My eye doctor can detect which disease? - Syphilis

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this new blog series "My eye doctor can detect which disease?". Some might surprise you, some might not. In light of the recent announcement of a huge spike in this disease in Alberta, I thought I would cover syphilis.

Yes. Syphilis.

“Over the past four years, the rate of reported syphilis infections has increased ten fold!”

While syphilis is a sexually transmitted infection it can show up in the eye much like most other STIs. While some symptoms occur in more obvious areas, as your eye doctor I’m not going to be examining anything beyond your eyes.

So why talk about this disease in particular? Over the past four years, the rate of reported syphilis infections has increased ten fold! Yikes! Syphilis is also tricky to diagnose. It can present in a lot of different ways and routinely becomes latent, hiding out in your body with no symptoms whatsoever!

What is your optomtrist looking for then, when considering the possibility of syphilis? A sore, called a chancre, can sometime occur on the eyelid or the white of the eye. It’s a painless ulcer that resolves on its own but is a pretty good indication that someone might have syphilis and requires testing.

These cute little spirals are syphilis and they are not your friend

These cute little spirals are syphilis and they are not your friend

If left undiagnosed, syphilis progresses to what we call secondary syphilis. Once we get to this stage we can see signs of inflammation in the eye like uveitis or optic neuritis, painful inflammations that can cause vision loss (either temporary or permanent). Less commonly, it can present as an eye infection or more benign inflammation with the eye simply appearing red.

If it goes on way too long we can move into tertiary syphilis which can start to impact you central nervous system and cause other nasty symptoms including the atrophy (a fancy word for loss of function) of your optic nerve or pupils that don’t respond properly to light.

Nobody wants syphilis, obviously, but if you think you might have it definitely talk to your family physician or your local STI clinic and get tested. Not knowing also risks spreading the infection and we know you don’t want to do that!

The good news is that syphilis can be treated with medication but typically requires the medication be injected. So even if you can treat syphilis it's always better to just not get it in the first place. You'll save yourself from an embarrassing discussion with your partner(s) if you protect yourself.

As always if you would like more information you can contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

Retinal detachment - A curtain coming down on your vision

Have you ever heard of a condition called retinal detachment?

We hope so, but if you're like most people you probably haven't. Even if you have heard of it, do you know what the symptoms are? Most people don't know but much like a heart attack, retinal detachments are considered medical emergencies and require immediate treatment to prevent permanent vision loss so let's make sure you know what to watch for!

"... a retinal detachment happens when a part of the retina pulls away from the underlying tissue. It can happen to anyone"

Let's start by understanding what a retinal detachment really is. Essentially, a retinal detachment happens when a part of the retina pulls away from the underlying tissue. Fairly quickly, that tissue dies since it is unable to get the oxygen and other nutrients it needs to survive. If left untreated it will usually spread and the entire retina will detach. Since we need our retina to see, if it fully detaches we lose the ability to see with that eye and unfortunately can't get it back. Caught early, it can be treated and stop the vision loss in its tracks

Who is at risk for a retinal detachment? Unfortunately, everyone. Some people have a higher risk, such as people with high nearsighted prescriptions or people with a family history of retinal detachment, but anyone with eyes can have their retina detach. Your retina may detach after an eye injury or accident but that's not required for a retinal detachment to occur.

This is what a detached retina looks like when your doctor looks inside your eye. It's not something we want to see!

So how do you catch and stop a retinal detachment? Well, the main thing is to have regular, dilated eye examinations. That helps your doctor of optometry check your peripheral retina for any problems like thin areas or retinal holes. Sometimes though your retina will look perfect and you still end up with a retinal detachment! So what then?

"Retinal detachments cause flashing lights, floating spots, curtains waving in your vision or a combination of all three!"

Most retinal detachments are highly symptomatic. People experience flashing lights, floating spots, a curtain waving in their vision or a combination of all three! There are many eye disorders that have similar symptoms including things that are relatively harmless like posterior vitreous detachment and ocular migraines but because a retinal detachment is so serious (meaning you can go totally blind)  it's important to have your doctor confirm the diagnosis. Don't try to make that judgment yourself. It's not worth the risk

If you have questions about retinal detachments or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

Subscription Contact Lenses - Great Choice or Bad Idea?

Contact lenses are wonderful devices. They allow us to see clearly without needing to fuss with glasses. The very first contact lenses that were invented were terrible for our eyes but people still wanted to wear them to get away from glasses! They've come a long way but contact lenses still carry a risk and people still can, and do, go blind from using them improperly.

Why am I telling you all that? To remind you the importance of a proper contact lens assessment by a contact lens fitting optician, an optometrist or an ophthalmologist.

What does that have to do with subscription contacts?

"... an improperly fitting contact lens can lead to vision loss."

Ordering your contacts from a subscription service may seem like a great idea but you must make sure that a professional is checking the fit of them on your eye. The problem, and the problem with all online orders, is they currently do not require you to provide a proper, up to date contact lens prescription (which IS different from your glasses prescription) to order a supply! That means you can order without anyone checking them on your eye! Many people assume if a contact lens doesn't fit them, they'll know. Sadly, that isn't true and an improperly fitting contact lens can lead to vision loss.

"Some Subscription contacts only provide 30-40% of the oxygen your eye needs which just isn't enough. Modern contacts allow 80-100% of the oxygen to your eye."

It's also vital to discuss your contact lens and vision needs with your doctor. We've studied a long time to understand how contacts and the eye work best! For example, did you know that the material used in the largest subscription contact lens service, methafilcon A, is a very old material that doesn't breathe well? That can cause the cornea, the front clear part of the eye, to swell. A swollen cornea has an increased risk of infection. That's no good.

Essentially the lower the Dk/t, the less oxygen that gets to the eye. The lens used by a major subscription contact lens service is made with a material,   Methafilcon A, with a Dk/t of only 18. Compare that with a different material, etafilcon A, found in Acuvue 1 Day Moist with a Dk/t of 28 which doesn't sound much better but when we check the graph, the curve is so steep that a Dk/t of 28 means we jump from 30-40% of the oxygen the eye needs when we have a Dk/t of 18 all the way to 80%.   Modern lenses have a Dk/t of more than 100. What that means is with a subscription lens your cornea only gets between 30-40% of the oxygen it needs. With a modern lens, you get 90-100%.

Essentially the lower the Dk/t, the less oxygen that gets to the eye. The lens used by a major subscription contact lens service is made with a material, Methafilcon A, with a Dk/t of only 18. Compare that with a different material, etafilcon A, found in Acuvue 1 Day Moist with a Dk/t of 28 which doesn't sound much better but when we check the graph, the curve is so steep that a Dk/t of 28 means we jump from 30-40% of the oxygen the eye needs when we have a Dk/t of 18 all the way to 80%. Modern lenses have a Dk/t of more than 100. What that means is with a subscription lens your cornea only gets between 30-40% of the oxygen it needs. With a modern lens, you get 90-100%.

But they're so cheap, right? Maybe. Let's do the math.

"Cheaper? Think again! A common subscription contact lens service costs $528/year. A year supply of dailies from Eye Spy costs only $460/year."

In Canada, a common subscription contact lens service costs you $40/month plus $4 shipping. Over 12 months that means you've spent $528 on your daily contact lenses.
Compare that to an equivalent daily lens at our office, the Acuvue 1 day Moist. A year supply from us costs you $560. I can hear you saying, "Aha! That costs more!" and you're right! But here's the thing, Acuvue offers a $100 rebate on a year supply of contacts which brings your cost down to only $460 for a year supply. Even better, we can direct bill to your insurance provider which lowers your out of pocket expense even more.

At the end of the day, you get to choose what you think is best for your eyes and your health. You get to decide where you want to purchase your contacts and glasses and that's okay! My job, and the job of eye care professionals everywhere, is to make sure you're making an informed decision. Subscription lenses aren't cheaper, they aren't healthier and they aren't safer but they are convenient and it's a neat idea to have contacts show up on your doorstep every month.

If you have questions about subscription contacts, any contact lens, or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

What’s the difference between an optician, optometrist and ophthalmologist?

I remember once while I was still in school and someone asked me what I was studying. I said that I was studying to be an optometrist and without batting an eye they looked at me and said “Oh, what’s it like to work with teeth?” So close but so far.

There is a lot of confusion out there about what we in the industry refer to as ‘The Three O’s’, perhaps better known as opticians, optometrists and ophthalmologists. Even for people who are reasonably familiar with the optical industry people often ask me what the difference is. It absolutely can be confusing but let’s think of it in a way most of us are very famliar with.

"Opticians are sort of like technicians."

Opticians are sort of like technicians. They receive an optical prescription and fill it. They are your lens and frame experts. In Alberta they take a two year course to learn how to fit lenses properly and take all the necessary and extremely important measurements. They learn all about how to adjust frames to fit your face properly as well as what frames will work best on which face shapes. They know all about things like progressives versus bifocals, refractive index, anti glare coatings and a whole bunch of other technical things that are vital to you getting the right lens. They are an integral part of  your vision care team.

In case you weren't sure, this is what an optometrist might look like.

In case you weren't sure, this is what an optometrist might look like.

"You should see an optometrist regularly to pick up any problems that are happening silently, with no symptoms."

Optometrists are like your family doctor. You have  any sort of problem with your eyes and we are the people you need to come and see. It might be a problem seeing, a red gooey eye or maybe you got something in your eye that won’t come out. You come see an optometrist and we’ll fix you up. Of course just like getting a yearly physical you don’t have to have something wrong to see an optometrist. In fact you should see one regularly to pick up any problems that are happening silently, with no symptoms.
Optometrists in Canada take a minimum of a three year undergraduate degree followed by a four year course at the only English speaking Optometry school in Canada at the University of Waterloo or the only Canadian French speaking school at the University of Montreal. They are then required to write national board exams before being licensed to work in Canada.

"Seeing an ophthalmologist requires a referral..."

Ophthalmologists are eye surgeons performing complex eye surgeries. They are medical doctors who have gone on to do even more schooling to specialize in the eye. Much like other specialists like brain surgeons, heart surgeons, kidney specialists etc you require a referral to see them. It is the job of an optometrist or your family doctor to refer you if there is an eye problem beyond what we are able to treat. For example, if you had a cataract that required surgery, an optometrist would refer you to see an ophthalmologist that specialized in cataract surgeries.

If you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

My eye doctor can detect which disease? - High blood pressure

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this new blog series "My eye doctor can detect which disease?". Some might surprise you, some might not. In today's blog I want to go over one that you might not expect: High blood pressure.

High blood pressure is extremely common. Approximately 20% of adults have high blood pressure with another 20% having high normal blood pressure (which puts them at higher risk of developing high blood pressure later on). Of these people another 20% are unaware that they have high blood pressure at all! This is important because as you may have heard high blood pressure is a silent killer. It has no symptoms so people are often not aware there is a problem until something serious happens like a heart attack or a stroke.

So how can your optometrist help? When we look inside of your eyes during a routine eye exam we aren't just looking for things like cataracts, macular degeneration and glaucoma. We're also looking for signs of systemic (or full body) problems like high blood pressure. The eyes are the only place in the body where we can directly look at your blood vessels without having to cut you open. This means that we can look and see exactly what is happening. In high blood pressure there a few key things that we are looking for.

In this picture you can see the silvering of some blood vessels and also see how some blood vessels are 'nicking' or pinching the ones underneath. This is typically what I see in the average person with uncontrolled, untreated high blood pressure.

  • Silvering of blood vessels - normally your blood vessels are a nice red colour but when someone has high blood pressure the blood vessel walls thicken. Over time this means that the blood vessels reflect more light and look more silver.
  • Wavy blood vessels - normal blood vessels in the eye follow a nice smooth path. If blood vessels are really curvy that can be an indication of high blood pressure.
  • Pressure on the blood vessels - as high blood pressure worsens the blood vessels may actually start to push down on other blood vessels restricting how much blood flows either in or out of your eye.
  • Bleeds - As those blood vessels crush each other blood can back up and eventually burst the blood vessel causing bleeds in your eye. You can also end up with white areas on your retina that aren't getting enough blood. Imagine it like squeezing a hose: no water comes out one end and water starts backing up on the other side of the blockage.
  • So much more - we can have things like leaking from blood vessels, swelling of the optic nerve and other signs.

This is high blood pressure gone seriously wrong. Uncontrolled high (very high) blood pressure over long periods of time can lead to a very unhealthy retina.

As you can see, there's no shortage of things that can go wrong in the eye with uncontrolled high blood pressure. Some of the more severe problems (Bleeding, leakage, swollen optic nerve etc) are fairly rare and only occur in very extreme untreated cases of high blood pressure. What I frequently see in my clinic are some of the early signs (the silvering, wavy blood vessels or pressure on blood vessels) and that let's me have a conversation about high blood pressure with you. In some cases your family doctor may already be aware and is either monitoring or already treating the issue. Sometimes though people have no idea and are shocked that they have high blood pressure and that it was found during a routine eye exam! It's important to keep blood pressure controlled to reduce your risk of so many very severe problems and early intervention and treatment is always better than trying to recover from something like a heart attack or stroke.

If you have any concerns that you might have high blood pressure I would urge you to book an appointment with your family doctor. While optometrists can detect high blood pressure it isn't our area of expertise to treat and manage high blood pressure effectively. If we detect it in office we always will send you back to your family doctor to both confirm the diagnosis and if needed start treatment. What's most important is remembering to have regular health checks with both your family doctor and your local doctor of optometry!

If you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

I should see an eye doctor for that? - Grandma had glaucoma

 

"...THEIR HEALTH HISTORY COULD BE YOUR HEALTH FUTURE."

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this blog series "I should see an eye doctor for that?". Some might surprise you, some might not. In today's blog we're going to talk about your why if grandma had eye problems, like glaucoma, you need to have regular eye exams.

Alright, we don't really mean JUST if grandma had eye problems. Grandma shouldn't take all the blame. If someone in your family has an eye disease it's important for you to know what it is and who has it! Why should it matter to you, a healthy person with perfect vision, that someone in your family has an eye disease? Unsurprisingly since you share at least some of their genes their health history could be your health future. 

It's all in your genes.

Many eye diseases are genetic which means that if someone in your family had them, you could too. Much like if someone in your family has diabetes, high blood pressure or heart disease you're at a higher risk of developing those same problems if someone in your family has glaucoma, macular degeneration or a host of other diseases you too are at a higher risk.

 

"80% OF EYE DISEASE HAS NO SYMPTOMS IN ITS EARLY STAGES"

A couple important points. When I say someone in your family I mean 'blood relatives'. For example if your step mother has glaucoma or your sister-in-law has macular degeneration you don't share their risk because you don't share their genes. It's also important to point out that an increased risk does not mean certainty. Simply because your mother has diabetes or glaucoma does not mean you are doomed to have the same problems but it does mean you need to be careful and get your health, including your eye health, checked regularly.

So what has a genetic link? Almost everything unfortunately. The big three eye diseases, glaucoma, macular degeneration and cataract all have a genetic component. Diseases like diabetes, high blood pressure, high cholesterol, stroke to name a few all directly impact the eye as well and often signs of those diseases will show up in the eye before they show up anywhere else!

This is one of the main reasons (though not the only one) why I recommend yearly eye exams. 80% of eye disease has no symptoms in its early stages and the only way to detect the problem and prevent it from getting worse is to have an eye doctor check the health of your eyes. Even if your vision is perfect there may be something going on that hasn't made itself obvious just yet.

As always, if you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

So if I come in for an eye exam, what are you going to do to me?

If you’ve been reading my blog you know there are a lot of reasons to come in for an eye exam even if you feel that your vision is perfect and that you don’t need glasses. You already understand that there’s the health and muscle function side of an eye exam that is just as important as how well you see. For many people who have never had an eye exam though they wonder what is involved. Anything new can be uncomfortable and if you feel like everything is fine people hesitate to come in. So let’s go over what an eye exam is all about.

When you first come for a visit we’re going to have you fill in a nice form with a lot of your personal medical information. We need this to rule in  or out certain eye problems and to know a bit more about your health. All of this information is kept strictly private and cannot be released to anyone or any group without your consent (this is true of ALL medical and personal information we obtain).

Once you’re all checked in there are some preliminary tests done by our optician. At Eye Spy Optometry we first get an estimate of how well your eyes are focusing using a machine called an auto-refractor. These results are what I use as a starting point to narrow down an exact prescription. Next, we take pictures of the back of your eye as well as scans of both your optic nerves and your maculae. The optic nerve is what sends the information back to your brain and is affected in many disorders including glaucoma. The macula is the part of your eye used for fine central detail. There are many things that could go wrong here too but one of the most common is macular degeneration. These scans give us the ability to detect changes that may be related to an eye condition much earlier than just looking inside of the eye.

Next you get to see me. I’ll review your medication and health information with you and then we jump right in. I check to see how you’re seeing with glasses if you have them, without if you don’t. I also check to see how well the eyes are working together and check pupils for signs of any neurological concerns. What comes next is the stereotypical part of the exam. I put a machine called a phoropter in front of your face and show you a variety of lenses, asking you which makes the image at the end of the room better. This is the part of the exam that causes people the most stress. Don’t worry though! My job is to help you through it and make sure we don’t come out with the wrong prescription. You can’t fail the test, I promise, because it isn’t a pass/fail sort of test! I will also have a look at the health of your eyes, inside and out, and finally I’ll check the pressure in your eyes, but not with that puff of air test!

This is a traditional phoropter (used in the 'Which is better, one or two?' test). At Eye Spy Optometry we have a more modern, digital phoropter.

This is a traditional phoropter (used in the 'Which is better, one or two?' test). At Eye Spy Optometry we have a more modern, digital phoropter.

The final step to your eye exam is to review everything. I’ll show you the photos and scans and explain what they mean, discuss any health concerns and review your prescription, if there is one. I’ll make any recommendations about how to help keep your eyes healthy or improve your vision that make sense based off of your results. Most importantly though, I’ll answer your questions. I do my very best to make sure everything we review together is clear but sometimes jargon slips in. Always feel comfortable asking questions and I’ll do my best to make sure it all makes sense.

If you do happen to need glasses there is ONE more thing that happens. You get to pick out frames! That’s the fun part of the exam. There are so many different colours, shapes and styles to pick from and wide range of prices to suit every budget that finding something that works for you is fun and stress free.

So book an appointment today! You know you should get everything checked out even if your vision is great. Now that you know what we do when you come to see us there’s no excuse not to give us a call at (403) 474-6744 or book online here.

As always, any questions feel free to contact us on Twitter, Facebook, Google + or via our website.

Hyperopia - A frustrating lack of focus

Much like myopia (or nearsightedness), hyperopia isn't a word you hear very often. If you've heard the term if was likely in your optometrists' office and you probably have it. Your doctor of optometry might have taken the easier route though and called it by it's common, though misleading, name 'farsightedness'.

I don't know about you but when I see the word farsighted it implies that you can see far away but not up close. That simply isn't true. A farsighted person may see clearly at all distances, may have trouble at near or may have trouble seeing at all distances! To understand why we need to understand what hyperopia really is.

Hyperopia occurs when the eye is 'too weak' and light focuses behind the retina. This generally is because either the cornea (the front of the eye) is too flat OR the eye is too short (it may be a combination of both). We are all born somewhat farsighted and as we age our eyes get bigger and the farsightedness decreases. In some people the farsightedness never fully goes away. Depending on how much farsightedness there is it can cause problems like amblyopia, only cause headaches and strain while reading or even go completely unnoticed for many years. How is this possible!?

Being able to see clearly without glasses while being farsighted is all thanks to the lens inside of the eye. Its job is to flex and change shape so we can see all distances clearly without needing reading glasses. One way of thinking is that when we are reading our eyes, without the lens, would be 'too weak'. The lens changing shape gives us more focusing power so we can see. People with hyperopia have eyes that are 'too weak' at all distances, not just looking up close. The natural lens in the eye compensates for the eye being too weak both far away and up close. If they have a mild amount of farsightedness this usually doesn't cause problems but as the prescription goes up the eye and lens have a harder and harder time compensating for the uncorrected hyperopia! This can lead headaches, eyestrain or blurred vision which in children can cause amblyopia.

Light focuses behind the retina in hyperopia

One of the very frustrating things about hyperopia is that in many people it doesn't become an issue until they are in their 40's. Hyperopia is different from presbyopia (the need for reading glasses) but the same thing that causes us to need reading glasses also causes distance vision to become blurrier in farsighted people. Remember how I mentioned that the lens in the eye compensates for the eye being too weak? Eventually, in all of us, that lens doesn't work as well as it once did. That will usually start with trouble reading but in farsighted people they also eventually have blurred distance vision as well. Going from never needing glasses to needing them to see at all distances is immensely frustrating to my farsighted patients and is sometimes difficult to adapt to.

So how do we deal with farsightedness? Glasses and contact lenses are the most common and easiest forms of treatment. Both glasses and contacts refocus the light coming into the eye allowing it to focus on the back of the eye clearly. You can also consider surgery, like LASIK or PRK though they don't work as well for hyperopia as they do myopia. I'll talk about surgical options more in another blog.

If you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

Floaters - Those annoying spots moving around in your vision

One of the most commonly asked questions I get asked  is "What are those things I see floating around in my vision." Most people don't think my answer of 'annoying' is nearly as funny as I do and usually would like a real answer about what is happening. So let's address a problem almost everyone experiences at some point in their life, the visual phenomenon known as floaters.

First of all, what are they? To understand that you need to know a bit about the vitreous jelly, which fills most of the eye and is where floaters form. The vitreous jelly is almost entirely water but it does have a matrix of 'stuff' (collagen and hyaluronic acid to be exact) that gives it a jelly like consistency. Don't think of it as jello though, it's more like an egg white. When we're really young the vitreous is really clear and everything is pretty much perfect. Over time though the jelly starts to break down and water leaks away. The collagen and hyaluronic acid are left behind and they clump forming the black or clear jelly blobs that we see moving around in our vision. What we are seeing is really just a shadow caused by these clumps. Floaters are easiest to see when the lighting is bright and the background is a light colour (so a bright sunny day with a blue sky or a brightly lit, white computer screen).

Floaters sort of look like this... but not really.

So, what can be done about a floater? Honestly, not much. The most effective therapy is something called a vitrectomy where they literally remove the entire jelly from your eye and replace it with a silicone oil or a saline solution. This is an extremely risky solution and I don't know a single retinal specialist that is willing to do this surgery on someone for floaters. There is a laser procedure as well that blasts the floaters.  This is a better solution than a vitrectomy but doesn't work as well. Many patients report that instead of having a few large floaters they now have a lot of small ones.

Why should we care about floaters? Often we don't. The odd floater moving around in your vision is certainly annoying but it isn't harmful. There are situations though where floaters are a huge concern:

  • You get a large number of new floaters all at once,
  • With those new floaters you also experience a flashing light in your peripheral (side) vision like a camera or lightning flash AND/OR
  • With those new floaters you notice a curtain waving in and out of your vision.

Any of those could mean that your retina has a tear or has detached. Retinal detachments are medical emergencies and can lead to complete loss of vision in hours. Retinal tears aren't quite as urgent but usually lead to a retinal detachment so you don't really want to mess around with them either.

Really, it's best to play it safe. If you have floaters and aren't sure if they were there before or you aren't sure if they're normal floaters come in for a dilated eye exam. We'll put drops in your eyes for this type of exam (which is fully covered by Alberta Health Care) to have the best possible look at the very far outer edges of your retina to make sure there aren't any problems. If something is wrong we will get you to a retinal specialist as quickly as possible and keep your vision safe.

If you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

For more information check out these links:

All About Vision - Floaters

Ask a Doctor of Optometry - Floaters

I should see an eye doctor for that? - Eye injuries

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this new blog series "I should see an eye doctor for that?". Some might surprise you, some might not. In today's blog I want to go review a situation where people assume they should go to an ER: Eye injuries

This is a topic that can be a bit tricky because optometrists deal with some eye injuries but not all of them.  A good rule of thumb is that if it's bleeding heavily or the eye is actually punctured (as in you have a nail stuck in your eye) please go to the ER. If you come to me I'll be sending you out the door to the ER as quickly as possible!

So where do doctors of optometry fit in? For pretty much everything else! I both love and hate lists but sometimes they're the best way to get an idea across. So, below find a list of some of the different eye injuries optometrists address that you might not expect!

Eye injuries are no fun at all.
 Top left: Black eye; Top right: Metallic object in eye; Bottom left: Chemical burn; Bottom right: Scratched eye

  • Chemicals in the eye - If you have gotten a chemical in your eye (household cleaner, hydrogen peroxide based contact lens solution, etc) your first stop should be your sink or shower to rinse out as much as humanly possible. Your next stop should be your optometrist. We can fully assess the damage and get you started on the right medications to get you healing and prevent an infection.
  • Objects in your eye - Like I mentioned above if something has punctured your eye (like a nail) or there's extreme bleeding you need to go to the ER for emergency treatment. If you have a piece of metal, small piece of wood or even an unknown object in your eye you can come and see me and I can remove it quickly and easily.
  • Scratches on your eye - If you scratch your eye somehow (paper cuts and sharp baby fingernails are common) come in and get it looked at. Usually these heal up well but we can check to make sure the damage isn't too serious, prescribe medications to prevent an infection and help with pain. Regardless of how you scratch your eye get it checked!
  • Impact to the eye - Did you get punched? Did your dog jump up and give you a black eye? Did you get hit in the face with a ball? These are all good reasons to come in and have your eye looked at. Usually there's just swelling and bruising from something like this but it's important to look at your retina. An impact to the eye that is hard enough to bruise can be enough to cause a retinal detachment and permanent vision loss.

If you're ever concerned about something related to your eyes and you aren't sure if your doctor of optometry is equipped to deal with your problem it's important that you call them and ask. Even if your optometrist isn't able to deal with something he or she can often  put you in touch with the right people, such as the on call ophthalmologist, and get you seen and treated sooner.

These types of issues are covered completely by Alberta Health Care. There is generally no charge to you for this type of visit (this can be up to the doctor's discretion. At Eye Spy Optometry we never charge for this type of visit).

If you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

Myopia? What's myopia?

Myopia is one of the most common eye conditions out there. I bet many of you reading this blog have myopia! So what is it? Myopia is the official, technical term for nearsightedness. Myopia affects approximately 40% of the North American population making it one of the most common vision problems. Despite that, many people don't really understand what myopia is! Let's shed some light on this important topic.

Myopia occurs when the eye is 'too strong' and light focuses too soon. This generally is because either the cornea (the front of the eye) is too steep OR the eye is too long (more commonly it's a combination of both). Most of us, including me, start becoming nearsighted in childhood and our vision gets progressively worse until early adulthood (around 25) at which point it stabilizes. In some cases myopia still gets worse even once we're in adulthood. It's important to remember that 'stable' vision really just means it isn't changing as much or as quickly. There are always some small changes year to year so the term stable is a bit misleading.

Luckily, myopia is very easy to treat. Glasses and contact lenses are the most common and easiest forms of treatment. Both glasses and contacts refocus the light coming into the eye allowing it to focus on the back of the eye clearly. You can also consider surgery, like LASIK or PRK which I'll talk about more in another blog.

The most common question I get from people about nearsightedness is how they can prevent it from getting worse. There are a few techniques that may help reduce how quickly a person becomes nearsighted or reduce how nearsighted they become and I'll discuss them all in more detail in a future blog. Current options to control myopia include multifocal contact lenses, Ortho-K lenses, progressives/bifocal glasses and atropine drops. The two that have shown the most success have been multifocal contacts and Ortho-K lenses and are believed to work by reducing defocus in the peripheral retina (meaning the outer edge of your eye isn't as out of focus as it might be with traditional lenses).

The biggest challenge facing us with myopia is that we still do not fully understand it. Your genetics play a role in whether you end up nearsighted or not but it isn't the whole story. Some recent research has found that people who spend more time outside have lower nearsighted prescriptions than those that spend more time indoors. The jury is still out on whether this is related to lower vitamin D levels, due to things just being further away or something else we haven't thought of yet.

If you have any questions about this or anything else feel free to contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

 

My eye doctor can detect which disease? - Chlamydia

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this new blog series "My eye doctor can detect which disease?". Some might surprise you, some might not. In honour of stampede we thought we would bring you the first in this blog series: Chlamydia.

Yes, seriously.

Please do not misunderstand, you will keep ALL of your clothes on during your eye exam. What allows us to detect chlamydia is not what you might think. Chlamydia actually can show up in your eyes.

I know it's a little gross but it's true. To you, as a patient, you would think that you just had pink eye. Much like a normal pink eye there will be a lot of gooey discharge from your eyes and your eye will be red and uncomfortable. The trouble with chlamydial pink eye is that you can use antibiotic drops constantly and it just won't go away! A normal pink eye will usually go away on its own in about a week even without treatment. People usually come in frustrated because they've been on medication for weeks and their pink eye isn't improving.

This is chlamydia. You don't really want to see what this looks like in the eye, do you?

So if antibiotic drops don't help how do you fix it? The good news is that chlamydia is easily treated with a single, strong dose of azithromycin in pill form. Once the bacteria is destroyed the eye infection (and other symptoms) will go away.

Remember that even if you can treat chlamydia quickly and easily it's always better to just not get it in the first place. You'll save yourself from an embarrassing discussion with your partner(s) if you protect yourself. Have a fun stampede but remember to stay safe!

As always if you would like more information you can contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

I should see an eye doctor for that? - Eye Infections

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this new blog series "I should see an eye doctor for that?". Some might surprise you, some might not. In today's blog I want to go over one that should be obvious: eye infections.

Eye infections, often known as pink eye, are really common. Your eye might be red, gooey, watery, itchy, sore and your vision may be blurred. They aren't pleasant. So if you wake up with a nasty red eye who are you going to call? If you said Ghostbusters congratulations for being born in the 80's. Assuming your eye isn't haunted though you're going to need a doctor. So, do you go see your medical doctor or your doctor of optometry?

Medical doctors are of course fully trained to deal with eye infections and can prescribe you what you need. So, why would you see an optometrist instead? 

1. Optometrists have specialized equipment. This equipment is designed to look closely at the eye to determine what type of infection you have, how serious it is and if it is actually an infection or something else. Most MDs do not. Having this information means we can target the infection directly leading to faster healing times and a lower chance of a misdiagnosis (which could make the problem worse depending on what is prescribed).

2. There's no wait! You can generally get in to see an optometrist within a few minutes. My MD is great but I almost always have to wait to get in even when I have an appointment. The wait times at an ER for something like this will be brutal because it's not an emergency and you'll be waiting for ages.

3. It's fully covered by Alberta Health Care. So long as you provide us with your Alberta Health Care number a visit for an eye infection is considered medically required.

So, it's faster, it's free and we have all the specialized equipment and training to make a good diagnosis and fix your infection. There's no reason not to come see an optometrist! After all, if you had a toothache would you go see your medical doctor or would you see your dentist?

If you want to read more feel free to check out the following links or as always you can contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

Canadian Association of Optometrists - Conjunctivitis

American Optometric Association - Conjunctivitis

All About Vision - Pink Eye

I should see an eye doctor for that? - Something's in my eye

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this new blog series "I should see an eye doctor for that?". Some might surprise you, some might not. In this blog let’s go over what to do if there’s something in your eye.

“These types of issue are covered completely by Alberta Health Care.”

Imagine this: You’re working in the shop. A piece of wood or metal gets in your eye. Or maybe you’re out innocently walking on a windy day when out of nowhere something flies into your eye and won’t come out. What do you do? What’s your first instinct? For most people it’s to rub their eyes. Please don’t (if there’s something sharp in there it will just scratch the front of the eye and be even more painful)! You might think to rinse it out with drops, saline, or water and that’s a fair instinct but what if that doesn’t work?

Ouch. If you get something in your eye don’t delay. Be seen by a doctor of optometry as soon as possible!

Ouch. If you get something in your eye don’t delay. Be seen by a doctor of optometry as soon as possible!

“… your doctor of optometry has all the right tools and training and can usually see you right away.”

For many people their next stop is either the emergency room or their family doctor. That’s a fair choice and certainly if something has punctured the eye or there’s extreme bleeding go to the ER. Otherwise your doctor of optometry has all the right tools and training and can usually see you right away.

What do we do? Well, first we numb your eye with a simple eye drop. Then under high magnification we use specialized tools designed specifically for the eye to remove whatever is stuck. Afterwards, if required, we would prescribe an appropriate medication to prevent infection or further injury. It’s as easy as that.

If you're ever concerned about something related to your eyes and you aren't sure if your doctor of optometry is equipped to deal with your problem it's important that you call them and ask. Even if your optometrist isn't able to deal with something he or she can often  put you in touch with the right people, such as the on call ophthalmologist, and get you seen and treated sooner.

These types of issues are covered completely by Alberta Health Care. There is generally no charge to you for this type of visit (this can be up to the doctor's discretion. At Eye Spy Optometry we never charge for this type of visit).

If you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

More questions? Book now and speak with one of our doctors!



Dry eye: the scourge of southern alberta

If you've lived in Calgary for more than a few days you are well aware that we live in an incredibly dry province. While I love chinook winds as much as the next person they definitely dry things out such as your skin, your mouth and of course your eyes. Dry eye feels like it should be a simple thing. Your eyes are dry so you need to add moisture, right?  Unfortunately, dry eye is a complex and multifactorial issue that can be a challenge to deal with.

To understand dry eye you have to understand tears. Our tears are not just water. There are actually three different layers to our tear film! The layer closest to our eye is a mucous layer that helps sweep capture and sweep debris from our eyes. The next layer is the main, watery layer we're all familiar with. Finally the outermost layer is an oily layer that helps keep our tears from evaporating.

The different tear layers on our eyes. All are required in perfect balance to prevent dryness.

All of these different tear layers need to be present and in a proper balance to prevent dryness and irritation. The amount and quality of tears produced can be affected by many things such as certain diseases, increasing age, being female, some medications and of course your environment.

As you can imagine with so many different factors there are many different types of dry eye. The two main types of dry eye occur when either not enough of the outer oily layer is produced so the watery layer evaporates (creatively called evaporative dry eye) or that not enough of the watery middle layer is produced which we call aqueous deficient dry eye.

There are different treatments for different types of dry eye and for different levels of dryness. My job is to figure out which type of dry eye you have and its severity and treat you appropriately. While artificial tears (eye drops) are required in almost all types of dry eye different artificial tears will work better for certain types of dryness than others and often will not be enough to deal with all of your symptoms.

If you are experiencing dry eye I would strongly encourage you to come and have your eyes checked. Chronic dry eye creates a nasty feedback loop causing your eyes to get drier and drier over time unless you intervene.

There is a lot more to know about dry eye. Stay tuned for future blogs about the types of dry eye, what makes it worse and how we treat your eyes.

Want more information about your own dry eye? Try our dry eye questionnaire!

If you want to read more feel free to check out the following links or as always you can contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

American Optometric Association - Dry Eye

Mayo Clinic - Dry Eye

All About Vision - Dry Eye

Ebola and the eye

Ebola has been making headlines around the world for weeks now. There’s a lot of fear and a lot of misinformation out there! I’ve spoken with many people and read many articles discussing the fear people have about the possibility of Ebola spreading to Canada. While I’m not an expert on Ebola by any stretch remember that Ebola is relatively difficult to transmit and the world is currently on high alert for anyone showing symptoms. Ebola is only transmitted through contact with infected fluids or tissues. The likelihood of it arriving in Canada is small and the chances of it spreading as it has in West Africa are also vanishingly small. Today’s blog is more for interest than anything else as I strongly doubt any of us reading this will be unlucky enough to ever meet someone suffering from the Ebola virus.

So what exactly does Ebola do to the eyes? In most cases the horrific images you may have seen or heard about with blood pouring from the eyes does not happen. That occurs in only about 20% of cases. While Ebola is certainly a terrible disease the external bleeding we imagine to happen to all Ebola patients again only happens to 20% of those infected. Most patients end up with the eyes being red, much like you would expect in someone with very dry eyes or pink eye. The majority of the ‘bleeding’ that occurs with Ebola is internal and is not actually seen.

Let’s now imagine that you were infected with Ebola but you pulled through. Can you expect any eye problems? Unfortunately yes. People who have survived Ebola are much more likely to get uveitis. Uveitis is perhaps better known as iritis and is an inflammation inside of the eye. People with uveitis have very sore, painful eyes that are sensitive to the light. It also causes blurred vision and if left untreated increases your risk for a variety of complications including blindness. Uveitis, is treatable with anti-inflammatory eye drops (steroids) and if treated early has no serious long term effects. If someone has uveitis it often will happen again in the future. No one knows why uveitis is more common in people who have recovered from Ebola as the disease is really not fully understood.

Ebola is certainly a scary disease and as it spreads in West Africa there has been a lot of panicking in the media. Always try to keep in mind that it is very unlikely to arrive in Canada and that even if it does it is unlikely to spread due to the many different infection control standards we have in this country.

If you do have any questions or concerns always feel free to contact us on Twitter, Facebook, Google + or via our website or phone us at (403) 474-6744.

For more information about Ebola:

The CDC - Ebola

CBC News - Ebola: Surviving Ebola

Huffington Post - Symptoms of Ebola

Measles and the eye

Recently the measles has been making the news a lot. It seems that hardly a day goes by without another report alerting us to an outbreak somewhere in Canada and it seems that Alberta has more than its fair share. While I was in school we touched only briefly on the measles since it was considered essentially eliminated in Canada. It can and does affect the eyes and since this resurgence I have refreshed myself on the dangers of the measles and what can happen to your vision.

All that said, I have seen measles in they eye before and it really took me by surprise.

While I worked in Malawi, Africa, a boy came in with a nasty looking pink eye and he was covered in spots. The doctor we were working with looked at us and said "What does this boy have." My colleague and I were stumped. "Measles of course!" he proclaimed as though it were the most obvious thing in the world. We had never seen measles before and were barely taught about it. It was considered an almost dead disease. As we have seen, that is not exactly the case.

A very, very close look at the measles virus.

The boy we treated in Africa recovered wonderfully and his eye cleared up. He was lucky. There are a lot of potential complications of measles. The most common is pink eye. Your eye could be red, gooey, and sore. It is also possible though to have retinal problems. The only symptom you might notice from those retinal issues would be that you were no longer seeing well or no longer seeing at all! If you have been diagnosed with measles or think you may have gotten the measles make sure you include an eye health check as you heal. This type of health exam is fully covered by Alberta Health Care and may just save your vision.

I would strongly encourage anyone who has not gotten the measles vaccine to consider having it done. I know some people may have a lot of questions or fears about vaccines and I'm happy to discuss any of those concerns with you either in office or through social media. The measles vaccine, while not 100% effective, will drastically reduce your risk of contracting the measles and suffering the potentially blinding eye complications.

If you have any questions about this or anything else feel free to contact us on TwitterFacebookGoogle +, via our website or phone us at (403) 474-6744.

Psychedelic, surreal, multi-coloured shapes in my vision!

Alberta is a land of ups and downs when it comes to weather (you may have noticed this recently with our ‘spring’ weather). +20C in December? -10C in July? -40C on Tuesday and +20C on Wednesday? These are just normal weather patterns here and as anyone who gets migraines can tell you it’s not fun. The wild temperature swings wreak havoc on our systems and can cause some funny things to happen.

You’re busy doing your thing when suddenly your vision goes a little funny. You may notice shapes or colours or motion in your vision, not right in the middle but just off to the side. The effect may get larger or smaller. It may move faster or slower or not at all. Sections of your vision may simply vanish and go dark or you may still be able to ‘see’ but things you know should be there just aren’t visible to you anymore (like whatever is supposed to be there pulled a chameleon on you and has become invisible). You may have never had this happen but if these symptoms sound familiar you’re not alone. If you had this happen and didn’t panic at least a little I’m impressed. I’m an optometrist and when this happened to me even though I fully recognized my symptoms and knew what was happening my heart rate bumped up a few notches. This event is known as an ocular migraine.

I know what you're thinking... what the heck did I eat? No, you aren't having a psychedelic trip, this is an example of an ocular migraine. Everyone experiences them differently though so if yours doesn't look exactly like this don't panic.

The term ocular migraine implies that you should get a headache afterwards. That’s not always the case. Some people do have migraine headaches after seeing these images in their vision but not everyone. You may have heard of people getting an aura that tells them they’re about to get a migraine. That’s essentially what this is. Auras or 'ocular migraines' usually last about 20 minutes and are followed by a return to normal vision and depending on the person a headache, a migraine, or absolutely no pain.

So, what the heck is going on? It’s not certain but what is believed to happen is that for some reason the blood vessels in the visual cortex (the very back of your brain… about as far from your eyes as you can get and still be in your head) shrink way down and not as much blood is getting through as before. This lack of blood flow means your brain can’t function the way it would like and you start to experience really bizarre things in your vision. It takes your brain, usually, about 20 minutes to figure out this isn’t normal at which point the blood vessels do one of two things. They either return to their normal size, blood flow returns to normal levels and you stop feeling like you ate a brownie you shouldn’t have OR the blood vessels expand to their maximum size stretching themselves to be as big as they can. It’s that extreme stretch that causes the horrible pain people experience with migraines. In some cases the vision changes can last longer than 20 minutes. This usually occurs if someone completely panics causing an adrenaline surge. The resulting stress levels can cause the visual changes to linger for about an hour.

Here’s the real kicker. There’s not much you can do about this. We think that all those blood vessel antics are caused by the same things that cause migraines… so, almost anything (certain smells or foods, weather patterns, stress, lack of sleep. The list goes on and on). Migraine medication can be helpful if a person is getting ocular migraines all the time and it’s seriously interfering with their life but otherwise we just recommend that a person sit back and enjoy the show for 20 minutes.  If you’re driving it is strongly recommended to pull over and wait it out. These vision changes are temporary and do not cause any damage to your eyes or your brain.

So rest assured that if you have been properly diagnosed with an ocular migraine your eyes are safe and sound. I would love to leave it at that but there is one more thing. Not all flashes in your eyes are harmless. Retinal holes, tears and detachments can cause symptoms including flashing lights in your vision, floaters and a curtain moving in and out of your vision. These flashes do not go away in 20 minutes and generally are noticed at the very edge of your vision. Retinal detachments are extremely serious and cause permanent loss of vision. If you experience flashing lights in your vision of any kind it is best to have it properly checked by an optometrist.  These visits are considered medically necessary and are fully covered by Alberta Health Care. I would advise against taking a risk. If you see flashing let an optometrist have a look at your retina to confirm everything is normal.

For more information feel free to contact us on TwitterFacebookGoogle +, via our website, phone us at (403) 474-6744 or come in anytime. You can also read more at the links below.

All About Vision - Ocular Migraine

More questions? Book now and speak with one of our doctors!