Who Should I Go to For My Eye Exam?

There is often much confusion regarding whom to see for an eye exam – after all there are three different “O’s” that care for eyes in various ways. Who should you choose? To answer this question, let’s first define who the three “O’s” are:

• Optometrists (O.D.’s) – A doctor of optometry receives his degree after four years of post graduate training in a college of optometry. Optometrists are licensed to perform comprehensive eye exams, prescribe glasses and contact lenses and to treat many types of eye disease including conjunctivitis (pink eye or red eye) and glaucoma. Optometrists typically do not perform surgery. Instead they receive additional training on understanding and treating the functional aspects of vision – how to help people see the best they can in their day to day lives.

• Ophthalmologists – Ophthalmologists are medical doctors (M.D.’s) or osteopaths (D.O.’s) who take a three to five year residency in eye care after they receive their medical degree. In addition to providing comprehensive eye examinations, ophthalmologists are able to prescribe eye medications and perform surgery. Some ophthalmologists go on for additional training and become specialists in certain areas such as retinal, corneal, cataract and glaucoma treatment.

• Opticians – Opticians are professionals specially trained to fit, fabricate and dispense eyeglasses. Many states also allow opticians to dispense contact lenses. Opticians do not perform comprehensive eye health examinations.

Which one should you choose for your routine comprehensive eye exams – an ophthalmologist or an optometrist? Obviously I may be biased, but I know today’s optometrists are well trained and skilled at detecting eye disease. If specialized medical or surgical treatment is ever needed, we will quickly arrange for you to see the right ophthalmologist who specializes in your particular eye care problem.

What Does 20/20 Vision Mean?

This is a common question that people seem to always ask eye doctors at social events. Typically optometrists and ophthalmologists refer to visual acuity in terms of the Snellen acuity eye charts. The Snellen acuity eye charts displays letters which become progressively smaller from the top to the bottom. In terms of Snellen acuity, 20/20 is considered normal vision for most people. From a statistic point of view what does this mean? In basically means that approximately 68.2% of the normal healthy population is able to have their vision corrected to this level. It also however means that approximately 15.9% of the normal healthy population has correctable vision that is better than this and that 15.9% of the normal healthy population has correctable vision that is worse than this.

In general 20/20 means that a person sees the same line of letters at 20 feet that a normal person sees from 20 feet. If a person has 20/40 vision, than this means that they can see the same line of letters at 20 feet that a normal person sees from 40 feet away. Therefore their vision is worse than normal. If a person has 20/15 vision, than this means that they can see the same line of letters at 20 feet that a normal persons sees from 15 feet away. Therefore their vision is better than normal.

Recap:

20/20 – Top number is where you are standing and the bottom number is where a normal person stands to see the same sized object or line of letters.

Now you know!

What is nearsightedness and how is it corrected?

Myopia or nearsightedness is a common vision disorder where by people can see objects up close, but are unable to focus clearly on objects in the distance. 

Nearsightedness is the result of two things, either a person's eye grows too long, or the outside of the eye is too steep or round, causing images to focus in front of the retina.

Symptoms of Nearsightedness

Typically, people will start to notice problems with their distance vision in their school years, but nearsightedness can develop at any age. It may also be a sign of a more serious medical problem, such as diabetes or cataracts, especially if the onset of nearsightedness is very sudden and dramatic.

Initial symptoms of nearsightedness include problems focusing on small objects far away like road signs or the channel guide on TV. People can find themselves squinting or developing frontal headaches from having to squint. Children often complain about being unable to see the board at school, while adults often complain about poor night vision or increased glare. Symptoms almost always worsen in low light level situations.

What Causes Nearsightedness?

There has been increased research in the area of nearsightedness in recent years, as the world has seen a sudden surge in the number of people requiring eyeglasses for distance vision correction. 

Early research studies suggest that nearsightedness may be related to near point stress, and numerous studies show that myopia increases along with a person’s level of education. 

Newer studies out of China also point towards dietary factors and excessive indoor time may play a significant role in the development of nearsightedness. However, these studies are far from complete. 

A study out of the UK at the St. Thomas Hospital also showed the genetics probably plays a significant role in the development of nearsightedness while environmental factors may only play a small or limited role.

Treatment options for nearsightedness

Treatment options for people affected by myopia or nearsightedness are numerous. Traditionally, eyeglasses have been the primary treatment option. However, patients also have access to contact lenses, laser vision correction, and intra-ocular lens implants. It is important to always discuss lifestyle and your work situation with your optometrist or ophthalmologist when determining your best treatment option or options.  It is also recommended that patients with nearsightedness receive regular eye health examinations by an optometrist or ophthalmologist every one to two years to ensure the health of their retina's. 

Meibominitis & Dry Eye

Meibomianitis is an inflammation of the oil glands or meibomian glands along your upper and lower eyelid margins. These oil glands produce the lipid or fat layer of your tear film, which coats the surface of your eye. The purpose of this lipid layer is to help prevent the water layer below from evaporating. When these meibomian glands or oil glands become inflamed, they no longer produce nice smooth clean oil. The oil can come out bubbly or thick, thus improperly coating the front of the eye.

Meibomianitis typically does not cause serious visual problems, but it can cause numerous comfort and cosmetic issues. Meibomianitis can cause your eyes to dry out, burn, itch, and water. All of which can lead to reduced vision, blurred vision, vision that fluctuates or vision that clears up with strong blinks. Meibomianitis can also cause your eyelids to swell or thicken and turn red, which can eventually lead to madarosis (eyelashes falling out). It can also lead to external hordeolums more commonly known as styes, which are simply clogged oil glands that have become inflamed.

TREATMENT OR PREVENTION:

The treatment for meibomianitis is fairly straight forward, and we encourage all of our patients to perform this treatment on a daily basis, regardless of whether or not they have meibomianitis.

Steps:

• Prior to getting in the shower in the morning, take a washcloth and heat it up under the tap with warmwater. Close your eyes, and lightly hold the warm washcloth over your eyes. Hold the cloth there until it cools off. Repeat this process for approximately 2 minutes.
• Than, lightly rub your eyelids with the wash cloth to force out all the old oil
• If you eyelids are really swollen than in the shower, take your washcloth and apply a small amount of baby shampoo to it (baby shampoo is used so that you eyes won’t burn, if they actually come in contact with the soap). Foam it up. Than lightly scrub you eyelid margins to remove any oil build up. Ensure that you thoroughly rinse away any soap residue.

Occasionally meibomianitis can get very bad, and medical therapy may be required. If this is the case, your optometrist or ophthalmologist may provide you with a topical antibiotic ointment. In some situations, oral antibiotics may also be used. 

To learn more about meibomianitis or to find out if meibomianitis is the cause of your vision problems, please contact one of our eye doctors and book and eye exam. 

High Blood Pressure and Your Eyes!

Having high blood pressure or hypertension (HTN) can have a serious impact on a persons overall well being along with the overall health of their eyes. It is estimated that approximately 22% of Canadians have hight blood pressure, but that only about half actually receive treatment for it. High blood pressure is considered to be a silent killer, as it often has no symptoms at all.

Elevated blood pressure is defined as having a systolic pressure of greater than 140mmHg or a diastolic pressure of more than 90mmHg. In the vast majority of people, there is no specific cause for their elevated blood pressure, but studies show that high blood pressure is more common in African Americans than in Caucasians and more common in the elderly. High blood pressure is also more likely to develop in people suffering from obesity or diabetes.

If blood pressure is aloud to remain elevated for any length of time, it can start to impact your health

The heart may become larger or weaker, which may lead to heart failure. Heart failure is when the heart cannot pump enough blood throughout the body

Aneurysms can form in blood vessels. Aneurysms are abnormal bulges or ballooning of an artery wall. Common locations are the brain, legs, stomach and spleen

Blood vessels in the kidneys can start to narrow, leading to kidney failure

Blood vessels can start to narrow throughout the body, which can lead to heart attacks, stroke, or kidney failure.

In men, high blood pressure can also cause erectile dysfunction

Blood vessels in the eyes can burst or bleed, which can lead to vision changes or blindness.

GENERAL SYMPTOMS:

• No symptoms
• Headaches or Morning Headaches
• Tinnitus (ringing in the ears)
• Dizziness
• Nose Bleeds
• Chest Pain
• Flushed or Pale Skin
• Nausea/Vomiting

EYE SYMPTOMS:

• Papilloedema (swelling of the optic nerve- can cause pain with eye movements or loss of colour vision)
• Blurred Vision
• Double Vision

TREATMENTS:

• Lifestyle 
• Lose Weigh
• Quit Smoking
• Eat a healthy diet
• Reduce Salt intake
• Reduce alcohol consumption
• Medications

**There are numerous types of high blood pressure medications on the market today. Only your family physician and yourself can determine the best type of medication for you.

For more information on High Blood Pressure or Hypertension, please visit the Heart and Stroke Foundation. If you are concerned that High Blood Pressure may be affecting your vision, please see your optometrist. Your optometrist has the knowledge and skill to work along with your family physician when managing your blood pressure.