What Is Intraoperative Aberrometry?

Yes, that is a mouthful, but the concept isn’t quite as hard as the name.

An Intraoperative Aberrometer is an instrument we can use in the operating room to help us determine the correct power of the implant we put in your eye during cataract surgery.

Cataract surgery is the removal of the cloudy natural lens of your eye and the insertion of a new artificial lens inside your eye called an intraocular lens (IOL).

The cloudy cataract that we are removing has focusing power (think of a lens in a camera) and when that lens is removed, we need to insert an artificial lens in its place to replace that focusing power. The amount of focusing power the new IOL needs has to match the shape and curvature of your eye.

To determine what power of lens we select to put in your eye, we need to measure the shape and curvature of your eye prior to surgery.  Once we get those measurements, we can plug those numbers into several different formulas to try and get the most accurate prediction of what power lens you need.

Overall, those measurements and formulas are very good at accurately predicting what power lens you should have. There are, however, several eye types where those measurements and formulas are less accurate at predicting the proper power of the replacement lens.

Long Eyes: People who are very nearsighted usually have eyes that are much longer than average.  This adds some difficulty with the accuracy of both the measurements and the formulas. There are special formulas for long eyes but even those are less accurate than formulas for normal length eyes.

Short Eyes: People who are significantly farsighted tend to have shorter-than-normal eyes.  Basically, the same issues hold true for them as the ones for longer eyes noted above.

Eyes with previous refractive surgery (LASIK, PRK, RK): These surgeries all change the normal shape of the cornea.  This makes the formulas we use on eyes that have had previous surgery not work as well when the normal shape of the cornea has been altered.

This is where intraoperative aberrometry comes in. The machine takes the measurements that we do before surgery and then remeasures the eye while you are on the operating room table after the cataract is removed and before the new implant is placed inside the eye. It then presents the surgeon with the power of the implant that the aberrometer thinks is the correct one.  Unfortunately, the power that the aberrometer selects isn’t always exactly right, but with the combination of the pre-surgery measurements and the intra-surgery measurements the overall accuracy is significantly enhanced.

The intraoperative aberrometry is also very helpful in choosing the power of specialty lenses like multi-focal and toric lenses.

We would encourage you to consider adding intraoperative aberrometry to your cataract surgery procedure if you have either a long or short eye (usually manifested as a high prescription in your glasses) or if you have had any previous refractive surgery.

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.

In our modern world, people spend hours on end staring at computer screens, smartphones, tablets, e-readers, and books that require their eyes to maintain close focus.

For most people (all except those who are nearsighted and aren’t wearing their glasses), their eyes’ natural focus point is far in the distance. In order to move that focus point from far to near, there is an eye muscle that needs to contract to allow the lens of the eye to change its shape and bring up-close objects into focus. This process is called accommodation.

When we accommodate to view close objects, that eye muscle has to maintain a level of contraction to keep focused on the near object. And that muscle eventually gets tired if we continuously stare at the near object. When it does, it may start to relax a bit and that can cause vision to intermittently blur because the lens shape changes back to its distance focal point and the near object becomes less clear.

Continuing to push the eyes to focus on near objects once the focus starts to blur will began to produce a tired or strained feeling in addition to the blur. This happens very frequently to people who spend long hours reading or looking at their device screens.

An additional problem that occurs when we stare at objects is that our eyes’ natural blink rate declines. The average person blinks about 10 times per minute (it varies significantly by individual) but when we are staring at something our blink rate drops by about 60% (4 times per minute on average). This causes the cornea (the front surface of the eye) to dry out faster. The cornea needs to stay moist in order to see clearly, otherwise little dry spots start appearing in the tear film and the view gets foggy. Think about your view through a dirty car windshield and how much that view improves when you turn the washers on.

So what should you do if your job, hobby, or passion requires you to stare at a close object all day?

Follow the 20-20-20 rule. Every 20 minutes, take 20 seconds and look 20 feet into the distance. This lets the eye muscle relax for 20 seconds, and that is generally enough for it to have enough energy to go back to staring up close for another 20 minutes with much less blurring and fatigue. It also will help if you blink slowly several times while you are doing this to help re-moisten the eye surface.

Don’t feel like you can give up those 20 seconds every 20 minutes? Well if you don’t, there is evidence that your overall productivity will decline as you start suffering from fatigue and blurring. So take the short break and the rest of your day will go much smoother.

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.

Nowdays, many people prefer shopping online to shopping in stores for many of their needs.

With technology constantly improving and evolving, people like the convenience of shopping online. Whether it’s clothing, electronics, or even food, you can easily find almost everything you need on the Internet.

Eyeglasses, unfortunately, are no different. Many online shops have been popping up in recent years, offering people that same convenience. But what they don’t tell you is that it comes at a price, and this article’s purpose is to shine a light on the negatives of shopping online for eyeglasses.

Here are some important reasons to avoid the temptation of ordering glasses online.

1. Accuracy- Instead of saving the most important point for last, we will focus on the main reason that ordering eyeglass online is not the best choice. Product accuracy is a huge reason that the online market has not completely taken off. Every person who needs eyeglasses needs to understand the process for how their prescription is obtained in order to truly understand why shopping online is not ideal. It is called an eyeglass prescription for a reason. Your ophthalmologist or optometrist is prescribing your lenses as if they were prescribing any form of medication. To take that prescription and hand it over to a website that does not require licensed workers to interpret the prescription is not the wisest choice. Equally as important as the prescription itself are the pupillary distance (PD) and the optical centers measurements. These measurements are not given at the time of the examination by the eye doctor, but instead are administered by the optician at the point of sale. Not having these measurements done accurately will negatively affect the quality of vision as much as an error in the prescription.
2. Quality- The quality of the product you are purchasing is often affected when making the decision to purchase online. Websites rely on low overhead, high volume, and lack of quality control. The online experience pales in comparison to the quality you will receive in a professional office. Skilled opticians who interpret and manufacture your eyeglass prescriptions are generally held to a much higher standard than an online website.
3. Warranty- Due to their low prices, many of these websites do not include much in the way of product warranty or guarantee. Local eyecare practices, however, stand behind your purchase. If there are issues with adjustment or a patient not being comfortable in a specific lens or product, professional optometrists and opticians are willing to work with you. This personal experience is not attainable on the web.
4. Coordination with Your Doctor- With the complexity of eyeglass lenses, the ease of working in house is always a benefit worth keeping in mind. Eyeglass lenses can be very complex products. Having the benefit of being able to work directly with the doctor gives the optician the best chance to put you in the exact lenses you need. There is a substantial difference in the percentage of error between shopping online and the care you get in a private practice.
5. Personal Experience- The biggest factor for many people is that the customized experience you get when shopping in person is something you cannot obtain by using the Internet. Dealing with the same opticians year in and out is something patients emphasize and appreciate. Just like people tend to keep the same doctors over the years, patients like knowing that the same people will be in charge of making/ordering their glasses. Shopping online will not offer that experience.

All of these factors should be carefully weighed when making the decision to shop online. While the initial price difference could entice you at first, know that it does come at a price. Whether it be a warranty, quality, or convenience issue, all of these are very important factors when buying glasses. People sometimes tend to discount how intricate eyeglasses are.

Purchasing eyeglasses is handled best in person by professionals who can provide you with the utmost care and quality.

Article contributed by Richard Striffolino Jr.

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.

Dry Eye Disease affects more than 5 million people in the United States, with 3.3 million being women and most of those being age 50 or over. And as people live longer, dry eye will continue to be a growing problem.

Although treatment options for dry eyes have improved recently, one of the most effective treatments is avoidance of dry eye triggers.

For some that might mean protecting your eyes from environmental triggers. To do that experts recommend using a humidifier in your home, especially if you have forced hot-air heat; wearing sunglasses when outside to help protect your eyes from the sun and wind that may make your tears evaporate faster; or being sure to direct any fans  - such as the air vents in your car - from blowing directly on your face. For others, it may mean avoiding medications that can cause dry eyes.

There is one other trigger that may need to be avoided that doesn’t get as much notice: the potentially harmful ingredients in cosmetics.

Cosmetics do not need to prove that they are “safe and effective” like drugs do. The FDA states that cosmetics are supposed to be tested for safety but there is no requirement that companies share their safety data with the FDA. There are also no specific definition requirements for labeling cosmetics as “hypoallergenic,” “dermatologist tested,” “ophthalmologist tested,” “sensitive formula” or the like, making most of those labels more marketing than science.

Things to watch out for in your cosmetics if you have dry eye include:

Preservatives

Preservatives are important to prevent the cosmetics from becoming contaminated but many are known to exacerbate dry eye. Common preservatives in cosmetics that could be adding to your dry eye problems (Periman and O’Dell, Ophthalmology Management August 2016) are: BAK (Benzalkonium chloride); Formaldehyde-donating (yes, Formaldehyde!) preservatives (often listed as DMDM-hydantoin, quaternium-15, imidazolidinyl urea, diazolidinyl urea and 2-bromo-2-nitropropane-1,3-diol); parabens; and Phenoxyethanol.  All of these preservatives in sufficient quantities can cause ocular irritation or inhibit the function of the Meibomian Glands that produce mucous that coats your tear film and keeps it from evaporating too quickly.

Alcohol

Alcohol is used in cosmetics mostly to speed the drying time but the alcohol can also dry the surface of the eye.

Waxes

Waxes can block the opening of the Meibomian Glands along the eyelid margin. If these glands are blocked they will not be able to supply the mucous and lipids necessary to the tear film to prevent it from drying too quickly. If you have trouble with dry eye it would be advisable not to apply eye liner behind the eyelashes along the lid edge where the Meibomian gland openings are.

Anti-aging products

While these may be safe and effective for the skin of the face they should not be used around the eyes. Most of these products contain some form of Retin A. These products have been shown to be toxic to the Meibomian glands and could be contributing to your dry eyes.

These components of cosmetics do not adversely affect everyone. However, if you suffer from dry eye and are not effectively able to keep your eye comfortable and your vision clear, you should investigate your cosmetics as a potential contributor to your problem.

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.

Living an overall healthy life is good for your eyes. Healthy vision starts with healthy eating and exercise habits.

There's more to complete eye health than just carrots. Are you eating food that promotes the best vision possible? Learn what foods boost your eye well-being and help protect against diseases. Here are important nutrients to look for when selecting your foods.

• Beta carotene or Vitamin A (helps the retina function smoothly): carrots and apricots
• Vitamin C (reduce risk of macular degeneration and cataracts): citrus and blueberries
• Vitamin E (hinders progression of cataracts and AMD): almonds and sunflower seeds
• Riboflavin (helps your eyes adapt in changes in light): broccoli and bell peppers
• Lutein (antioxidant to maintain health while aging): spinach and avacado
• Zinc (transfers vitamin A to the retina for eye-protective melanin productions and helps with night vision): beans and soy beans
• DHA (helps prevent Dry Eye): Fatty fish like salmon and tuna

Keep in mind, cooked food devalues the precious live enzymes, so some of these foods are best eaten raw.

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.

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

If you wear 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:

#1--Preventing Skin Cancer

One huge way that sunglasses provide a medical benefit is in the prevention of 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.

#2--Decreasing Risk For Eye Disease

There is mounting evidence that lifetime exposure to UV light 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, these growths can interfere with your vision and require surgery to remove them.

#3--Preventing Snow Blindness

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

#4--Protection From Wind, Dust, Sand

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

#5--Decreasing Headaches

People can get headaches if they are 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.

#6--Clearer Vision When Driving

We have all experienced an episode of driving, coming around a turn, looking directly into the direction of the setting or rising sun, and having difficulty seeing well enough to drive safely. 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.

Need a  chuckle or a groan?  Here you go...

1. Did you hear about the guy who just found out he was color blind?  It hit him right out of the purple!

2. What happened to the lab tech when he fell into the grinder?  He made a spectacle of himself.

3. Why is our staff so amazing?  They were all bright pupils!

4. Why did the smartphone have to wear glasses?  It lost all of its contacts.

5. What did one pupil say to the other?  I’m dilated to meet you.

6. What do you call a potato wearing glasses?  A Spec-Tater!

7. What do you call an optician living on an Alaskan island?  An optical Aleutian.

8. What was the innocent lens’s excuse to the policeman?  "I’ve been framed, officer!"

9. Where is the eye located?  Between the H and the J.

10. Where does bad light end up?  In Prism!

Is it safe to use "Redness Relief" eye drops regularly?

The short answer is NO.

Here’s the slightly longer answer.

There are several eye “Redness Relief” products on the over-the-counter market, such as those made by Visine, Clear Eyes, and Bausch & Lomb - as well as generic versions sold by pharmacy chains.

Most commonly, the active ingredient in redness relief drops is either Tetrahydrozoline or Naphazoline. Both of these drugs are in a category called sympathomimetics.

Sympathomimetics, the active ingredient in redness relief drops, work though a process called vasoconstriction, an artificial clamping down of the superficial blood vessels on the eye surface. These blood vessels often dilate in response to an irritation. This increase in blood flow is trying to help repair whatever irritation is affecting the surface of the eye. Clamping down on those vessels by using a vasoconstrictor counteracts the body’s efforts to repair the problem.

The other downside to repetitively using redness relief drops is that after the vasoconstrictor wears off the vessels often dilate to an even larger degree than when the process started. This stimulates you to use the drops again.

All of these drops carry these same two warnings on their labels:

Do not overuse as it may produce increased redness of the eye.

Stop using and ask a doctor if you experience eye pain, changes in vision, continued redness or irritation of the eye condition worsens or persists for more than 72 hours.

Does anyone read those warnings?  Almost never.

These drops are meant to be used for a VERY short duration - one or two days. That’s it!

They are not meant to be used indefinitely and they are certainly not meant to be used daily.

Take a good look at that first warning: MAY PRODUCE INCREASED REDNESS OF THE EYE.

If you are using redness relief drops repetitively you are likely making your eye redness WORSE, not better.

If you have been using redness relief drops daily you need to stop and replace them with an artificial tear or lubricating drop - something that DOES NOT say “gets the red out.”

After you make that switch your eyes are initially going to be red as your blood vessels take time to regain their normal vascular tone without the vasoconstrictor clamping down on them. The lubricating drop will actually help to repair the damage done by exposure to adverse conditions. This will decrease the inflammatory signals that make the vessels dilate. You will actually be doing something helpful to the surface of your eyes instead of just masking everything by artificially clamping down on your vessels and decreasing the flow of oxygen and nutrients to the front surface of your eye.

Using redness relief drops if you wear contacts is an even worse idea. If you put the drop in with your contact in, the contact will hold onto the drug and keep it on your eye surface longer, thus likely increasing the vasoconstriction. 

Your cornea has no blood vessels in it and it depends on the blood vessels in the conjunctiva over the whites of the eye to bring in nutrients and oxygen. The other source of oxygen for the cornea is what it gets from diffusion from the atmosphere and that is also cut down by the presence of the contact lens.

The redness relief drop combined with the contact lens are now BOTH reducing the levels of oxygen getting to the cornea. Decreased oxygen to the cornea is one of the biggest risks for contact lens-related infections, including corneal ulcers.

Don’t get me wrong, I’m not condemning redness relief drops if used appropriately for a very short time to soothe the eyes if they have been temporarily exposed to elements that made them irritated. For a day or two redness relief drops are fine. But for long-term use or for use while wearing your contacts they are much more likely to cause problems than to provide any benefits.

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.

Is making an appointment for a comprehensive eye exam for your children on your back-to-school checklist? It needs to be.

No amount of new clothes, backpacks or supplies will help your child succeed in school if they have an undetected vision problem. 

The difference between eye exams and vision screenings

An annual exam done by an eye doctor is more focused than a visual screening done at school. School screenings are simply "pass-fail tests" that are often limited to measuring a child’s sight clarity and visual acuity up to a distance of 20 feet. But this can provide a false sense of security.

There are important differences between a screening and a comprehensive eye exam.

Where a screening tests only for visual acuity, comprehensive exams will test for acuity, chronic diseases, color vision and make sure the eyes are working together properly. This means a child may pass a vision screening at school because they are able to see the board, but they may not be able to see the words in the textbook in front of them.

Why back-to-school eye exams matter

Did you know that 1 out of 4 children has an undiagnosed vision problem because changes in their eyesight go unrecognized? 

Myopia, or nearsightedness, is a common condition in children and often develops around the ages of 6 or 7. And nearsightedness can change very quickly, especially between the ages of 11 and 13, which means that an eye prescription can change rapidly over a short period of time. That’s why annual checkups are important.

Comprehensive eye exams can detect other eye conditions. Some children may have good distance vision but may struggle when reading up close. This is known as hyperopia or farsightedness. Other eye issues such as strabismus (misaligned eyes), astigmatism or amblyopia (lazy eye) are also detectable. 

Kids may not tell you they're having visions issues or even realize it. They may simply think everyone sees the same way they do. Kids often give indirect clues, such as holding books or device screens close to their face, having problems recalling what they've read, or avoiding reading altogether. Other signs could include a short attention span, frequent headaches, seeing double, rubbing their eyes or tilting their head to the side.

What to expect at your child's eye exam

Before the exam, explain that eye exams aren’t scary, and can be fun. A kid-friendly eye exam is quick for your child. After the doctor tests how she sees colors and letters using charts with pictures, shapes, and patterns, we will give you our assessment of your child’s eyes. 

If your child needs to wear glasses, we can even recommend frames and lenses best for their needs.

Set your child up for success

Staying consistent with eye exams is important because it can help your kids see their best in the classroom and when playing sports. Better vision can also mean better confidence because they are able see well. 

Because learning is so visual, making an eye examination a priority every year is an important investment you can make in your child's education. You should also be aware that your health insurance might cover pediatric eye exams.

With clearer vision, help make this school year their best ever!