vision syndrome (CVS). Worse still, many people try to compensate for their blurred vision by leaning forward, or by tipping their head to look through the bottom portion of their glasses. These unnatural postures can lead to headaches, neck and shoulder pain, and backaches.

Computer Glasses Reduce Errors and Increase Productivity

Are computer glasses worth the extra cost of a second pair of glasses?

Yes, they are. Research has shown that, in addition to increasing comfort and decreasing the risk of CVS, prescription computer glasses can reduce errors and productivity loss caused by vision problems during computer work.

A study conducted at the University of Alabama School of Optometry found that even minor changes from the optimum lens power for computer work can cause a 38% decrease in accuracy for tasks performed on a computer and a 9% loss in worker productivity. The researchers concluded that, because of productivity gains from workers wearing computer glasses, companies that pay for computer eyewear for their employees could experience a benefit/cost ratio of $18 for every $1 spent.

Computer Lens Designs

There are a number of special purpose lens designs that work well for computer glasses. Because these lenses are prescribed specifically for computer use, they are unsuitable for driving or general-purpose wear.

The simplest computer glasses have single vision lenses with a modified lens power prescribed to give the most comfortable vision at the user's computer screen. These lenses reduce the amount of focusing the eyes have to do to keep images on the computer screen clear and provide the largest field of view, reducing the need for head tilting and other unnatural posture changes during computer work.

For older computer users, a specially designed occupational progressive lens for computer use is sometimes a better option. Progressive lenses for computer use have a larger intermediate zone than regular progressive lenses for a wider, more comfortable view of the computer screen.

Another option for presbyopic computer users is an occupational lined bifocal or trifocal, with larger intermediate and near zones than regular designs.

Your eyecare professional can help you decide which lens design will best suit your needs.

Lens Coatings and Treatments

Anti-reflective (AR) coating can make your computer glasses even more comfortable. This coating reduces glare caused by reflections of overhead fluorescent lighting that can occur in uncoated eyeglass lenses.

Also, because many office environments are too bright for optimum visual comfort, a light tint is often a good idea as well.

Finally, some of the newer computer lenses are specifically designed to block the short-wavelength, blue light that is emitted from computer screens. Blue light is associated with glare, eyestrain and potentially more serious long-term vision problems.

Computer Vision Syndrome

Computer Vision Syndrome Q & A

Computer Vision Syndrome Q & A

What can I do when my eyes tire out from too much reading and computer use?

This is a common problem. See your eye doctor about computer eyeglasses that will help you focus more accurately and with less effort. When prescribed properly, these glasses can also help you read printed material. Lenses also can have tints and coatings to make your eyes feel a lot better.

Also, take frequent breaks (every 15-20 minutes) from reading or computer use. Look at something far away, like an object outside a window, to relax your focusing muscles. And make sure the lighting is correct for the activity you are doing — bright for reading and a bit dimmer for computer work.

Is it necessary to wear special eye protection when working on the computer? Is such protection necessary if I already wear prescription eyeglasses?

Not necessarily. However, there is increasing concern about high-energy visible (HEV) light wavelengths that are emitted from digital displays. New research is revealing that excessive exposure to this segment of blue light can damage retinal cells, leading to long-term vision problems such as age-related macular degeneration (AMD) and cataracts.

Eyestrain is another issue. Having an accurate, up-to-date prescription and an ergonomically appropriate workstation can make a huge difference in managing your visual comfort while using your computer. Also, consider adding an anti-reflective coating on your lenses to minimize glare.

My eyes become sensitive to light when I do a lot of reading on a computer screen. Sometimes, the words seem to change size. Also, my distance vision sometimes is blurred after I do computer work. Is this computer vision syndrome, and what should I do about it?

Yes, all these symptoms suggest you have computer vision syndrome (CVS). Focusing problems are common among people who spend a lot of time at a computer. We can prescribe eyeglasses that will help you be more comfortable and should relieve your symptoms. You can also help yourself by making sure your work station is efficient and comfortable. Check out the lighting, height of your screen, angle of your screen, hand position, etc.

Can your eyes and face get burned by computer monitors?

No. If they could, you'd see a lot of red-faced and red-eyed people.

My eyes often become red when I read a book or use a computer. Will eye drops help?

Your eyes becoming red could be a sign that you are having trouble focusing. Have your eyes examined to see if you should wear glasses to alleviate near vision stress. See an eye doctor before using over-the-counter eye drops on a regular basis. Your doctor will be able to determine if you need drops and, if so, which type of eye drops will be best for you.

How can I relieve eye stress from working at a computer all day?

To relieve eyestrain from prolonged computer use, take frequent breaks during your work day. About every 15 minutes, look up and far away, preferably out a window or across the room. Also, make sure your work station is correctly structured and lighted. Your screen or monitor should be positioned about 20 to 26 inches from your eyes, slightly below eye level. Tilt the screen slightly away from you at the top, the way you would hold a book, to reduce glare from reflected light. Adjust the screen contrast to be comfortable, and make sure the room lighting isn't too bright.

Also, see your eye doctor for regular exams to monitor your vision. Even a slight vision change can cause eyestrain during computer work. Special computer glasses can help you see your screen with less focusing effort, and your eye doctor can advise you about lens coatings and tints that can also help relieve eyestrain.

Frequently Asked Questions: Computer Vision Syndrome and Computer Glasses

Frequently Asked Questions: Computer Vision Syndrome and Computer Glasses

Who is affected by computer vision syndrome?

Computer eyestrain affects more than 70% of the approximately 143 million Americans who work on a computer on a daily basis, according to the American Optometric Association (AOA). In fact, more than 90% of adults report using digital devices more than two hours a day.

And grown-ups aren't the only ones affected. Though computer vision syndrome (CVS) is often associated with adult computer users, children may be even more vulnerable to the condition.

What are the symptoms of CVS?

Symptoms of computer vision syndrome include:

Headaches
Loss of focus
Burning/tired eyes
Red eyes
Double/blurred vision
Eye twitching
Dry eyes
Neck and shoulder pain

What causes computer vision syndrome?

CVS is caused by the increased demands of computer-generated images on our eyes and visual systems and by the prolonged and/or repetitive nature of computer work.

Our eyes have little problem focusing on most printed material, which is characterized by dense black characters with well-defined edges. Characters on a computer screen, however, don't have the same high contrast or well-defined borders. The luminous elements (pixels) that create images on a computer screen are brightest at the center and diminish in intensity toward their edges. This makes it more difficult for our eyes to focus accurately on computer-generated images compared with images printed with ink in a book or magazine.

As our eyes struggle to gain and maintain focus on images on a computer screen, this continuous flexing of the eyes' focusing muscles creates fatigue and the burning, tired-eyes feeling that is so common after long hours at the computer.

In addition, it's common for computer users to fall into bad postural habits and remain in these positions for extended periods of time, causing muscle strain, fatigue and headaches.

What can I do about CVS?

A pair of computer eyeglasses can help relieve many of the symptoms of CVS. Unlike regular eyeglasses, computer glasses are prescribed specifically for the distance from your eyes to your computer screen. This reduces the focusing demands on your eyes during computer use to lessen eye fatigue and reduce the risk for eyestrain and other computer-related vision problems.

Will glare screens prevent CVS?

A glare filter for your computer screen may help somewhat, but it will not solve all your computer vision problems. Filters can reduce glare from overhead lights or outdoor sunlight reflecting off the surface of your computer screen. But they do nothing to prevent the vision problems related to the constant refocusing of your eyes when working at a computer.

Only when your eyes can focus clearly at the plane of proper distance on the computer screen can they experience relief from the fatiguing effects of CVS. An anti-reflective coating (AR) is also highly recommended on all computer eyeglasses.

Will anti-reflective coating on my eyeglasses eliminate glare?

Anti-reflective (AR) coatings reduce glare from light reflecting off the front and back surfaces of your eyeglass lenses. So, like filters for your computer screen, AR coatings for eyeglass lenses are helpful, but they do not address the primary cause of most CVS symptoms.

However, special coatings and filters may help protect your eyes from long-term vision problems caused by blue light exposure. Also referred to as high-energy visible (HEV) light exposure, blue light can reach deeper into the eye than ultraviolet light and, over time, may damage your retina.

Will computer eyeglasses make the screen clearer?

Yes, because they will eliminate the constant refocusing effort that your eyes go through when viewing the screen. Research has also shown that wearing computer eyeglasses increases productivity and accuracy.

Do computer glasses look like safety glasses?

No. Almost any style of frame can be used for computer glasses. Also, the lenses of computer glasses don't have to pass the stringent impact-resistance standards required of lenses in safety glasses.

Should computer lenses be tinted?

If you work in a very bright office, you may benefit from a light tint applied to your computer lenses. This can cut the amount of light that reaches your eyes and provide relief in some cases. But tints and filters don't address the underlying cause of computer eyestrain.

If I don't have symptoms of CVS, do I still need computer eyewear?

Maybe. Research has shown that even computer users who are not experiencing symptoms of CVS may benefit from wearing computer eyewear. An eye exam with a computer vision specialist is the best way to determine if computer glasses might be helpful for you.

Will insurance pay for these glasses?

In some cases, yes. If you have medical coverage, but not vision insurance, the exam portion of the cost may be covered by your medical carrier. If you have vision insurance, you may be entitled to an annual exam, which could be used to cover the computer exam and a portion of the cost of the computer eyewear.

Will my reading glasses work at the computer?

Not necessarily. As with anything else you do in life, it's important to have the right tool for the job. You would not use a hammer when you need a screwdriver. The same goes for your vision. You would not use distance glasses for doing close work.

So, in most cases, your reading glasses are probably not going to do the job at the computer. Reading glasses are usually prescribed to optimize vision at a distance of approximately 14 to 16 inches from your eyes. Computer glasses are designed to provide optimum vision at a normal computer distance — usually 20 to 28 inches from your eyes.

Isn't ergonomics the solution to computer eyestrain?

Ergonomics can be defined as the science of designing and arranging things people use to enable interaction in the most efficient and safe manner possible. Taking these steps can be an important component of preventing and treating CVS. But ergonomics alone - placing a computer screen at a comfortable height and distance from the user, for example - cannot fix a vision problem. This can be achieved only with prescription eyewear.

Will wearing computer eyeglasses make my eyes worse?

No. There is no evidence that wearing computer glasses harms your eyes or causes changes such as myopia (nearsightedness), farsightedness or astigmatism. In fact, some research suggests that reducing focusing stress with special lenses for reading or computer use may slow the progression of myopia in some school-aged children. And blue-light blocking computer lenses will limit your exposure to potentially harmful HEV rays, limiting cumulative damage to retinal cells.

Worker Productivity and Computer Vision Syndrome

Worker Productivity and Computer Vision Syndrome

If you use a computer at work, you probably already know that a long day of staring at your screen can lead to eyestrain, tired eyes, headache, muscle aches and other symptoms of computer vision syndrome (CVS).

But did you know that CVS can also cause more mistakes and lost productivity, too?

CVS Increases Vision Problems in the Workplace

According to the American Optometric Association (AOA), the most frequent health complaints among computer workers are vision-related. Studies suggest 50% to 90% of computer users suffer from visual symptoms of computer vision syndrome. These symptoms include eyestrain, dry eyes or eye irritation, blurred vision and double vision.

With increasing numbers of employees using a computer at work, CVS is becoming a major public health issue. The AOA reports that approximately 10 million eye exams are performed annually in the United States due to vision problems related to computer use.

Worker Productivity and CVS

A study conducted by the University of Alabama at Birmingham (UAB) School of Optometry examined the relationship between the vision of computer workers and their productivity in the workplace. The study found:

There is a direct correlation between proper vision correction and productivity. This relationship particularly is evident with complex and/or repetitive computer tasks such as data entry.

There is a direct correlation between proper vision correction and the time required for a computer worker to perform a task. Computer-related tasks took much longer when the subjects wore glasses with less than the optimum correction for computer work.
Reduced productivity from vision problems can occur even if the computer user is unaware of having a vision problem. Performance on a specific task can suffer significantly — by as much as 20% — from minor vision problems.

"Our data strongly suggest that improving the visual status of workers using computers results in greater productivity in the workplace, as well as improved visual comfort," said Kent Daum, OD, PhD, the study's chief investigator.

Computer Eyewear and the Bottom Line

According to the UAB study, employers who invest in computer eyewear for their employees can experience a positive impact on their bottom line from such a program.

The authors of the study concluded:

Providing computer vision care to all employees who use computers, even those who are not experiencing CVS symptoms, results in significant productivity gains and cost savings for employers.

Musculoskeletal problems, which may be caused by computer-related vision problems, can potentially be minimized or eliminated by including computer vision care in a comprehensive ergonomics program.

Employees performing tasks with particularly demanding visual requirements, such as accounting, document editing, CAD (computer-assisted design) work, electronic design and engineering, could benefit even more from computer eyewear than the average computer worker.

A computer vision benefits program likely will also reduce incidence of workers' compensation claims among computer workers.

"Our study confirms that investing in optimal computer eyewear for employees results in a significant cost-benefit ratio," Dr. Daum said.

Contact Lenses

Bifocal and Multifocal Contact Lenses

Bifocal and Multifocal Contact Lenses

Bifocal and multifocal contact lenses are designed to give you good vision when you reach your 40s. Beginning at this age, you may need to hold reading material - like a menu or newspaper - farther from your eyes to see it clearly. This condition is called "presbyopia."

Bifocal and multifocal contact lenses are available in both soft and rigid gas permeable (GP) materials.

Bifocals, Multifocals - What's the Difference?

Bifocal contacts lenses (like bifocal eyeglass lenses) have two powers - one for seeing clearly far away and one for seeing clearly up close. Multifocal contact lenses, like progressive eyeglass lenses, have a range of powers for seeing clearly far away, up close and everywhere in between. ("Multifocal" is also used as a catch-all term for all lenses with more than one power, including bifocals.)

Types of Multifocal Contact Lenses

Based on design, there are basically two types of multifocal contact lenses:

Simultaneous vision lenses. With these lenses, both distance and near zones of the lens are in front of your pupil at the same time. Although this might sound unworkable, after a short period of time your visual system learns to use the power you need and ignore the other lens power(s), depending on what you are looking at. Simultaneous vision lenses are the most popular type of multifocal contact lens. They are nearly always soft lenses and are available in two designs:

Concentric ring designs - These are bifocal lenses with either the distance or near power in the center of the lens, with alternating rings of distance and near powers surrounding it.

Aspheric designs - These are progressive-style multifocal lenses, with many powers blended across the lens surface. Some aspheric lenses have the distance power in the center of the lens; others have the near power in the center.

Alternating vision (or translating) lenses. These are GP multifocal lenses that are designed like bifocal eyeglass lenses. The top part of the lens has the distance power, and the bottom part of the lens contains the near power. When you look straight ahead, your eye is looking through the distance part of the lens. When you look down, your lower lid holds the lens in place while your pupil moves (translates) into the near zone of the lens for reading.

Will Multifocal Contact Lenses Work for Me?

Most people who try multifocal contact lenses are happy with them. But some compromises may be necessary when you wear these lenses. For example, your distance vision with multifocal contact lenses may not seem clear enough, or you may have trouble with glare at night or not being able to see small print.

In some cases, a person with presbyopia may prefer monovision or modified monovision. Both of these fitting strategies use single vision lenses - that is, lenses that each have only one power - instead of multifocals.

In monovision, you wear a single vision contact lens on one eye for your distance vision and a single vision contact lens on the other eye that has a prescription for your near vision. In modified monovision, you wear a single vision "distance lens" on one eye and a multifocal contact lens on the other eye to help you see better up close.

To determine the best contact lenses for your vision needs when you reach "bifocal age," call our office for a consultation.

Contact Lens Basics

Contact Lenses for the 'Hard-to-Fit' Patient

Contact Lenses for the "Hard-to-Fit" Patient

Not everyone is well suited to the most common types of contact lenses. If you have one or more of the following conditions, contact lens wear may be more challenging:

astigmatism
dry eyes
presbyopia
giant papillary conjunctivitis (GPC)
keratoconus
post-refractive surgery (such as LASIK)

But "challenging" doesn't mean impossible. Often, people with these conditions can wear contacts quite successfully. Let's take a closer look at each situation - and possible contact lens solutions.

Contact Lenses for Astigmatism

Astigmatism is a very common condition where the curvature of the front of the eye isn't round, but is instead shaped more like a football or an egg. This means one curve is steeper or flatter than the curve 90 degrees away. Astigmatism won't keep you from wearing contact lenses - it just means you need a different kind of lens.

Lenses specially designed to correct astigmatism are called "toric" lenses. Most toric lenses are soft lenses. Toric soft lenses have different corrective powers in different lens meridians, and design elements to keep the lens from rotating on the eye (so the varying corrective powers are aligned properly in front of the different meridians of the cornea).

In some cases, toric soft lenses may rotate too much on the eye, causing blur. If this happens, different brands that have different anti-rotation designs can be tried. If soft lens rotation continues to be a problem, gas permeable (GP) lenses can also correct astigmatism.

Contact Lenses for Dry Eyes

Dry eyes can make contact lens wear difficult and cause a number of symptoms, including:

a gritty, dry feeling

feeling as if something is in your eye

a burning sensation

eye redness (especially later in the day)

blurred vision

If you have dry eyes, the first step is to treat the condition. This can be done in several ways, including artificial tears, medicated eye drops, nutritional supplements, and a doctor-performed procedure called punctal occlusion to close ducts in your eyelids that drain tears away from your eyes.

Once the dry eye condition is treated and symptoms are reduced or eliminated, contact lenses can be tried. Certain soft contact lens materials work better than others for dry eyes. Also, GP lenses are sometimes better than soft lenses for dry eye sufferers, since these lenses don't dry out the way soft lenses can.

Replacing your contacts more frequently and reducing your wearing time each day (or removing them for specific tasks, such as computer work) can also reduce dry eye symptoms when wearing contacts.

Contact Lenses for Giant Papillary Conjunctivitis (GPC)

Giant papillary conjunctivitis (GPC) is an inflammatory reaction on the inner surface of the eyelids. One cause of GPC is protein deposits on soft contact lenses. (These deposits are from components of your tear film that stick to your lenses and become chemically altered.)

Usually, changing to a one-day disposable soft lens will solve this problem, since you just throw these lenses away at the end of the day before protein deposits can accumulate on them. Gas permeable lenses are also often a good solution, as protein deposits don't adhere as easily to GP lenses, and lens deposits on GP lenses are more easily removed with daily cleaning.

In some cases of GPC, a medicated eye drop may be required to reduce the inflammation before you can resume wearing contact lenses.

Contact Lenses for Presbyopia

Presbyopia is the normal loss of focusing ability up close when you reach your 40s.

Today, there are many designs of bifocal and multifocal contact lenses to correct presbyopia. Another option for presbyopia is monovision. This is wearing a contact lens in one eye for distance vision and a lens in the other eye that has a power for near vision.

During your contact lens fitting we can help you decide whether bifocal/multifocal contact lenses or monovision is best for you.

Contact Lenses for Keratoconus

Keratoconus is a relatively uncommon eye condition where the cornea becomes thinner and bulges forward. The term "keratoconus" comes from the Greek terms for cornea ("kerato") and cone-shaped ("conus"). The exact cause of keratoconus remains unknown, but it appears that oxidative damage from free radicals plays a role.

Gas permeable contact lenses have historically been the treatment option of choice for mild and moderate keratoconus. Because they are rigid, GP lenses can help contain the shape of the cornea to prevent further bulging of the cornea. They also can correct vision problems caused by keratoconus that cannot be corrected with eyeglasses or soft contacts.

The last few years have produced quite a bit of innovation in contact lenses for keratoconus. There are now several soft lenses for keratoconus, as well as many scleral lenses. These are large lenses made of GP material that remain completely above the cornea, with the outer edge of the lens resting on the white of the eye (sclera).

Another option is called "piggybacking," where soft and GP lenses are worn together on the eye for greater comfort than a GP alone would provide. Hybrid contact lenses that have a GP center surrounded by a soft "skirt" can produce the same effect.

Contact Lenses After Corrective Eye Surgery

Hundreds of thousands of people each year have LASIK surgery to correct their eyesight. Sometimes, vision problems remain after surgery that can't be corrected with eyeglasses or a second surgical procedure. In these cases, gas permeable contact lenses - including large GP scleral lenses - can often restore visual acuity and eliminate problems like glare and halos at night.

GP lenses are also used to correct vision problems after corneal transplant surgery, including irregular astigmatism that cannot be corrected with eyeglasses.

Problem-Solving Contact Lens Fittings Cost More

Fitting contact lenses to correct or treat any of the above conditions will generally take much more time than a regular contact lens fitting. These "hard-to-fit" cases usually require a series of office visits and multiple pairs of trial lenses before the final contact lens prescription can be determined. Also, the lenses required for these conditions are usually more costly than regular soft contact lenses. Therefore, fees for these fittings are higher than fees for regular contact lens fittings. Call our office for details.

Find Out if You Can Wear Contact Lenses

If you are interested in wearing contact lenses, call our office to schedule a consultation. Even if you've been told you're not a good candidate for contacts because you have one of the above conditions or for some other reason, we may be able to help you wear contact lenses safely and successfully.

Eye Exams for Contact Lenses

Eye Exams for Contact Lenses

For many people, contact lenses provide greater convenience and more satisfying vision correction than eyeglasses. Here is what's involved in a typical contact lens exam and fitting:

A Comprehensive Eye Exam Comes First

Before you are fitted with contact lenses, a comprehensive eye exam is performed. In this exam, your eye doctor determines your prescription for corrective lenses (just a glasses prescription at this point) and checks for any eye health problems or other issues that may interfere with successful contact lens wear.

If all looks good during your eye exam, the next step is a contact lens consultation and fitting.

What to Expect During a Contact Lens Fitting

The first step in a contact lens fitting is a consideration of your lifestyle and your preferences regarding contact lenses, such as whether you might want to change your eye color with color contact lenses or if you're interested in options such as daily disposables or overnight wear. Although most people choose soft contact lenses, the advantages and disadvantages of rigid gas permeable (GP) lenses will likely be discussed as well.

If you are over age 40 and need bifocals, your eye doctor or contact lens specialist will discuss ways to deal with this need, including multifocal contact lenses and monovision (a prescribing technique where one contact lens corrects your distance vision and the other lens corrects your near vision).

Contact Lens Measurements

Just as one shoe size doesn't fit all feet, one contact lens size doesn't fit all eyes. If the curvature of a contact lens is too flat or too steep for your eye's shape, you may experience discomfort or even damage to your eye. Measurements that will be taken to determine the best contact lens size and design for your eyes include:

Corneal curvature. An instrument called a keratometer is used to measure the curvature of your eye's clear front surface (cornea). This measurement helps your doctor select the best curve and diameter for your contact lenses. If your eye's surface is found to be somewhat irregular because of astigmatism, you may require a special lens design known as a "toric" contact lens. At one time, only gas permeable contact lenses could correct for astigmatism. But now, there are many brands of soft toric lenses, which are available in disposable, multifocal, extended wear and colored versions.

In some cases, a detailed mapping of the surface of your cornea (called corneal topography) may be done. Corneal topography provides extremely precise details about surface characteristics of your cornea and creates a surface "map" of your eye, with different contours represented by varying colors.

Pupil and iris size. The size of your pupil and iris (the colored part of your eye) can play an important role in determining the best contact lens design, especially if you are interested in GP contact lenses. These measurements may be taken with a lighted instrument called a biomicroscope (also called a slit lamp) or simply with a hand-held ruler or template card.
Tear film evaluation. To be successful wearing contact lenses, you must have an adequate tear film to keep the lenses and your cornea sufficiently moist and hydrated. This test may be performed by placing a liquid dye on your eye so your tears can be seen with a slit lamp, or with a small paper strip placed under your lower lid to see how well your tears moisten the paper. If you have dry eyes, contact lenses may not be right for you. Also, the amount of tears you produce may determine which contact lens material will work best for you.

Trial Lenses

In many cases, trial lenses will be used to verify the contact lens selection. Lenses will be placed on your eyes and your doctor will use the slit lamp to evaluate the position and movement of the lenses as you blink and look in different directions. You will also be asked how the lenses feel. Typically you'll need to wear these trial lenses at least 15 minutes so that any initial excess tearing of the eye stops and your tear film stabilizes. If all looks good, you will be given instructions on how to care for your lenses and how long to wear them. You will also receive training on how to handle, apply and remove the lenses.

Follow-up Visits Confirm the Fit and Safety
Your contact lens fitting will involve a number of follow-up visits so your doctor can confirm the lenses are fitting your eyes properly and that your eyes are able to tolerate contact lens wear. A dye (like the one used to evaluate your tear film) may be used to see if the lenses are causing damage to your cornea or making your eyes too dry.

Often, your doctor will be able to see warning signs even before you begin to notice them. If such warning signs are evident in your follow-up visits, your doctor may recommend trying a different lens or lens material, using a different lens care and cleaning method, or adjusting your contact lens wearing time. Occasionally, it may be necessary to discontinue contact lens wear altogether.

Your Contact Lens Prescription

Once you find a contact lens that fits properly, is comfortable for you, and provides good vision, your doctor will write a contact lens prescription for you. This prescription will designate the contact lens power, the curvature of the lens (called the base curve), the lens diameter, and the lens name and manufacturer. In the case of GP contact lenses, additional specifications may also be included.

Routine Contact Lens Exams

Regardless of how often or how long you wear your contact lenses, your eyes should be examined at least once a year to make sure your eyes remain healthy and tolerant of contact lens wear.

Gas Permeable (GP) Contact Lenses

Gas Permeable (GP) Contact Lenses

Gas permeable (GP) contact lenses, also known as rigid gas permeable (RGP) lenses, are rigid contacts made of silicone-containing compounds that allow oxygen to pass through the lens material to the eye. Though not as popular as soft contact lenses, GP lenses offer a number of advantages.

Advantages of Gas Permeable Lenses

GP lenses allow your eyes to "breathe." Getting oxygen to the eye reduces the risk of problems caused by hypoxia (reduced oxygen supply). Because GP lenses are made with oxygen-permeable silicone, they allow more oxygen to reach the front surface of the eye than traditional hydrogel soft contact lenses. (However, many of the new silicone hydrogel soft contact lenses are comparable to GPs for oxygen delivery.)

GP lenses provide sharper vision. Because they maintain their shape on the eye, GP lenses provide sharper vision than soft lenses, which can fluctuate in shape. And gas permeable lenses don't contain water, so they are not prone to drying out. Many soft lenses contain a large percentage of water and will compromise vision if they start to dry out.

GP lenses last longer. GP lenses are rigid, so there's no worry about ripping or tearing them. They are also easier to keep clean and don't need to be replaced frequently like soft lenses. With proper care, a single pair of GP lenses can last a year or longer. Since they're long-lasting, GP lenses can be less expensive than soft lenses in the long run.

GP lenses can slow the progression of nearsightedness. GPs used for overnight orthokeratology - also called corneal reshaping, or ortho-k - have been shown to reduce the progression of myopia (nearsightedness) in some children. Overnight ortho-k also enables clear daytime vision without the use of glasses or contacts.

GPs are great for multifocal designs and problem corneas. Many wearers feel that GP multifocals offer superior vision to soft bifocals. GPs are also the most common choice for eyes that have been compromised by corneal diseases, or for people who still need vision correction after refractive surgery such as LASIK.

The Downside of GP Contact Lenses

So why doesn't everyone wear GP lenses? Potential disadvantages of GP lenses (compared with soft lenses) include:

Need for adaptation. Unlike wearing soft lenses, which are immediately comfortable, you may need a few weeks before you can wear GP lenses comfortably all day. Initially, you may be able to wear the lenses only a few hours daily until your corneas adapt to them. But if you can tough it out for those first few days, you may be pleasantly surprised at how comfortable GP lenses become.

Inability to wear part-time. To fully adapt to GP lenses and to stay comfortable wearing them, you have to wear them every day. If you stop wearing them for several days, you will be more aware of the lenses on your eyes and you'll have to re-adapt to the lenses.

Increased possibility of dislodging. Because they are smaller than soft lenses, gas permeable lenses can dislodge from your eyes during contact sports or if you rub your eyes aggressively.

Vulnerability to sand and dust. GP lenses don't conform to the shape of your eye like soft lenses do, so it's possible for sand or dust to get under your lenses at the beach or on a windy day. (You can minimize this risk by wearing wrap-style sunglasses outdoors.)

Higher initial and replacement costs. Unlike soft lenses, which come in off-the-shelf sizes, GP lenses are always custom-made to the shape of your eye. This makes GP lenses more expensive to purchase, and to replace if you lose them. Also, it can take up to a week to get a GP lens replaced. So it's a good idea to purchase a spare pair to avoid the inconvenience of being without your GP lenses if you lose or break one.

Hybrid Contact Lenses

Since comfort is the primary barrier to GP use, an interesting innovation is the hybrid contact lens. These lenses have a GP center, surrounded by a soft lens "skirt." The goal of hybrid lenses is to provide the clarity of a gas permeable lens and wearing comfort of a soft lens.

Call for More Information and a Trial Fitting

To see if gas permeable lenses are right for you, call our office for more information and to schedule a trail fitting.

Orthokeratology

Orthokeratology

Orthokeratology, or "ortho-k," is the process of reshaping the eye with specially designed rigid gas permeable (GP) contact lenses. The goal of ortho-k is to flatten the front surface of the eye and thereby correct mild to moderate amounts of nearsightedness and astigmatism. This process is also known as corneal reshaping, and by brand names such as CRT (Corneal Refractive Therapy) and Bausch & Lomb's Vision Shaping Treatment (VST).

How Ortho-k Works

The GP lenses for ortho-k are applied at bedtime and worn overnight. While you sleep, the lenses gently reshape the front surface of your eye (the cornea) to correct your vision, so you can see clearly without glasses or contact lenses when you're awake. The effect is temporary - generally enough to get you through a day or two - so you must wear the reshaping lenses each night to maintain good vision during the day.

Who Is a Candidate for Ortho-k?

Orthokeratology is frequently a good option for nearsighted individuals who are too young for LASIK surgery or for some other reason are not good candidates for vision correction surgery. Because it can be discontinued at any time without permanent change to the eye, people of any age can try the procedure, as long as their eyes are healthy.

Ortho-k is particularly appealing for people who participate in sports, or who work in dusty, dirty environments that can make contact lens wear difficult.

What Results Can You Expect from Ortho-k?

The goal for ortho-k is to correct your vision to 20/20 without eyeglasses or contact lenses during the day. In FDA trials of both CRT and VST lenses, more than 65% of patients were able to achieve 20/20 visual acuity after wearing the reshaping lenses overnight. More than 90% were able to see 20/40 or better (the legal vision requirement for driving without glasses in most states).

Success rates for ortho-k tend to be higher for mild prescriptions. Call our office to find out if your prescription is within the range that can be successfully treated with ortho-k.

Ortho-k Can Slow the Progression of Nearsightedness

Several clinical studies have indicated that corneal reshaping lenses can reduce the rate of myopia progression in nearsighted children. When worn only at night, these lenses can slow down eye growth - the source of progressing myopia - by more than 50% compared with glasses and soft contacts, according to multiple studies. In another study, published in 2014, participants used a daytime-wear GP in one eye and an ortho-k lens in the other, and no eye growth was found over a one-year period in the ortho-k eye.

How Long Does Ortho-k Take?

Though you may see some improvement in your vision after a day or two of overnight ortho-k, it can take several weeks for the full effect to be apparent. During this time, your vision will not be as clear as it was with glasses or contacts, and you are likely to notice some glare and halos around lights. It's possible you may need a temporary pair of eyeglasses for certain tasks, like driving at night, until your vision is fully corrected by the ortho-k lenses.

Is Ortho-k Comfortable?

Some people have comfort issues when attempting to wear gas permeable contact lenses during the day. But since ortho-k GP lenses are worn during sleep, comfort and lens awareness are generally not a problem.

Cost of Orthokeratology

Ortho-k is a significantly longer process than a regular contact lens fitting. It requires a series of office visits and potentially multiple pairs of lenses. Also, GP lenses used for ortho-k are more costly than most regular contact lenses. Therefore, fees for orthokeratology are higher than fees for regular contact lens fittings.

Can I Have LASIK After Ortho-k?

Yes, it's possible to have LASIK surgery after orthokeratology. But because ortho-k lenses reshape your corneas, you must stop wearing the lenses for a period of time (usually several months) so your eyes can return to their original shape and stabilize. Be sure to tell your LASIK surgeon that you've worn ortho-k lenses, so they can advise you how long you should wait before having the surgery.

Toric Contact Lenses for Astigmatism

Toric Contact Lenses for Astigmatism

Contact Lenses for Astigmatism

If you have astigmatism - a common condition where the eye isn't perfectly round, but more football- or egg-shaped - then you'll need specially designed contact lenses to achieve clear vision.

You have several options: "Toric" soft contact lenses are the most common choice, but there are also gas permeable (RGP or GP) lenses and hybrid lenses.

How Do Toric Lenses Work?

When you have astigmatism, different meridians of your eye need different amounts of correction for nearsightedness or farsightedness. Imagine the front of your eye is like the face of a clock: A line drawn from the 12 to the 6 is one meridian, a line from the 1 to the 7 is another, and so on.

Soft toric contact lenses have different powers in different meridians of the lens to correct variations in the eye's shape. They also have design elements to keep the lens from rotating on your eye, so the meridians of the lens stay aligned with the meridians of your eye.

Today, you can choose from many brands and styles of soft toric lenses. So if Brand A doesn't fit properly or rotates too much, Brand B may perform better. Getting a good toric fit might mean trying a few brands of lenses.

Many Options in Soft Toric Lenses

Soft toric lenses are available for daily wear (lenses you remove before sleep) and extended wear (lenses approved for overnight wear). There are also soft toric lenses to enhance or change your eye color and multifocal toric lenses if you have presbyopia.

And if soft toric lenses don't adequately correct your astigmatism, gas permeable lenses will often do the trick.

Gas Permeable Lenses for Astigmatism

If you have a mild to moderate amount of astigmatism, you may want to consider gas permeable contact lenses. GP lenses usually provide sharper vision than soft toric lenses. And because GP lenses are rigid and maintain their shape on the eye, a toric design usually isn't needed. The astigmatism due to unequal curves on the front surface of your eye is corrected by a layer of tears that forms between your eye and the spherical back surface of the GP lens.

If you have a stronger prescription, or if regular gas permeable lenses fail to correct your astigmatism adequately, toric GP lens designs are also available.

Hybrid Contact Lenses

Hybrid lenses have a rigid GP center surrounded by a "skirt" of soft lens material. The idea of hybrids is to combine the excellent optics of a GP lens with the comfort of a soft lens. And unlike soft lenses, the vision provided by hybrids does not depend on position, so lens rotation is not an issue.

Cost of Contacts for Astigmatism

Properly fitting a soft toric contact lens takes more time and requires more expertise than fitting regular soft contacts. Fitting GPs and hybrids can take more time and expertise as well, and lens material cost is higher than with spherical contact lenses. Consequently, our fees for patients with astigmatism are higher than our regular contact lens fees.

Call for More Information

Call our office today to learn more about contact lens options for astigmatism and to schedule a contact lens consultation to find out which lenses are the best solution for you.

Eye Exams

Eye Exams for Children

Eye Exams for Children

As a parent, you may wonder whether your pre-schooler has a vision problem or when a first eye exam should be scheduled.

Eye exams for children are extremely important. Experts say 5% to 10% of pre-schoolers and 25% of school-aged children have vision problems. Early identification of a child's vision problem is crucial because, if left untreated, some childhood vision problems can cause permanent vision loss.

When Should Kids Have Their Eyes Examined?

According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. Children then should receive additional eye exams at 3 years of age, and just before they enter kindergarten or the first grade at about age 5 or 6.

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually or according to their eye doctor's recommendations.

Early eye exams also are important because children need the following basic visual skills for learning:

Near vision
Distance vision
Eye teaming (binocularity) skills
Eye movement skills
Focusing skills
Peripheral awareness
Eye/hand coordination

Because of the importance of good vision for learning, some states require an eye exam for all children entering school for the first time.

Scheduling Your Child's Eye Exam

Your family doctor or pediatrician likely will be the first medical professional to examine your child's eyes. If eye problems are suspected during routine physical examinations, a referral might be made to an ophthalmologist or optometrist for further evaluation. Eye doctors have specific equipment and training to help them detect and diagnose potential vision problems.

When scheduling an eye exam, choose a time when your child is usually alert and happy. Specifics of how eye exams are conducted depend on your child's age, but an exam generally will involve a case history, vision testing, determination of whether eyeglasses are needed, testing of eye alignment, an eye health examination and a consultation with you regarding the findings.

After you've made the appointment, you may be sent a case history form by mail, or you may be given one when you check in at the doctor's office. The case history form will ask about your child's birth history (also called perinatal history), such as birth weight and whether the child was full-term. Your eye doctor also may ask whether complications occurred during the pregnancy or delivery. The form will also inquire about your child's medical history, including current medications and past or present allergies.

Be sure to tell your eye doctor if your child has a history of prematurity, has delayed motor development, engages in frequent eye rubbing, blinks excessively, fails to maintain eye contact, cannot seem to maintain a gaze (fixation) while looking at objects, has poor eye tracking skills or has failed a pediatrician or pre-school vision screening.

Your eye doctor will also want to know about previous ocular diagnoses and treatments involving your child, such as possible surgeries and glasses or contact lens wear. Be sure you inform your eye doctor if there is a family history of eye problems requiring vision correction, such as nearsightedness or farsightedness, misaligned eyes (strabismus) or amblyopia ("lazy eye").

Eye Testing for Infants

It takes some time for a baby's vision skills to develop. To assess whether your infant's eyes are developing normally, your eye doctor may use one or more of the following tests:

Tests of pupil responses evaluate whether the eye's pupil opens and closes properly in the presence or absence of light.
"Fixate and follow" testing determines whether your baby can fixate on an object (such as a light) and follow it as it moves. Infants should be able to perform this task quite well by the time they are 3 months old.
Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed.

Eye Testing for Pre-School Children

Pre-school children can have their eyes thoroughly tested even if they don't yet know the alphabet or are too young or too shy to answer the doctor's questions. Some common eye tests used specifically for young children include:

LEA symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
Retinoscopy is a test that involves shining a light into the eye to observe how it reflects from the retina (the light-sensitive inner lining of the back of the eye). This test helps eye doctors determine the child's eyeglass prescription.
Random dot stereopsis uses dot patterns to determine how well the two eyes work as a team.

Eye and Vision Problems that Affect Children

Besides looking for nearsightedness, farsightedness and astigmatism (refractive errors), your eye doctor will examine your child's eyes for signs of the following eye and vision problems commonly found in young children:

Amblyopia. Also called "lazy eye," this is decreased vision in one or both eyes despite the absence of any eye health problem or damage. Common causes of amblyopia include strabismus (see below) and a significant difference in the refractive errors of the two eyes. Treatment of amblyopia may include patching the dominant eye to strengthen the weaker eye.

Strabismus. This is misalignment of the eyes, often caused by a congenital defect in the positioning or strength of muscles that are attached to the eye and control eye positioning and movement. Left untreated, strabismus can cause amblyopia in the misaligned eye. Depending on its cause and severity, surgery may be required to treat strabismus.

Convergence insufficiency. This is the inability to keep the eye comfortably aligned for reading and other near tasks. Convergence insufficiency can often be treated successfully with vision therapy, a specific program of eye exercises.

Focusing problems. Children with focusing problems (also called accommodation problems) may have trouble changing focus from distance to near and back again (accommodative infacility) or have problems maintaining adequate focus for reading (accommodative insufficiency). These problems often can be successfully treated with vision therapy.

Eye teaming problems. Many eye teaming (binocularity) problems are more subtle than strabismus. Deficiencies in eye teaming skills can cause problems with depth perception and coordination.

Vision and Learning

Experts say that 80% of what your child learns in school is presented visually. Undetected vision problems can put them at a significant disadvantage. Be sure to schedule a complete eye exam for your child prior to the start of school.

Preparing for an Eye Exam

Preparing for an Eye Exam

Eyecare experts recommend you have a complete eye exam every one to three years, depending on your age, risk factors, and physical condition.

Children. Some experts estimate that approximately 5 percent to 10 percent of preschoolers and 25 percent of school-aged children have vision problems. According to the American Optometric Association (AOA), all children should have their eyes examined at 6 months of age, at age 3 and again at the start of school. Children without vision problems or risk factors for eye or vision problems should then continue to have their eyes examined at least every two years throughout school.

Children with existing vision problems or risk factors should have their eyes examined more frequently. Common risk factors for vision problems include:

Premature birth
Developmental delays
Turned or crossed eyes
Family history of eye disease
History of eye injury
Other physical illness or disease

The AOA recommends that children who wear eyeglasses or contact lenses should have their eyes examined at least every 12 months or according to their eye doctor's instructions.

Adults. The AOA also recommends an annual eye exam for any adult who wears eyeglasses or contacts. If you don't normally need vision correction, you still need an eye exam every two years up to the age of 40, depending on your rate of visual change and overall health. Doctors often recommend more frequent examinations for adults with diabetes, high blood pressure and other disorders, because many diseases can have an impact on vision and eye health.

If you are over 40, you may need to be examined more frequently than every other year to check for common age-related eye problems such as presbyopia, cataracts and macular degeneration.

Because the risk of eye disease continues to increase with advancing age, everyone over the age of 60 should be examined annually.

Who Should I See for My Eye Exam?

There are two kinds of eye doctors - ophthalmologists and optometrists. Who you should see depends on your needs and preferences.

Ophthalmologists are medical doctors (MDs or DOs) who specialize in eyecare. In addition to prescribing eyeglasses and contacts, ophthalmologists are licensed to perform eye surgery and treat medical conditions of the eye. Ophthalmologists generally undergo eight or more years of training after college.

Optometrists (ODs) are eye doctors who can prescribe glasses and contacts and treat medical conditions of the eye with eye drops and other medicines. They are not licensed to perform eye surgery. Optometrists generally receive four or more years of training after college.

How Much Does an Eye Exam Cost?

Eye exams are available in many settings, from discount optical stores to surgical offices, so the fees can vary widely. Additionally, fees can vary depending on whether the exam is performed by an optometrist or an ophthalmologist, and the type of services that are included in the exam.

Generally speaking, contact lens exams cost more than regular eye exams. Likewise, an additional or higher fee may be charged for specialized services such as laser vision correction evaluations.

Many insurance plans cover at least a portion of eye exam services. Check to see what your benefits are and which eye doctors in your area participate in your plan before you make an appointment. Then be sure to give your doctor's office your insurance information to verify coverage.

What Information Should I Take with Me to My Eye Exam?

It's important to have some basic information ready at the time of your eye examination. Bring the following items to your exam:

All eyeglasses and contact lenses you use routinely, including reading glasses.
A list of any medications you take (including dosages).
A list of any nutritional supplements you take (including dosages).
A list of questions to ask the doctor, especially if you are interested in contact lenses or laser vision correction surgery.

Finally, also bring your medical or vision insurance card if you will be using it for a portion of your fees.

Why Are Eye Exams Important?

Why Are Eye Exams Important?

Regardless of your age or physical health, it's important to have regular eye exams.

During a complete eye exam, your eye doctor will not only determine your prescription for eyeglasses or contact lenses, but also check your eyes for common eye diseases, assess how your eyes work together as a team and evaluate your eyes as an indicator of your overall health.

Who Should Get Their Eyes Examined?

Eye examinations are an important part of health maintenance for everyone. Adults should have their eyes tested to keep their prescriptions current and to check for early signs of eye disease. For children, eye exams can play an important role in normal development.

Vision is closely linked to the learning process. Children who have trouble seeing or interpreting what they see will often have trouble with their schoolwork. Many times, children will not complain of vision problems simply because they don't know what "normal" vision looks like. If your child performs poorly at school or exhibits a reading or learning problem, be sure to schedule an eye examination to rule out an underlying visual cause.

What Is the Eye Doctor Checking for?

In addition to evaluating whether you have nearsightedness, farsightedness or astigmatism, your eye doctor will check your eyes for eye diseases and other problems that could lead to vision loss. Here are some examples of the conditions that your eye doctor will be looking for:

Amblyopia. This occurs when the eyes are misaligned or when one eye has a much different prescription than the other. The brain will "shut off" the image from the turned or blurry eye. If left untreated, amblyopia can stunt the visual development of the affected eye, resulting in permanent vision impairment. Amblyopia is often treated by patching the stronger eye for periods of time.
Strabismus. Strabismus is defined as crossed or turned eyes. Your eye doctor will check your eyes' alignment to be sure that they are working together. Strabismus causes problems with depth perception and can lead to amblyopia.
Eye diseases. Many eye diseases, such as glaucoma and diabetic eye disease, have no obvious symptoms in their early stages. Your eye doctor will check the health of your eyes inside and out for signs of early problems. In most cases, early detection and treatment of eye diseases can help reduce your risk for permanent vision loss.
Other diseases. Your eye doctor can detect early signs of some systemic conditions and diseases by looking at your eye's blood vessels, retina and so forth. They may be able to tell you if you are developing high blood pressure, high cholesterol or other problems. For example, diabetes can cause small blood vessel leaks or bleeding in the eye, as well as swelling of the macula (the most sensitive part of the retina), which can lead to vision loss. It's estimated that one-third of Americans who have diabetes don't know it; your eye doctor may detect the disease before your primary care physician does, especially if you're overdue for a physical.

What's the Difference Between a Vision Screening and a Complete Eye Exam?

Vision screenings are general eye tests that are meant to help identify people who are at risk for vision problems. Screenings include brief vision tests performed by a school nurse, pediatrician or volunteers. The eye test you take when you get your driver's license renewed is an example of a vision screening.

A vision screening can indicate that you need to get an eye exam, but it does not serve as a substitute for a comprehensive eye exam.

A comprehensive eye examination is performed by an eye doctor and will involve careful testing of all aspects of your vision. Based upon the results of your exam, your doctor will then recommend a treatment plan for your individual needs. Remember, only an eye doctor can provide a comprehensive eye exam. Most family physicians and pediatricians are not fully trained to do this, and studies have shown that they can miss important vision problems that require treatment.

Treatment plans can include eyeglasses or contact lenses, eye exercises or surgery for muscle problems, medical treatment for eye disease or simply a recommendation that you have your eyes examined again in a specified period of time.

No matter who you are, regular eye exams are important for seeing more clearly, learning more easily and preserving your vision for life.

Your Comprehensive Eye Exam

Your Comprehensive Eye Exam

A comprehensive eye exam includes a number of tests and procedures to examine and evaluate the health of your eyes and the quality of your vision. These tests range from simple ones, like having you read an eye chart, to complex tests, such as using a high-powered lens to examine the health of the tissues inside of your eyes.

Here are some tests you are likely to encounter during a routine comprehensive eye exam:

Retinoscopy

This test helps your doctor get a good approximation of your eyeglasses prescription. For retinoscopy, the room lights are dimmed and an instrument containing wheels of lenses (called a phoropter) is positioned in front of your eyes. You will be asked to look at an object across the room (usually the big "E" on the wall chart or screen) while your doctor shines a light from a hand-held instrument into your eyes from arm's length and flips different lenses in front of your eyes.

Based on the way the light reflects from your eye during this procedure, your doctor can get a very good idea of what your eyeglasses prescription should be. This test is especially useful for children and non-verbal patients who are unable to accurately answer the doctor's questions.

With the widespread use of automated instruments to help determine eyeglass prescriptions today, many doctors forgo performing retinoscopy during comprehensive eye exams. However, this test can provide valuable information about the clarity of the internal lens and other media inside the eye. So doctors who no longer perform this test routinely may still use it when examining someone who may be at risk of cataracts or other internal eye problems.

Refraction

This is the test your doctor uses to determine your exact eyeglasses prescription. During refraction, the doctor puts the phoropter in front of your eyes and shows you a series of lens choices. He or she will then ask you which one of the two lenses in each choice ("1 or 2," "A or B," for example) makes the letters on the wall chart look clearer.

Based on your answers, your doctor will determine the amount of nearsightedness, farsightedness and/or astigmatism you have, and the eyeglass lenses required to correct these vision problems (which are called refractive errors).

Autorefractors and Aberrometers

Your eye doctor also may use an autorefractor or aberrometer to help determine your glasses prescription. With these devices, you rest your chin and head on the instrument and look ahead at a pinpoint of light or other image.

An autorefractor evaluates the way images focus on your retina, where vision processing takes place, without the need for you to say anything. This makes autorefractors especially useful when examining young children or people who may have difficulty with a regular ("subjective") refraction. Automated refractions and subjective refractions are often used together during a comprehensive exam to determine your eyeglasses prescription.

An aberrometer uses advanced wavefront technology to detect even obscure vision errors based on the way light travels through your eye.

Cover Test

While there are many ways for your eye doctor to check how your eyes work together, the cover test is the simplest and most common.

During a cover test, the eye doctor will have you focus on a small object at distance and will then cover each of your eyes alternately while you stare at the target. As they do this, eye doctors observe how much each eye has to move when uncovered to pick up the fixation target. The test is then repeated as you focus on a near object.

Cover tests can detect even very subtle misalignments that can interfere with your eyes working together properly (binocular vision) and cause amblyopia or "lazy eye."

Slit-Lamp Examination

The slit lamp is an instrument that the eye doctor uses to examine the health of your eyes. Also called a biomicroscope, the slit lamp gives your doctor a highly magnified view of the structures of the eye, including the lens behind the pupil, in order to thoroughly evaluate them for signs of infection or disease.

The slit lamp is basically an illuminated microscope that's mounted on a table and includes a chin and head rest so you can rest comfortably while the doctor looks at your eyes. After the doctor looks at the front of your eye, additional hand-held lenses may be used to also examine your retina (the light-sensitive inner lining of the back of the eye.)

Tonometry (Glaucoma Testing)

Tonometry is the name for a variety of tests that can be performed to determine the pressure inside your eye. Elevated internal eye pressure can cause glaucoma, which is vision loss due to damage to the sensitive optic nerve in the back of the eye.

One common method used for tonometry is the "air puff" test - where an automated instrument discharges a small burst of air to the surface of your eye. Based on your eye's resistance to the puff of air, the machine calculates the pressure inside your eye - called your intraocular pressure (IOP).

Though the test itself can be startling, nothing but air touches your eye during this measurement, and there's no risk of eye injury from the air puff test.

Another popular way to measure eye pressure is with an instrument called an applanation tonometer, which is usually attached to a slit lamp. For this test, a yellow eye drop is placed on your eyes. Your eyes will feel slightly heavy when the drops start working. This is not a dilating drop — it is simply a numbing agent combined with a yellow dye. Then the doctor will have you stare straight ahead in the slit lamp while he or she gently rests the bright-blue glowing probe of the tonometer on the front of each eye and manually measures the intraocular pressure.

Like the air puff test, applanation tonometry is painless and takes just a few seconds.

Since glaucoma is often the result of an increase of pressure inside the eye, these are important tests for ensuring the long-term health of your eyes.

Pupil Dilation

Your comprehensive exam may include the use of dilating drops. These medicated eye drops enlarge your pupil so your doctor can get a better view of the internal structures in the back of the eye. Dilating drops usually take about 20 minutes to start working. When your pupils are dilated, you will be sensitive to light, because more light is getting into your eye. You may also notice difficulty reading or focusing on close objects. These effects can last for up to several hours, depending on the strength of the drops used.

If you don't have sunglasses to wear after the exam, disposable sunglasses will be provided to help you drive home. Dilation is very important for people with risk factors for eye disease, because it allows for a more thorough evaluation of the health of the inside of your eyes.

Summary

These are the most common tests performed during a standard comprehensive eye exam. Depending on your particular needs, your doctor may perform additional tests or schedule them to be performed at a later date.

Eyeglasses

Eyeglass Frame Materials

Eyeglass Frame Materials

Finding eyeglasses with the qualities that are most important to you could be as simple as choosing a frame material, each distinguished by its own strengths.

You can also choose frames based on factors such as color, hypoallergenic materials, durability, lightness, price and uniqueness.

Metal Frames

Metal is the most popular material for eyeglass frames. There are many types of metal to choose from, with each having its own distinctive properties.

Titanium. This premium metal is very strong, durable and corrosion-resistant. It's also 40% lighter than other metals, as well as hypoallergenic, making it a nearly perfect material for eyeglass frames. Titanium frames are available in several colors.

Beta titanium. This is an alloy of predominantly titanium, with small amounts of aluminum and vanadium. These other metals in the alloy make beta titanium more flexible than 100% titanium, for easier fitting adjustments.

Memory metal. This is a titanium alloy composed of roughly 50% titanium and 50% nickel. Frames made of memory metal are extremely flexible and can be twisted or bended to an extreme and still return to their original shape. This feature makes memory metal frames great for kids or anyone who is hard on their glasses.

Beryllium. This lower-cost alternative to titanium resists corrosion and tarnishing, making it an excellent choice for anyone with high skin acidity or for anyone who spends a good amount of time in or around salt water. It's also lightweight, strong, flexible and available in a wide range of colors.

Stainless steel. This is an iron-carbon alloy that also contains chromium. Stainless steel frames are lightweight, strong, durable, flexible and corrosion-resistant. They also can be produced in matte or polished finishes.

Monel. This popular, inexpensive material is an alloy of nickel and copper. It is less costly than other metals, but - depending on the quality of the plating used - monel frames may or may not discolor and cause skin reactions over time.

Aluminum. Aluminum offers a unique look and is therefore most commonly seen in high-end eyewear. Frames made from aluminum are lightweight and highly corrosion-resistant.

Plastic Frames

Zyl. This material (also called zylonite or cellulose acetate) is a lightweight and relatively inexpensive type of plastic. It's also the most popular plastic used for eyeglass frames. Zyl frames are available in a wide variety of colors, including multi-colored models and frames with different layers of color.

Propionate. This is a nylon-based plastic that is strong, flexible, lightweight and hypoallergenic. Propionate is often used in sports frames because of its durability.

Nylon. This frame material is still occasionally used. Nylon is strong, lightweight and flexible, but it can become brittle with age. For this reason, it has for the most part been replaced by nylon blends - polyamides, copolyamides and gliamides - which are more durable.

Combination Frames

As you might guess, these are frames that have both metal and plastic components. Popular in the 1950s and 1960s, combination frames have made a comeback, in a wider variety of colors than the classic models.

Mix It Up!

Each frame material offers its own advantages and style features. For eyewear that fits every occasion in your life, consider purchasing more than one pair of glasses, and choose a different frame material for each pair.

For example, you may want a conservative-style frame made of durable, lightweight titanium for work. But on weekends, you may want something with more color or style, like a zyl frame in laminated colors or a combination frame with a modern spin on that classic retro look.

Lens Options for Eyeglasses

Lens Options for Eyeglasses

When it comes to choosing eyeglass lenses, it's no longer a simple choice of "glass or plastic?" Let's look at your many options in eyeglass lenses in detail:

Want Thinner, Lighter Lenses? Choose a High Index Lens Material

Nearly everyone can benefit from thinner, lighter lenses. High index lenses can be up to 50% thinner than regular glass or plastic lenses, and they're usually much lighter, too.

Though these lenses are especially beneficial if you have a strong eyeglasses prescription, they can make a noticeable difference in the appearance of virtually any pair of glasses. High index lenses bend light more efficiently than regular glass or plastic lenses, so less lens material is required to correct your vision.

Various high index lenses are available today in different price points based on how much thinner they are compared with regular plastic lenses. The lenses are classified by their "index of refraction" (or "refractive index").

Generally, lenses with a higher index of refraction will be thinner (and usually more expensive) than lenses with a lower index. The index of refraction of regular plastic lenses is 1.50. The refractive index of high index plastic lenses ranges from 1.53 to 1.74. Those in the range of 1.53 to 1.59 are about 20% thinner than regular plastic lenses, whereas 1.74 high index lenses are about half the thickness of regular plastic lenses.

Most popular lens designs (single vision, bifocal, progressive, photochromic, etc.) come in high index materials, and your doctor or optician will know which ones are available in your prescription. Bifocal and trifocal high index lenses are also available, though the selection is more limited.

Note: High index lenses reflect more light than regular glass or plastic lenses, so anti-reflective (AR) coating is highly recommended for these lenses (see below).

Slim Down with Aspheric Lenses

To make high index lenses even more attractive, most of them have an "aspheric" design. This means that, instead of having a round (or "spherical") curve on the front surface, these lenses have a curve that gradually changes from the center of the lens to the periphery. This makes aspheric lenses noticeably flatter for a slimmer, more attractive lens profile.

Though aspheric lenses offer advantages for all prescriptions, they are particularly beneficial if you are farsighted. Aspheric lenses greatly reduce the magnified, "bug-eye" look caused by regular, highly curved lenses for farsightedness, and they greatly reduce the "bulge" of the lenses from the frame. And because they have a slim profile, aspheric lenses have less lens mass, making them much lighter. Aspheric lenses also provide superior peripheral vision compared with conventional lenses.

Note: Because they have flatter curves than regular lenses, aspheric lenses may cause more noticeable reflections. Anti-reflective (AR) coating is recommended for these lenses (see below).

Polycarbonate and Trivex Lenses: Tough as Nails

Polycarbonate and Trivex lenses are special high index lenses that offer superior impact resistance. These lenses are up to 10 times more impact resistant than regular plastic lenses, making them an ideal choice for children's eyewear, for safety glasses, and for anyone with an active lifestyle who wants a thinner, lighter, safer lens.

Polycarbonate lenses have a refractive index of 1.59, making them 20% to 25% thinner than regular plastic lenses. They are also up to 30% lighter than regular plastic lenses, making them a good choice for anyone who is sensitive to the weight of eyeglasses on their nose.

Trivex lenses may be slightly thicker than polycarbonate lenses, but they provide comparable impact resistance, and like polycarbonate lenses, they block 100% of the sun's harmful UV rays.

AR Coating: Better Vision, Better Appearance

All eyeglass lenses reflect some light, which reduces the amount of light that enters the eye to form visual images. This can have an impact on vision, especially under low-light conditions, like when driving at night. Lens reflections can also cause glare, further reducing vision in these situations.

The amount of light reflected depends on the lens material. Conventional glass or plastic lenses reflect about 8% of incident light, so only 92% of available light enters the eye for vision. Thinner, lighter lenses made of high index materials reflect up to 50% more light than regular glass or plastic lenses (up to 12% of available light).

Anti-reflective (AR) coating reduces lens reflections and allows more light to enter the eye for better night vision. Regardless of the lens material, eyeglass lenses with AR coating transmit over 99% of available light to the eye.

By eliminating surface reflections, anti-reflective coating also makes your lenses nearly invisible. This greatly improves the appearance of your eyewear and allows others to see your eyes, not the reflections in your glasses.

When cleaning lenses with anti-reflective coating, be sure to use the products recommended by your optician. Because AR coating eliminates reflections that can hide small scratches, you'll want to take care not to scratch AR-coated lenses, as scratches on these lenses may be more visible than scratches on an uncoated lens.

Scratch-Resistant Coatings

No eyeglass lens material - not even glass - is scratch-proof. However, a lens that is treated front and back with a clear, hard coating does become more resistant to scratching, whether it's from dropping your glasses on the floor or occasionally cleaning them with a paper towel. Kids' lenses, especially, benefit from a scratch-resistant hard coat.

Nearly all high index lenses (including polycarbonate) come with a factory-applied scratch-resistant coating for added durability. This coating is optional for regular plastic lenses. However, to safeguard your investment in your eyewear, scratch-resistant coating should be considered for all eyeglass lenses. The only exception is glass lenses, which are naturally hard and scratch-resistant.

To further protect your eyeglasses from scratches, keep your glasses in a protective case when you're not wearing them. Also, never clean your lenses without first rinsing them with a cleaning solution or water. Rubbing a dry, dusty or dirty lens with a cleaning cloth or towel can cause scratches, even on lenses with a scratch-resistant coating.

Ultraviolet (UV) Treatment

Just as you use sunscreen to keep the sun's UV rays from harming your skin, UV treatment in eyeglass lenses blocks those same rays from damaging your eyes. Overexposure to ultraviolet light is thought to be a cause of cataracts, retinal damage and other eye problems.

Most high index lenses have 100% UV protection built-in. But with regular plastic lenses, a lens treatment is required for these lenses to block all UV rays. This UV treatment does not change the appearance of the lenses and is quite inexpensive.

Photochromic Lenses: Right in Any Light

Photochromic lenses are convenient indoor-outdoor eyeglass lenses that automatically darken to a sunglass shade outside when exposed to sunlight, and then quickly return to a clear state indoors. These lenses also provide 100% protection from the sun's UV rays and are available in a wide variety of lens materials and designs, including bifocal and progressive lenses.

The amount of darkening that most photochromic lenses undergo depends on how much UV radiation they are exposed to. As a general rule, these lenses won't get as dark behind the windshield of your car or truck, because the glass blocks out much of the sun's UV rays that cause the lenses to change color.

Men's Eyeglass Frames

Men's Eyeglass Frames

When it comes to eyeglasses, most men may want style, but are most interested in comfort, fit and durability. In fact, very few men will forsake comfort and fit just to look good.

Comfort and Fit

Here are some key areas to check out to make sure the eyeglass frames you choose will be comfortable and fit well.

To ensure the temples (the pieces that extend to your ears) aren't too snug on the sides of your head, choose frames that are wide enough for your face. The edge of the frames should protrude slightly beyond your face so the temples don't put pressure on your head as they extend back to your ears.

Next, make sure the temples are long enough. Many frame styles are available in more than one temple length. So if you find a frame you like but the temples seem too short, ask your optician if a longer temple is available. For a comfortable fit, the curve at the end of the temple should extend over your ear without pressing down upon it.

Also, check the nosepiece for comfort and fit. Many glasses have soft, silicone nose pads that can be adjusted for a customized fit. For frames without adjustable nose pads, the frame should fit securely without pinching the bridge of your nose.

When you pick up your new eyeglasses, move your head up and down, and bend over (as if to pick up something up from the floor) to see how well your glasses stay in place. With properly adjusted nose pads and temples, your glasses should stay comfortably in place.

Durability

For extra-durable eyeglasses, consider choosing frames made from titanium, stainless steel or "memory metal." Titanium and stainless steel are stronger and more durable than other metal frame materials, and frames made of memory metal, a titanium-based alloy, return to their original shape even if they are severely bent or twisted.

What About Fashion? Five Trends in Men's Eyeglasses

Men's frame styling has become more masculine in recent years, with classic shapes and sizes now re-born with a modern twist.

Masculine shapes such as aviator glasses and double brow-bar styles have seen a resurgence in popularity, but in fresh colors and materials and slightly pared-down in size.
Larger and bolder eyeglass frames are becoming popular again for men. Keep in mind that the biggest styles work best on men with larger body types. Smaller frames are still around and still work well with smaller faces.
Rimless and semi-rimless styles (where the eyeglass lens is held in place to the temple simply by a screw or a wire) are perfect for the man who wants a modern or minimalist look. Combine rimless frames with anti-reflective lenses, and the glasses practically disappear.
Titanium frames are very popular with men and rate high in both the function and fashion categories. These premium metal frames are super lightweight, non-corrosive, very durable and stylish as well.
For a younger, hip or retro look, many men are turning to plastic frames. Lightweight and comfortable, plastic frames come in a wide variety of designs including bold, black '50s-style frames and modern designs with layers of colors laminated together to create a unique effect.

Specialty Eyewear

Specialty Eyewear

When it comes to eyewear, "one-size-fits-all" doesn't always apply. In fact, it's rare that one pair of eyeglasses is suitable for all situations.

Whether you want optimum vision and comfort for a specific activity, such as computer use, work, hobbies or driving, or you need glasses that provide an extra margin of safety for work or recreation, special-purpose eyeglasses will usually meet these needs better than your "everyday" glasses.

Computer Glasses

If you spend a lot of time in front of a computer, you probably already know that eyestrain, fatigue and muscle strains are common problems associated with prolonged computer use. "Computer glasses" have lenses that are specially designed to maximize your vision at the intermediate and close-up distances you use during computer work. Computer-specific eyewear will give you the best correction for these distances and help reduce eyestrain.

Reading and Hobbies

If you wear bifocals, you may find you have to tip your head back slightly to use the reading portion of the lens. That's fine for most things, but if you want to sit and read a novel, this head-back posture can cause neck discomfort and fatigue. Often, a pair of single vision reading glasses is a much better solution for prolonged reading and other detailed near vision tasks, such as sewing or needlepoint work.

Working in the Yard or with Power Tools

Lawn mowers, power trimmers, grinding tools and other power tools can all cause serious eye injuries from high-speed projectiles. Even something as simple as hammering a nail can cause flying debris. Safety glasses are a must for these activities.

Sports Eyewear

Did you know that wearing specially tinted eyeglass lenses can improve your visual acuity on the tennis court, golf course or slopes? Sport-specific eyewear can enhance performance by improving visual clarity while protecting your eyes from injury.

Driving Glasses

Driving glasses come in two different categories: sunglasses designed specifically for driving and clear prescription driving glasses. Many sunglasses made for driving feature polarized lenses to reduce glare and special tints to enhance contrast for safer, more comfortable vision on the road on sunny days. Eyeglasses for night driving should include your distance prescription and anti-reflective (AR) coating to reduce the glare from streetlights and oncoming headlights and allow more light to reach your eyes for better vision on dark roadways.

The Basics of Eyeglasses

The Basics of Eyeglasses

Eyeglasses are more popular today than ever, despite the availability of contact lenses and vision correction surgery.

Frame styles branded with high profile designer names are always in demand. And eyeglass frame materials have evolved with the advent of new plastics and various types of metals.

For safety glasses, you may want an extra tough plastic, such as polycarbonate. If you suffer from skin allergies, hypoallergenic metals such as titanium or stainless steel are good choices.

Certain frames are made with highly flexible metal alloys, which reduce the possibility of breakage. Spring hinges are also good choices for added durability and are a great option for children's eyewear.

Eyeglass Frame Styles

Eyeglasses have also become quite popular as fashion accessories. Many people change their frames to match their wardrobes. Your appearance, personal taste and lifestyle should all be considered when choosing eyeglasses.

Multi-colored inlays, composite materials, designer emblems, and enhancements such as insets of precious stones are commonly found in popular frame styles.

Rimless styles have become more popular in recent years as an understated way to wear eyeglasses without obvious frames. Rimless styles mainly involve attaching plastic or metal temples directly onto the lenses rather than onto a frame.

Advances in Eyeglass Lenses

You also have many options when choosing the lenses for your eyeglasses. Among the most popular types of lenses and lens options prescribed today are:

Aspheric lenses have a slimmer, more attractive profile than other lenses. They also eliminate that magnified, "bug-eye" look caused by some prescriptions.
High index lenses are made of new materials that enable the lenses to be noticeably thinner and lighter than regular plastic lenses.
Wavefront technology lenses are custom fabricated based on precise measurements of the way light travels through your eye, allowing for excellent clarity.
Polycarbonate lenses are thinner, lighter and up to 10 times more impact-resistant than regular plastic lenses. These lenses are great for safety glasses, children's eyewear, and for anyone who wants lightweight, durable lenses.
Photochromic lenses are sun-sensitive lenses that quickly darken in bright conditions and quickly return to a clear state in ordinary indoor lighting.
Polarized lenses diminish glare from flat, reflective surfaces (like water) and also reduce eye fatigue.
Anti-reflective coatings are among the most popular add-ons for lenses. They can dramatically improve the look and comfort of your glasses by minimizing the amount of light that reflects off the surface of your lenses, which also has the added benefit of reducing glare and thus easing eye fatigue.
Other lens coatings include scratch-resistant, ultraviolet treatment, and mirror coatings.

Eyeglass Lenses for Presbyopia

Presbyopia is the normal, age-related loss of near focusing ability that makes reading and other close-up tasks more difficult after age 40.

This means that the usual type of eyeglass lenses you've likely been accustomed to wearing, known as single vision lenses, no longer will work well for you.

Multifocal eyeglass lenses available for presbyopia correction include:

Bifocals. Lenses with two powers - one for distance and one for near - separated by a visible line.
Trifocals. Lenses with three powers for seeing at varying distances - near, intermediate and far - separated by two visible lines.
Progressive lenses. These lenses have many advantages over bifocals and trifocals because they allow the wearer to focus at many different distances, not just two or three. Because they have no lines, progressive lenses allow a smooth, comfortable transition from one distance to another.
Variable focus lenses. These innovative new multifocal lenses offer a larger field of view than conventional bifocals, trifocals and progressive lenses and can easily be adjusted to give you the power you need for any task.

If you see well in the distance without the need for eyeglasses, then simple reading glasses with single vision lenses may be all you need to deal with near vision problems caused by presbyopia.

Women's Eyeglass Frames

Women's Eyeglass Frames

Need new eyeglasses? The choices in women's frames are nearly unlimited. But that's sometimes the problem: How do you find the frame styles that look best on you?

Narrowing Down Your Choices

Ask yourself a few questions before shopping for eyewear:

Do I want a frame that's delicate or bold, retro or modern, conservative or "out there"?
Do I plan to wear this frame at work? For social occasions?
What colors am I drawn to and look best on me?
What are the main colors in my wardrobe?
What face shape do I have?
What do I like about my current eyeglasses? What do I dislike?

The answers to these questions will help your optician narrow your search to frames that you are most likely to be happy with.

Judging Fit and Comfort

According to eyewear industry research, most women are more interested in the way eyeglasses look, while most men are more interested in comfort and fit. But let's face it. If the frame doesn't fit well or isn't comfortable, you won't want to wear it.

Here are some tips on how to judge the fit of frames:

To ensure the temples aren't too snug on the sides of your head, choose frames that are wide enough for your face. The edge of the frames should protrude slightly beyond your face so the temples don't put pressure on your head as they extend back to your ears.
Are the temples long enough? The curve at the end of the temple should extend over your ear without pressing down upon it.
Check the nosepiece for comfort and fit. Many glasses have soft, silicone nose pads that can be adjusted for a customized fit. For frames without adjustable nose pads, the frame should fit securely without pinching the bridge of your nose.
When you pick up your new eyeglasses, move your head up and down, and bend over (as if to pick up something up from the floor) to see how well your glasses stay in place. With the properly adjusted nose pads and temples, your glasses should stay comfortably in place.

How Many Frames Do You Need?

Most women don't hesitate to buy more than one pair of shoes, so why balk at buying more than one pair of eyeglasses?

Your eyewear is as much a fashion accessory as anything else you wear. And while few of us have an unlimited budget, money spent on multiple pairs of eyeglasses is well spent - especially if you have a varied wardrobe for work, home and social wear.

If you're really on a tight budget, then by all means choose one frame that you'll be happy wearing with any outfit and in any situation. But it doesn't mean you have to choose a plain, thin metal frame if you really like eyewear that's bold and colorful. Remember, this frame is going to be on your face every single day, and you have to like how it looks on you.

Low Vision

How To Cope With Low Vision

How to Cope With Low Vision

Low vision is the term used to describe reduced eyesight - either blurred vision (usually 20/70 or worse) or an incomplete field of view - that cannot be fully corrected with eyeglasses, contact lenses or eye surgery. The primary causes of low vision are eye diseases, such as macular degeneration, glaucoma and diabetic retinopathy. But low vision also can be inherited or caused by an eye or brain injury.

A person with low vision is not blind: they have some useful sight. But the degree of their visual impairment can make daily tasks, such as reading and driving, difficult or impossible.

Though children as well as adults can be visually impaired, low vision is mostly a problem that afflicts seniors. Vision loss after a lifetime of good eyesight can be very traumatic, leading to frustration and depression.

Many people who develop eye problems that cause low vision lose their jobs. According to the U.S. Census Bureau's American Community Survey of 2010, the employment rate for visually disabled Americans ages 21-64 (working age) was only 37.2 percent, and the full-time/full-year employment rate was only 24 percent.

Not being able to drive safely, read quickly, or easily see images on a television or computer screen can cause people with low vision to feel shut off from the world. They may be unable to get around town independently, earn a living or even shop for food and other necessities. Some visually impaired people become completely dependent on friends and relatives, while others suffer alone.

Thankfully, in many cases, people with impaired vision can be helped by low vision devices, which include eyeglass-mounted magnifiers, handheld magnifiers and telescopes, and stand-alone magnifiers. There are many ingenious low vision devices and strategies that can help visually impaired individuals get the most out of their remaining sight and, in many cases, continue to live independently.

If you have hazy or blurred vision, light sensitivity, loss of peripheral vision, night blindness, a need for more light than before, unusual floaters or spots, or difficulty reading, your first step is to see an eyecare professional for a complete exam. These could be the first signs of a serious eye disease such as macular degeneration, glaucoma, or retinitis pigmentosa. Or, they could mean you are developing a cataract that needs removal. Whatever the case, it's wise to take action before further vision loss occurs.

If your eye doctor finds you have vision loss that cannot be corrected with eyewear, medical treatment or surgery, you will be referred to a low vision specialist. Usually an optometrist, a low vision specialist can evaluate the degree and type of vision loss you have, prescribe appropriate low vision aids, and help you learn how to use them.

The low vision specialist can also recommend non-optical adaptive devices, such as large-print publications, audio books, special light fixtures and signature guides for signing checks and documents. If necessary, your eye doctor or low vision specialist can also refer you to a counselor to help you cope with your loss of vision.

Low Vision Aids for Computer Users

Low Vision Aids for Computer Users

In general, visually impaired people can use the same low vision aids for viewing a computer screen and reading e-mail as they do for other reading activities. In addition, special software has been developed to increase the size of print and images on computer screens and convert printed information into audible messages that are "read" by a synthetic voice.

These innovative low vision devices let partially sighted people do the same computer-related tasks as fully sighted people - such as word-processing, creating and using spreadsheets and viewing Web pages online.

Increasing Print and Image Sizes

Most computer operating systems and Internet browsers allow you to increase the size of Web pages and text on your computer screen to make them more visible to partially sighted users.

Here are a few simple tips for adjusting text size:

In browsers such as Microsoft Internet Explorer, Mozilla Firefox, Google Chrome and Apple Safari, you can enlarge text and images on your screen by holding down the Control ("Ctrl") key on your keyboard and tapping the "+" key. (It's Command-shift-+ if you're a Mac user.)
To reduce the text and images again, tap the "-" key while holding down the Control key.
You also can hold down the Control key, and then use the wheel on your mouse to increase or decrease the text size on your screen.
Still another way to enlarge text on your screen is to use the "Text Size" or "Make Text Larger" command within "View" in the drop-down menu bar that appears at the top of your screen, but only when you use popular software programs such as Microsoft Word and Outlook.

Large-print display software goes the extra step and displays not just larger text, but also icons, mouse pointers and other navigation items at larger sizes.

For better visibility, it's also a good idea to purchase a large LCD display for your desktop computer - a screen that measures at least 20 inches diagonally can be a big help. Another option is to use a screen magnifier placed in front of your display.

Talking Computers

People with tunnel vision from glaucoma or central blind spots from macular degeneration may find it difficult and tiring to read an entire computer screen. This is one reason that "talking computers" were invented.

Talking computers are based on optical character recognition (OCR) systems that first scan text in a word-processing document or Web page, and then convert the text to sounds. The result is a synthetic voice that reads aloud not only the actual text but also important navigation items such as the cursor location. Voice systems are available from several major software companies.

Your Mouse

Some people with low vision, especially if they are good typists, like to use keyboard commands instead of a mouse, because it can be easier to type a keyboard command than to move the cursor to a precise place on the screen with a mouse.

If you would rather use a mouse, choose one that is ergonomically designed for comfort and ease of use. One great innovation is a wheel that is mounted in the center of the mouse and lets you scroll up and down the screen just by moving the wheel with your finger.

A wireless optical mouse is another good option, because your movements aren't limited by the wire leading from the mouse to the computer. If you sometimes experience hand cramps, try using a bigger mouse that lets your hand stay in a more open position, instead of clenched up.

A common source of frustration is a mouse set at a speed that is too fast or too slow. If you're a Windows user and you can't control your mouse because it seems to "zoom" across the screen, you can adjust this by clicking on the Start menu, then Control Panel, then Mouse. There you'll find all kinds of mouse behavior settings, including the pointer speed.

Eliminate Display Flicker and Enhance Contrast

If images on your computer monitor seem to flicker, you can usually eliminate this by adjusting the screen refresh rate, which is how often your monitor redraws the content on the screen. If you use Windows, go to the Start menu, then Control Panel, then Display, then Change Display Settings, then Advanced Settings, then Monitor. Set the refresh rate to 70 Hz (hertz) or higher.

You can eliminate flicker problems altogether by purchasing a liquid crystal display (LCD), which doesn't require images to be "refreshed" like a traditional cathode ray tube (CRT) monitor. For this reason, LCD screens typically cause less eyestrain. For the best screen visibility for someone with low vision, choose an LCD display with a high contrast ratio. Your local computer retailer can help you identify these models.

LASIK and Vision Surgery

Corneal Inlays and Onlays

How to Cope With Low Vision

A person with low vision is not blind: they have some useful sight. But the degree of their visual impairment can make daily tasks, such as reading and driving, difficult or impossible.

Corneal Transplant

Corneal Transplant

A corneal transplant - also called keratoplasty (KP), penetrating keratoplasty (PKP), or corneal graft - is the surgical removal of the central portion of the cornea (the normally clear front surface of the eye) followed by replacement with a donor "button" of clear corneal tissue from an eye bank.

Corneal transplants are performed when, because of disease or injury, the cornea becomes scarred or damaged in such a way that it causes vision problems that cannot be corrected with eyeglasses, contact lenses, or refractive surgery such as LASIK.

The National Eye Institute estimates that approximately 40,000 corneal transplants are performed each year in the United States. The success rate for keratoplasty is quite high, but up to 20% of patients may reject their donor corneas. When signs of rejection occur, aggressive medical treatment with steroids can often overcome the reaction and save the cornea. Some studies report keratoplasty success rates of 95% to 99% at five to 10 years after surgery.

Reasons for Corneal Transplants

A common cause for keratoplasty is keratoconus, a degenerative condition in which the cornea becomes thinner and bulges forward in an irregular cone shape. In mild cases, keratoconus can be treated with rigid gas permeable (GP) contact lenses. But in advanced stages of the condition, the contact lenses can no longer be tolerated on the eye. According to the National Keratoconus Foundation, 20% to 25% of patients with keratoconus will require corneal transplant surgery to restore vision.

Other indications for keratoplasty include traumatic injuries to the eye and corneal scarring from infections, chemical burns or other causes. A corneal transplant also may be required in cases of corneal degenerative diseases and corneal ectasia (thinning and bulging of the cornea that is similar to keratoconus) after LASIK or other laser vision correction surgery.

The Corneal Transplant Procedure

Typically, corneal transplants are performed on an outpatient basis, meaning you will not need overnight hospitalization. Local or general anesthesia is used, depending on your health, age and whether you prefer to be asleep during the procedure. The surgeon uses a trephine (an instrument like a cookie cutter) or a laser to cut and remove a round area of damaged or diseased tissue in the center of your cornea, and replaces it with the clear donor tissue.

The donor "button" is attached to your remaining cornea with very fine sutures (less than half the thickness of a human hair). These sutures stay in place for months or even years, until the eye is fully healed and stable.

Recovering from a Corneal Transplant

The total recovery time for a corneal transplant may be up to a year or longer. Initially, your vision will be blurry and the site of your corneal transplant may be swollen and slightly thicker than the rest of your cornea. Eye drops to promote healing and help your body accept the new corneal graft will be needed for several months.

You should keep your eye protected at all times after surgery by wearing a shield or a pair of eyeglasses so that nothing inadvertently bumps your eye. As your vision improves, you will gradually be able to return to your normal daily activities.

Vision After Keratoplasty

Some patients notice improvement in their vision the day following surgery. However, large amounts of astigmatism are common after a corneal transplant. Your vision and eyeglasses prescription will fluctuate for several months after surgery, and vision changes may persist for up to a year.

Gas permeable contact lenses usually provide the best vision correction after keratoplasty, as some irregularity of the corneal surface is common. Glasses with polycarbonate lenses should be worn over the contact lenses for eye protection.

After healing is complete and the sutures are removed, it may be possible to have LASIK or some other laser vision correction procedure to reduce astigmatism and enhance your ability to see without glasses or contact lenses.

Corrective Eye Surgery Basics

Corrective Eye Surgery Basics

Tired of wearing glasses or contact lenses? Today, several surgical methods can correct your eyesight and give you the freedom of seeing well without corrective lenses.

Approaches to corrective eye surgery range from laser reshaping of the eye's surface in procedures such as LASIK and PRK to surgical insertion of artificial lenses to correct eyesight. Here's a brief summary of several refractive surgery options:

PRK

PRK (photorefractive keratectomy) was the first laser vision correction procedure approved in the United States, receiving FDA approval in 1995. It soon became a popular alternative to radial keratotomy (RK), which was the only viable surgical treatment for nearsightedness available at the time. PRK promised to reduce or eliminate many of the complications of RK, including fluctuating vision, glare, halos around lights, infection, unpredictable outcomes, decreased visual acuity and regression (return of nearsightedness).

Like LASIK, PRK uses an excimer laser to remove corneal tissue to reshape the eye and correct vision. But with PRK, the laser treatment is applied directly to the surface of the cornea, rather than under a flap of corneal tissue as in LASIK. Visual outcomes after PRK are comparable to those after LASIK. But the eye is uncomfortable for a couple of weeks after PRK, until the thin outer protective layer of the cornea (the epithelium) grows back. Also, vision can be quite blurred for a week or two after PRK until the eye heals.

The number of PRK procedures declined sharply when LASIK was introduced, because there is usually little or no discomfort after LASIK and vision recovers faster. However, PRK has made a comeback in recent years due to more effective pain management techniques and because it poses less risk of certain complications. Recent studies also indicate that PRK and LASIK produce similar outcomes.

LASIK

LASIK (laser-assisted in situ keratomileusis) is like PRK, except that a thin, hinged flap is made on the cornea prior to the laser treatment. This flap is lifted and folded back, and laser energy is applied to the underlying corneal tissue to reshape the eye. Then the flap is replaced, acting like a natural bandage. LASIK's main advantage over PRK is that there is little or no discomfort immediately after the procedure, and vision is usually clear within hours rather than days.

LASEK

LASEK (laser-assisted sub-epithelial keratomileusis) is a modification of LASIK in which the corneal flap is thinner, containing only epithelial cells. The delicate epithelium is removed by loosening it from the underlying cornea with an alcohol solution. It's then pushed to the side and the laser treatment is applied. The epithelial "flap" is then replaced and covered with a bandage contact lens until it reattaches to the underlying cornea. In most cases, there is less post-operative discomfort with LASEK compared to PRK, and vision recovery may be faster. LASEK is sometimes preferred over LASIK in cases when the patient's cornea is judged to be too thin for a safe LASIK procedure.

Epi-LASIK

Epi-LASIK is very much like LASEK, except a special cutting tool is used to separate the epithelium from the underlying cornea prior to the laser treatment. This eliminates the possibility of an adverse reaction to alcohol placed on the eye and may quicken the healing process after surgery, compared with LASEK. Like LASEK, epi-LASIK is sometimes preferred over LASIK if there are concerns about corneal thickness.

Bladeless, All-Laser LASIK

Blade-free LASIK involves the use of another laser rather than a mechanical cutting tool to create the flap in LASIK. Sometimes called IntraLASIK, iLASIK or femto LASIK, this procedure eliminates the risk of certain complications that can occur when the flap is created with a microkeratome.

Wavefront LASIK or PRK

Wavefront (or "custom") LASIK or PRK means the laser treatment is determined by a computerized mapping of the power of your eye called wavefront analysis. Wavefront-guided procedures are more precise than ablations determined by using only an eyeglasses prescription, and they can correct subtle optical imperfections called "higher-order aberrations" that regular ablations can't treat. Several studies show wavefront-guided ablations provide sharper vision than conventional (non-wavefront) LASIK or PRK, and may reduce the risk of nighttime glare and halos.

CK (conductive keratoplasty) is a non-laser refractive surgery that uses a hand-held instrument to deliver low-heat radio waves to a number of spots in the peripheral cornea. This causes the corneal tissue to shrink in these areas, which increases the curvature of the cornea, thereby correcting mild amounts of farsightedness or restoring usable near vision to people over 40 who have presbyopia.

CK for presbyopia is called NearVision CK, and it can be used to correct presbyopia for people who previously had LASIK surgery.

Phakic IOLs

Phakic IOLs (intraocular lenses) are small lenses inserted inside the eye to correct vision problems. The lenses can be placed in front of or behind the pupil. "Phakic" refers to the fact that the eye's natural lens remains in the eye during the procedure.

Phakic IOL implantation can correct higher amounts of nearsightedness than LASIK. But because it's an internal eye procedure, there are more risks. Cost of the procedure is also significantly higher.

Refractive Lens Exchange

Refractive lens exchange (or RLE) is another non-laser, internal eye procedure. RLE is much like cataract surgery. But instead of removing the eye's natural lens that has grown cloudy, the surgeon removes a clear natural lens and replaces it with an artificial lens of a different shape, usually to reduce or eliminate high amounts of farsightedness.

RLE has a higher risk of complications and is more expensive than LASIK. Also, removing the natural lens of a young patient will eliminate near focusing ability, which means reading glasses are required. For these reasons, RLE typically is used only in cases of severe vision correction needs.

Cataract Surgery

Yes, even cataract surgery can be considered a refractive procedure. New lens implants can partially restore a person's near vision in addition to correcting nearsightedness and farsightedness. These lenses, called multifocal IOLs or accommodating IOLs, currently are being used by many cataract surgeons, with promising results.

While Medicare and health insurance will cover basic costs of cataract surgery, you can elect to pay out-of-pocket for the extra costs of these more modern lenses that potentially can restore a full range of vision.

LASIK

LASIK

LASIK, short for laser-assisted in situ keratomileusis, is the most popular refractive surgery available today. Each year, more than one million LASIK procedures are performed in the United States.

LASIK has become the premier surgery for vision correction because it's quick and painless, there is little or no discomfort after the procedure and vision recovery is rapid - some patients already see 20/20 the following day.

LASIK can correct nearsightedness, farsightedness and astigmatism. With a special technique called monovision, it can also reduce the need for reading glasses among patients over age 40 who wear bifocals.

Am I a Good Candidate for LASIK?

To be a good candidate for LASIK, you should be at least 18 years old, have healthy eyes, and have adequate corneal thickness, since LASIK corrects your vision by removing tissue from your cornea to reshape your eye.

Chronic dry eye problems, corneal diseases and other abnormalities may disqualify you from having LASIK surgery. In order to know for sure if you are a good candidate, a comprehensive eye exam is required. For your convenience, we are happy to provide LASIK pre-operative exams and consultations at our office. Call us for details.

Important considerations when deciding whether to have LASIK are your expectations and your ability to accept a less-than-perfect outcome. LASIK can reduce your dependence on glasses and almost always gives you the ability to function well without the need for glasses or contact lenses. But there are no guarantees, and LASIK doesn't always create perfect vision. In some cases, your vision after LASIK may be permanently less clear than it was with glasses before the procedure. You have to ask yourself if you're willing to accept the risk of such an outcome before you decide to have LASIK surgery.

Remember: LASIK is an elective procedure, not a required one.

The LASIK Procedure

LASIK is an ambulatory procedure. You walk into the surgery center, have the procedure and walk out again. The actual surgery usually takes less than 15 minutes for both eyes, but expect to be at the surgery center for an hour or more.

LASIK is a two-step procedure. In the first step, the surgeon creates a thin, hinged flap of tissue on your cornea with an instrument called a microkeratome or with a laser. This flap is folded back and the second step - the laser reshaping of your eye - begins. After the laser treatment, which usually takes less than a minute, the flap is repositioned and the surgeon moves on to your other eye.

What Is Wavefront LASIK?

Wavefront LASIK (also called wavefront-assisted, wavefront-guided or custom LASIK) means the laser treatment (or "ablation") is determined by a computerized mapping of the power of your eye called wavefront analysis. Wavefront-guided procedures are more precise than ablations determined by using only an eyeglasses prescription, and they can correct subtle optical imperfections of the eye called "higher-order aberrations" that regular ablations can't treat. Several studies show wavefront-guided ablations provide sharper vision than conventional, non-wavefront LASIK and may reduce the risk of nighttime glare and halos.

After LASIK Surgery

After the procedure, your surgeon or an assistant will apply medicated eye drops and clear protective shields over your eyes. You can open your eyes and see well enough to walk without glasses, but you must have someone drive you home.

You will be expected to use medicated eye drops several times a day for a week or so to protect your eyes from infection and help them heal properly. You will also be told to use artificial tears frequently to keep your eyes moist and comfortable.

You should rest and not use your eyes much when you get home from surgery that day. You may also be more comfortable if the lights in your house are dimmed.

The following day, you should be seeing well enough to drive and can resume most activities. Be careful, however, not to rub your eyes until your eye doctor tells you it is safe to do so.

Usually, you will be asked to return to the surgery center the following day so your surgeon or another eye doctor at the center can check your vision and make sure your eyes appear as they should. At this visit, you typically will be given additional instructions about using eye drops and artificial tears, and you will be able to ask the doctor any questions you have.

From this point forward (and sometimes for this "day one" visit as well), your post-operative care may be performed by an eye doctor other than your LASIK surgeon. When your post-operative care is provided by a doctor other than your surgeon or another doctor at the surgery center, it's called co-management. We are happy to provide post-operative care for you at our office through a co-management agreement with your surgeon. Call our office for details.

What If My Vision Is Still Blurry After LASIK?

Though most patients see quite clearly in a matter of days after LASIK, it can take several months before your eyes are completely stable. Until then, improvements in your vision can still occur. But if several months pass and your vision is still blurred, see your LASIK surgeon. Usually a second LASIK surgery (called an enhancement) can sharpen your eyesight further.

If for some reason an enhancement is not indicated or desired, eyeglasses or contact lenses may help. We will be happy to examine your eyes and discuss the different options with you.

Eyewear After LASIK

Keep in mind that, even if your vision seems perfect after LASIK, you still need eyewear.

When outdoors, it's important to protect your eyes from the sun's harmful rays with sunglasses that provide 100% UV protection. If you play sports when wearing sunglasses, make sure the lenses have polycarbonate lenses for extra protection. And anytime you're working with power tools or doing anything else when an eye injury is possible, you should wear safety glasses with polycarbonate lenses.

If you're over 40 (or soon will be), it's likely you'll need reading glasses after LASIK. Also, many LASIK patients can benefit from a pair of prescription eyeglasses for night driving. Though these lenses may have only a mild prescription, they often can make your vision sharper for added safety and comfort.

Eye Care After LASIK

And don't forget to continue to have routine eye exams after LASIK. Even if your vision is perfect, you still need to have your eyes checked for glaucoma and other potential problems on a regular basis. Routine exams also help you make sure your vision stays stable after LASIK.

LASIK - Criteria for Success

LASIK - Criteria for Success

Laser eye surgery isn't for everyone. Here are six guidelines to help you decide if LASIK is right for you:

Are your eyes healthy? If you have any condition that can affect how your eyes respond to surgery or heal afterwards, wait until that condition is resolved. Examples include chronic dry eyes, conjunctivitis ("pink eye") and any eye injury. Some conditions, such as cataracts, keratoconus and uncontrolled glaucoma, may disqualify you completely.
Are you an adult? You need to be at least 18 years of age to have LASIK. (Younger patients can sometimes be treated as an exception. Discuss this with your surgeon.)
Is your vision stable? Many teenagers and young adults experience changes in their prescription for eyeglasses or contact lenses from year to year, especially if they are nearsighted. Make sure your prescription is stable for a 12-month period before having LASIK. If it's not and you proceed anyway, you may need another surgery next year!
Are you pregnant? Hormonal changes during pregnancy can cause swelling in your corneas, changing your vision. Dry eyes are also common when you're pregnant. Also, eye medications (antibiotics and steroids) used during and after LASIK may be risky for your baby, whether unborn or nursing. Wait a few months after your baby is born before having LASIK.
Certain systemic and autoimmune diseases may be disqualifiers, too. Examples include rheumatoid arthritis, type 1 diabetes, HIV and AIDS. Basically, if your body has any trouble with healing, your corneas may not heal properly after LASIK. Opinions vary among surgeons as to which diseases are automatic disqualifiers and which ones might pose acceptable risks in certain cases.
Your prescription must be within certain limits. For example, very high amounts of myopia, which would require removal of too much corneal tissue, may preclude LASIK or make another type of refractive surgery a better option. For example, many surgeons feel a phakic IOL procedure provides a better visual outcome and poses less risk than LASIK for nearsighted prescriptions higher than -9.00 diopters.

LASIK Risks and Complications

LASIK Risks and Complications

If you are considering LASIK and worry that something could go wrong, you might take comfort in knowing that it's very rare for complications from this procedure to cause permanent, significant vision loss. Also, many complications can be resolved through laser re-treatment.

Selecting the right eye surgeon probably is the single most important step you can take to decrease any risks associated with LASIK. An experienced, reputable surgeon will make sure you are a good candidate for LASIK before a procedure is recommended. And if problems develop during or after the procedure, the surgeon should work closely with you to resolve them.

How Common Are LASIK Complications?

Public confidence in the LASIK procedure has grown in recent years because of a solid success rate involving millions of successful procedures in the United States. With increasingly sophisticated technology used for the procedure, most LASIK outcomes these days are very favorable.

The U.S. military also has adopted the use of refractive surgery, including LASIK, to decrease troops' reliance on prescription eyewear. As of 2008, more than 224,000 military personnel had undergone laser vision correction, with most seeing 20/20 or better after the procedure without corrective eyewear. The rate of complications among military has also been low. In fact, according to one study, only one in 112,500 patients required medical disability retirement due to complications from laser vision correction.

LASIK Complication Rates

Experienced LASIK surgeons report that serious complication rates can be held well below 1 percent if surgical candidates are screened and carefully selected. You may be eliminated as a candidate, for example, if you are pregnant or have certain conditions such as diabetes that may affect how well your eyes heal after LASIK. Discuss any health conditions you have with your eye doctor during your LASIK consultation or pre-operative exam.

Large pupil sizes also might be risk factors for LASIK complications, because pupils in dark conditions could expand beyond the area of the eye that was treated. Again, make sure you discuss any concerns about these or other matters with your eye surgeon.

Other Considerations About LASIK Risks

While the great majority of LASIK outcomes are favorable, there is still that fraction of less than 1 percent of people who experience sometimes serious and ongoing vision problems following LASIK. No surgical procedure is ever risk-free.

Some LASIK patients with excellent vision based on eye chart testing still can have bothersome side effects. For example, it's possible a patient may see 20/20 or better with uncorrected vision after LASIK but still experience glare or halos around lights at night.

When you sign the LASIK consent form prior to surgery, you should do so with a full understanding that, even in the best of circumstances, there is a slight chance something unintended could occur. Even so, most - but not all - problems eventually can be resolved.

Common LASIK Complications

When LASIK complications occur, they are sometimes associated with the hinged flap that's created in the cornea (the clear front covering of the eye) in the first step of the LASIK procedure. This flap is lifted prior to re-shaping the underlying cornea with a laser, and is then replaced to form a natural bandage.

If the LASIK flap is not made correctly, it may fail to adhere correctly to the eye's surface. The flap also might be cut too thinly or thickly. After the flap is placed back on the eye's surface, it might begin to wrinkle. These types of flap complications can lead to an irregularly shaped eye surface.

Studies indicate that flap complications occur in from 0.3 percent to 5.7 percent of LASIK procedures, according to the April 2006 issue of American Journal of Ophthalmology. But inexperienced surgeons definitely contribute to the higher rates of flap complications. Again, remember that you can improve your odds of avoiding LASIK risks by selecting a reputable, experienced eye surgeon.

Some problems associated with LASIK flap complications include:

Irregular astigmatism. Irregular astigmatism can result from a less than smooth corneal surface or from laser correction that is not centered properly on the eye. Resulting symptoms may include double vision or "ghost images." In these cases, the eye may need re-treatment (also called an "enhancement").

Diffuse lamellar keratitis (DLK). Also nicknamed "sands of the Sahara," DLK is inflammation that can occur under the LASIK flap after surgery. In rare cases, DLK leads to corneal scarring. Potentially permanent vision loss can occur without prompt treatment with therapies such as antibiotics and topical steroids. The flap also might need to be lifted and rinsed to remove inflammatory cells and prevent tissue damage.

Ectasia (or keratectasia) is bulging of the cornea that can occur from a flap being cut too deeply, when too much tissue is removed from the cornea during LASIK, or when the cornea was initially weakened as evidenced from corneal topography mapping prior to LASIK. Resulting distorted vision likely cannot be corrected with laser enhancement, and rigid contact lenses or corneal implants (Intacs) may be prescribed to hold the cornea in place.

Other, more commonly reported LASIK complications include:

Dry eye. Almost half of all patients report problems with dry eye in the first six months following LASIK, according to the April 2006 issue of American Journal of Ophthalmology. These complaints appear related to reduced sensitivity of the eye's surface immediately following the procedure. If you have this problem, temporary remedies such as artificial tears or prescription dry eye medication may be needed along with oral flaxseed oil capsules.

After about six months to a year, however, most of these types of complaints disappear when healing of the eye is complete. People who already have severe dry eye usually are eliminated as LASIK candidates.

Significant undercorrection, overcorrection, or regression. An overcorrection or undercorrection of your vision problem means your vision may remain slightly blurred from residual nearsightedness, farsightedness or astigmatism. Regression is when your eyesight is optimal at first after LASIK, but then begins to deteriorate over time (due to a return of some nearsightedness, for example). These problems can usually be corrected with an enhancement LASIK procedure.

Eye infection or irritation. In some rare cases, you may develop an eye infection, inflammation, or irritation that requires treatment with eye drops containing antibiotics or anti-inflammatory medication such as steroids.

Vision Changes Unrelated to LASIK

If you have LASIK in your 20s or 30s, be aware that your reading vision will change as you get older. This has nothing to do with your LASIK surgery - it's caused by a normal age-related loss of focusing ability called presbyopia. Because of presbyopia, most LASIK patients (like anyone else who sees well without glasses in younger years) will need reading glasses after age 40.

Surgery for Presbyopia

Surgery for Presbyopia

Presbyopia is the normal age-related loss of near focusing ability. If you're over 40 and have to move the newspaper farther away to read it, you are beginning to experience presbyopia.

Even if you've had your vision corrected with LASIK surgery in your 20s or 30s, you'll still experience reading vision problems from presbyopia in your 40s, 50s and beyond.

When the time comes, most people deal with presbyopia by wearing reading glasses or eyeglasses with bifocal or progressive ("no-line bifocal") lenses. But if you want greater freedom from glasses after age 40, there are surgical options for the correction of presbyopia as well:

Monovision LASIK

Monovision is a presbyopia-correcting technique where your eye doctor prescribes lens powers for one eye to see clearly across the room (leaving it slightly blurred up close) and the other eye to see well up close (making it slightly blurry far away). The two eyes still work together as a team, but one eye does more of the work for your distance vision, and the other supplies more of your near vision.

Though it may sound odd, monovision contact lens fittings have been done for years, and most presbyopes who try monovision adapt to it quite well. Reading glasses may still be needed for very small print or sustained reading, but a person can usually be glasses-free most of their day with monovision.

Recently, LASIK surgeons have begun using this monovision technique as well, and success rates should be as good as or better than monovision with contact lenses. Before you commit to monovision permanently with LASIK surgery, however, try it with contact lenses first. If it works for you with contacts, you can then proceed with monovision LASIK with greater confidence (provided you meet the other criteria of a good candidate for LASIK).

Monovision CK (NearVision CK)

CK (conductive keratoplasty) uses a hand-held probe to deliver controlled radio-frequency energy to specific spots in the periphery of the cornea. This shrinks the corneal tissue in these spots and steepens the central cornea, making the eye more nearsighted.

NearVision CK, the version of CK for presbyopia, uses a monovision approach and is performed on one eye only. NearVision CK is less invasive and less expensive than LASIK, and is a good option for someone who only needs reading glasses - that is, someone who is presbyopic but has no nearsightedness or astigmatism.

The effects of CK tend to fade over time. So at some point, additional procedures may be needed. As with monovision LASIK, it's a good idea to first try monovision with contact lenses to make sure you're comfortable with it before proceeding with NearVision CK surgery.

Multifocal IOLs and RLE

Multifocal intraocular lenses (IOLs) are a variation of the lens implants that have been used for years in cataract surgery. But instead of having just one lens power to correct nearsightedness or farsightedness, these new lenses have multiple powers to correct vision at all distances.

Multifocal IOLs can be used in cataract surgery to replace the eye's cloudy natural lens, or they can be used to replace a clear natural lens that has just lost its ability to change shape for reading due to presbyopia. This second procedure is called refractive lens exchange (RLE).

Because both cataract surgery and RLE are intraocular procedures, they have more associated risks than less invasive procedures like LASIK and CK. Possible complications of IOL procedures include glaucoma and retinal detachment.

Accommodating IOL (Crystalens®)

Another type of IOL that's used in the same manner as a multifocal IOL is the "accommodating" IOL. This intraocular lens has just one lens power, but the central optical portion of the device is supported by structures called haptics that enable the lens to move slightly forward and backward inside the eye in response to focusing effort. In this manner, an accommodating IOL restores some of the eye's ability to change focus on demand.

The accommodating IOL is approved for use in the United States as part of cataract surgery, and has the same risks as other intraocular lens surgeries.

Multifocal LASIK (PresbyLASIK)

PresbyLASIK is a multifocal variation of LASIK that is available in Europe and Canada, but is not yet FDA approved in the U.S. In PresbyLASIK, the excimer laser creates concentric rings of different powers on the cornea (much like the alternating powers on a multifocal soft contact lens) to provide good vision at all distances.

Studies show presbyopic patients are quite pleased with the overall performance of PresbyLASIK, though many of them still need to wear eyeglasses for some activities. Also, though near vision after PresbyLASIK is usually good in bright light, reading glasses are usually required in low-light situations.

Corneal Inlays

Corneal inlays are another surgical solution for presbyopia. In this procedure, a very small, circular device is implanted within the cornea to improve near vision. The surgery is less invasive than procedures involving larger implantable lenses that are placed deeper in the eye, so it may include fewer risks for many people.

Sports Vision

Contacts and Glasses That Enhance Performance

Contacts and Glasses That Enhance Performance

Good vision is critical for nearly every sport. To determine the effect of visual acuity on sports performance, British optometrist Geraint Griffiths and others tested the performance of Wimbledon tennis players and UK national clay pigeon shooting champions when their vision was blurred with special goggles. Overall, the tennis players and marksmen showed a 25% worsening of performance when their visual acuity was only slightly blurred by the goggles.

In addition to providing sharp vision, sports eyewear offers a number of additional benefits to help athletes and sports enthusiasts of all ages perform at their highest level:

Protection from Impact-Related Injuries

No one can perform at their best during sports if they are worrying about an injury. Compared with regular eyewear, sports eyewear offers a primary benefit of superior impact resistance and eye protection.

According to the American Academy of Ophthalmology, more than 42,000 sports-related eye injuries occur annually in the United States, and about 43% of those affected are children younger than 15.

Experts agree that many, if not most, of these injuries can be prevented with protective eyewear, such as safety goggles with polycarbonate lenses. Polycarbonate lenses are up to 10 times more impact-resistant than regular eyeglass lenses and can withstand impact from a ball or other projectile traveling at up to 90 miles per hour.

Contact lenses alone offer no protection from sports-related eye injuries, and regular eyeglasses designed for everyday wear are not strong enough nor are they designed to offer adequate eye protection during sports.

While safety eyewear should be considered for every activity that has the potential for eye injury, it is essential for the following sports: baseball, softball, basketball, hockey, football, handball, racquetball, squash, field hockey, lacrosse, soccer, swimming and pool sports, fishing, tennis and volleyball. Paintball "war games" are another activity for which safety eyewear is a must.

Protection from UV

Another danger during outdoor sports, even in winter, is ultraviolet (UV) radiation from the sun. Excessive exposure to UV rays has been associated with eye diseases such as cataracts and ocular tumors. You can also get a sunburn on your eye - called photokeratitis - which is very painful and can cause long-term damage to the cornea (the clear front surface of the eye).

Skiers should always wear tinted goggles or sports sunglasses that block 100% of the sun's UV rays, since these harmful rays are stronger at higher altitudes. UV also bounces off snow (even on cloudy days) to increase one's exposure. Anyone participating in outdoor water sports also needs UV protection, since UV rays reflect off bodies of water.

Some contact lenses offer UV protection. However, since contacts cover only the center part of your eye and can't do anything for uncovered areas, you should still wear UV-blocking sunglasses, preferably with a close-fitting, wraparound style. Wide-brimmed hats are also helpful to reduce exposure of your eyes and face to UV rays.

Color Enhancement

In some lighting conditions, "keeping your eye on the ball" is not as easy as it sounds. Sports eyewear with special tints can help. Amber-colored "shooting glasses" are popular with hunters because they increase the contrast of birds, clay pigeons, etc. against an overcast sky.

In recent years, several eyeglass lens manufacturers have created special tints for sport sunglasses that increase contrast and improve visibility in a wide variety of indoor and outdoor lighting conditions. Your eye doctor or professional optician can show you samples of these lenses and help you decide which tints are best suited for your needs.

Light Control

Polarized sports sunglasses reduce glare from reflective surfaces, making them extremely beneficial for fishing and other water sports. They can also reduce glare from sunlight reflecting off a sandy beach or light-colored pavement, such as an outdoor basketball court.

Anti-reflective (AR) coating is another glare reducer. AR-coated sports glasses reduce lens reflections at night if you're playing under bright lights. AR coating is also a good idea for the back surface of sport sunglasses. It reduces glare from "bounce-back" reflections that occur when sunlight hits the back of your lenses.

Photochromic lenses are another way to control light for optimum visibility and performance. These lenses darken automatically outdoors in response to UV rays from the sun. They reduce the intensity of light reaching your eyes to a more comfortable level and provide 100% UV protection at the same time.

Convenience and Comfort

Many people choose to wear contact lenses for sports, even if they prefer eyeglasses at work and for other daily activities. Contact lenses offer unobstructed peripheral vision and more natural-appearing vision, with no unwanted changes in image sizes that eyeglasses can sometimes produce.

One-day disposable soft contact lenses are an excellent option for sports, because they don't require cleaning. You wear them just once and then throw them away. This makes them especially attractive to someone who normally wears eyeglasses.

And because they are made of a soft, oxygen-permeable material, one-day soft lenses require little or no adaptation. So even if you haven't worn contact lenses for a week or longer, you can usually wear a pair of one-day disposable lenses comfortably for a full day of sports or other activities.

Remember, though contacts offer visual and other advantages over glasses for sports (you don't have to worry about them fogging up or falling off when you're perspiring, for example), you still need to wear protective eyewear over contact lenses to protect your eyes from injuries and/or UV damage.

Protective Sports Eyewear

Protective Sports Eyewear

Today, sports eyewear can be spotted on almost anyone who picks up a ball, bat, racquet or stick — whether they play in the major leagues or the Little League. Fortunately, coaches, parents and players now realize that wearing protective eyewear for sports pays off in several ways. The risk of eye damage is reduced or eliminated, and the player's performance is enhanced by the fact that they see well. In fact, many clubs today do not permit their members to participate without wearing proper eye gear.

Initially, there was some resistance by children who worried about "looking funny" when they wore protective eyewear. Today, sports goggles are an accepted part of everyday life, much the way bike helmets have become the norm. In addition, both children and adults like the image that wearing protective eyewear gives them: it shows they mean business on the playing field.

If You're Not Wearing Protective Eyewear, Consider This

Prevent Blindness America reports that hospital emergency rooms treat 40,000 eye injuries every year that are sports-related. Sports such as racquetball, tennis and badminton may seem relatively harmless, but they involve objects moving at 60 miles per hour or faster. During a typical game, a racquetball can travel between 60 and 200 miles per hour. Another potential danger is that the racquets themselves move at high speed in a confined space and often make contact with one another.

Flying objects aren't the only hazard. Many eye injuries come from pokes and jabs by fingers and elbows, particularly in games where players are in close contact with each other. Basketball, for example, has an extremely high rate of eye injury.

These are great reasons to wear protective eyewear, but another aspect has to do with performance. It used to be common for people with mild to moderate prescriptions to simply participate in sports without wearing their glasses or contacts. But sharp vision is a vital ingredient to performing well in nearly every sport, and participating in sports when you have less than 20/20 vision is counterproductive.

Features to Look for

Prescription glasses, sunglasses and even on-the-job industrial safety glasses don't provide adequate protection for sports use. Sports goggles are made in a variety of shapes and sizes. Some are even designed to fit in helmets used for football, hockey and baseball. Sports goggles should allow the use of helmets when the sport calls for it.

Lenses in sports eyewear are usually made of polycarbonate. Since polycarbonate is such an impact-resistant lens material, it works well to protect eyes from fast-moving objects. Polycarbonate lenses also have built-in ultraviolet (UV) protection and are coated to be scratch resistant — valuable properties for outdoor sports.

Polycarbonate is the material of choice for sports lenses, but the eyewear frame plays just as important a role. Different sports require different types of frames, which has led to development of sport-specific frames. Sport frames are constructed of highly impact-resistant plastic or polycarbonate, and most come with rubber padding to cushion the frame where it comes in contact with your head and the bridge of your nose.

Some sports styles are contoured, wrapping slightly around the face. This type of goggle works well for biking, hang-gliding, and sailing. Contact lens wearers especially benefit from the wraparound style, which shields your eyes from wind and dust.

A Note About Handball Goggles

At one time, handball goggles for those with no need for vision correction were simply goggles with small openings in place of lenses. It was eventually recognized that the high speed of handballs compressed the ball enough to protrude through the opening and cause serious eye damage. All goggles worn for handball and racquetball should include impact-resistant polycarbonate lenses for adequate protection during these sports.

Important Fitting Considerations

Sport goggles must be properly fitted to the individual wearer. This is particularly important with children because there is a temptation to purchase a larger goggle than what is needed so the youngster has "room to grow." Some growing room is acceptable, since sports goggles are made to be somewhat flexible in their width adjustment. However, if the frames are oversize, they will not protect the way they were designed, leaving a potential for damage when there is impact to the head or the face. It's a risk not worth taking.

By the same token, permitting a youngster to continue wearing goggles that he or she has outgrown can be just as dangerous. First, the frames will be uncomfortable, tempting the child to take them off. Second, the frames may obstruct peripheral vision, leading to poor performance with a potential for impact from unseen sources to one side or another.

Review the fit of your youngsters' sports eyewear each year to ensure that they are still providing proper protection and are fitting comfortably. Make sure the padding inside the sides of the goggle rests flush with the face and the eyes are centered in the lens area.

Scuba Diving Masks and Swim Goggles

Scuba Diving Masks and Swim Goggles

When they're in the water, swimmers, snorkelers and scuba divers who wear eyeglasses or contact lenses could benefit from prescription swim goggles or masks.

These special types of sports eyewear require a prescription that is different from a regular eyeglasses prescription because of the unique characteristics of an underwater environment. Water itself acts as a magnifier, which is why fish in a tank or other underwater objects sometimes appear larger than they actually are. Since light travels and bends differently through water than it does through air, your eye care professional will need to modify your eyeglasses prescription so your underwater sports eyewear gives you the same clear vision your glasses provide on dry land.

Also, depending on the style of diving mask or swim goggles you choose, an adjustment to your prescription may be necessary because the corrective lenses may be positioned closer or farther from your eyes than the normal position of your eyeglass lenses.

Scuba Diving and Snorkeling Masks

Prescription lenses for scuba diving masks are available in one of two forms: either the entire front of the mask is a prescription lens, or corrective lenses are inserted separately between the mask and your eyes. If the dive mask comes with prescription lenses, they may be either custom-made for your vision correction needs, or they can come pre-made in a prescription for nearsightedness or farsightedness that is the same for both eyes.

Most people who require corrective lenses have a similar prescription for both eyes, so a dive mask with pre-made lenses will usually provide adequate vision for reading gauges and maneuvering around underwater. Even though pre-made prescription lenses don't correct astigmatism, most people who have astigmatism can function quite well with a spherical (meaning "without astigmatism") correction in the water.

Dive masks made with lenses designed specifically to your measurements and prescription are generally more expensive than their pre-made counterparts.

Some diving masks are designed to allow customized prescription lens inserts to be attached to the inside of the front of the mask. This option provides a more accurate vision correction. But, depending on the depth, temperature and type of water that you're in, fogging may be a bit more problematic with lens inserts.

If you're a contact lens wearer, however, you might benefit from a diving mask that allows prescription lens inserts because they provide the option of wearing or not wearing contacts. If you have the contact lenses in for a dive, there's no need for the prescription insert. If you go diving without your contacts on, you can put the prescription lens inserts in the mask for a clear underwater experience.

Because of the potential risk of contamination of contact lenses underwater, it's generally a better idea to dive and swim without them. Another option is to wear one-day disposable soft contacts, and discard them as soon as you're back on dry land.

Swim Goggles

Swimming goggles are much smaller and fit closer to your eyes than a diving mask. They are designed to protect your eyes from the water and be sleek and unobtrusive at the same time, so as not to interfere with your speed and motion. A rubber or silicone seal surrounds the lenses to keep water away from your eyes.

As with dive masks, swim goggles are available with pre-made prescription lenses that are the same power for both eyes. Because swim goggles generally are used in a pool setting, these pre-made prescription lenses will usually provide adequate vision. However, custom-made prescription swimming goggles are also an option.

Shooting Glasses and Hunting Eyewear

Shooting Glasses and Hunting Eyewear

Hunters and gun enthusiasts require eye protection, whether at a shooting range or in the woods. All firearms have a certain amount of recoil, and many shooting activities take place outdoors, where wind, sun, dust, tree branches and brush all can cause eye injuries.

Pre-made, nonprescription sports goggles are usually acceptable if you don't require vision correction or if you wear contact lenses. Most of these goggles have a wraparound style to shield the eyes from wind and dust. However, lens quality can vary in pre-made goggles. Make sure the lenses are made of polycarbonate, which is the most impact-resistant material available.

Frame Features to Look for

If you need prescription lenses in order to focus well, or if you simply want to use the best shooting eyewear available, shooting glasses in styles similar to aviator sunglasses are always popular.

Eyewear designed specifically for shooters, however, has a few more features than the traditional aviator-shaped frame for everyday (or "dress") wear. Most importantly, the frame should be a safety-rated model, with a strong rim to hold the lenses in place. Some styles have a "sweat bar" that runs the width of the frame above the lenses to add more stability to the frame and keep it steady on the face. Others have special padding on the frame around the eyes to cushion the frame against your face in case the gun recoils too far. It also helps to shield your eyes from wind and dust.

The temples of shooting glasses are often designed with spring hinges that allow the frame to flex without breaking when recoil occurs. Also popular are temples that wrap around the ear in the "cable" style to help keep the frame in place.

Adjustable nose pads are a good idea so the frame can be fit in the optimum position, and softer silicone pad materials provide additional comfort.

The frames of shooting glasses are constructed of any number of ophthalmic materials, including titanium and other metals, regular plastic and tough polycarbonate.

Choose the Right Lenses

Polycarbonate lenses with a scratch-resistant hard coat and built-in ultraviolet protection have been the lenses of choice for shooting glasses for many years. This lens material is highly impact-resistant to provide you with maximum "blow-back" and "bounce-back" protection. Recently, new lens materials have been developed that are also very impact-resistant.

Many nonprescription shooting glasses come with several pairs of interchangeable lenses for use under different lighting conditions. Prescription lenses can be made to order in whatever color you deem most appropriate.

Many shooters are comfortable in lenses that are yellow or orange. Lenses in these hues block haze and blue light and enhance the orange color of the target. The brighter yellow the lens color is, the better it is for use in foggy or low-light conditions.

Alternatively, a light purple color, which is actually a combination of a neutral gray and vermilion, is good for enhancing the orange of the target against a background of tall trees. Vermilion itself is useful to highlight conditions where there is poor background, such as trees, and to enhance the target against the background. Gray is a neutral, or "true," color that lets you see all colors as they are. Gray shooting lenses do not enhance the target, but they are good in bright sunlight.

Polarized shooting lenses can be made in almost any color. Polarized lenses reduce glare from light bouncing off highly reflective surfaces, making them an excellent choice when hunting near bodies of water.

What Sports Vision Doctors Can Do for You

What Sports Vision Doctors Can Do for You

Seeing "20/20" isn't the only measure of good vision. Visual acuity (20/20, etc.) is certainly important. But good vision involves a set of several skills, including depth perception, peripheral visual field awareness, eye-hand coordination and more.

All these vision skills are extremely important in sports, whether you play golf, soccer, baseball, basketball or racquet sports.

If you want to perform your best in sports, you may benefit from seeing an eyecare practitioner who specializes in sports vision - even if you already have 20/20 vision. This is because a typical eye exam usually doesn't include tests of visual skills important to sports performance.

Sports vision testing is more extensive and can be tailored to the specific sport you are interested in. During a sports vision exam, it's not unusual for the examiner to include tests to evaluate how well you see while you are moving around outdoors and interacting with other objects or players.

Many professional athletes work on their sports vision, but so do high school and college athletes, recreational golfers, tennis players and even billiards players. Some non-sports professionals also benefit from the same vision training, including law enforcement personnel and pilots.

When you visit a sports vision specialist, he or she will probably give you a complete eye exam and will ask you questions about your activities. More testing will determine your sports-related needs. These tests may include the use of three-dimensional, holographic images so you can react to them as in real life, and computerized tests that measure your reaction time and eye-hand coordination.

Depending on your particular sport, actual on-field measuring of your reactions to various sports situations may be included. Many sports vision specialists will attend your games or matches to evaluate your vision performance. They may also study videos of your games.

You may need only one visit to a specialist to set you on your way to better visual skills for sports. However, in many cases, a comprehensive sports vision training program is a better option to help you develop your sports vision skills so they become second nature.

Sunglasses

Nonprescription Sunglasses

Nonprescription Sunglasses

Fashion sunglasses with nonprescription lenses are called "plano" sunglasses in the eyewear industry. This category of sunglasses is huge and offers many choices in styling, designer names and frame materials.

Part of the popularity of nonprescription sunglasses is due to the fact that more than 30 million Americans wear contact lenses. Anyone who wears contacts needs plano sunglasses to protect their eyes from the sun's harmful UV rays. Sunglasses help keep contacts from drying out when outdoors, and shield the eyes from windblown debris.

And, of course, sunglasses just look cool!

Fashion Trends

Shapes and styles of plano sunglasses for men and women for the past few seasons have run the gamut: sporty wraparounds, glamorous cat-eyes and "Jackie Os," sleek futuristic styles that hug the face, small retro-looking shapes, large and sometimes bulbous "bubble" wraps, rectangular and angular styles, and even styles embellished with jewels.

Modern styles that have been popular recently, such as sleek wraps and Jackie O shapes, are given fresh energy with details like rhinestones and faux diamonds made of cubic zirconium. Lenses are tinted in a variety of colors, including blue, yellow, rose, orange, purple, black and coral.

Rimless and semi-rimless plano sunglasses (which have lenses held in place by a wire or plastic thread) are carrying some very unique lens shapes, cut in unusual angles. Additionally, some plastic sunglass frames are featuring cut-outs and other details to give them a more distinctive look.

Sunglass Materials

Options for frame materials used in nonprescription sunglasses include plastic (often called "zyl"), and premium metals such as titanium, stainless steel, aluminum and beryllium. These metals are strong yet very lightweight for comfort, and are also hypoallergenic and corrosion-resistant.

Many sunwear styles today incorporate both metal and plastic into the frame design, giving them a unique look.

Shopping for Sunglasses

When you shop for sunglasses, first make sure the frame fits comfortably on your face. Just like when buying prescription eyeglasses, follow these tips to make sure you have a good fit:

Choose frames that are wide enough for your face. The edge of the frames should protrude slightly beyond your face so the temples don't put pressure on your head as they extend back to your ears.
Are the temples long enough? The curve at the end of the temple should extend over your ear without pressing down upon it. (Some styles have straight temples that don't curve around the ear.)
Check the nosepiece for comfort and fit. The frame should fit securely without pinching the bridge of your nose.
While wearing the sunglasses, move your head up and down, and bend over (as if to pick up something up from the floor). If they're fitting properly, the sunglasses should stay comfortably in place.

The color and shape of the frame you choose depends on your personal style and preference. Don't be afraid to go bold - plano sunglasses are as much a fashion statement as they are a form of eye protection.

Choosing the Right Lenses

Make sure the lenses block 100 percent of the sun's harmful UV rays. Sunglasses don't have to be expensive to provide this level of protection.

If you plan on wearing the sunglasses for sports, choose styles with lightweight, impact-resistant polycarbonate lenses for an extra margin of safety.

Performance and Sport Sunglasses

Performance and Sport Sunglasses

The boom in outdoor sports activities like mountain biking, snowboarding, rock climbing, kayaking, skiing, golfing and in-line skating has also created a demand for sports- and performance-oriented sunglasses.

These special-purpose sunglasses are designed to be exceptionally light and comfortable, able to withstand extreme conditions and stay comfortably in place during any activity.

Lenses

Perhaps the most important aspect of effective sports sunwear is the optical quality and visual enhancement properties of the lenses. In particular, sports and performance lenses are available in a wide variety of tints to modify light in certain ways to enhance contrast. This allows you to see certain objects (a tennis ball, for example) with greater clarity to enhance your reaction time.

Polycarbonate lenses are the lens of choice for most sport sunglasses because they are lightweight, super strong and more impact-resistant than lenses made of other materials.

Polarized lenses are also in demand, because they reduce glare from light reflecting off flat surfaces such as water or a field of snow. There is, however, some debate about the advisability of polarized lenses for sports like downhill and mogul skiing, since seeing sunlight reflecting from icy patches on the slopes is often beneficial.

Frames

materials such as polyamide, which keeps its shape even under stress.>span class="s1"> Styles are typically aerodynamic, with sleek lines. No-slip temple grips and nose pads are popular features to help keep the eyewear in place despite wearer perspiration during the heat of competition.

What's Your Sport?

Each sport has its own unique visual requirements, which has led to the development of sport-specific sunglasses. Frames and lenses are now available that are targeted specifically to the golfer, the cyclist, the boater, the rock climber and so on.

For example, a certain lens tint might help a golfer notice subtle changes in the direction of the blades of grass on a green that could affect the line of their putt, while a completely different tint might be better to help a hunter see the contrast of a flying bird against an overcast sky.

If you prefer to be a Jack (or Jill) of all sports, there are also multipurpose sports sunglasses that feature interchangeable lenses with different tints for different sports and lighting conditions.

Prescription Sunglasses

Prescription Sunglasses

If you currently wear eyeglasses for nearsightedness, farsightedness or astigmatism, you should strongly consider purchasing a second pair of glasses: prescription sunglasses.

Why? Because prescription sunglasses are often the best solution when you want clear, comfortable vision outdoors or when you're driving on a sunny day. They eliminate glare and the need for squinting in bright conditions, which can reduce vision and cause eyestrain.

Even if you normally wear contact lenses and nonprescription (plano) sunglasses, there will be times when your contacts dry out or become uncomfortable - especially on the beach, where you battle the effects of sand, sun, wind and water. Prescription sunglasses enable you to be outdoors all day without these discomfort problems or the hassle of dealing with your contacts.

A Better Solution for Driving

If you normally wear prescription eyeglasses, you face a dilemma when driving on sunny days. You can purchase "clip-on" sunglasses (or a modern magnetic version of them) for your eyeglasses. But these can sometimes scratch your lenses or can be difficult to put on without taking off your glasses - which can be dangerous when driving.

Another solution is to purchase one pair of prescription eyeglasses that have photochromic lenses - the kind that darken automatically outdoors. The problem here is that these lenses often won't darken properly inside a vehicle because some of the sun's UV rays are blocked by your car or truck's windshield glass.

For convenience and comfort, the best solution for seeing in the sun is prescription sunglasses. For easy access and so you don't forget them, store them in your car or boat so they're always there when you need them.

Many Lens Styles Available

Prescription sunglasses are available in a wide variety of lens materials and designs, including high index plastic and progressive ("no-line bifocal") lenses. For boating, fishing and driving, polarized lenses offer superior glare protection from light reflecting off water and roadways.

If you plan on wearing your prescription sunglasses when playing sports, working with power tools or engaging in other activities that have the potential of causing eye injuries, choose lightweight lenses made of polycarbonate or Trivex. Lenses made of these materials are far more impact-resistant than glass or plastic sunglass lenses.

As with regular prescription eyeglasses, frame styles for prescription sunglasses are nearly unlimited. The only exception is that prescription sunglasses cannot be made in the same extreme wraparound styles as some nonprescription sunglasses. However, models with a lesser-curved wraparound style are available.

Sunglasses for Kids

Sunglasses for Kids

Children may not be as interested as adults are in wearing sunglasses as a fashion accessory, but because kids spend so much time outdoors in direct sunlight, they need sun protection even more than adults do.

In fact, some experts say we get up to half of our lifetime exposure to solar ultraviolet (UV) radiation by the time we're 18 years old.

Many Styles Available

Children's sunglasses are available in a wide variety of styles and sizes, so you should have no trouble finding sunglasses your child will enjoy wearing. In fact, virtually any children's frame can be transformed into sunglasses by adding prescription or non-prescription sun lenses.

Metal frames are very popular for children's sunglasses because of their durability. Wraparound styles like those worn by adults are also popular in scaled-down versions for kids. Because they fit closer to the face than traditional frame styles, wraparound sunglasses provide superior UV protection not only for your child's eyes, but for the delicate skin around their eyes as well.

Choose Lenses with 100% UV Protection

The most important thing when choosing children's sunglasses is to make sure the lenses block 100% of the sun's ultraviolet (UV) rays. The harmful effects of UV radiation are cumulative over our lifetime. By limiting your youngster's exposure to UV rays during childhood, you may be decreasing their risk of cataracts and other eye problems when they become adults.

Polycarbonate lenses are great for kids' sunglasses because they have 100% UV protection built-in, and they are lighter and much more impact-resistant than lenses made of other materials. And they can be tinted to nearly any shade.

Photochromic polycarbonate lenses are a good choice for kids who need prescription eyewear. These lenses darken automatically when exposed to the sun's UV rays and then quickly return to a clear state indoors - so one pair of eyeglasses does the job of two! They also provide 100% UV protection.

Don't Forget the Accessories!

To protect your investment in your child's sunglasses, purchase a durable, hard-shell carry case for them. Also, make sure your son or daughter knows how to clean and care for their eyewear. Getting sunglass cords (commonly called "retainers") is also a good idea. These are attached to the temples of the frame so your child can remove their sunglasses and the eyewear will stay with them - hanging from their neck instead of being misplaced.

Problems and Diseases

Amblyopia (Lazy Eye)

Astigmatism

Blepharitis

CMV Retinitis

Cataracts

Cornea Transplant

Cornea Transplant (Conditions)

Diabetic Retinopathy

Dry Eye Syndrome

Eye Allergies

Floaters and Spots

Glaucoma

Hyperopia

Keratoconus

Macular Degeneration

Myopia

Ocular Hypertension

Pingueculae

Pink Eye (Conjunctivitis)

Presbyopia

Ptosis

Retinal Detachment

Retinitis Pigmentosa

Stye

Uveitis

Vision Over 40

Dry Eye After Menopause

Dry Eye After Menopause

Studies show that more than 14% of older Americans have dry eye syndrome, or "dry eye." If you are 50 or older and female, your chance of developing dry eye is even greater. In fact, the American Academy of Ophthalmology says hormonal changes make older women twice as likely as older men to develop dry eye and accompanying symptoms such as eye irritation and blurred vision.

Women who have undergone menopause may experience disrupted chemical signals that help maintain a stable tear film. Resulting inflammation also can lead to decreased tear production and dry eye. Some theories indicate that a decline in a hormone known as androgen could be an underlying cause of dry eye in older women.

What Can You Do if You Are Older and Develop Dry Eye?

While levels of the female hormone estrogen also decrease following menopause, studies have not shown any beneficial effect of estrogen hormone replacement therapy (HRT) in relieving dry eye.

If you are over age 40 and have been diagnosed with dry eye, you may want to avoid laser vision correction surgery. Procedures such as LASIK and PRK can permanently affect nerve function of your eye's clear surface (cornea) and worsen dry eye problems. If you choose to have a refractive surgery consultation, be sure to tell your examining eye doctor about your dry eye condition. Your doctor can perform special tests to determine if your eyes are moist enough for laser vision correction.

If you have already been diagnosed with dry eyes, make sure you are being appropriately treated for other conditions associated with both aging and dry eye, such as rheumatoid arthritis and thyroid autoimmune disease.

Also, keep in mind that many medications commonly prescribed to adults over age 40 may cause or worsen dry eye problems. Examples include diuretics (often prescribed for heart conditions) and antidepressants. If you suspect a medication may be the underlying cause of your dry eye, be sure to discuss this with your doctor. It's possible that changing to a different medical treatment may be equally effective without causing dry eye problems. Also, concurrent treatment of your dry eye may be necessary.

Finally, it's possible that allergies or other problems that cause eye inflammation may be the underlying cause of your dry eye symptoms. Your eye doctor may recommend over-the-counter or prescription eye drops to relieve both your eye allergies and inflammatory dry eye problems.

How Progressive Lenses Work

Multifocal Eyeglass Lenses

Just as eyeglass frames have continually changed to reflect the latest fashions, eyeglass lenses also have evolved. This is particularly true for multifocal lenses - eyeglass lenses with more than one power to help those of us over age 40 deal with the normal, age-related loss of near vision called presbyopia.

History of Multifocal Eyeglass Lenses

Benjamin Franklin, the early American statesman and inventor, is credited with creating the first multifocal eyeglass lenses. Prior to Franklin's invention, anyone with presbyopia had to carry two pairs of eyeglasses - one for seeing distant objects and one for seeing up close.

Sometime around 1780, Franklin cut two lenses in half (one with a distance correction and one with a correction for near) and glued them together, so the top half of the new lens enabled the wearer to see things far away and the bottom half helped them see up close.

This lens, with a line extending across the entire width of it, was first called the Franklin bifocal and later became known as the Executive bifocal.

Modern Multifocal Lenses

The right multifocal lenses for you will depend on your age, your visual needs, your budget and other factors.

Bifocals. There have been many changes to bifocal eyeglass lenses since Franklin's original design, making these two-power lenses thinner, lighter and more attractive. Today, the most popular bifocal for eyeglasses is called a flat-top (FT) or straight-top (ST) design. The part that contains the power for near vision is a D-shaped segment (or "seg") in the lower half of the lens that is rotated 90 degrees so the flat part of the "D" faces upward.

FT or ST bifocals (sometimes called D-seg bifocals) are available in different-sized near segments. The most popular version sold in the United States has a near segment that is 28 millimeters wide and is therefore called the ST-28 (or FT-28 or D-28) bifocal. This design offers a generous field of view for reading, yet keeps the near seg small enough to be cosmetically pleasing.

Other available bifocal designs include lenses with round near segments and bifocals where the near seg extends across the entire width of the lens (Executive bifocals).

All bifocals, however, have a limitation: Though they provide good vision for distance and near, they can leave the wearer's intermediate vision (for distances at arm's length) blurry. Which brings us toâ€¦

Trifocals. Trifocal eyeglass lenses have an additional ribbon-shaped lens segment immediately above the near seg for seeing objects in the intermediate zone of vision - approximately 18 to 24 inches away.

This intermediate segment provides 50% of the magnification of the near seg, making it perfect for computer use and for seeing your speedometer and other dashboard gauges when driving.

Trifocals are especially helpful for older presbyopes - those over age 50 - who have less depth of focus than younger presbyopes. (Younger presbyopes may still be able to see objects at arm's length reasonably well through the top part of their bifocals.)

As with bifocals, the most popular trifocals have a flat-top (FT) design, with the near and intermediate segments being 28 mm wide. Trifocals with 35 mm wide segments are also popular.

Limitations of Bifocals and Trifocals

Although bifocals and trifocals are very functional, they pose a problem - the visible lines in the lenses. Most people prefer not to advertise their age by wearing multifocal eyeglass lenses with lines in them that everyone can see.

The lines in bifocals and trifocals cause a vision problem as well. Because they mark well-defined changes in power within the lenses, as the wearer's eyes move past the lines, there is an abrupt change in how objects appear. This "image jump" can be difficult for some wearers to adapt to.

Some years ago, these limitations of conventional bifocals and trifocals led to a major breakthrough in multifocal eyeglass lens design: progressive lenses.

Progressive Multifocal Lenses

Progressive multifocal lenses (also called progressives, progressive addition lenses, and PALs) are true "multi-focal" lenses. Instead of having just two or three powers, progressives gradually change in power from the top to the bottom of the lens, offering a large number of powers for clear vision at all distances - distance, intermediate, near and everywhere in between.

And because there are no visible lines or abrupt changes of lens power in progressive lenses, there is no "image jump," so the wearer's vision generally is more comfortable and seems more natural.

Because of these advantages, progressive lenses have become the most popular multifocal lenses sold in the United States.

Multifocal Contact Lenses

Multifocal Contact Lenses

Once we reach our mid-40s, presbyopia - the normal, age-related loss of flexibility of the lens inside our eye - makes it difficult for us to focus on near objects.

In the past, reading glasses were the only option available to contact lens wearers who wanted to read a menu or do other everyday tasks that require good near vision.

Today, a number of multifocal contact lens options are available for you to consider. Multifocal contact lenses offer the best of both worlds: no glasses, along with good near and distance vision.

Types of Multifocal Contact Lenses

Some multifocal contact lenses have a bifocal design with two distinct lens powers - one for your distance vision and one for near. Others have a multifocal design somewhat like progressive eyeglass lenses, with a gradual change in lens power for a natural visual transition from distance to close-up.

Multifocal contacts are available in both soft and rigid gas permeable (RGP or GP) lens materials and are designed for daily wear or extended (overnight) wear. Soft multifocal lenses can be worn comfortably on a part-time basis, so they're great for weekends and other occasions if you prefer not to wear them on an all-day, every day schedule.

For the ultimate in convenience, one-day disposable soft multifocal lenses allow you to discard the lenses at the end of a single day of wear, so there's no hassle with lens care.

In some cases, GP multifocal contact lenses provide sharper vision than soft multifocals. But because of their rigid nature, GP multifocal contacts require some adaptation and are more comfortable if you condition your eyes by wearing the lenses every day.

Hybrid multifocal contacts are an exciting new alternative. These lenses have a GP center and a soft periphery, making it easier to adapt.

Astigmatism? No Problem

All types of multifocal contact lenses - GP, soft, and hybrid - are available to correct astigmatism at the same time as presbyopia.

Monovision

Until you have a contact lens fitting, there's no way to know for sure if you'll be able to adapt successfully to wearing multifocal contact lenses. If multifocal lenses aren't comfortable or don't give you adequate vision, a monovision contact lens fitting may be a good alternative.

Monovision uses your dominant eye for distance vision and the non-dominant eye for near vision. Right-handed people tend to be right-eye dominant, and left-handed folks left-eye dominant. But your eyecare professional will perform testing to make that determination.

Usually, single vision contact lenses are used for monovision. One advantage here is that single vision lenses are less costly to replace, lowering your annual contact lens expenses. But in some cases, better results can be achieved using a single vision lens on the dominant eye for distance vision and a multifocal lens on the other eye for intermediate and near vision. Other times, your eyecare professional may choose a distance-biased multifocal on your dominant eye and a near-biased multifocal on the other eye. These techniques are referred to as "modified monovision" fits.

Multifocal Eyeglass Lenses

How Progressive Lenses Work

Progressive addition lenses (also called progressives or PALs) are the most popular multifocal lenses sold in the United States. Sometimes called "no-line bifocals," these line-free multifocals provide a more complete vision solution than bifocals. Instead of having just two lens powers like a bifocal - one for distance vision and one for up close - progressives have a gradual change in power from the top to the bottom of the lens, providing a range of powers for clear vision far away, up close and everywhere in between.

Progressive lenses provide the closest thing to natural vision after the onset of presbyopia - the normal age-related loss of near vision that occurs after age 40. The gradual change of power in progressives allows you to look up to see in the distance, look straight ahead to clearly see your computer or other objects at arm's length, and drop your gaze downward to read and do fine work comfortably close up.

While progressive lenses typically are worn by middle-aged and older adults, a recent study suggests that they may also be able to slow progression of myopia in children whose parents also are nearsighted.

Choosing the Right Frame for Progressive Lenses

Because a progressive lens changes in power from top to bottom, these lenses require frames that have a vertical dimension that is tall enough for all powers to be included in the finished eyewear. If the frame is too small, the distance or near zone of the progressive lens may end up too small for comfortable viewing when the lens is cut to fit into the frame.

To solve this problem and to expand options in frame styles, most progressive lens manufacturers now offer "short corridor" lens designs that fit in smaller frames. Today, an experienced optician can usually find a progressive lens that will work well in nearly any frame you choose.

Different Progressives for Different Purposes

Many different progressive lenses are available on the market today, and each has its own unique design characteristics. There are even progressive lenses designed for specific activities. For example, for the computer user, special "occupational" progressive lenses are available with an extra-wide intermediate zone to maximize comfort when working at the computer for prolonged periods of time. Other designs for office work have a larger reading portion.

Adaptation

It may take a few minutes to a few days before you are completely comfortable with your first pair of progressive lenses, or when you change from one progressive lens design to another. You have to learn how to use the lenses so that you are always looking through the best part of the lens for the distance you are viewing. While you get used to the lenses, you may notice a slight sensation of movement when you quickly move your eyes or your head. But for most wearers, progressive lenses are comfortable right from the start.

Occupational Bifocals and Trifocals

Occupational Bifocals and Trifocals

An occupational lens is a type of multifocal that is specifically suited for performing a particular job or hobby. Glasses with these lenses are special-purpose eyewear and are not designed for everyday wear. By strategically placing the near, intermediate and far vision zones on certain areas of the lens, specific visual tasks are made easier.

The Double-D Bifocal: For Reading and Overhead Near Work

The Double-D is an occupational bifocal that consists of a D-shaped flat-top bifocal at the bottom of the lens and an upside-down flat-top near segment located at the top of the lens. The rest of the lens area consists of distance correction.

People in occupations such as auto maintenance and repair can benefit from a Double-D occupational bifocal. This design allows workers to be able to see well up-close, both when looking down and when looking up to work on the undercarriage of a car on a lift. Mail clerks and others who read documents and may need to file them overhead might also find this lens useful at work.

The E-D Trifocal: For When You Need to See Everywhere, but Especially at Arm's Length

The E-D trifocal has the distance correction in the top half of the lens and an intermediate correction for vision at arm's length in the bottom half of the lens. The line separating these two zones extends across the entire width of the lens, like an Executive bifocal. But in the E-D trifocal, a small D-shaped segment for near vision is embedded within the intermediate zone.

The E-D trifocal is an excellent choice for someone who needs a wide field of view at arm's length, but also needs to see clearly close up and in the distance. A television production person, who must keep an eye on several TV monitors while being able to read notes from a clipboard and recognize someone across the room, would be a good candidate for this lens.

Need to Read All Day at Work?

Sometimes, a common multifocal can become an occupational lens simply by changing the position of the intermediate or near segment or the characteristics of the progressive design.

For example, if your job requires you to read most of the day, you may want to consider a separate pair of glasses for work that have the bifocal or trifocal segments placed higher than normal in the lens. This would enable you to read or use your computer for extended periods without having to tip your head back in an uncomfortable posture.

Or you may want to try an "office" progressive lens, which has a larger, wider intermediate zone for computer use and a smaller zone for distance vision. These occupational lenses give you more usable vision for your computer and desk work, yet still provide adequate distance vision for spotting people across the room. However, because the distance zone of occupational progressive lenses is limited, they're not suitable for driving or for other tasks that require a wide field of view in the distance.

What About on the Golf Course?

If you're a golfer and wear multifocal lenses, you know these lenses can be a problem on the course. The near vision zones of bifocal, trifocal and progressive lenses can interfere with your view of the ball, requiring you to tilt your head down in an uncomfortable posture. Everyday multifocals can also make lining up a putt much more difficult.

The solution? Consider trying an occupational multifocal commonly called a "golfer's bifocal." The small (usually round) near segment is placed very low and in the outside corner of just one lens, so it's completely out of the way when you address your ball or line up a putt. But it still gives you enough near vision to read your scorecard or browse a menu for lunch in the clubhouse.

Customized Eyewear Solutions

Nearly all adults - especially anyone over age 40 who needs multifocal lenses - can benefit from having more than one pair of eyeglasses, with the second pair having an occupational design.

Vision Over 60

Eight Ways To Protect Your Eyesight

Eight Ways to Protect Your Eyesight

Sight-threatening eye problems affect one in six adults aged 45 and older. And the risk for vision loss increases with age. In fact, a recent American Academy of Ophthalmology (AAO) report estimates that more than 43 million Americans will develop age-related eye diseases by 2020.

Tips for Protecting Your Eyes

To protect your eyesight and keep your eyes healthy as you age, consider these simple guidelines:

Be aware of your risk for eye diseases. Find out about your family's health history. Do you or any of your family members suffer from diabetes or have high blood pressure? Are you over the age of 65? Are you an African-American over the age of 40? Any or all of these traits increase your risk for sight-threatening eye diseases. Regular eye exams can detect problems early and help preserve your eyesight.
Have regular exams to check for diabetes and high blood pressure. If left untreated, these diseases can cause eye problems. In particular, diabetes and high blood pressure can lead to diabetic retinopathy, macular degeneration, glaucoma and ocular hypertension.
Look for changes in your vision. If you start noticing changes in your vision, see your eye doctor immediately. Trouble signs include double vision, hazy vision and difficulty seeing in low light conditions. Other signs to look for are frequent flashes of light, floaters, and eye pain and swelling. All of these signs and symptoms can indicate a potential eye health problem that needs immediate attention.
Exercise more frequently. According to the AAO, some studies suggest that regular exercise - such as walking - can reduce the risk of macular degeneration by up to 70%.
Protect your eyes from the sun's UV rays. You should always wear sunglasses with proper UV protection to shield your eyes from the sun's harmful rays. This may reduce your risk of cataracts and other eye damage.
Eat a healthy and balanced diet. Numerous studies have shown that antioxidants can possibly reduce the risk of cataracts. These antioxidants are obtained from eating a diet containing plentiful amounts of fruits and colorful or dark green vegetables. Studies have also shown that eating fish rich in omega-3 fatty acids may also prevent macular degeneration.
Get your eyes checked at least every two years. A thorough eye exam, including dilating your pupils, can detect major eye diseases such as diabetic retinopathy, which has no early warning signs or symptoms. A comprehensive eye exam also can ensure that your prescription for eyeglasses or contact lenses is accurate and up-to-date.
Don't smoke. The many dangers of smoking have been well documented. When it comes to eye health, people who smoke are at greater risk of developing age-related macular degeneration and cataracts.

Following these steps is no guarantee of perfect vision throughout your lifetime. But maintaining a healthy lifestyle and having regular eye exams will certainly decrease your risk of sight-stealing eye problems and help you enjoy your precious gift of eyesight to the fullest.

How Your Vision Changes as You Age

How Your Vision Changes as You Age

Just as our physical strength decreases with age, our eyes also exhibit an age-related decline in performance - particularly as we reach our 60s and beyond.

Some age-related eye changes, such as presbyopia, are perfectly normal and don't signify any sort of disease process. Similarly, cataracts can be considered an age-related disease that is extremely common among seniors and can be readily corrected with cataract surgery.

Some of us, however, will experience more serious age-related eye diseases that have greater potential for affecting our quality of life as we grow older. These conditions include glaucoma, macular degeneration and diabetic retinopathy.

When Do Age-Related Vision Changes Occur?

Presbyopia. After you pass the milestone age of 40, you'll notice it's more difficult to focus on objects up close. This normal loss of focusing ability is called presbyopia and is due to hardening of the lens inside your eye.

For a time, you can compensate for this decline in focusing ability by just holding reading material farther away from your eyes. But eventually you'll need reading glasses, multifocal contact lenses or multifocal eyeglasses. Some corrective surgery options for presbyopia also are available, such as monovision LASIK and conductive keratoplasty (CK).

Cataracts. Even though cataracts are considered an age-related eye disease, they are so common among seniors that they can also be classified as a normal aging change. According to the Mayo Clinic, about half of all 65-year-old Americans have some degree of cataract formation in their eyes. As you enter your 70s, the percentage is even higher. It's estimated that by 2020 more than 30 million Americans will have cataracts.

Thankfully, modern cataract surgery is extremely safe and so effective that 100% of vision lost to cataract formation usually is restored. If you are noticing vision changes due to cataracts, don't hesitate to discuss symptoms with your eye doctor. It's often better to have cataracts removed before they advance too far. Also, multifocal lens implants are now available. These advanced intraocular lenses (IOLs) potentially can restore all ranges of vision, thus reducing your need for reading glasses as well as distance glasses after cataract surgery.

Major Age-Related Eye Diseases

Macular degeneration. Macular degeneration (also called age-related macular degeneration or AMD) is the leading cause of blindness among American seniors. According to the National Eye Institute (NEI), macular degeneration affects more than 1.75 million people in the United States. The U.S. population is aging rapidly, and this number is expected to increase to almost 3 million by 2020. Currently there is no cure for AMD, but medical treatment may slow its progression or stabilize it.

Glaucoma. Your risk of developing glaucoma increases with each decade after age 40 - from around 1% in your 40s to up to 12% in your 80s. The number of Americans with glaucoma is expected to increase by 50% (to 3.6 million) by 2020. If detected early enough, glaucoma can often be controlled with medical treatment or surgery, and vision loss can be prevented.

Diabetic retinopathy. According to the NEI, approximately 10.2 million Americans over age 40 are known to have diabetes. Many experts believe that up to 30% of people who have diabetes have not yet been diagnosed. Among known diabetics over age 40, NEI estimates that 40% have some degree of diabetic retinopathy, and one of every 12 people with diabetes in this age group has advanced, vision-threatening retinopathy. Controlling the underlying diabetic condition in its early stages is the key to preventing vision loss.

How Aging Affects Other Eye Structures

While normally we think of aging as it relates to conditions such as presbyopia and cataracts, more subtle changes in our vision and eye structures also take place as we grow older. These changes include:

Reduced pupil size. As we age, muscles that control our pupil size and reaction to light lose some strength. This causes the pupil to become smaller and less responsive to changes in ambient lighting. Because of these changes, people in their 60s need three times more ambient light for comfortable reading than those in their 20s. Also, seniors are more likely to be dazzled by bright sunlight and glare when emerging from a dimly lit building such as a movie theater. Eyeglasses with photochromic lenses and anti-reflective coating can help reduce this problem.
Dry eyes. As we age, our bodies produce fewer tears. This is particularly true for women after menopause. If you begin to experience burning, stinging or other eye discomfort related to dry eyes, your eye doctor can help you select an artificial tear or prescription dry eye medication to increase your comfort throughout the day.
Loss of peripheral vision. Aging also causes a normal loss of peripheral vision, with the size of our visual field decreasing by approximately one to three degrees per decade of life. By the time you reach your 70s and 80s, you may have a peripheral visual field loss of 20 to 30 degrees.

Because the loss of visual field increases the risk for automobile accidents, make sure you are more cautious when driving. To increase your range of vision, turn your head and look both ways when approaching intersections.Â

Decreased color vision. Cells in the retina that are responsible for normal color vision decline in sensitivity as we age, causing colors to become less bright and the contrast between different colors to be less noticeable. In particular, blue colors may appear faded or "washed out." While there is no treatment for this normal, age-related loss of color perception, you should be aware of this loss if your profession (for example, artist, seamstress or electrician) requires fine color discrimination.
Vitreous detachment. As we age, the gel-like vitreous inside the eye begins to liquefy and pull away from the retina, causing "spots and floaters" and (sometimes) flashes of light. This condition, called vitreous detachment, is usually harmless. But floaters and flashes of light can also signal the beginning of a retinal detachment - a serious problem that can cause blindness if not treated immediately. If you experience flashes and floaters, see your eye doctor immediately to determine the cause.

What You Can Do About Age-Related Vision Changes

A healthy diet and wise lifestyle choices - including exercising regularly, maintaining a healthy weight, reducing stress and not smoking - are your best natural defenses against vision loss as you age. Also, have regular eye exams with a caring and knowledgeable optometrist or ophthalmologist.

Be sure to talk to your eye doctor about any concerns you have about your eyes and vision. Tell them about any history of eye problems in your family and any health problems you may have. Also, let your eye doctor know about any medications you take, including non-prescription vitamins, herbs and supplements.

Tips for Coping With Vision Loss

Tips for Coping with Vision Loss

Many normal, age-related problems affecting vision can be addressed with practical solutions, such as extra lighting for reading recipes or tinkering with garage projects.

In fact, after about age 60, you may find you need additional illumination for most tasks performed indoors or in darker conditions outdoors. This is because your eye's pupil no longer opens as widely as it once did to allow light to enter. Because less light is reaching your retina, where vision processing occurs, images are no longer as sharp as they once were.

To help offset this problem, you might consider extra steps such as:

Installing task lighting underneath kitchen cabinets or above stoves to help illuminate darker corners.
Making sure you have enough lighting to brighten work surfaces in your garage, sewing room or other areas where you need to see fine details.
Asking your employer to install additional lighting, if needed, at your work space.

Also, make sure you have regular eye exams that include critical tests for older eyes to rule out potentially serious age-related eye diseases that may affect vision quality. Your eye doctor also can advise you about the best vision correction options to reduce the effects of normal age-related declines in near vision, color vision and contrast sensitivity.

Cataracts, which are very common in the over-60 age group, also can cause cloudy or hazy vision. Cataracts usually are easily remedied with surgery that removes the eye's cloudy lens and replaces it with an artificial one.

What Can You Do About Permanent Vision Loss?

Unfortunately, some age-related eye diseases — including glaucoma, advanced macular degeneration and diabetic retinopathy — can cause serious vision loss and blind spots.

Many low vision devices are available to assist people with permanent vision loss so they can perform daily living tasks more easily. These devices include:

Strong magnifying lenses with extra illumination for reading and other near vision work.
Audio tapes, specially adapted computer or television screens, and telescopes.
Lens filters and shields to reduce glare.

Vision Loss and the Elderly

One disturbing trend noted in recent years has been an increased tendency in our society to overlook or neglect the vision correction needs of elderly citizens, including those living in nursing homes.

As an example, researchers say almost one third of older Americans diagnosed with glaucoma receive no treatment for this potentially blinding eye disease.

Consequences of delaying vision correction or needed treatment, especially in elderly people, can be severe. Uncorrected vision problems can contribute to falls that seriously injure elderly people and greatly reduce their confidence in their ability to live independently.

If you have older relatives or friends living alone or in a nursing home, consider serving as their advocate to make sure they receive appropriate vision care and treatment of age-related eye diseases, to maximize their quality of life.

Vision Insurance

What Is Vision Insurance?

What Is Vision Insurance?

The cost of routine eye exams and prescription eyewear can be of real concern, especially for large families. In many cases, vision insurance can lower these annual expenses.

A vision insurance policy is not the same as health insurance. Regular health insurance plans protect you against financial losses due to unexpected eye injuries or disease. Vision insurance, on the other hand, is a wellness benefit designed to provide routine eye care, prescription eyewear and other vision-related services at a reduced cost.

Where Can I Get Vision Insurance?

Group vision insurance can be obtained through your company, association, school district, etc., or through a government program such as Medicare or Medicaid.

Also, as an individual, you have the option of purchasing your own vision benefit plan.

Vision insurance is often a value-added benefit included in indemnity health insurance plans, health maintenance organization (HMO) plans and plans offered by preferred provider organizations (PPOs):

Indemnity health insurance is traditional insurance, which allows policyholders to access medical providers of their choice.
An HMO is a group of healthcare professionals - doctors, laboratories, hospitals and the like - employed to provide health care services to plan members at discounted rates. Usually, health plan members are required to access health care only from HMO providers.
A PPO is a network of healthcare professionals organized to provide healthcare services to plan members at a fixed rate below "retail" prices. Plan members may opt to access out-of-network providers, but usually at a greater cost.

What Kinds of Vision Insurance Plans Are Available?

Vision insurance typically comes in the form of either a vision benefits package or a discount vision plan.

Typically, a vision benefits package provides enrollees eye care services in exchange for an annual premium or membership fee, a yearly deductible (a dollar amount) for each enrolled member and a co-pay (a smaller dollar amount) each time a member accesses a service.

A discount vision plan provides eye care at fixed discounted rates after an annual premium or membership fee and a deductible are paid.

Both kinds of vision insurance can be custom-designed to meet the different requirements of a wide range of customers, including school districts, unions, and big and small companies.

What Does Vision Insurance Cover?

Vision insurance generally covers the following services and products:

Annual eye examinations
Eyeglass frames
Eyeglass lenses
Contact lenses
LASIK and PRK vision correction at discounted rates

Generally, services acquired from network providers are cheaper than services from out-of-network providers.

What Are My Payment Options?

Typically, if group vision insurance is available from your employer, you pay for it through payroll deductions or flexible spending accounts (FSAs).

An FSA, sometimes called a cafeteria plan, allows an employee to use pre-tax dollars to purchase selected health benefits such as vision insurance. You save money because you receive the full benefit of income that has been set aside for health costs, making it not subject to or reduced by taxation.

If you purchase an individual vision insurance plan because your employer doesn't offer a group plan (or because you are self-employed), you can expect to be billed monthly or annually.

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Eye Care Articles

Are Contact Lenses a Good Choice for Kids?

Children's Vision FAQs

Controlling Nearsightedness in Children

Learning-Related Vision Problems

Vision Therapy for Children

Your Infant's Visual Development

Children and Computer Vision Syndrome

Computer Eyestrain: 10 Steps for Relief

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Computer Vision Syndrome Q & A

Frequently Asked Questions: Computer Vision Syndrome and Computer Glasses

Worker Productivity and Computer Vision Syndrome

Bifocal and Multifocal Contact Lenses

Contact Lenses for the "Hard-to-Fit" Patient

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Preparing for an Eye Exam

Why Are Eye Exams Important?

Your Comprehensive Eye Exam

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The Basics of Eyeglasses

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How to Cope With Low Vision

Low Vision Aids for Computer Users

How to Cope With Low Vision

Corneal Transplant

Corrective Eye Surgery Basics

LASIK

LASIK - Criteria for Success

LASIK Risks and Complications

Surgery for Presbyopia

Contacts and Glasses That Enhance Performance

Protective Sports Eyewear

Scuba Diving Masks and Swim Goggles

Shooting Glasses and Hunting Eyewear

What Sports Vision Doctors Can Do for You

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Performance and Sport Sunglasses

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Amblyopia (Lazy Eye)

Astigmatism

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Cornea Transplant (Conditions)

Diabetic Retinopathy

Dry Eye Syndrome

Eye Allergies

Floaters and Spots

Glaucoma

Hyperopia

Keratoconus

Macular Degeneration

Myopia

Ocular Hypertension

Pingueculae

Pink Eye (Conjunctivitis)

Presbyopia

Ptosis

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Retinitis Pigmentosa

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Dry Eye After Menopause

Multifocal Eyeglass Lenses

Multifocal Contact Lenses

How Progressive Lenses Work

Occupational Bifocals and Trifocals

Eight Ways to Protect Your Eyesight

How Your Vision Changes as You Age

Tips for Coping with Vision Loss