Eyesight and Health

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Makeup Tips for Eye Health

The products you use around your eyes play an important part in your eye health. Similar to brushing your teeth daily, eye hygiene and removal of make-up is essential. We all react to products on our skin differently and for those of us who are more sensitive, hypo-allergenic products are preferable. For those with dry eyes or contact lens wearers, it is particularly important to develop healthy habits with eye hygiene.
Eye make-up products; whether they are applied to our eyelashes or around our eyes, affect different anatomical parts of the eye. Below are some tips for different eye make-up application.

-Eyeliner. When using eyeliner, be mindful that application on the waterline (inner eyelid) can block the meibomian glands (see image 1) and contaminate the eye 1.  A study done in the Faculty of Science at Waterloo found that within 5 minutes, 15-30% more make-up particles were found in the tear film when eyeliner was applied to the waterline, compared to application outside of this 1. Our meibomian glands secrete the lipid layer of our tears which stop our tears from evaporating and thus it is important that these glands are open and functioning. Shortly after application of eyeliner, there are demonstrated changes to the tear film and its stability 2.
Eyeliner application if used, should avoid the waterline to reduce its effect on our tears.

BlogPic1 resized

Image 1. Layers of tears.

-Eyeshadow. This is applied further from the glands and inner structures of the eyes, however certain types of eye shadows that smear easily, may also end up in your tear film. Studies show that this product in addition to mascara, can cause the greatest discomfort amongst many cosmetic products 3. Contact lens wearers should also be mindful that eyeshadow may deposit on their contact lenses and this should be avoided 3.

-Mascara. This is a common make-up item that needs to be changed regularly. Our skin has normal bacteria such as Staphylococcus Aureus and some people may have a build-up of bacteria on their eyelashes termed ‘anterior blepharitis’. A maximum of 3-month use of a mascara wand before replacement is important to reduce harbouring bacteria 4. When your optometrist performs a slit lamp microscopy exam, they look at your lashes for signs of blepharitis. If this is present, you may need an additional eyelid cleaner such as an antibacterial foam, which is used to scrub your lids and lashes at least once per day. Research has demonstrated that mascara can also cause pigmentation inside the eye at the lacrimal sac (part of the duct to the lacrimal system which contains anatomical structures used for tear production and drainage) 5.

-Anti-ageing eye creams. These creams are often applied around the eyes. Research shows that the retinoids present in these eye creams can negatively affect meibomian gland function (the glands which secrete the oil in our tears), and potentially contribute to dry eye disease 2. Studies investigating the effect of systemic isotretinoin on animal models demonstrated signs of blepharitis and meibomian gland ductal epithelium thickening, as well as decreased mature gland acini, which contribute to the lipid (oily) layer of our tears 2. There was also reduction in the number and size of meibomian gland acini (see image 2) 2. Human studies of those taking systemic isotretinoin for acne also demonstrated dry eye symptoms, blepharitis and Meibomian gland dysfunction. The lacrimal gland, which secretes the aqueous tears, also releases isotretinoin. “The potential impact of the usage of anti-aging facial and eye creams and gels on developing meibomian gland dysfunction and dry eye syndrome is great” 2.

pic 2

Image 2. A single meibomian gland has clustered acini that secrete meibum. (Knop et al, 2011.)

• Pigmented products used over many years, may accumulate in the conjunctivae and the lacrimal system 2,6. The conjunctiva is a mucous membrane forming most of the surface of the eye – the white part of the eye you see in the mirror.

• Cosmetic products may also cause contact lens spoliation 2.

Removal of make-up before going to sleep is essential. Water alone cannot effectively remove cosmetic products, whereas surfactants in cosmetic removal products dissolve and alter the solubility of oils and waxes found in make-up 2. Note that water-proof mascara is removed best by oils, so investing in an oil-based make-up remover is beneficial 2. Oil-free make-up removal products have different surfactant concentrations which are good at removing cosmetics, however may solubilize the sebum in the eyelids and irritate the skin around your eyes 2. Your optometrist has eye-lid wipes and antibacterial foams that may also be used for make-up removal, particularly for those with dry/sensitive eyes.
The Tear Film & Ocular Surface Society Dry Eye Workshop (DEWS 2) latest report notes that exposure to cosmetic products, many of which contain toxic products, can elicit dry eye symptoms 7. For those with very sensitive eyes and/ or moderate to severe dry eyes, your optometrist may recommend avoiding eye make-up.

**Take home messages **
• The best way to ensure no additional irritation of the eyes, dry eyes and deposits on your contact lenses is to avoid eye make-up.
• When make-up is applied, avoid the inner part of the eye, particularly the waterline, as this can affect your tears and cause irritation.
• Retinoids present in anti-ageing creams and gels can contribute to dry eye and meibomian gland dysfunction.
• Ensure you have a good make-up remover that you use before going to sleep.
• Ensure all make-up products are changed regularly and that make-up brushes are washed regularly too.
• Your optometrist examines the health of your eye with a slit lamp microscope and can detect signs of cosmetic products depositing on the eye, tear film and/or your contact lenses.

 

References
1. Alison Ng, Katharine Evans, Rachel V. North, Christine Purslow. Migration of Cosmetic Products into the Tear Film. Eye & Contact Lens: Science & Clinical Practice, 2015; DOI: 10.1097/ICL.0000000000000124
2. Alison Ng, Katharine Evans, Rachel V. North, Christine Purslow. Impact of Eye Cosmetics on the Eye, Adnexa, and Ocular Surface. Eye & Contact Lens: Science & Clinical Practice, 2016. 42(4): 211-220. DOI: 10.1097/ICL.0000000000000181
3. Gao Y & Kanengiser BE. Categorical evaluation of the ocular irritancy of cosmetic and consumer products by human ocular instillation procedures. J Cosmet Sci 2004; 55: 317– 325.
4. Pack LD et al. (2008). Microbial contamination associated with mascara use. Optometry. Oct;79(10):587-93. doi: 10.1016/j.optm.2008.02.011.
5. Clifford, Luke & Jeffrey, M & Maclean, H. (2011). Lacrimal sac pigmentation due to mascara. Eye (London, England). 25. 397-8. 10.1038/eye.2010.209.
6. Ciolino, Joseph & M Mills, David & R Meyer, Dale. (2009). Ocular Manifestations of Long-Term Mascara Use. Ophthalmic plastic and reconstructive surgery. 25. 339-41. 10.1097/IOP.0b013e3181ab443e.
7. Gomes, J et al. (2017_. TFOS DEWS II iatrogenic report. Ocul Surf. Jul;15(3):511-538. doi: 10.1016/j.jtos.2017.05.004.

Interesting uses for contact lenses

Did you know that contact lenses are not just used for vision correction? There are many special applications of contact lenses – some of them are quite surprising!

Cosmetic

I recently saw a patient with a badly scarred and blind eye. He was uncomfortable with the way the eye looks especially in photos so was wondering whether there was anything he could do to improve the cosmesis! We’ve all seen the wacky cosmetic coloured contact lenses (cat’s eyes anyone?) but what if you just want a ‘normal’ looking eye? Well, prosthetic contact lenses are the answer. I decided to fit my patient with a hand painted soft prosthetic contact lens with a black pupil – it is painted as an exact match to his uninjured eye! The result is quite impressive! Check out the before and after photos (consent obtained to share images)

Before:

Faiz before websize copy

After:

Faiz after websize copy

Therapeutic

Contact lenses are also commonly used as bandages or barriers for people who suffer from recurrent corneal problems or if their eyelashes grow in the wrong direction. The contact lens protects the surface of the eye and prevents scratches, abrasions and even opportunistic infections.

[1] Contact lenses can also act as a tool for rehabilitating the ocular surface in ocular surface disease, especially severe dry eye. Dry eye is a very common problem among a wide demographic of the population. Mild to moderate dry eye is usually treated successfully with lubricating eye drops, warm compresses/lid massage and changes in diet. However, severe dry eye is associated with significant ocular health problems and can be very debilitating as symptoms are quite significant. In cases of severe dry eye often associated with autoimmune conditions such as Sjogren’s syndrome and Graves’ disease; bandage contact lenses can help retain the tear film on the eye, leading to increased comfort for the patient.[2]

Drug delivery

Eye drops are the most common method of therapeutic drug delivery to the eye, accounting for 90% of all ocular medications.[3] However, eye drops are actually significantly inefficient as they have a short retention period on the eye limiting just how much drug can be absorbed by the eye. As the medication drains from the eye quickly through the tear ducts and into the nose, unwanted drug can be then be absorbed systemically.[4] This then increases the likelihood of systemic side effects. Medication impregnated on a contact lenses would be slowly released into the eye which suggests a better rate of absorption and therefore drug effectiveness. This technology could be applied to glaucoma medication, as well as anti-inflammatory and antibiotic drugs.

Contact lenses can be used in many ‘non-traditional’ ways for cosmetic, therapeutic and even drug administering reasons, not just for vision correction.

 

References

[1] DeNaeyer GW. Therapeutic applications of contact lenses. Contact Lens Spectrum. 2010; May:

[2] Harthan JS. Therapeutic use of mini-scleral lenses in a patient with Graves’ ophthalmopathy. J Optom. 2014; 7(1): 62-66.

[3] Bourlais CL, Acar L, Zia H, Sado PA, Needham T, Leverge R. Ophthalmic drug delivery systems. Prog Retin Eye Res. 1998;17:33–58.

[4] Wilson CG. Topical drug delivery in the eye. Exp Eye Res 2004;78:737–43.

By | 2018-06-28T07:03:01+00:00 17th February 2016|Contact Lenses, Eyesight and Health|0 Comments

UV and the Eye

Image credit: Essilor Australia

Moderate exposure to ultraviolet radiation (UVR) from the sun is a necessary part of maintaining normal health (read the next blog for more about this!). However, excessive exposure to UVR has no health benefits and actually leads to adverse consequences for not only the skin, but also the eye. Interestingly, the eye occupies less than two percent of the whole body surface area, but it represents the ONLY organ system to allow the penetration of visible light deep into the human body.

So what are the known eye health effects of UVR?

Photokeratitis and photoconjunctivitis

Acute inflammation of the cornea (photokeratitis) and the conjunctiva (photoconjunctivitis) occur within a few hours of UVR exposure. These reactions can be likened to sunburn of the very sensitive tissues of the eyeball and eyelids. Photokeratitis and photoconjunctivitis are very painful conditions, but they are temporary reactions and do not seem to result in long-term damage to the eye or vision.

Pterygium

A pterygium is when the conjunctiva (clear membranous tissue covering the sclera or white part of the eye) becomes dysplastic and grows towards and over the cornea. Pterygium has been linked to prolonged UV exposure and is attributed to the accumulatively damaging effects of UVR. If the pterygium grows close to the pupil, it needs to be surgically removed otherwise, the eye will be blind. Pterygiums are found in 10% of Queenslanders (nearly half a million people!).

Cataracts

Cataracts are the leading cause of blindness in the world. The World Health Organisation estimates that up to 20% of cataracts may be caused by over-exposure to UVR. UVR is absorbed by the lens of the eye which leads to damage of the lens which may result in cataract formation. Cataract is when the lens of the eye becomes cloudy, making vision hazier and not completely correctable with glasses or contact lenses. Surgery is performed to remove the cloudy lens and replace it with a clear artificial lens.

Cancer of the eyelid

The eyelid region is one of the most common sites for non-melanoma skin cancers such as basal cell carcinoma and squamous cell carcinoma. Cancers of the eyelid account for 5 to 10% of all skin cancers of the human body. Like skin cancer of the rest of the human body, cancers of the eyelid are caused by the accumulative effects of UVR.

Age-related macular degeneration

Age-related macular degeneration is the leading cause of blindness in the western world. The retina is highly susceptible to photochemical damage from continuous exposure of light and oxygen. The cornea and lens block a major portion of UVR (see Figure 1) from reaching the retina. Although the relationship between UV light exposure and AMD is unclear, we know that short wavelength radiation (UV and even blue light from the visible spectrum) induce significant oxidative stress to the retina which may increase risk of the development of macular degeneration.

Check out our next blog to find out the best ways to protect our eyes from UV radiation!

References

Bergmanson, P.G., Sӧderber, P.G. The significance of ultraviolet radiation for eye diseases. A review with comments on the efficacy of UV-blocking contact lenses. Ophthalmic Phys Optics. 2002; 15(2): 83-91.
Cruickshanks, K.J., Klein, R., Klein, B.E. Sunlight and Age-Related Macular Degeneration: The Beaver Dam Eye Study. Arch Ophthalmol. 1993; 111(4):514-518.

By | 2018-06-28T07:03:01+00:00 28th October 2015|Eyesight and Health|0 Comments

Hormones and Dry Eye

Dry eye is a very common problem, affecting people of all ages, gender and occupations. The symptoms of dry eye include red, itchy, stingy, gritty/sandy and watery eyes. These symptoms are often exacerbated by wind, air conditioning and computer use. Research shows however that dry eye is more prevalent in contact lens wearers, females and as we get older. So why are females more affected than males? The simple answer is hormones.

Karen came to see me a month ago about her red, irritated and watery eyes which had been annoying her over the past few weeks. Karen reported using lubricating eye drops every now and then but found that the drops were only effective for 15-20mins before her eyes would be irritated again. Karen had recently celebrated her 52nd birthday and currently wears glasses for reading and the computer. I asked Karen about her general health and she reported starting hormone replacement therapy medication for menopausal symptoms approximately two months ago. During our consultation, Karen and I discussed hormonal changes and how this can affect our eyes. Karen had never thought that her eye symptoms might be related to her hormonal symptoms!

Research has found that 60 percent of menopausal women are affected by dry eye but only 16 percent of these women realise that their hormones are to blame. For women affected by dry eye symptoms due to hormonal changes, using normal lubricating drops every now and then is unlikely to provide them with much relief; it is like putting a band aid on an abscess – it kind of works for a bit but is not really addressing the real problem.

So how does a change in hormones bring about a change in the eye? Research shows that plummeting hormones levels affect the ocular tissues and the composition of tears. Androgens, or sex hormones including both testosterone and estrogen can influence tear production. As we age, our androgen levels naturally decrease. As women start out with less androgens to begin with, a dramatic decrease in hormones during menopause and then continued reduction with increased age, androgen levels may fall below the amount needed for optimum eye health leading to the onset of dry eye. So if a lack of hormones is responsible for dry eye, one should be able to replace these hormones through medication (ie HRT) and alleviate the symptoms, right? Wrong. The Women’s Health Initiative study of over 25 000 women found an increased risk of dry eye in women using HRT. The role of HRT in menopausal women is unclear as some researchers support the idea that medication improves both quality and quantity of tears, whereas others have shown that it increased the incidence of dry eye.

So what did I suggest for Karen? I prescribed consistent use of lubricating eye drops to help alleviate symptoms and recommended changes in diet to help encourage quality tear production so that at least the tears that are produced are of good quality. Karen has been doing well for the past month now using this treatment regime to manage her dry eye.

Keep a look out for a future blog post on nutrition tips for healthy eyes.

References

Sullivan DA, Yamagami H, Liu M, et al. Sex steroids, the meibomian gland and evaporative dry eye. Adv Exp Med Biol 2002;506A:389-99.

Schaumberg DA. Hormone replacement therapy and dry eye syndrome. JAMA 2001;286:2114.

By | 2018-06-28T07:03:01+00:00 1st October 2015|Eyesight and Health|0 Comments

Surprising health conditions that optometrists find first!

They say that the eyes are the window to your soul, but did you know they are also a window to your overall health?  Signs of many health conditions including those associated with an increased risk of heart disease and stroke can be seen with an eye exam. The retina, or the back of your eye, is the only place in your body where your blood vessels and nerves can be seen without needing to cut you open! This makes regular eye examinations essential in detecting important medical issues in their very early stages! Some of the health conditions that can be detected during an eye exam include:

  • Cancer
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Multiple sclerosis
  • Rheumatoid arthritis

Cancer

An eye exam may just save your life in this case! Everything from brain tumours to metastases in the eye from breast and lung cancers to leukaemia can be detected by an eye test. Patients will often be unaware of the cancer unless it is affecting their centre of vision, otherwise it may go undetected for a critical period of time which will likely influence the overall prognosis.

Diabetes

One of the very first signs of Type 2 Diabetes (before any symptoms have arisen!) is small amounts of bleeding in the retina.1 This is a sign of diabetic retinopathy, one of the most leading causes of vision loss in people with diabetes. If left untreated, blindness can result, however the outcome is greatly improved if the condition is caught early and successfully managed. When diabetic retinopathy is detected in the early stages, lifestyle changes such as weight management, exercise and diet control can prevent further damage to the eye and subsequently, vision.

High blood pressure

High blood pressure often causes weakening and narrowing of the arteries, characteristic changes that can be seen by an optometrist during your eye exam. Multiple studies2,3 have found a strong association between heart disease and narrowing of the retinal blood vessels, which adds further credence to the importance of regular routine eye exams.

Multiple sclerosis

Optic neuritis (inflammation of the optic nerve) can be a harbinger of MS which is a degenerative disease of the nervous system (it can also be the result of an infection or other causes too).4 Optic neuritis occurs in 75 percent of people with MS and is the first sign of the disease in up to 25 percent of cases.

Rheumatoid arthritis

Approximately one quarter of all people with rheumatoid arthritis have problems with their eyes – dry eye being to most common issue.5 Rheumatoid arthritis is an inflammatory disease with autoimmune links that affects the small joints of in the hands and feet. Dry eye is often associated with rheumatoid arthritis.

 

Most people don’t realize that by visiting their optometrist for an eye examination, and importantly, having their ocular health assessed, signs of many health conditions can detected. Once detected, these health conditions can then be actively treated and managed to ensure better prognosis and overall outcome for the patient.

 

References

[1] Lorenzi M, Gerhardinger C. Early cellular and molecular changes induced by diabetes in the retina. Diabetologia. 2001; 44:791-804.
[2] Witt N, Wong TY, Hughes AD, Chaturvedi N, Klein BE, Evans R, McNamara M, Thom SA, Klein R. Abnormalities of retinal microvascular structure and risk of mortality from ischemic heart disease and stroke. Hypertension. 2006; 47: 975–981.

[3] Wong TY, Klein R, Richey Sharrat A, Duncan BD, Couper DJ, Tielsch JM, Klein BE, Hubbard LD. Retinal arteriolar narrowing and risk of coronary heart disease in men and women: the atherosclerosis risk in communities study. Journal of the American Medical Association. 2002; 287(9): 1153-1159.

[4] Gordon-Lipkin E, Chodkowski B, Reich S, Smith SA, Pulicken M, Balcer LJ, Frohman EM, Cutter G, Calabresi PA. Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis. Neurology. 2007; 69(16): 1603-1609.

[5] Fujita M, Igarashi T, Kurai T, Sakae M, Yoshino S, Takahashi H. Correlation between dry eye and rheumatoid arthritis activity. American Journal of Ophthalmology. 2005; 140(5): 808-813.

 

By | 2015-10-21T13:04:25+00:00 29th September 2015|Eye conditions, Eyesight and Health|0 Comments

Travelling with Contact Lenses!

So this Friday, I am heading to the airport with my twin sister to fly out of Australia and travel around Europe for almost four weeks! I am currently starting the packing process (what do I pack?!) and my sister, who is an orthoK wearer, asked what she should do with her contact lenses while travelling.  It got me thinking about how many of my patients ask me the same thing!

For some people, travelling with contact lenses is so much of a hassle that they will prefer to leave them at home and just wear glasses. However, I say you don’t have to give up contact lens wear while travelling – especially as they are very convenient when you are do lots of swimming, hanging out at the beach, playing sports (think skiing, beach games, backyard cricket, golf etc) and sightseeing!

Contact Lens websizeThera Tears websize

 

Here are some tips for travelling with your contact lenses to ensure clear vision and healthy eyes!

  • If wearing contact lenses during plane travel, always use lubricating eye drops to prevent the lenses from dehydrating and making your eyes red and sore. Use non-preserved drops (Thera Tears are great!) every 1-2 hours.
  • Again for plane travel, it is a good idea to keep your contacts, case and travel sized solution in your carry-on luggage just in case you and your checked bags get separated!
  • Consider wearing daily disposable contact lenses while you travel. These lenses are worn once, so fresh lenses are worn every day and you eliminate the need to carry heavy and bulky lens solutions.
  • Bring spare lenses! Even if you are only travelling for 2 weeks and you wear monthly lenses, if you accidently tear or lose a lens you will be caught short!
  • Make sure you have your prescription up to date and take it with you just in case.

Travelling is such a fun and exciting time and there is so much to see while we travel so make sure to take care of your contacts and your eyes so you don’t miss a thing!

By | 2018-06-28T07:03:01+00:00 24th September 2015|Eyesight and Health|1 Comment

Beating blindness with vegetable oil

Many patients often ask whether fish oil supplements are beneficial in protecting their eyesight. (Check out our blog post on Omega 3!) But what about vegetable based oils?

Interestingly, scientists working at the Research Centre on Ageing at the Health and Social Services Centre at the University Institute of Geriatrics of Sherbrooke, have been studying strategies for protecting retinal pigment epithelium cells by incubating them with vegetable oils. Dysfunction of the RPE (retinal pigment epithelium) is found in retinal diseases and age-related macular degeneration, which is the leading cause of blindness in elderly people in Australia.

Findings published in the Canadian Journal of Physiology and Pharmacology suggest that incubating retinal cells with vegetable oils induces important changes in the cell membrane, which may have a beneficial effect in preventing or slowing the development of retinopathy.

The researchers discovered that vegetable oil fatty acids incorporate in retina cells and increase the plasma membrane fluidity aiding the transmission of light signals through the eye. They concluded that a diet low in trans-unsaturated fats and rich in omega-3 fatty acids and olive oil may reduce the risk of retinopathy.

In addition, the research suggests that replacing the neutral oil used in eye drops, such as medicated eye drops and lubricating eye drops, with oil that possesses valuable biological properties for the eye could also contribute to the prevention of diseases of the retina.

Said, T., Tremblay-Mercier, J., Berrougui, H., Rat, P., Khalil, A. Effects of vegetable oils on biochemical and biophysical properties of membrane retinal pigment epithelium cells. Canadian Journal of Physiology and Pharmacology, 2013, 91(10): 812-817

 

 

By | 2018-06-28T07:03:01+00:00 26th August 2015|Eyesight and Health|0 Comments

How to protect your eyes from the digital world

We live in a digital age, which means that most of us are leading increasingly digital lives. Research shows that more than 90% of people spend between 3 to 10+ hours every day on digital devices.1
Digital usage

So what does this mean for our eyes? Well, the sheer amount of time we spend on digital devices means that many of us can suffer from Computer Vision Syndrome with symptoms including irritated eyes, blurred vision, fatigue, and even headaches and neck and/or back pain.2 The widespread daily (or sometimes continuous!) use of computers, laptops, tablets, smartphones, and even TVs means that many of us are being exposed to unprecedented amounts of blue light. LCD screens and florescent lighting emit a strong spike in blue and ultraviolet light. So why should we care about blue light?

Blue light is a component of visible light and is referred to as high energy visible light (HEV). It sits alongside ultraviolet (UV) light in the electromagnetic spectrum. Most people are aware that UV light is harmful to not only our skin but also our eyes, as it has been shown to contribute to the development of cataracts and may also lead to other eye diseases such macular degeneration.

Scientists are only now beginning to investigate the long-term health effects of blue light. Recent studies suggest that the blue end of the visible spectrum can also causes retinal damage akin to UV light and can possibly lead to the same eye conditions as prolonged UV exposure.

Electromagnetic spectrum
The eye damage from blue light occurs because the pigment absorbing cells of the retina are harmed by absorbing these high energy light rays when they enter our eyes.3 This precipitates a gradual oxidation and deterioration of the macula (highly sensitive part of the retina responsible for our central vision), leaving the eye more susceptible to degenerative conditions such as macular degeneration (MD). Blue light is also partially absorbed by the crystalline lens inside the eye (lens responsible for allowing us to focus) which contributes to the formation of cataract.3,4

So is it just the older generation (those who have a higher risk of developing macular degeneration and cataract purely based on age) who should care about blue light? No. There is a growing body of evidence suggesting that cumulative lifetime exposure to blue light contributes to earlier eye damage and formation of MD and cataract. In early childhood, the cornea and crystalline lens effectively blocks UV light from penetrating the anterior eye tissues and reaching the retina. However, blue light is still able to pass through these tissues, reach the retina and start bringing about early changes to retinal metabolism which can subsequently lead to tissue damage.5

Blue light has also been shown to stimulate a newly discovered subtype of retinal cell that controls aspects of our circadian rhythms.

Exposure to blue wavelengths, particularly at night, has been shown to be disruptive to our normal sleep patterns.3,6 Combine this with the proliferation of electronic screens which is increasing our exposure to blue light, it is no wonder that so many of us suffer from poor quality sleep. Think of your teenager. Does he or she use a computer, iPod or phone prior to bedtime? Does this teenager have difficulty going to bed when you ask and then wakes up tired the next morning? This could all be due to the use of these electronic devices, and the associated exposure to blue light, which results in the disruption of normal circadian rhythms. This means that it is more difficult to fall asleep (the light from the screen has tricked the brain into thinking it is day time!) and sleep quality is poor leading to tiredness the next day.4

So what can we do about blue light to protect our eyes from these potentially harmful rays? In this day and age, it is not practical to give up the use of digital devices, so we need something that allows us to continue using these devices, but to do so safely by protecting our eyes. We are all familiar with the use of UV blocking lenses (some contact lenses, spectacle lenses and sunglasses) to guard against cancers of the eyelid, eye surface damage and cataracts, but did you know that it is now possible to prescribe spectacle lenses on the basis of wavelength selective light filtration ie the ability to filter blue light and prevent it from reaching our eyes?

Blue control is a new innovative anti-reflection coating that meets the demands of a very digital world. The coating works by effectively reflecting blue light emitted from digital devices, and even fluorescent lighting, thereby reducing its transmission into and absorption by the eye.7

As the widespread use of smartphones, tablet devices and computers increases the time we face a screen, more and more people suffer from eyestrain symptoms. One cause of this is believed to be the blue light emitted from the display on such devices. A new innovative anti-reflection coating known as Blue Control reduces the amount of blue light reaching our eyes by 35 percent.7

Considering our digital world, it could be suggested that spectacle lenses can now be used not just for vision correction but also maintenance of eye health!

blue control lenses

References

  1. 2012 VisionWatch Findings: A survey among 10,000 adults across America about their use of digital media and symptoms of vision stress, conducted by The Vision Council.
  2. Blehm C, Vishnu S, Khattak A, Mitra S, Yee RW (2005). Computer vision syndrome: a review. Survey Ophthalmol. 50(3):253-262, Elsevier Inc.
  3. Holzman DC. What’s in a color? The unique human health effects of blue light. Environmental Health Perspectives. 2010; 118(1): A22-27.
  4. Roberts, J.E. (2011) Photobiology of the Human Lens. Original research article, Fordham University, Department of Natural Sciences, New York, NY.
  5. Sliney, D. H. (2005) Exposure geometry and spectral environment determine photobiological effects on the human eye. Photochem. Photobiol. 81, 483-489.
  6. LeGates TA, Fernandez DC, Hattar S. Light as a central modulator of circadian rhythms, sleep and affect. Nature Reviews Neuroscience. 15: 443-454 (2014)
  7. Hoya Lens Australia. http://www.hoyalens.com.au/BlueControl

 

By | 2018-06-28T07:03:01+00:00 11th February 2015|Eyesight and Health, Glasses|0 Comments

Changes to Medicare for optometrist consultations

The 2014 federal government budget announced wide sweeping changes across Medicare, and although it went largely unreported in the news, optometry has also been affected. As 2015 began, three major changes to Medicare funding for optometry services have occurred.

Firstly the Medicare scheduled fee and rebate for optometry services have both been cut by 5%. Since the late 1990’s, the scheduled fee has increased at a rate below CPI, or since 2012, not at all.  Now it has been cut and will be frozen again until mid 2018. These changes see the government rebate fall further behind the true cost of providing quality eye care.

Secondly, there have been changes to eligibility of patients for a full comprehensive eye examination rebate. Prior to 1st January 2015, if you were without symptoms, Medicare patients were eligible to receive the full rebate for a comprehensive eye examination once every two years. From 1st January 2015 patients aged 65 years and over are now eligible for the full rebate for a comprehensive eye examination every year, but patients under 65 years are now only eligible for the same every three years. This is a positive change for older Australians, but for those under 65, this is not a positive move in ensuring the nation’s eye health and it is unfortunately not evidence based.

It’s important to note that if you are symptomatic, you should present to your optometrist at any time as the full rebate may apply in your instance, even if it falls within the one- or three-year interval.

Finally, prior to 1st January 2015 the Medicare fee schedule for optometrists was capped. This means that unlike most other healthcare providers, optometrists were unable to charge for their professional services beyond the scheduled fee.  Any fees billed above the scheduled fee became ineligible for patients to claim a Medicare rebate.

Optometry was the only health profession to be subject to government set capping, in place since the profession became included in Medicare in 1975. Now optometrists may set their own fees for clinical services under Medicare. This means that, in line with other healthcare providers, optometrists can charge above the Medicare scheduled fee without impacting the patient’s ability to claim the Medicare rebate.

What does this mean for you, as a patient of Gerry & Johnson Optometrists?

  1. Our professional consultation fees at GJO will now be standardised, instead of varying up and down dependent on the Medicare rebate as they have previously. Click here for information on our professional fees schedule, which we have adopted in line with the recommendations of Optometry Australia.
  2. We will still use the Easyclaim system we have been using since early 2009, where we claim your Medicare rebate for you on the spot and it is paid back onto your cheque or savings card. Your Medicare rebate will unfortunately reduce, however people over 65 may see an increase in their overall rebate amount over the course of their clinical care.
  3. We are no longer able to bulk bill concession card holders and patients over 65 as we have previously, but have introduced a discount on optical products to assist with balancing costs.
  4. We are now able to include use of our cutting edge diagnostic technology in all consultations without additional charge, or at a reduced fee. This will be explained to you where relevant to your clinical care.

Our focus still remains entirely on providing you with the pinnacle of professional care for your vision and your eye health.

By | 2018-06-28T07:03:02+00:00 30th January 2015|Eyesight and Health, In the news|0 Comments

Blurred distance vision doesn’t always mean glasses

“So Mary, after all of our extensive testing, I am prescribing glasses for you to wear at work when using the computer.”

Mary looked at me perplexed. “But I can see the computer clearly. It’s my distance vision that is the problem!”

Mary came to see me at the end of last year as she felt like her eyesight was deteriorating. She had previously been prescribed glasses approximately six months before to wear occasionally for distance vision blur like when driving at night or watching TV. While on a holiday overseas, Mary found that she was becoming more and more reliant on her glasses for sightseeing and just generally wandering around, but even when wearing her glasses, her vision still wasn’t very good and her eyes felt uncomfortable.

I found that Mary actually had almost perfect visual clarity at distance and that her eyes were in fact struggling with close vision. Essentially, Mary’s aiming and focussing systems were dysfunctional at close range which was then creating a problem with her distance vision. The way to manage Mary’s vision problems was not to prescribe glasses for long distance (she didn’t need them!) but to address the dysfunction with her close vision. Mary was a little sceptical about my plan for her eyes, but she believed in me enough to agree to give glasses at the computer a try! I saw Mary two months after her initial visit to see how she had gotten on.

“How have you been going with your glasses Mary?”

“Well for the past couple of weeks, I haven’t found I’ve needed my glasses as much because I can see! Things don’t look blurry anymore – I can pick my son up at night after soccer training and even see the tennis scores on the TV now! Also my eyes feel so much more comfortable – they don’t feel like they are constantly straining.”

This case sounds a little abstract in that a patient presented with a distance vision problem but the testing revealed a near vision problem. The cause is actually quite common but can be very easily missed if visual efficiency (not just visual clarity ie reading letters on the letter chart) is not assessed during the eye test too! At Gerry & Johnson, we delve further into how the eyes work together as dysfunctions in one area of vision can create symptoms in another.

Convergence excess is the binocular vision problem where the eyes ‘over-turn in’ to see things close up and then get ‘locked’ in and can’t straighten out for comfortable distance vision. As a result, the eyes are not sure where they are pointing in space and then cannot give our focussing system the right information to allow our eyes to focus on whatever we are trying to see. This results in a perceived blur in the distance. Research shows that binocular vision dysfunctions are common among the general population, as studies have found the prevalence to be somewhere between 20 and 30 percent.1,2 Convergence excess, like other binocular vision anomalies, needs to be actively managed to prevent it from affecting a person’s performance in their work or at school.


 References

  1. Purcell LR, Nuffer JS, Clements SD, Clausen LR, Schuman DO, Yolton RL. The cost of effectiveness of selected optometric procedures. J Am Optom Assoc 1983;54:643-7.
  2. Hokoda SC. General binocular dysfunctions in an urban optometry clinic. J Am Optom Assoc 1985;56:560-2.
By | 2018-06-28T07:03:02+00:00 30th January 2015|Eye conditions, Eyesight and Health|0 Comments