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Ocular Surface Disease (Dry Eye Syndrome)
Dry eye syndrome (DES) is an underestimated and under diagnosed condition. There are millions of Americans that put up with symptoms, think that it’s just the norm, and never seek treatment. Fortunately we know more about the cause and contributing factors of this disease than ever before. This has spawned new medications and treatments that help us help patients deal with this very real disease.
Symptoms of DES
- Stinging
- Burning
- Foreign body sensation
- Redness
- Excessive tearing
- Blurred vision
Factors that increase your risk of having DES
- Age – DES increases with age
- Gender – Females have a much higher incidence of DES
- Contact lens wear
- Environmental
Dry windy environments
Heat and air conditioning
Computer use
Smoking
- Systemic Disease
Sjogren’s syndrome
Rheumatoid Arthritis
Lupus
Diabetes
HIV/AIDS
Hypertension
Parkinson disease
Sarcoidosis
Crohn’s disease
Vitamin A deficiency
- Ocular Conditions
Blepharitis
Allergic conjunctivitis
Meibomian gland dysfunction
Corneal dystrophies
- Medications
Antianxiety
Antidepressants
Antihistamines
Diuretics
Hormone replacement therapy
Oral steroids
Preservative eye drops
Systemic Beta blockers
Topical Glaucoma medications
- Diet
Diets low in Omega 3’s or with a high ratio of Omega 6 to Omega 3
Treatment of DES starts with an evaluation to determine which of the above factors you are dealing with. A treatment program based on those findings and appropriate monitoring and follow up care are set in place. The treatment of DES may include some or many of the following medications and strategies:
- Non preserved eye drops
- Lid heat and massage
- Omega 3 supplementation
- Anti inflammatory medications
Lotemax
Restasis
AzaSite
Doxycycline
- Punctal plugs
- Environmental considerations
Work space ergonomics
Computer lenses to create a microclimate around the eyes
Dry eye syndrome is a true disease process with concrete treatments available. Call our office and set up a dry eye evaluation today.
Computer Eyewear – GUNNAR OPTICS
Computer Vision Syndrome (CVS) causes eyestrain, blurred vision, headaches, dry eyes and loss of productivity due to the unique visual demands computers place on our visual system. We have seen a drastic increase in the time spent using computers in the workplace as well as at home. The impact of this ocular stress may range from mild discomfort to severe, debilitating vision loss and structural changes in the eye.
The best place to start to deal with symptoms of CVS is with a comprehensive eye examination. Through case history and measurements of the way your eyes focus and align, we can recommend changes in the physical setting of your workplace as well as prescribe special computer eyewear to alleviate your symptoms.
One of the key components to treating CVS is a unique pair of glasses designed for the intense pressures we put on our visual system while working on the computer. The type of lens depends on the individual and is certainly not one size fits all. Think of computer eyewear as a tool. A carpenter or plumber shows up on the job with a truck full of tools to do their jobs safely and effectively. Computer users need to have the proper tools in the form of specific eyewear to do their jobs safely and effectively as well.
As I mentioned earlier, there is not one style of computer eyewear that works for everyone. If you are under age 40 you may need some lenses that simply relieve the stress of focusing for a prolong period of time. These are usually single vision lenses. They will incorporate any underlying myopia, hyperopia and astigmatism but have a focal length more appropriate for the computer distance. Contact lens wearers can wear this type of lens over their contacts. If you are over 40 you will probably need a computer progressive lens that has different focal properties for viewing the monitor as well as paperwork on your desk. With any of these lenses, they will be specifically made for the computer and would not be appropriate for full time wear.
We recommend GUNNAR DIGITAL PERFORMANCE EYEWEAR for our computer users. These lenses come in a single vision and computer progressive design. Whether you need a prescription, wear contact lenses or don’t currently need a distance prescription, there is a Gunnar lens designed for you.
The GUNNAR Solution
- Wrap design limits air flow, creating a high humidity area to lubricate your eyes
- Signature tints filter out harsh fluorescent light
- Premium PureCoat by ZEISS anti-reflective coating reduces reflections
- Lightweight and ergonomic for all-day use
- Slight magnification built into the lense
GUNNAR Benefits
- Minimizes dry, itchy eyes
- Relaxes ocular muscle and decreases eyestrain
- Enhances contrast for sharper, clearer vision and reduces glare
- Increases visual endurance and productivity
- Optimized for your unique prescription
GUNNAR Results*
Patients were interviewed before and after using Gunnar Performance Eyewear and provided the following results:
- 100% reported improved ease of viewing
- 96% reported reduction in eyestrain
- 90% would recommend use of GUNNARS
- 80% reported their eyes were less tired when wearing GUNNARS
- 79% said that wearing GUNNAR eyewear increased productivity
*Based on the results of GUNNAR Optiks’ Market Test questionnaires, conducted March – April, 2009
It all starts with a comprehensive vision exam. Measure the distance from the bridge of your nose to your computer monitor and bring that information with you to the examination. This will help us determine the optimum lens power for your computer glasses. Give us a call at Hillsboro Vision Clinic (503-648-5522) and set up your examination today.
DAILY DISPOSABLE CONTACT LENSES
The fastest growing mode of contact lens wear is daily disposable contact lenses. Traditionally, soft contact lenses have been fit with a two week or monthly replacement schedule. Cooper Vision, Ciba, Vistakon and Bausch & Lomb are the four major contact lens manufacturers. Each company has embraced the daily disposable market and there are many fine lenses that our doctors fit.
Advantages of daily disposable contacts
- New lenses every day
- No lens care solutions to buy
- Excellent lenses for non-compliant teenagers
- Excellent lenses for swimmers
- Excellent lenses for patients with allergies
- Excellent lenses for dry eye patients
- Excellent lenses for occasional wearers
Disadvantage of daily disposable contacts
- Initially more expensive
Keep in mind the fact that you do not have to buy contact lens care solution makes the overall cost very comparable to two week lenses. The manufacturers are also very eager to promote the daily disposable lenses and offer substantial rebates. Let the doctors at Hillsboro Vision Clinic fit you in a week’s worth of these lenses so you can see the advantages before you decide if daily disposables are right for you.
COSMETIC CONTACT LENSES FOR HALLOWEEN
As Halloween approaches the topic of decorative contact lenses always comes up. Contact lenses are medical devices regulated by the Food and Drug Administration. A prescription is required to purchase any contacts whether they are tinted or not. Many street vendors, novelty stores, websites and salons sell decorative contact lenses illegally.
Contact lenses ride on the front surface of your eye, the cornea. A lens that fits poorly or is used by an untrained wearer can lead to serious eye conditions and possibly blindness. As eye doctors, we need to see the lens on the eye to determine if the fit is safe. We do this every day in clinic with diagnostic lenses we have at our disposal in the office. At one time a large contact lens manufacturer, CIBA, had a product called Wildeyes. We had diagnostic Wildeyes lenses and could fit and write a prescription for them. Due to poor sales, CIBA discontinued the Wildeyes line of lenses.
Because it is somewhat of a fringe product, none of the large contact lens manufacturers are currently making decorative contacts. The small, niche manufacturers do not have the relationships with the doctors to supply them with the diagnostic lenses for fitting. So we can’t fit the lens and write a prescription. This leaves the consumer who wants these contacts in a tough position. Either go without or get them without a prescription and risk eye injury and infections. Until something changes and lenses can be fit properly, we recommend leaving these lenses out of your costume plans.
ASTIGMATISM AND CONTACT LENSES
A common misconception we hear in our clinic is that patients believe they can’t wear contact lenses because of astigmatism. This is simply not true with technology that has been incorporated into today’s contact lenses.
Astigmatism is usually caused by the cornea, the front surface of the eye, being slightly out of round. Uncorrected astigmatism causes blurry vision and eye strain and can affect near as well as distance vision. During the refraction process (the part of the vision exam when we ask all those questions about what looks better) we can determine the exact amount and orientation of your astigmatism. After your refraction, glasses lenses can be ground to your specifications and those lenses are mounted in a frame. Set with your new specs, you’re on your way.
Contact lenses require a diagnostic lens fitting. Our doctors have ten different brands of contact lenses (toric lenses) especially designed for astigmatism. Armed with your refraction and a topography of your cornea we choose the lens that we feel will provide the best vision and eye health. The lenses are placed on the eye and allowed to stabilize for a few minutes and then evaluated for clarity, comfort and fit. If the first lens does not perform as we would like we try different lenses until we achieve the perfect fit. In most cases we can send you out the door the first day with either your exact prescription or something very close.
If you are a new contact lens wearer we will train you how to insert and remove the lenses. You will receive a case, some cleaning and storage solution and we’ll set up a one week follow up visit. At the follow up we evaluate the success of our initial fit and adjust or change lenses if necessary. In most cases one or two visits is enough to finalize the prescription.
If you happen to be a patient with very high astigmatism there are custom made soft and rigid contact lenses that are highly successful. So don’t let astigmatism keep you out of contact lenses. The doctors at Hillsboro Vision Clinic are experts in fitting patients with astigmatism. Call us at 503-648-5522 and set up an appointment for a fit today. Learn more about our clinic at www.hillsborovisionclinic.com.
HOW OFTEN SHOULD YOU SEE YOUR EYE DOCTOR?
HOW OFTEN SHOULD YOU SEE YOUR EYE DOCTOR?
I’m often asked how often a person should have their eyes examined. The answer depends on several factors including age, general health, current prescription, contact lens wear, visual demand, eye diseases and systemic medications.
- Infants should have their eyes checked before they are one year old. Dr. Andreason participates in the InfantSEE program which provides a free exam to infants less than a year old.
- Children should be checked at three years and then before entering kindergarten. If children at these young ages have a need for correction they should be seen at a minimum on a yearly basis and possibly more frequently if necessary.
- Adolescent and teenagers’ bodies are growing rapidly and there is a tendency for the eyes to change quickly as well. Yearly exams are advised at these ages. If the doctor feels things are very stable they may recommend an exam every two years.
- Contact lens wearers should have yearly examinations to make sure the cornea is healthy and tolerating the contact lenses. Contact lens prescriptions are only good for one year and a contact lens refit is needed to renew the prescription much like certain medication prescriptions.
- Highly myopic (nearsighted) should be seen yearly for two reasons. First, their prescriptions tend to change more often and need to be updated and secondly, they need a retinal evaluation due to an increased risk of retinal problems.
- Diabetic patients need to be seen yearly to monitor their prescription and to check the eyes for diabetic vascular changes.
- Computer users put tremendous strain on their visual system which can lead to fatigue, discomfort and blurred vision. Yearly examinations and perhaps special computer glasses can help these patients cope with the demand computer use creates.
- Glaucoma, macular degeneration and cataract patients will be seen from every three months to yearly depending on the needs of the individual patient.
- Healthy young adults between the early 20’s and late 30’s can usually go two years between exams if they do not wear glasses or contact lenses.
- High risk medication patients taking drugs such as Plaquenil or Temoxifen should be seen every 6 months for a retinal evaluation.
As a general rule yearly exams are advised taking into account the special cases above. If eye health is stable and the prescription is not changing an exam every two years is a reasonable option.
If you have any questions about your personal situation, feel free to call the office and talk to one of the doctors or please visit our website at www.hillsborovisionclinic.com.
