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Sunglasses are more than just a fashion statement - they’re important protection from the hazards of UV light.

If you wear are sunglasses mostly for fashion that’s great, just make sure the lenses block UVA and UVB rays.

And if you don’t wear sunglasses, it’s time to start.

Here are your top 6 reasons for wearing sunglasses:

Preventing Skin Cancer

The strongest evidence that sunglasses provide a medical benefit is in preventing skin cancer on your eyelids. UV light exposure from the sun is one of the strongest risk factors for the development of skin cancers.  

Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.

About 90 percent of non-melanoma skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun.

Your eyelids, especially the lower eyelids, are also susceptible to UV light and they do develop skin cancers somewhat frequently.

Many people who now regularly apply sunscreen to help protect them from UV light often don’t get that sunscreen up to the edge of their eyelids because they know the sunscreen is going to make their eyes sting and burn. Unfortunately, that leaves the eyelids unprotected. You can fix that by wearing sunglasses that block both UVA and UVB rays.

Decreasing Risk For Eye Disease

There is mounting evidence that lifetime exposure to UV light without protection can increase your risk of cataracts and macular degeneration. It also increases your risk of getting growths on the surface of your eye called Pinguecula and Pterygiums.  Besides looking unsightly they can interfere with your vision and require surgery to remove them. All of those problems are better off with prevention than treatment.

Preventing Snow Blindness

The snow reflects UV light and the exposure can be intense enough on a sunny day to cause a burn on your cornea like what happens when people are exposed to a bright welding arc.

Protection From Wind, Dust, Sand

Many times, when you are spending time outdoors and it is windy, you risk particles blowing in the wind getting into your eyes. Sunglasses help protect you from that exposure. The wind itself can also make your tears evaporate more quickly and cause the surface of your eye to dry and become irritated and then cause the eye to tear again.

Decreasing Headaches

People can get headaches if they are very light sensitive and don’t protect their eyes from bright sunlight. You can also bring on a muscle tension headache if you are constantly squinting because the sunlight is too bright.

Clearer Vision When Driving

We have all experienced an episode of driving, coming around a turn and going directly into the direction of the setting or rising sun that causes our vision to be significantly impaired. Having sunglasses on whenever you are driving in sunlight helps prevent those instances. Just a general reduction in the glare and reflections that sunlight causes will make you a better and more comfortable driver.

So it’s time to go out there and find yourself a good pair of sunglasses that you look great in, and that protect your health too.

Your eye-care professional can help recommend sunglasses that are right for your needs.

Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

As an eye doctor, diagnosing a red eye can be challenging. Are we dealing with an infection, allergy, inflammation or dryness?

One of the most common questions I get is, “Doc, my eyes are red, burning, itchy, and tearing. Is this dry eye or from allergies?” The short answer is it could be one, both or neither. I’ll outline various ways these conditions present clinically and the treatments for them.

The hallmark symptom of allergy – meaning if you have this symptom you almost definitely have the condition – is itching. Red, watery, ITCHY eyes are almost invariably due to an allergen, whether environmental or medicinal. It is one of the most common ocular conditions we, as eye doctors, treat - especially when plants are filling the air with pollen as they bloom in the spring and then die off in the fall.

The itching occurs because an immune cell called a Mast cell releases histamine, causing the itching sensation. It can be quite unbearable for the sufferer, causing them to rub their eyes constantly, which unbeknownst to them, actually increases the amount of histamine in the eye, leading to worsening of the symptoms.

Treatments may include:

  • Over-the-counter or prescription allergy drops (mostly anti-histamines or mast cell stabilizers).
  • Topical steroids (to get the inflammation under control).
  • Cool compresses applied to the eye.

Patients sometimes need to take drops every day to keep their symptoms under control.

Dry eye can have many of the same symptoms as allergic eye disease, with the eye being red and possibly watery (‘My eyes are tearing how could it be dry eyes?’). The main exceptions are that people with dry eyes tend to complain more of burning and a foreign body sensation - like there is sand or gravel in the eye - rather than itchiness.

Dry eye is a multi-faceted disease with many different causes and treatments. Treatment ranges from simple re-wetting eye drops to long-term medications (both topical and oral), as well as non-medicinal treatments such as eyelid heating treatment.

So how do we determine the difference? The first question I ask patients who complain of red, watery, uncomfortable eyes is, “What is your MAIN symptom? Itching or burning?” The answer will likely direct which course of treatment we take, and as those treatments sometimes overlap, you may have a component of both dry eye and allergy.

That is important to distinguish because many of the treatments we use for allergies - like antihistamine eye drops - can sometimes make the dryness worse. Though neither of these conditions is 100% curable (except maybe for allergy, where if you remove the allergen, you obviously won’t get symptoms!). We have many tools in our treatment arsenal to keep the symptoms at bay.

Unfortunately, dry eye and allergy aren’t the only two things that can cause your eye to have the multiple symptoms of red, watery, itchy, burning eyes. There are other problems, such as Blepharitis, that can produce a similar appearance, as well as bacterial and viral infections.

So before embarking on a particular therapy, it is wise to have a good exam to help you get on the right track of improving your symptoms.

Article contributed by Dr. Jonathan Gerard

We will be open on Feb 16 from 9-12 and on Feb 20 from 12-5.

There are several different variations of Glaucoma, but in this article we will mainly focus on Primary Open Angle Glaucoma. This means that there is no specific underlying cause for the Glaucoma like inflammation, trauma or a severe cataract. It also means that the drainage angle where fluid is drained from the inside of the eye into the bloodstream is not narrow or closed.

Closed or Narrow Angle Glaucoma, which will be discussed in another article, is treated differently from Open Angle Glaucoma

In the U.S., Primary Open Angle Glaucoma (POAG) is by far the most common type of Glaucoma we treat.

Glaucoma is a disease where the Optic Nerve in the back of the eye deteriorates over time, and that deterioration has a relationship to the Intraocular Pressure (IOP).  Most - but not all - people diagnosed with Glaucoma have an elevated IOP.  Some people have fairly normal IOP’s but show the characteristic deterioration in the Optic Nerve. Regardless of whether or not the pressure was high initially, our primary treatment is to lower the IOP. We usually are looking to try to get the IOP down by about 25% from the pre-treatment levels.

The two mainstays of initial treatment for POAG in the U.S. are medications or laser treatments. There are other places in the world where Glaucoma is initially treated with surgery. However, while surgery can often lower the pressure to a greater degree than either medications or laser treatments, it comes with a higher rate of complications. Most U.S. eye doctors elect to go with the more conservative approach and utilize either medications - most often in the form of eye drops - or a laser treatment.

Drops

There are several different classes of medications used to treat Glaucoma.

The most common class used are the Prostaglandin Analogues or PGA’s.  The PGA’s available in the U.S. are Xalatan (latanaprost), Travatan (travapost), Lumigan (bimatoprost) and Zioptan (tafluprost).

PGA’s are most doctors’ first line of treatment because they generally lower the IOP better than the other classes; they are reasonably well tolerated by most people; and they are dosed just once a day, while most of the other drugs available have to be used multiple times a day.

The other classes of drugs include beta-blockers that are used once or twice a day; carbonic anhydrase inhibitors (CAI’s ), which come in either a drop or pill form and are used either twice or three times a day; alpha agonists that are used either twice or three times a day; and miotics, which are used three or four times a day. All of these other medications are typically used as either second-line or adjunctive treatment when the PGA’s are not successful in keeping the pressure down as single agents.

There are also several combination drops available in the U.S. that combine two of the second-line agents (Cosopt, Combigan, and Symbrinza).

Laser

The second option as initial treatment is a laser procedure.

The two most common laser treatments for Open Angle Glaucoma are Argon Laser Trabeculoplasty (ALT) or Selective Laser Trabeculoplasty (SLT).  These treatments try and get an area inside the eye called the Trabecular Meshwork - where fluid is drained from the inside of the eye into the venous system - to drain more efficiently.

These treatments tend to lower the pressure to about the same degree as the PGA’s do with over 80% of patients achieving a significant decrease in their eye pressure that lasts at least a year.  Both laser treatments can be repeated if the pressure begins to rise again in the future but the SLT works slightly better as a repeat procedure compared to the ALT.

Article contributed by Dr. Brian Wnorowski, M.D.

We’re excited to offer our patients a new lens solution! The Ultimate Lens Package by Essilor combines three technologies in one lens for your ultimate in vision, clarity and protection. Watch to learn more and make an appointment to experience it for yourself!

After a lot of hard work with EyeMotion, our website company, we’re pleased to be launching our brand-new website.  Our goal has been to create a site that would assist you in learning about us, whether it’s finding our location or email form, reading about our wonderful eye doctors, or discovering some of our quality products and services.

Have questions about an eye issue?  We think you might also benefit from our great optometric content on eye diseases and conditions.

Our plan is to use this area to keep you informed on new offerings, sales, trunk shows, events, and so much more.  Check back here from time to time to keep updated.

We’re glad you found us, and we hope to see you soon!

Cole Hann collection of videos

It could be a retinal vein occlusion, an ocular disorder that can occur in older people where the blood vessels to the retina are blocked.

The retina is the back part of the eye where light focuses and transmits images to the brain. Blockage of the veins in the retina can cause sudden vision loss. The severity of vision loss depends on where the blockage is located.

Blockage at smaller branches in the retinal vein is referred to as branch retinal vein occlusion (BRVO).  Vision loss in BRVO is usually less severe, and sometimes just parts of the vision is blurry.  Blockage at the main retinal vein of the eye is referred to as central retinal vein occlusion (CRVO) and results in more serious vision loss. 

Sometimes blockage of the retinal veins can lead to abnormal new blood vessels developing on the surface of the iris (the colored part of your eye) or the retina. This is a late complication of retinal vein blockage and can occur months after blockage has occurred. These new vessels are harmful and can result in high eye pressure (glaucoma), and bleeding inside the eye.

What are the symptoms of a retinal vein occlusion?

Symptoms can range from painless sudden visual loss to no visual complaints. Sudden visual loss usually occurs in CRVO. In BRVO, vision loss is usually mild or the person can be asymptomatic. If new blood vessels develop on the iris, then the eye can become red and painful. If these new vessels grow on the retina, it can result in bleeding inside the eye, causing decreased vision and floaters – spots in your vision that appear to be floating.

Causes of retinal vein occlusion

Hardening of the blood vessels as you age is what predisposes people to retinal vein occlusion.  So retinal vein occlusion is more common in people over the age of 65. People with diabetes, high blood pressure, blood-clotting disorders, and glaucoma are also at higher risk for a retinal vein occlusion.

How is retinal vein occlusion diagnosed?

A dilated eye exam will reveal blood in the retina. A fluorescein angiogram is a diagnostic photographic test in which a colored dye is injected into your arm and a series of photographs are taken of the eye to determine if there is fluid leakage or abnormal blood vessel growth associated with the vein occlusion. An ultrasound or optical coherence tomography (OCT) is a photo taken of the retina to detect any fluid in the retina. 

Treatment for retinal vein occlusion

Not all cases of retinal vein occlusion need to be treated. Mild cases can be observed. If there is blurry vision due to fluid in the retina, then your ophthalmologist may treat your eye with a laser or eye injections. If new abnormal blood vessels develop, laser treatment is performed to cause regression of these vessels and prevent bleeding inside the eye. If there is already a significant amount of blood inside the eye, then surgery may be needed to remove the blood.

Outlook after retinal vein occlusion

Prognosis depends on the severity of the vein occlusion. Usually BRVO has less vision loss compared to CRVO. The initial presenting vision is usually a good indicator of future vision. Once diagnosed with a retinal vein occlusion, it is important to keep follow-up appointments to ensure that prompt treatment can be administered to best optimize your visual potential.

 

 Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Are you thinking about starting to wear contact lenses or switching to a different type of contact?

Wearing contacts can make a big difference in the way you see things – such as sharper details and brighter colors. And technology has made contacts more comfortable than ever.

While we look forward to discussing contact lenses and working closely with you to find the right type of lens to meet your needs, here are some things for you to think about:

Reasons to consider contact lenses

  • Contact lenses move with your eye, allow a natural field of view, have no frames to obstruct your vision and greatly reduce distortions.
  • Unlike glasses, they do not fog up or get water spots.
  • Contact lenses are excellent for sports and other physical activities.
  • Many people feel they look better in contact lenses.
  • Compared to eyeglasses, contacts may offer better, more natural sight.

Some things to remember about contact lenses

  • Compared to glasses, contact lenses require a longer initial examination and more follow-up visits to maintain eye health. Lens care also requires more time.
  • If you are going to wear your lenses successfully, you will have to clean and store them properly, adhere to lens-wearing schedules and make appointments for follow-up care.
  • If you are wearing disposable or planned replacement lenses, you will have to carefully follow the schedule for disposing the used lenses and using new ones.

Contact lens types

There are two general types of contact lenses: hard and soft.

Rigid gas-permeable (RGP):

The hard lenses most commonly used today are rigid gas-permeable lenses (RGP). They are made of materials that are designed for their optical and comfort qualities. Hard lenses hold their shape, yet allow the free flow of oxygen through the lenses to the cornea of your eye. 

RGPs provide excellent vision, have a short initial adaptation period, and are easy to care for. RGPs are comfortable to wear, have a relatively long life, and correct most vision problems.

The disadvantages are that RGPs require consistent wear to maintain how comfortable they feel, and can occasionally slip off-center of the eye.

Soft contact lenses:

Soft lenses are the choice of most contact wearers. These lenses are comfortable and come in many versions, depending on how you want to wear them.

Disposable-wear lenses are removed nightly and replaced on a daily, weekly, biweekly, or monthly basis and are easy to get used to wearing.

Daily-wear contacts do not need to be cleaned and are great for active lifestyles but don't correct all vision problems and vision may not be as sharp as with RGP lenses. 

Extended-wear soft contacts can usually be worn up to seven days without removal. Be sure to ask us about extended-wear contacts and a possible greater risk of eye infections. 

Colored soft contacts change your eye color, the appearance of your eye, or both. They are available by prescription and should only be worn after an eye exam and fitting by an eye-care professional. Over-the-counter colored contacts are illegal in some states and pose a serious danger to your eye health.

Bifocal or multifocal

Bifocal or multifocal contact lenses are available in both soft and RPG varieties. They can correct nearsightedness, farsightedness and astigmatism in combination with presbyopia. Visual quality is often not as good as with single vision lenses; however, for some people the ability to correct presbyopia is worth it.

Contacts are a great fit for many patients but don't forget to be prepared

Carry a backup pair of glasses with a current prescription—just in case you have to take out your contacts. Contacts can make your eyes more light-sensitive, so don't forget to wear sunglasses with UV protection and a wide-brim hat when you’re in the sun.

Hygiene is the most critical aspect to successfully wearing contacts

When cared for properly, contact lenses can provide a comfortable and convenient way to work, play, and live the millions of people who wear them. While contact lenses are usually a safe and effective form of vision correction, they are not entirely risk-free. 

Contact lenses are medical devices, and failure to wear, clean, and store them as directed can increase the risk of eye infections. Not following your eye doctor’s directions raises the risk of developing serious infections. Your habits, supplies, and eye doctor are all essential to keeping your eyes healthy. 

We’re here to help

If you are interested in wearing contact lenses, we will provide you with a thorough eye examination and an evaluation of your suitability for contact lens wear. Contact us today for more information about contact lenses and to schedule a contact-fitting exam. We’ll discuss the best options for your visual and lifestyle needs.

 

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

The word “astigmatism” is used so much in the ophthalmic world that most people have talked about it when discussing their eye health with their doctor.

“Astigmatism” comes from the Greek “a” - meaning “without” - and “stigma” - meaning “a point.” In technical ocular terms, astigmatism means that instead of there being one point of focus in the eye, there are two. In other words, light merges not on to a singular point, but on two different points.

This is experienced in the real world by blurred, hazy vision, and can sometimes lead to eye strain or headaches if not corrected with either glasses or contact lenses.

Astigmatism is not a disease. In fact, more than 90% of people have some degree of astigmatism.

Astigmatism occurs when the cornea, the clear front surface of the eye like a watch crystal, is not perfectly round. The real-world example we often use to explain astigmatism is the difference between a basketball and a football.

If you cut a basketball in half you get a nice round half of a sphere. That is the shape of a cornea without astigmatism.

If you cut a football in half lengthwise you are left with a curved surface that is not perfectly round. It has a steeper curvature on one side and a flatter curve on the other side. This is an exaggerated example of what a cornea with astigmatism looks like.

The degree of astigmatism and the angle at which it occurs is very different from one person to the next. Therefore, two eyeglass prescriptions are rarely the same because there are an infinite number of shapes the eye can take.

Most astigmatism is “regular astigmatism,” where the two different curvatures to the eye lie 90 degrees apart from one another. Some eye diseases or surgeries of the eye can induce “irregular astigmatism,” where the curvatures are in several different places on the eye’s surface, and often the curvatures are vastly different, leading to a high amount of astigmatism.

Regular astigmatism is treated with glasses, contact lenses, or refractive surgery (PRK or Lasik). Irregular astigmatism, such as that caused by the eye disease keratoconus, usually cannot be treated with these conventional methods. In these circumstances, special contact lenses are needed to treat the condition.

The next time you hear that either you or a loved one has astigmatism, fear not.

It is easily corrected, and although astigmatism can cause your vision to be blurry it rarely causes any permanent damage to the health of your eyes.

If you experience blurred vision, headaches or eye strain, having a complete eye exam may lead to a diagnosis and treatment of this easily-dealt-with condition.

 

Article contributed by Dr. Jonathan Gerard

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

The retina is the nerve tissue that lines the inside back wall of your eye. Light travels through the pupil and lens and is focused on the retina, where it is converted into a neural impulse and transmitted to the brain. If there is a break in the retina, fluid can track underneath the retina and separate it from the eye wall. Depending on the location and degree of retinal detachment, there can be very serious vision loss.

Symptoms

The three 3 F’s are the most common symptoms of a retinal detachment:

  • Flashes: Flashing lights that are usually seen in peripheral (side) vision.

  • Floaters: Hundreds of dark spots that persist in the center of vision.

  • Field cut: Curtain or shadow that usually starts in peripheral vision that may move to involve the center of vision.

Causes

Retinal detachments can be broadly divided into three categories depending on the cause of the detachment:

Rhegmatogenous retinal detachments: Rhegmatogenous means “arising from a rupture,” so these detachments are due to a break in the retina that allows fluid to collect underneath the retina. A retinal tear can develop when the vitreous (the gel-like substance that fills the back cavity of the eye) separates from the retina as part of the normal aging process.

The risk factors associated with this type of retinal detachment:

  • Lattice degeneration – thinning of the retina.

  • High myopia (nearsighted) - can result in thinning of the retina.

  • History of a previous retinal break or detachment in the other eye.

  • Trauma.

  • Family history of retinal detachment.

Tractional retinal detachments: These are caused by scar tissue that grows on the surface of the retina and contraction of the scar tissue pulls the retina off the back of the eye. The most common cause of scar tissue formation is due to uncontrolled diabetes.

Exudative retinal detachments: These types of detachments form when fluid accumulates underneath the retina. This is due to inflammation inside the eye that results in leaking blood vessels. The visual changes can vary depending on your head position because the fluid will shift as you move your head. There is no associated retinal hole or break in this type detachment. Of the three types of retinal detachments, exudative is the least common.

Diagnostic tests

  • A dilated eye exam is needed to examine the retina and the periphery. This may entail a scleral depression exam where gentle pressure is applied to the eye to examine the peripheral retina.

  • A scan of the retina (optical coherence tomography) may be performed to detect any subtle fluid that may accumulate under the retina.

  • If there is significant blood or a clear view of the retina is not possible then an ultrasound of the eye may be performed.

Treatment

The goal of treatment is to re-attach the retina to the eye wall and treat the retinal tears or holes.

In general, there are four treatment options:

  • Laser: A small retinal detachment can be walled off with a barrier laser to prevent further spread of the fluid and the retinal detachment.

  • Pneumatic Retinopexy: This is an office-based procedure that requires injecting a gas bubble inside the eye. After this procedure, you need to position your head in a certain direction for the gas bubble to reposition the retina back along the inside wall of the eye. A freezing or laser procedure is performed around the retinal break. This procedure has about 70% to 80% success rate but not everyone is a good candidate for a pneumatic retinopexy.

  • Scleral buckle: This is a surgery that needs to be performed in the operating room. This procedure involves placing a silicone band around the outside of the eye to bring the eye wall closer to the retina. The retinal tear is then treated with a freezing procedure. Vitrectomy: In this surgery, the vitreous inside the eye is removed and the fluid underneath the retina is drained. The retinal tear is then treated with either a laser or freezing procedure. At the completion of the surgery, a gas bubble fills the eye to hold the retina in place. The gas bubble will slowly dissipate over several weeks. Sometimes a scleral buckle is combined with a vitrectomy surgery.

Prognosis

Final vision after retinal detachment repair is usually dependent on whether the macula (central part of the retina that you use for fine vision) is involved. If the macula is detached, then there is usually some decrease in final vision after reattachment. Therefore, a good predictor is initial presenting vision. We recommend that patients with symptoms of retinal detachments (flashes, floaters, or field cuts) have a dilated eye exam. The sooner the diagnosis is made, the better the treatment outcome.

 

Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

The jury is still out on that question. There is some supportive experimental data in animal models but no well-done human studies that show any significant benefit.

What you shouldn’t do is pass up taking the AREDS 2 nutritional supplement formula, which is clinically proven to reduce the risk of severe visual loss in. Almost all the data supporting the POSSIBLE benefits of bilberry in visual conditions is related to NON-HUMANS. Stick with the AREDS 2 formula that has excellent clinical evidence.

So, what is bilberry and why do some people use it?

Bilberry (Vaccinium myrtillus), a low-growing shrub that produces a blue-colored berry, is native to Northern Europe and grows in North America and Asia. It is naturally rich in anthocyanins, which have anti-oxidant properties.

During World War II, British pilots in the Royal Air Force ate bilberry jam, hoping to improve their night vision. No one is exactly sure where the impetus to do this came from, but it is believed that this event is what lead to some widespread claims that bilberry was good for your eyes.

A study by JH Kramer,  Anthocyanosides of Vaccinium myrtillus (Bilberry) for Night Vision - A Systematic Review of Placebo-Controlled Trials, reviewed most of the literature pertaining to the claim that bilberry improves night vision. He found that the four most recent trials, which were all rigorous randomized controlled trials (RCTs), showed no correlation with bilberry extract and improved night vision. A fifth RCT and seven non-randomized controlled trials reported positive effects on outcome measures relevant to night vision, but these studies had less-rigorous methodology.

Healthy subjects with normal or above-average eyesight were tested in 11 of the 12 trials. The hypothesis that V. myrtillus improves normal night vision is not supported by evidence from rigorous clinical studies. There is a complete absence of rigorous research into the effects of the extract on subjects suffering impaired night vision due to pathological eye conditions.

Even though there is no solid evidence in human studies that bilberry produces any positive visual effects on night vision there is some experimental evidence that implies it might be useful in some ocular conditions whose mode of action is oxidative stress. There are recent epidemiologic, molecular and genetic studies that show a major role of oxidative stress in age-related macular degeneration.

There have been some studies showing oxidative protective effects of bilberry in non-human models. 

In Protective effects of bilberry and lingonberry extracts against blue-light emitting diode light-induced retinal photoreceptor cell damage in vitro, Ogawa et al showed in cultured mouse cells that adding bilberry extract to cells before subjecting them to high-energy short-wavelength light that the cells survived better mostly by reducing the amount of reactive oxidative molecules. 

In Retinoprotective Effects of Bilberry Anthocyanins via Antioxidant, Anti-Inflammatory, and Anti-Apoptotic Mechanisms in a Visible Light-Induced Retinal Degeneration Model in Pigmented Rabbits, Wang et al found similarly improved survival of pigmented rabbit retinal cells when exposed to bilberry abstract prior to high-intensity light.

But bilberry is not without potential side effects.

Bilberry possesses anti-platelet activity; it may interact with NSAIDs, particularly aspirin. And excessive drinking of bilberry juice may cause diarrhea. One study of 2,295 people given bilberry extract found a 4% incidence of side effects or adverse events. Further, bilberry side effects may include mild digestive distress, skin rashes and drowsiness. Chronic uses of the bilberry leaf may lead to serious side effects. High doses of bilberry leaf can be poisonous.

Bilberry has not been evaluated by the Food and Drug Administration for safety, effectiveness, or purity.

 

Article contributed by Dr. Brian Wnorowski, M.D.

Maui is one of the lushest, most vibrant places on earth. Yet its intense sunlight creates conditions that hide the beauty of the island. That’s why PolarizedPlus2® technology goes beyond shielding your eyes from glare and harmful UV to reveal and enhance the world’s true vivid colors in detail.

A wrinkle on the retina - which is also known as an epiretinal membrane (ERM) or a macular pucker - is a thin, translucent tissue that develops on the surface of the retina.

The retina is the inner layer that lines the inside of the back of the eye and is responsible for converting the light image into an electrical impulse that is then transmitted to the brain. An epiretinal membrane that forms on the retina goes unnoticed by the patient many times, and is only noticed during a dilated eye exam by an eye doctor.

Epiretinal membranes can become problematic if they are overlying the macula, which is the part of the retina that is used for sharp central vision. When they become problematic they can cause distortion of your vision, causing objects that are normally straight to look wavy or crooked.

Causes of a wrinkle on the retina

The most common cause is age-related due to a posterior vitreous detachment, which is the separation of the vitreous gel from the retina. The vitreous gel is what gives the eye its shape, and it occupies the space between the lens and the retina. When the vitreous gel separates from the retina, this can release cells onto the retina surface, which can grow and form a membrane on the macula, leading to an epiretinal membrane.

ERMs can also be associated with prior retinal tears or detachments, prior eye trauma or eye inflammation. These processes can also release cells onto the retina, causing a membrane to form.

Risk factors

Risk for ERMs increases with age, and males and females are equally affected.

Both eyes have ERMs in 10-20% of cases.

Diagnostic testing

Most ERMs can be detected on a routine dilated eye exam.

An optical coherence tomography (OCT) is a noninvasive test that takes a picture of the back of the eye. It can detect and monitor the progression of the ERM over time.

Treatment and prognosis

Since most ERMs are asymptomatic, no treatment is necessary. However, if there is significant visual distortion from the ERM or significant progression of the membrane over time, then surgical intervention is recommended. There are no eye drops, medications, or nutritional supplements to treat or reverse an ERM.

The surgery is called a vitrectomy with membrane peeling. The vitrectomy removes the vitreous gel and replaces it with a saline solution. The epiretinal membrane is then peeled off the surface of the retina with forceps.

Surgery has a good success rate and patients in general have less distortion after surgery.

 

Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

One of the hardest questions eye care professionals deal with every day is when to tell people who are having difficulty with their vision to stop driving.

Giving up your driving privilege is one of the most difficult realities to come to terms with if you have a problem that leads to permanent visual decline.

The legal requirements vary from state to state. For example, in New Jersey the legal requirement to drive, based on vision, is 20/50 vision or better with best correction in one eye for a “pleasure” driving license. For a commercial driving license, the requirement is 20/40 vision or better in both eyes.

In some states there is also a requirement for a certain degree of visual field (the ability to see off to the sides).

According to the Insurance Institute for Highway Safety, the highest rate of motor vehicle deaths per mile driven is in the age group of 75 and older (yes, even higher than teenagers). Much of this increased rate could be attributable to declining vision. There are also other contributing factors such as slower reaction times and increased fragility but the fact remains that the rate is higher, so when vision problems begin to occur with aging it is extremely important to do what is necessary to try to keep your vision as good as possible.

That means regular eye exams, keeping your glasses prescription up to date, dealing with cataracts when appropriate and staying on top of other vision-threatening conditions such as macular degeneration, glaucoma and diabetes.

It is our responsibility to inform you when you are no longer passing the legal requirement to drive. Although there is no mandatory reporting law in all states, it is recorded in your medical record that you were informed that your vision did not pass the state requirements to maintain your privilege. And, yes, it is a privilege - not a right - to drive.

If you have a significant visual problem and your vision is beginning to decline, you need to have a frank discussion with your eye doctor about your driving capability. If you are beginning to get close to failing the requirement you need to start preparing with family and love ones about how you are going to deal with not being able to drive, preferably before it becomes absolutely necessary.

We have had the very unfortunate occurrence of having instructed a patient that he should stop driving because his vision no longer met the requirements only to have him ignore that advice and get in an accident. Don’t be that guy. Be prepared, have a plan.

 

Article contributed by Dr. Brian Wnorowski, M.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ. This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician.

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