Why can we help so many seemingly various conditions with Vision Therapy? It’s all about the eye-brain connection.
Vision is a Learned Skill
Vision is a learned skill that develops along with other skills as a baby grows. Movement and vision are significantly interrelated and the development of vision has to do with the types and varieties of experiences a child has.
It is important to remember that the eyes are part of the brain system. The eyes “see” but the brain “interprets.” A person can have 20/20 eyesight, which measures visual acuity at a distance, and still have a visual skills problem making near work — like reading, writing, or using a computer — extremely difficult. In fact, seeing 20/20 is just one of 20 visual skills necessary to succeed in reading, learning, sports, and in life.
20 Visual Skills
SEE THE 20 VISUAL SKILLS REQUIRED FOR GOOD VISION.
CHILDREN WITH VISUAL SKILLS PROBLEMS
Most visual skill deficiencies reveal themselves when a child enters school because the learning environment is increasingly more demanding of young learners. One out of four children have undiagnosed vision problems. If you’ve ever heard a parent say, “My child is so smart but still, he struggles in school and every day, homework is a battle!” you are hearing a common pain felt by parents of kids who have undiagnosed vision problems. The truth is, once the visual barrier is removed, these kids love school and love to learn.
ADULTS WITH VISUAL SKILL DEFICIENCIES
Adults who have managed to graduate high school in spite of a vision skills problem may not pursue college or may drop out early because the demanding workload for reading is just too much. These incredibly smart adults become very skilled at avoiding reading in their personal life as well as at work — and it’s no wonder when reading can be physically painful and exhausting for them! When you consider how few jobs there are that do not include working on a computer, it is easy to see why an adult who suffers from a vision skills problem may have limited career choices and growth opportunities. Learn more about how we help adults with visual skill deficiencies.
REFINING VISION SKILLS: COLLEGE STUDIES
Because good vision is a learned skill it is also a skill that can be enhanced. High school graduates who want to optimize their reading and comprehension efficiency can benefit from Vision Therapy. Our customized programs prepare college students in a way that no other type of college-prep can: By enhancing the eye/brain connection. When visual efficiency, comfort, and stamina is at it’s peak, students can learn faster, easier, and work longer more comfortably than ever before. These skills support learning while in school and professional success for a lifetime.
REFINING VISION SKILLS: SPORTS
Sports Vision Training is a secret weapon of professional athletes that they never talk about. As you know, the skills difference is very small between successful athletes and those who don’t make the cut so fine-tuning all areas of play is critical.
Further developing vision skills improves:
reaction time
focusing speed
eye tracking
peripheral awareness
visual processing speed
eye/hand coordination
and clutch concentration
We have helped high-school students improve their sports performance to levels that allow them to receive scholarships for college and then move on to pro teams. We have helped aspiring young athletes early in their sports career gain an edge in their performance. We even help weekend warriors improve their game just for bragging rights. Whatever level you play, Sports Vision Training will give you an edge.
BONUS: Athletes that complete our Sports Vision Training also report improved learning and performance in the classroom as a result of improved visual skills.
BRAIN INJURY REHABILITATION
When you understand the vital connection between the eyes and brain for seeing, comprehension, and coordination it is easy to realize how a traumatic brain injury, such as a stroke or concussion, can disrupt or distort the flow of information from the eyes to the brain. When vision problems due to a brain injury go untreated, the rehabilitation process can be adversely affected. It is absolutely imperative that any rehabilitation program includes a thorough evaluation of the performance of the visual system.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Children whose academic performance is significantly advanced compared to others their age are categorized as gifted. Yet, educators who work with children and teens identified as Gifted and Talented understand that though these students may be exceptional in some academic work, they may struggle to learn in other areas of study. It can be extremely hard to identify these kids as their giftedness can allow them to compensate in the areas in which they struggle. They are also most likely to work extra hard to compensate for a learning dysfunction they are intuitively aware of but struggle to express to parents or teachers. These kids are often referred to as Twice Exceptional.
MEET MITCH
Mitch was identified as Gifted and Talented as early as First Grade. This isn’t surprising considering he was reading by the age of two. But by middle school, he began acting out at school and at home. His pediatrician diagnosed him with ADD/ADHD and prescribed medication.
Mitch’s mom, Denise, says, “As parents, we resisted medicating Mitch. But by 6th grade, we felt out of options. We just needed something to help us get through social situations, school, and the acting out.”
However, Denise, still didn’t feel right about the ADD diagnosis. When he advanced to his Freshman year, his struggles seemed to grow.
HITTING THE WALL
“He could verbally answer homework questions with me just fine,” Denise says, “but he would break into tears when I asked him to write it down. It seemed like a temper tantrum.”
She says his eye doctor gave Mitch proper prescription lenses but never picked up on any vision issues. School testing continued to give no answers.
“I always felt like something just wasn’t right but couldn’t put my finger on it,” says Denise. Mitch, a self-professed math and science geek, went to one 3D movie and never wanted to go see another. He got motion sickness all the time. He expressed no interest in wanting to learn to drive. They had to find as many of his schoolbooks as possible as audio downloads because he could learn by listening.
But these cues are difficult to connect if you don’t know that visual performance skills are different than 20/20 sight. Kids who suffer don’t realize that they are seeing things differently than everyone else. They don’t know how to express the problem with how their eyes are functioning.
CRITICAL REFERRAL
Finally, after a friend heard Denise’s concerns, she referred her to Highline Center for Vision Performance (HCVP). They quickly made an appointment to take advantage of the complimentary Vision + Learning Screening.
“Mitch lit up when they began asking him questions,” says Denise of the initial consultation with HCVP. “I could see his relief that someone finally understood. His self-esteem improved almost immediately just knowing that he could be helped.”
Tests went on to reveal that Mitch’s reading efficiency were at a 3rd grade level. His tracking speed (one of 20 measurable visual skills) was higher – at an 8th grade speed – but at only 50% comprehension. In order to achieve “quality” comprehension, he dropped down to a 5th grade speed. It’s no wonder he struggled with his high school studies!
Denise was thrilled with her visit to Highline and with Mitch’s response. However, the family pediatrician thought Vision Therapy was fake and discouraged them from participating. Regardless, Denise was certain they were on the right track and moved forward with Vision Therapy anyway.
GRADUATION
Mitch was highly motivated to do his Vision Therapy homework and graduated within five months at which point his reading efficiency was at grade level 13.6 (a freshman in college) and his reading comprehension went up to 90%.
Denise says, “About ¾ of the way through Vision Therapy, he was able to complete schoolwork in the classroom so he was bringing home less work. It was amazing! His eye muscles were keeping up with his intelligence. Everything in school is easier now. There are no more meltdowns.”
Now, Mitch is a typical teenager eager to drive and loves seeing movies in 3D. His writing has improved dramatically and he continues successfully in his school’s Gifted and Talented program.
IN REVIEW
Currently, Mitch’s pediatrician still believes Vision Therapy is a hoax and that Mitch just outgrew his ADD.
Denise believes that Mitch’s behavioral issues were related to his undiagnosed vision disorders. They are currently considering taking him off his medication.
“His medication is a non-stimulant and is short lived in his system,” says Denise. “Before Vision Therapy, we could always tell at the end of the day that it was wearing off because that’s when his behavior would change. However now, we don’t have the meltdowns anymore and Mitch has confessed that he often doesn’t take it over the weekends anymore and we don’t even notice.”
Highline, often sees students who have vision disorders and are misdiagnosed with ADD/ADHD. In Mitch’s case, Dr. Jeri Schneebeck is convinced that Mitch’s acting out was from his frustration.
“You have this incredibly intelligent person who is trying so hard to keep up with his peers and failing – it’s no surprise that he had outbursts,” says Dr. Jeri. “Once we begin improving vision skills by teaching the eyes and brain to coordinate, it’s like a weight is removed and he can finally move forward. It’s a joy to see.”
“The frustration and inability to communicate that there is a problem is simply overwhelming to these kids,” adds Nancy Stevens, Vision Therapist at HCVP. “But we find, time and time again, that once they successfully complete Vision Therapy, they are happier in every facet of their lives. The ability to successfully learn opens up their future in incredible ways.”
Mitch’s mom, Denise, continues to be a vocal advocate for Vision Therapy and shares her story frequently with other parents who have smart kids that struggle in school.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Nowadays, sports eyewear tells the world that you are a serious player. It doesn’t matter whether you bat in Little League or skate with the pros, eye gear for sports offers a long list of benefits.
Protective eyewear, such as specialized goggles and wraparound frames with polycarbonate lenses, helps to reduce or eliminate your risk of eye damage. An added bonus is that performance is often enhanced, due to the high quality vision provided from eyewear made for wearing on the playing field.
Eye gear for sports is not merely recommended, but now mandated by many clubs. Members are required to wear proper protective eyewear in order to participate in activities. Once upon a time, kids used to cringe at the concept of wearing goggles, but just like bike helmets have become the norm – sports goggles are now accepted as part of the uniform and regarded as ultra-cool.
Protect Your Eyes from Fast and Furious Sports Action
If you’re still unconvinced about your need to wear protective eyewear for sports, take a look at these scary statistics:
Hospital emergency rooms treat 40,000 eye injuries annually, which are sports-related
Tennis and badminton are played with objects that zoom at 60 mile per hour or faster. With racquetball, the ball can whizz by at 60 to 200 miles per hours.
Activities such as racquetball involve racquets that swing at lightning speed in a confined space where crashes are inevitable.
Many sports are filled with pokes and jabs from elbows or fingers. Even basketball is associated with a high incidence of injuries to the eye.
Up Your Performance with Sports Eyewear
Until recently, people with mild to moderate vision correction used to play their games without wearing eyeglasses or contacts. Yet top performance in any sport is dependent upon sharp vision. Eye gear and goggles for sports allow you to compete at your best, with 20/20 eyesight.
Key Features of Sports Glasses
Sports eyewear does not share the same characteristics as regular eyeglasses, sunglasses or industrial safety glasses. Crafted in a variety of shapes, sports eye gear is specialized to suit the specific needs of each respective sport. Many types of eyewear are even designed to fit into helmets worn when playing football, baseball or hockey.
Protective lenses are generally made from polycarbonate, a durable and impact-resistant material that boasts full UV protection for outdoor action. Polycarbonate lenses are also scratch-resistant, which is a valuable feature for many rough sports.
The frames are typically designed from highly-impact resistant plastic or polycarbonate, and they are coated with rubber padding at every point that connects with your face. Some frame styles are contoured to wrap around your face, which provides secure coverage for activities such as hang-gliding, sailing and biking. Non-prescription wraparound shapes are useful for contact lens wearers, as they block your eyes from dust or wind.
Classic handball goggles used to be fashioned as plain goggles with small openings instead of lenses. That style was abandoned once it was realized that the high speed of handballs actually compressed the balls enough to penetrate through the goggle opening and seriously damage the orbital bones around your eye. Modern and effective goggles for handball and racquetball include polycarbonate lenses that protect your eyes.
Importance of a Good Fit
There’s no such thing as one-size-fits-all when it comes to sports goggles. Proper sizing is critical for top-notch function. For kids, many parents may be tempted to purchase larger goggles so that they’ll be long-lasting with room to grow. Yet if the frames are truly oversized, they won’t protect the child’s eyes adequately. Impact or blows to the face or head won’t be cushioned properly.
On the flipside, wearing sports goggles that are too small is just as hazardous. Not only will the child be constantly tempted to take them off due to discomfort, but the eyewear will also disturb peripheral vision. Without a good view of all that’s happening around your child, sports performance will be compromised. Hits from unseen sources on the sidelines are another risk factor.
The fit of sports goggles should be reassessed each year. The eyewear should still feel comfortable and provide proper eye protection. The padding on the interior of the goggles must rest flush with your or your child’s face, and eyes should be centered in the lens zone.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Dr. Nick Doyle, O.D., talks about Keratoconus and various eye conditions that can be helped with specialty contact lenses.
KERATOCONUS & SPECIALTY LENSES
Hi everybody! This is Dr. Nick Doyle from Highline Vision Center and I’m one of the four optometrists here. I just wanted to take an opportunity to talk to you today a little bit about one of my passions and areas of expertise within the practice, which is seeing patients who have Keratoconus and specifically fitting those patients with specialty contact lenses.
TYPES OF REFRACTIVE ERROR
To understand a little bit about what we’re talking about in the first place, it’s helpful to talk a little bit about different types of what we call refractive error, or what you may know as your prescription for glasses or contact lenses, and up here we’ve listed the four different, main types of refractive error:
Myopia
Hyperopia
Astigmatism
Presbyopia
The most two common being myopia and hyperopia which we know as nearsightedness and farsightedness, and then astigmatism and then presbyopia. And presbyopia is simply the type of refractive error that we start to see around 38 to 42 years old when the lens inside the eye gets a little bit less flexible, and that’s when our patients start to need reading glasses or bifocals or even progressive lenses.
ASTIGMATISM
I’m going to touch a little bit more on astigmatism correction because I think astigmatism sometimes gets just a little bit of a bad rap because it sounds different than nearsightedness or farsightedness, and astigmatism really is when the cornea, or the front surface of the eye, is more curved in one direction than another, it’s not totally spherical, and so the common example that we’ll use, that’s a little bit extreme but it helps to get the point across, is your eye is the shape of a football rather than the shape of a baseball.
TOPOGRAPHY
One of the instruments that we will be talking about a little bit in regards to diagnosis, not only of keratoconus but astigmatism, is a corneal topographer. And, a corneal topographer takes a detailed image of the front surface of your eye or your cornea, and it helps us to really easily visualize those curvature changes on the cornea. This [see graphic at 2:23] happens to be a topography map of a patient who has absolutely no astigmatism correction. You’ll see there’s a uniform color here on the map on the right; it looks pretty uniform yellow, and we’ll contrast that with a patient who has what we call “with the rule” astigmatism [see graphic at 2:52]. And, you’ll very readily see that this particular image has what we call a characteristic hourglass shape where you see what we call these hotter colors, your reds, kind of pinks, and oranges concentrated into this figure eight or hourglass shape, and that just indicates that this patient’s cornea is more curved in this direction. So, this is a patient who has what we call regular, “with the rule” astigmatism and we can use glasses and contacts to correct for that.
CORNEAL ECTASIA
We’re going to get into talking a little bit about keratoconus at this point, and keratoconus is a type of what we call a corneal ectasia. As many medical terms do, ectasia comes from a Greek word ectasis, which means stretching, and so we’ll get into that a little bit, but keratoconus, or the corneal ectasias in general, are types of corneal diseases that cause progressive thinning and steepening or that stretching of the front surface of your eye. When you talk about the cornea, in general, it’s about the thickness of a credit card, give or take a little bit, so you can imagine what stretching something that thin, that accounts for about two-thirds of the light bending power of your eye, in general, can do to your vision. But, there’s some basic, different types of ectasias that we deal with in the office, keratoconus being the main one.
There’s a slight variation of keratoconus that we call marginal degeneration keratoglobus, which is a much more severe form of keratoconus, and then we can sometimes see these corneal ectasias in patients who’ve undergone refractive surgeries such as RK (radial keratotomy), PRK, and lasik, potentially if they had too much surgery for what their corneas could handle. Thankfully, we don’t see this often because most of the refractive surgery offices in the area, especially the ones we send our patients to, do a very good job of screening patients to make sure they don’t have any underlying corneal conditions that could cause this.
KERATOCONUS
If we get into talking a little bit more specifically about keratoconus, because that’s what the majority of this presentation deals with, it sounds like it’s rare because the numbers would tell us that, really, it’s about 50 to 230 people per
100,000 in the population, it’s actually quite common. I see keratoconus easily on a weekly basis, depends on the week – sometimes on a daily basis. Usually the onset of this, even though it may not be detected at this time, is before puberty. Sometimes keratoconus will progress through your early forties, and it really depends on a lot of different genetic factors, but it typically affects both sexes, men and women equally.
There are genetic factors that are at play here, and, again, we’ll talk a little bit more about that because that’s an opportunity that we have now available to us to detect this thing a little bit earlier. Some patients have some specific enzyme abnormalities that can cause this to happen; there are certain rare connective tissue disorders that can cause this to happen. We talked a little bit about refractive surgery, things like lasik being at play here, but I want to touch specifically on two of the more common things that we will see, and that is patients who have chronic allergies and do a lot of eye rubbing. And we’re not just talking about eye rubbing occasionally, we’re talking about people who are really rubbing their eyes constantly because they’re always itching.
Keratoconus is a progressive disease, remember we talked about that stretching, but it causes progressive steepening or more curvature to the cornea and thinning of that cornea. Remember, that cornea is pretty thin already. We talked about it being about the thickness of a credit card. The younger that you are when you develop keratoconus, the faster that it progresses, and we can kind of use that a little bit to our advantage in some of the treatments that are available. We’ll get into that a little bit later.
This is a profile image of someone’s eye who has keratoconus. You can see that it’s starting to form kind of a cone shape on the front surface here because the front surface of that eye is starting to get a little bit thinner; it’s starting to become more curved or stretched.
IRREGULAR CORNEAL ASTIGMATISM
And so, if we contrast this topography map of a patient who has keratoconus with the one that we saw earlier that was kind of that nice regular figure eight or hourglass type shape, you’ll notice that there’s still that hot spot of colors here where the cornea is more curved, but that spot up here is missing, and that’s because keratoconus causes very irregular or asymmetrical astigmatism correction. This gets very difficult sometimes for us to correct with standard glasses because it’s almost like the front surface of the eye is warped, and so no matter what we do with a lens and a pair of glasses, that light passes through the lens and the glasses, the glasses bend the light as they’re supposed to do to – try to correct the prescription – and then that light hits this warped surface again and it kind of scatters everywhere. We do have ways to deal with this.
PACHYMETRY
This is a similar patient with keratoconus, it’s what we call a pachymetry map. The pachymetry map helps us to measure the thickness of the front surface of the eye. Remember we talked about keratoconus also causing thinning of the front surface, and so you can see right down here where that highly curved area is, you’ll see that these thickness numbers, which are measured in microns, are much thinner than they are in this top surface of the cornea. Again, pretty irregular; it’s not very uniform.
IMPACT ON VISION
And so, you can imagine the impact this has. And, this could be for someone, even what they see when they’re fully corrected with glasses and have keratoconus. Again, because glasses in some patients with keratoconus just aren’t all that effective, but people will often report a lot of halos around lights at night, they’ll report things like streaks through lights, and we’re going to talk a little bit about how we treat these types of things and get these people seeing better.
TREATMENT
The first step, at least in our office, in my patients, the first step is really to talk to patients about eye rubbing. We talked about that being a big risk factor for keratoconus, but we need to stop eye rubbing immediately because there’s some anecdotal case studies that tell us that patients who stop eye rubbing, there’s a significant reduction in the progression, and to help with that, we’ll also start treating patients for any allergies they might have using antihistamine drops, steroid drops, things of that nature.
There’s some other treatments for keratoconus, some of them relatively new – one of them is CXL, stands for corneal collagen cross linking. So, we’ll talk a little bit about what that is, talk about some methods for improving your vision if you have keratoconus. The end stage as far as keratoconus, if it progresses too quickly or too much for us to be able to correct your vision anymore with these other methods would be corneal transplantation, and we do have a fair amount of patients we see still who have had corneal transplants, although it’s a fairly invasive surgery, usually we can get them seeing better with contact lenses and things of that nature after surgery.
COLLAGEN CROSSLINKING: CXL
Collagen crosslinking is a surgical procedure. There are a number of corneal specialists in the area who we refer patients to to have this done. You see on the left we kind of compare cross-linking to having a gel nail done, and I know that sounds kind of silly, but the process is kind of similar in the sense that we’re essentially hardening a resin or hardening something using a chemical reaction that involves UV light.
So, the eye on the right is a patient that’s having cross-linking done. What they do when they do a cross-linking procedure is they essentially are putting riboflavin drops on the surface of the eye and exposing it to certain wavelengths of light, and the cornea is made up of a collagen beam structure, a collagen network, that gives it its strength, the reaction between the light and the riboflavin causes that collagen to become very tightly knit and artificially hardened. And so, what we’re doing is essentially aging the eye on purpose. The collagen in our body actually starts to cross-link itself after we’re 40 years old anyway, which is why we talked about keratoconus progressing through your 40s. It tends to naturally slow down because of this, but we can artificially make that happen and slow the progression through this procedure. And this is something that’s relatively new within the last five or ten years. It’s very safe when done in the right hands, but it’s something that can really stop the progression. It can’t reverse the damage that’s already done but it certainly helps us out in the long run.
SCLERAL LENSES
The treatment modality that I’m very passionate about and that I work with frequently is a type of contact lens that’s called a scleral lens, and you’ll see someone holding one of them right here. It’s a very large, or larger than normal, gas permeable or hard contact lens. These are custom made lenses. In many patients, when we show them this lens for the first time they think it’s going to be uncomfortable, but actually, the exact opposite is true. This lens, and we’ll see this in a minute, doesn’t actually touch your cornea. It doesn’t rest on your cornea at all; it fits on the white part of your eye, which makes it very comfortable, and it also means that we’re able to get a contact lens onto the surface of the eye to get the patient seeing better without it continually rubbing over that cone or that area of keratoconus and steepening on the front surface of the eyes. Ultimately it’s a little bit healthier option long-term for these patients to avoid scarring.
WHY DO THEY WORK?
So why does this work better than say a pair of glasses? Well, these contact lens, remember we talked about the patient who has keratoconus having an eye, or front surface of the eye rather, that’s a little bit warped, and so this kind of contact lens actually allows us to create a perfectly smooth, spherical surface on the front of the eye. It’s kind of like we’re temporarily putting an artificially perfect cornea over the one that’s warped, so it allows light to really pass through that lens and create a clear image. Oftentimes, I will see patients who are 20/80, 20/100, even 20/150 out of glasses, and we can get them to see 20/20 out of a scleral lens.
FITTING SCLERALS
From the side, this is what a scleral lens looks like. The lens rests on the white part of the eye, it vaults over the cornea here. There’s space in between the back surface of the lens and the cornea, which we can also see on this OCT scan. This is an instrument we use to help us to fit these lenses, and in doing that, again, we’re not rubbing on the cornea, we’re not creating scarring long term, but we’re getting the patient better vision. This is the same view, or a slightly different view rather, using the same instrument, the OCT instrument, showing where the lens lands on the sclera, or the white part of the eye. Here you can see this transition line here between the sclera and where the cornea actually starts.
OTHER USES FOR SCLERAL LENSES
Scleral lenses are very useful to us for patients with corneal ectasias and keratoconus, but they’re actually useful for multiple different applications. They can be useful for patients who have very severe dry eye, that’s because when you put these lenses in, you actually fill the lens with saline, and so that saline stays between the back surface of the contact lens and the front surface of the eye all day long until you take the lens out, and so for patients with a very severe dry eye that we can’t treat by other means, this is an option because it kind of creates a sealed environment for that patient where their cornea is just bathed in saline solution all day long.
We can use these lenses in patients who have had corneal scarring either due to previous surgery or some type of injury; we use them, as we talked about, in patients who had corneal transplants, and some of them are even useful in patients who have higher prescriptions or patients who need a multifocal type of lens that helps them to see up close and far away; that have higher amounts of astigmatism, and they’re useful for that because some of the lenses, soft lenses, that we use for this just don’t come in parameters high enough to help these patients.
INSERTION, REMOVAL, AND CARE OF LENSES
These are multiple applications for these lenses. They’re a little bit different to put in than a soft contact lens; they require a different technique, which obviously, we teach all of our patients how to do this safely and efficiently, but they require a special insertion and removable devices. They require the patient to fill the lens with saline before they put it in, but the solutions for, as far as cleaning, the lenses are very similar to your standard soft lens solutions, in the sense that we can get what we call multi-purpose solutions, kind of an all-in-one type of storage and cleaning solution. So yes, they take a little bit of getting used to, a little bit of retraining, but we find that most people readily adapt to doing this without any issues.
INSURANCE
We talked about scleral contact lenses being more of a custom option, which sounds a little more expensive, and yes it can be, but insurance often covers these, and vision benefit plans often will cover these under a visually necessary or medically necessary rider on the patient’s plan, and so we do help patients all the time to work with their insurance to make sure that we get the best coverage for these lenses, and obviously we go over all of these costs associated before we even start fitting these contact lenses, but, oftentimes, we can get these lenses almost fully covered by patient’s vision plans, which is nice for those patients who really do need them.
SUPPORTING LOCAL BUSINESS
This is an image of how these lenses are cut; they come from a button of plastic, which is a special type of plastic that’s used to make contact lenses. It’s very breathable. They put the lens on a lathe, and a computer controls how this lens is cut. This is actually an image from a laboratory in Lakewood. The laboratory is called Advanced Vision Technologies; we’ve been using them for all of our gas permeable lenses for a number of years. Now, they do a great job. They’re a locally owned business, which is fantastic, and they have their own designs, which is awesome, because they’re constantly innovating and developing new designs. We’re lucky to have them right in our backyard because they actually ship lenses all over the world.
THE FUTURE
What is the future of keratoconus? What’s the future of scleral contact lens fitting? What technologies are coming down the pipeline here to help us and help patients who have keratoconus? This is the process of something that we call the EyePrintPro lens, which is something that’s now available. The EyePrintPro is very interesting, you may wonder what this blue goo is. I’ve actually had this done on my eye to see what it was like. It’s not painful at all, but the blue goo is a dental impression material that’s been FDA approved for the front surface of the eye, and it helps the contact lens practitioner to be able to take an exact mold of the patient’s eye, who has a keratoconus, and in some patients, who we just can’t get a standard scleral contact lens to work for, this is extremely helpful because we would send this impression back to the laboratory, they can scan it, and they can essentially 3d print a lens that’s custom made exactly for that patient’s eye. Super useful technology; pretty new over the last five years. It’s gaining more and more popularity, but we’re pretty excited that this is something that’s available to us at this point.
On the diagnostic side, this is a genetic test that we can now use called Avigen. Avigen tests, it’s just a cheek swab, so painless, but it tests for 75 genes and over 2000 variations of those genes that influence keratoconus, and so we get a very detailed report back after sending this test into the lab, and we can essentially tell a patient what their risk for developing keratoconus is. Why does this become useful? This becomes useful especially in our patients who, maybe they have keratoconus and we see their children for exams, and we’re starting to see some astigmatism correction, but their topography map is slightly suspicious, but we don’t really know, and so we can do this test very easily with them, find out what their risk is, and potentially monitor them a little more closely, so that if they start to change at all we can get them in right away for cross-linking, so that, hopefully, we don’t end up in a spot where we even need scleral lenses or potentially a corneal transplant down the road.
We can treat this patient for allergies and talk to them about allergies, eye rubbing, sooner to avoid any issues down the road. This is something, that for me, is super exciting because it’s going to allow us to know what’s going on faster than we ever have before.
QUESTIONS?
So that’s about all for today’s presentation, so hopefully that was informative. It’s something that I really enjoy doing. I really enjoy seeing patients in the office and helping them with issues like this, but if you have any questions at all regarding either this presentation or you might have keratoconus or know someone who has keratoconus, please have them call us at the office, the number is listed below.
We’re happy to talk to you about this and happy to do anything we can to help you.
Have a great day!
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Your eyes are constantly producing tears, which is vital to keep your eyes healthy, comfortable, and seeing properly. People suffer from dry eyes because of a chronic lack of lubrication and moisture on the eye’s surface. Tears cover the eye’s surface to keep it moist and wash away dust and debris that could damage the cornea and lead to an eye infection. Read more to learn about the causes and symptoms of dry eye or schedule an exam today to find relief!
Symptoms of Dry Eye
Dry Eyes, also called dry eye syndrome or dry eye disease, affects each person differently. Individuals may experience only one symptom or multiple symptoms outlined below, but the good news is there is no reason to suffer from these symptoms.
Burning Eye Sensation
Scratchy or Itchy Eye Sensation
Aching and Sore Eye Sensation
Dry Eye Sensation
Foreign Body Sensation (Feeling like something is in your eye.)
Fatigued or Tired Eyes
Red Eyes
Light Sensitivity
Excessive Tearing
Blurred Vision
Some of these conditions may be present at all times or only at certain times.
Some people may only notice discomfort when trying to wear contact lenses or when they are in windy conditions that cause air to be blowing directly on their face (like when driving with the vent blowing). Whether you suffer all the time or some of the time, we can determine a treatment plan that helps.
Causes of Dry Eye
Like with many health conditions, eye-related and otherwise, there isn’t one clear cause, but instead many potential causes. Similar to symptoms, some people may have more than one cause contributing to their dry eye symptoms.
Lifestyle
Computer use | When working at a computer or portable digital device, we tend to blink our eyes less frequently, leading to greater tear evaporation.
Contact lenses | Many people express exaggerated dry eye symptoms when wearing contact lenses.
Indoor environment | Air conditioning, ceiling fans, and forced-air heating decrease indoor humidity and increase tear evaporation.
Outdoor environment | Dry climates, high altitudes, and dry or windy conditions have lower humidity.
Air travel | The air in airplanes is intended to be extremely dry.
Smoking | Smoke can become an eye irritant.
Medical
Aging | Dry Eye symptoms can become apparent at any age but are more common as people age.
Menopause | Post-menopausal women are at greater risk than same-aged men.
Health Conditions | Certain diseases can contribute to dry eye problems. This is why it is important to share your complete medical history with your eye care provider.
Medications | Many prescription and nonprescription medicines increase the risk of dry eye symptoms. For this reason, remember to share a full prescription list with your eye care provider.
Eyelid Problems | Incomplete closure of the eyelids when blinking or sleeping can cause severe dry eyes.
Eye Surgery| LASIK, Cataract Surgery, and other corneal refractive surgery can cause dry eyes. However, in most cases, dry eye discomfort after surgery is temporary.
Allergies | Allergies and some allergy medications can cause dry eyes.
If you believe you may be suffering from dry eye, reach out to your eye doctor to schedule an eye appointment to discuss your symptoms and determine a treatment plan that will work best for you.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Vision involves a complex relationship between the brain, eyes, and the nerves connecting them to keep them working together smoothly. Most people aren’t shocked to learn a child’s eyes are not fully developed upon birth. However, some are surprised to learn that a child’s vision development spans many years and some childhood activities can encourage healthy eye development.
Vision in Infancy
Vision development begins during pregnancy, but it doesn’t get very far. At birth, babies only see black, white, and shades of gray and cannot stare or focus on objects. During the first month, your infant will begin to blink in response to light, track moving objects, and focus or stare at items up to ten inches away.
As time passes, your child will become even more engaged in their environment and bodies, mostly their hands. Focusing on objects that are further and further away, improving their tracking abilities, and starting to reach for objects.
Even if everything is developing normally, it is still a good idea to schedule your child’s first eye exam early! Give our office a call to see what age we recommend your child’s first exam. While your child may be unable to speak to the doctor, read the eye chart, or answer one or two when asked which is better, our team can gather information about general eye health and ensure they are on the proper development track. Early detection of eye health and vision problems can help to ensure setbacks in learning and growth don’t occur.
Early Childhood Vision Development
As your child continues to grow, so do their visual skills. Your child will begin to focus on categorizing and labeling things, such as colors, shapes, and body parts. If your child has vision problems, you may notice issues with their ability to complete these categorizations. However, even if they are doing well, it is still important to schedule your child another eye exam around three years of age. Schedule a comprehensive eye exam before your child enters school to provide enough time to catch and correct any vision problems.
Visual health also has an impact on your child’s physical development. Early childhood is a critical developmental stage when children develop fine-motor and gross-motor skills, including drawing, jumping, catching, kicking, and throwing a ball.
When your child begins to enter a classroom setting, undiagnosed vision issues may start to take a toll. Even if they are unable to express in words why they are struggling, keep a close eye on the way your child is learning and interacts with their materials and environment. Here are some things you may notice:
It takes your child longer than others to complete the same task.
It takes your child longer than others to learn something.
If your child begins to complain of headaches or tired eyes.
Your child begins squinting or frequently rubbing their eyes.
Your child starts tilting their head, holding things too close to their face, or closing one eye to see.
Or if your child begins avoiding activities that require near or distance vision.
Undetected vision problems can cause developmental and educational delays, so it’s important to schedule eye exams every year once your child turns three unless directed by your eye doctor. Your child needs to have all of the necessary tools required to succeed, and we can help! Give us a call or schedule your child’s first eye exam today with our office.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Health benefits can be tricky to navigate, specifically a Flexible Spending Account or FSA. FSAs can be a tremendous benefit when used correctly. Unfortunately, many people unknowingly forfeit money when their FSA renews, usually on January 1st.
What is a Flexible Spending Account (FSA)
A Flexible Spending Account is an excellent way for individuals to set aside additional funds to cover expected or unexpected healthcare costs throughout the year. When working with FSAs, employers typically offer a structure that allows employees to deposit part of their paycheck directly into their FSA before withdrawing taxes. That means you can cover qualified medical expenses with pre-taxed income.
However, there are some stipulations to FSAs that are important to know before getting started. FSAs have a “use it or lose” rule. This means the money accumulating in your account throughout the year needs to be used by the end of the year, or you lose access to using it on your healthcare expenses.
Understanding Your Options
Not everyone has an FSA. If you are unsure if your company offers an FSA or if you are enrolled in it, start by reaching out to your company’s benefits coordinator, usually your HR Manager. They will provide you with the necessary information to become informed about your health benefit options.
If you have an FSA, be sure to understand these key parts of your plan.
Your total contribution per pay period.
What your employer contributes (if they do).
How to submit a claim and receive the reimbursement.
Any details around the plan’s potential grace period or carryover.
A grace period, usually two to three months, allows an employee to submit a claim that may go past the end of the calendar year. If you have a standard FSA that expires on January 1st, your grace period might extend to mid-March. While not all plans offer carryover if your’s does you may be allowed to keep up to $550 for the following year’s expenses.
Making a Plan
Don’t be one of the people who lose a portion of their income by not using their FSA funds! Once you understand your plan’s details, make a plan for how to spend your money. Not all healthcare expenses qualify for an FSA reimbursement. However, the eye exam you have been putting off, that second or backup pair of frames, or even additional contact lenses when you are getting low all qualify.
Want to learn more about your benefits or how to use your flex spending on necessary eye care needs? Schedule an appointment today or give us a call!
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
If you had an eye health emergency today, do you know where to go for the best and most efficient care? We’ve all had health emergencies arise at one point in time and in most cases rushing to the urgent care or emergency room is appropriate. However, if the health issue is regarding your eyes or vision you may want to rethink your emergency plan. Eye doctors are prepared to treat most eye care emergencies in office and many eye doctors also have after hours care for these emergent eye care cases.
Call your eye care provider first to see if you should be seen by your optometrist or if your situation is better addressed in the emergency department or urgent care. Seeing your eye doctor for an eye emergency is usually best because:
Many emergency rooms and urgent care facilities lack the proper equipment for proper eye exams
In an emergency room or urgent care facility you will probably see a general health practitioner rather than a specialized eye care professional like your optometrist
Misdiagnosis could impact your vision and eye health permanently
“To get the best eye care in an emergency, we recommend that you have an eye health emergency plan. Eye care is essential so it’s important to have an optometrist that you see annually who can also address any eye care issues or emergencies that arise between your annual exams. Make sure your loved ones also have an eye care emergency plan for their own eye health,” says Dr. Jean DeMoss, President of the Colorado Optometric Association’s Board of Directors.
SYMPTOMS THAT NEED IMMEDIATE ATTENTION
Black spots or flashes of light
Curtain-like disappearance of vision
Injury/trauma to the eye
Eye pain (pain is an indicator of inflammation or injury)
Seeing halos or rainbows around light
Loss of peripheral (side) vision
Sudden hazy or blurred vision
Sudden vision loss in one eye
Red, crusty or swollen eyelids
Pupils are different sizes
Sudden double vision
SYMPTOMS THAT NEED AN EYE EXAM SOON
Blurred or double vision
Excessive tearing or watering of your eyes
Itchy, burning, or dry eyes
Difficulty seeing in dark environments
Seeing spots or ghost-like images
Light sensitivity
Eye strain and/or frequent mild headaches
6 COMMON EYE EMERGENCIES THAT YOUR OPTOMETRIST IS PREPARED TO TREAT
BLUNT EYE TRAUMA
Apply a cold compress without putting pressure on the eye to reduce pain and swelling.
Severe pain or reduced vision require immediate care from an eye doctor.
EYE CUT, PUNCTURE OR FOREIGN BODY TO THE EYE OR EYELID
Do not attempt to remove an object from your eye or eyelid.
Do not wash out the eye for punctures, cuts or foreign bodies.
Do not bandage the eye.
Do not rub the eye.
Protect the eye with a rigid shield, like sunglasses or the bottom half of a paper cup and see an eye doctor immediately.
CHEMICAL BURN OF THE EYE
Flush eye(s) thoroughly with saline (preferably) or water for 15 minutes and get to an eye care professional immediately.
For individuals with contact lenses, attempt to remove them first.
Do not try to neutralize the chemical with another chemical or substance.
SUDDEN VISION CHANGES OR LOSS
Address quickly with your optometrist to avoid permanent vision loss and rule out more serious health issues like stroke, nerve damage, neurological issues, and retinal or corneal defects.
RED EYE
Red eye with discharge needs to be examined by an optometrist as soon as possible for correct identification and treatment for the type of conjunctivitis (pink eye). Emergency rooms have a history of overprescribing antibiotics for conjunctivitis when 80% of cases are viral.
Red eye could also indicate uveitis or ocular herpes, which can be sight-threatening making quick and proper evaluation by an eye doctor important.
PUPILS ARE DIFFERENT SIZES (PUPIL ANISOCORIA)
If you were born with this condition, it is benign.
If this is a new symptom, whether it’s constant or sporadic, schedule an exam with your optometrist as soon as possible as this could be vision threatening.
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
Your vision is one of your five senses responsible for allowing you to enjoy the world around you and create unforgettable memories. We may be biased, but we think vision is the greatest of the five senses! The only way to guarantee you will see your best year after year is by scheduling a comprehensive eye exam today!
Why are yearly eye exams important? Here are our top three reasons:
Eye exams & clear vision help increase success at school, work, and more.
Exams can catch asymptomatic conditions before vision loss occurs.
Eye exams can provide insight into other health-related issues.
A Clear Vision to Success
According to experts, 80% of the information presented in school is visual! Based on this statistic, you can see clear vision is essential to a child’s success in the classroom. Help your children feel prepared during their school year by scheduling a yearly eye exam.
Vision Screenings Vs. An Exam
Schools commonly provide vision screenings to help detect vision problems in younger children. However, a vision screening is not a replacement for a yearly comprehensive eye exam. Screening tests cannot diagnose the problem. These tests cannot detect any health concerns we may find during a standard eye exam but only flag that a comprehensive eye exam is needed.
Improving Your Visual Comfort
Yearly exams aren’t just essential for your child’s success, but your own as well! In addition to the health insights, we will mention below, a yearly eye exam allows you to improve your vision comfort at home and at work! According to recent studies, daily screen time use is set to surpass 8 hours! With almost a third of your day on a digital device, a pair of blue light-blocking lenses may be the perfect addition to your attire.
Reducing Your Risk of Eye Disease
As you age, you develop a higher risk for many medical eye diseases. Some eye-related conditions can appear with no symptoms, affecting your long-term vision health. Specifically, many people who develop glaucoma often don’t show symptoms at first. Individuals suffering from glaucoma usually develop irreversible vision loss before they have learned that something is wrong. A routine exam can detect signs like high eye pressure and other early signals before any serious damage to your vision occurs.
Detecting Issues During Your Annual Eye Exam
An annual comprehensive eye exam can detect changes in your body that may result in other health-related issues. For example, your eyes can tell us if you have diabetes, high blood pressure, high cholesterol, or even cancer. During your eye exam, our doctors will evaluate many aspects of your eye health, including the blood vessels in your retina, which are predictors of the health of blood vessels throughout your entire body.
Reduce your risk for diabetes, hypertension, hypercholesterolemia, and other health conditions by scheduling your exam today. Questions? Contact our office via phone or search our website for more information.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.
While the term myopia control may sound unfamiliar or scary, it may be a perfect fit for your family’s eye care needs! Myopia control is the medical term used to describe specific treatments to slow the progression of nearsightedness in children. According to healthychildren.org, nearsightedness is a common vision problem that often begins between 6 and 14 and affects roughly 5% of preschoolers, 9% of school-aged children, and 30% of adolescents.
Your Child’s Eye Development
Myopia occurs when the eyeball is too long (from front to back) or if your eye’s cornea is too curved. As a result, the light that enters your eye falls short of the retina, causing your eye to have a harder time focusing the way it should. This lack of focus results in distant objects being blurry and close objects being clear.
Myopia generally gets worse through adolescence, which is why we see increasing percentages of myopia in older age groups. In most cases, an individual’s prescription will start to stabilize in their early twenties. However, for some this stabilization may take longer and can result in higher myopia prescriptions later in life. Severe myopia can lead to a higher risk for some vision-threatening complications including, glaucoma, cataracts, retinal detachment, and even blindness.
Myopia Control Options
The good news is eye care professionals have four ways to offer myopia control treatment, listed below. Interested in learning what myopia control treatments we offer? Call our office to schedule an appointment today!
atropine eye drops
multifocal contact lenses
myopia control glasses
orthokeratology (ortho-k)
Atropine Eye Drops
Atropine eye drops dilate your pupils and can relieve focusing fatigue by temporarily limiting the eye’s ability to change focus automatically. This process, known as accommodation, may be what accounts for its effectiveness in reducing myopia progression in children. According to All About Vision, some studies have shown that atropine can reduce myopia progression by up to 77%.
Multifocal Contact Lenses
Multifocal contact lenses provide clear vision at all distances for people who have nearsightedness, farsightedness, astigmatism, and/or presbyopia. Some studies have revealed that multifocal contacts can also help slow the progression of myopia in some children. Results provided by one study found that the children who wore multifocal lenses daily had a 50% reduction in the progression of their myopia compared to the children who wore regular soft contacts.
Myopia Control Glasses
Multifocal eyeglass lenses work similarly to multifocal contacts and have similar results in the studies conducted to slow the progression of nearsightedness in children.
Orthokeratology
Orthokeratology, more commonly referred to as ortho-k, involves specially designed gas permeable contact lenses worn only while sleeping and removed when awake. Based on your prescription, our team will recommend a treatment schedule intended to reshape your eye and reduce the lengthening of the eyeball over time. Ortho-K lenses reshape your eye at night and provide temporary vision correction during the day.
If your child is nearsighted, ask us about treatment options during your next exam! Our eye care team will help determine if myopia control is right for them.
Ready to Schedule An Appointment?
The Highline Vision Center team is looking forward to seeing you soon. Our practice utilizes state-of-the-art technology to deliver personal and comprehensive eye care for your entire family.