Back to school - Time for an eye exam?

It's mid August. Summer is slowly leaving us and our thoughts turn to back to school (at least in part because the ads on TV and in stores are everywhere)! In the run up to going back to school parents typically think about shopping for new clothes, school supplies and worrying about schedules.

Have you thought about an eye exam for your kids?

You definitely should. One in four children has a visually related learning difficulty. I've lost count of the number of children I've seen who have been told they have a learning disability when in reality the problem was their vision. It can be hard to catch up if for the first several years of school you struggled to see and fell behind in the basics of reading, writing and math.

This is all very preventable. Make sure your child comes in for their first exam at age 6 months  and then is seen every year after. If they're older than 6 months and haven't had an eye exam yet be sure to get them checked soon! You might be thinking, 'Why? My child sees just fine and passed a vision screening at school." Well, we can't rely on vision screenings. They really should be called sight screenings since they're only checking sight (as in 20/20 or not) and not vision. Optometrists don't just check sight. We check how well the eyes work together and how sight is processed. Children don't have a solid understanding of how the world should look and children often assume what they see is what everyone else sees too. Many times vision screenings also only check sight with both eyes open. If one eye has a high prescription it will be missed and can lead to amblyopia.

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Seeing 20/20 is important but it isn't everything. Book an eye exam to make sure your child isn't suffering from an undiagnosed vision problem.

So what should you watch for? Often there are no obvious symptoms of a vision problem (especially if it's a problem with only one eye). When a child is having vision related learning problems though they may reverse words when writing or copying, confuse the same word in the same sentence, skip lines while reading or read the same line twice to name only a few possible problems.

The best way to prevent and avoid problems is to have your child's eye examined yearly. Children's eye exams are fully covered by Alberta Health Care every year (or more frequently if required). The Alberta Association of Optometrists also has the Eye See, Eye Learn program for children age 5 to receive a free pair of glasses if required!

There's no excuse! Book your child's eye exam today.

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

Amblyopia - How do we treat it?

My last blog about amblyopia discussed what amblyopia is and why it happens. It’s been a while so if you forget what amblyopia was or missed that blog follow the link back and find  out more before reading about how we treat amblyopia.

So what do we do about amblyopia? It’s actually not all that difficult! If there is a large amount of farsightedness or astigmatism our first step is to correct the prescription. A lot of parents get lost about now. We’ve just spent the last several minutes explaining to them that their child can’t see properly even with glasses and now we’re saying that they need glasses to fix the problem. This is especially tricky if there is no change in how well the kid sees without glasses or with!  It’s totally fair to question what we’re doing and why. The idea is to provide the eye (or eyes) with a nice sharp image. It may not make any difference in how well they see at first but over time as the eyes receive a nice sharp image they will learn more and more how to see better. If we go back to our earlier analogy with the flowers it’s sort of like watering the poor neglected flower. Just because you watered it doesn’t mean it instantly comes back to health and looks amazing. It takes care and time to nurse that flower back into full bloom.

If the amblyopia is only in one eye or is strabismic (eye turn) patching an eye is often required. The reason we have to patch in cases where only one eye is affected is  because if we don’t the better eye will just take over and keep doing all the work. This prevents the weaker eye from doing any work and slows or eliminates how well it will improve. The good news is that research has found that patching is NOT required all day every day! In fact it is only required for a few hours each night though we do recommend that the patient does some visually stimulating activities like reading, colouring or even video games.

There are certainly some cases that are more complicated and require more intervention and far more intensive vision therapy. Some patients may eventually require an eye surgery if they have an eye turn but the majority of patients with amblyopia can be easily treated so long as it is detected early. The older we are the harder it is to treat amblyopia as our brains are more set in their ways. So book your kids in for an eye exam today! You may think they see just fine, they may seem to see well but remember amblyopia may only affect one eye and young kids often don’t realize what they aren’t seeing!

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.

Doctors of Optometry Canada - Amblyopia

Mayo Clinic - Amblyopia

 

Amblyopia - An introduction to a common and confusing problem

Let me introduce you to one of the  most commonly misunderstood eye disorders that occurs in children and can continue into adulthood: amblyopia. Why is amblyopia so confusing? The biggest problem is that it’s hard to explain in a way that makes sense to everyone. So let’s hunker down and understand what amblyopia is.

Amblyopia is often also called lazy eye. This is horribly confusing because strabismus (where the eye turns in, out, up or down all or most of the time) is also commonly called a lazy eye. While an eye turn can lead to amblyopia, it doesn’t always and many people have amblyopia without an eye turn. Confused yet? What is amblyopia then? Officially it is decreased vision, even with glasses on, without any other disease or health problem being present. To really understand amblyopia though we need to know where it comes from. Remember that when we are born we don’t see perfectly well! In fact our eyes develop and learn how to see from the time we’re born until we are about eight years old.

There are two types of amblyopia. One type is called refractive  (meaning related to the prescription) the other type is called strabismic (meaning that there is an eye turn). The prescription related type of amblyopia is almost always caused by either very high amounts of farsightedness or very high amounts of astigmatism that have not been corrected with glasses. Sometimes this will happen in only one eye but it will often happen in both. The problem is that if you have a very large amount of farsightedness or astigmatism it’s not possible to see well at any distance.  Strabismic amblyopia occurs when an eye is always turned out or turned in. Since that eye is always off to the side our brain edits out any images from it and it doesn’t get used. This is a great example of use it or lose it! Remember that when we are young our eyes are still learning how to see. If during that time, when we are learning how to see, our eyes never have a clear image (or just isn't used!) we never develop the ability to see as well as we should. To put it another way imagine you had two potted flowers. One flower you diligently watered and fertilized every day but the other flower you more or less ignored. Even if they started out with the same potential the flower that got taken care of would thrive while the other would wither away. Eyes are obviously not exactly the same but an eye that gets daily stimulation with sharp clear images will learn and develop much better than an eye that doesn’t.

So what do we do about it? I'll cover how we treat amblyopia in my next blog! Until then if you want to read more feel free to check out the following links or as always contact us on Twitter, Facebook, Google + or via our website or phone us at (403) 474-6744.

Doctors of Optometry Canada - Amblyopia

Mayo Clinic - Amblyopia

Retinoblastoma - Eye Cancer in Kids

There’s a story that’s been going around on social media about retinoblastoma, a rare but serious eye cancer that affects young children (I reposted it here). I realize that most people have probably never even heard of retinoblastoma and given how serious it is I thought it was worth writing about. It can be treated and, like any cancer, the sooner it’s caught the better the outcome.

So first, what is retinoblastoma? It is a cancer of the retina itself caused by a genetic mutation that can happen all on its own or be inherited. The reason it happens in young kids and not older people is the cells that lead to retinoblastoma are only found in children. They are called retinoblasts and their job is to divide and fill in the retina as the child grows (our eyes aren’t fully developed when we’re born). If they start growing and dividing uncontrollably we end up with a retinoblastoma.

So how do you detect it? The best way is to have regular eye exams. Remember that kids can start getting eye exams as young as 6 months old! You can also detect retinoblastoma yourself as a parent  by watching out for a few key things. If your child’s pupil appears white in photographs,  your child has developed an eye turn (also called a strabismus or lazy eye) or the eye is red and irritated or doesn’t seem to see as well I would strongly advise getting your child seen by your optometrist or family doctor as soon as possible. It is very important to note that most white pupils, eye turns and red, irritated eyes are not cancer. There are a variety of potential causes of these signs, some serious, others less serious and it is the job of your optometrist to  figure it out.

If you see this in a picture of your child you want it's important to have it checked immediately.

So what do you do if you do find that your child has retinoblastoma? How can it be treated?Your retinal oncologist (fancy name for an ophthalmologist or eye surgeon that specializes in eye cancer)  will set up a treatment plan depending on the size, type and location of the tumour. The number one priority in all cases of eye cancer is to save the person’s life. Retinoblastoma is fast growing and there is a possibility of it spreading to other parts of the body or into the brain. Saving the eye or the vision is less important than saving the child’s life. Radiation, chemotherapy, cryotherapy and a number of other  common cancer treatments are typically used to start in an effort to reduce the size of the tumour or eliminate it. In some cases it is necessary to remove the eye. Even if they eye itself can be saved it often is not able to see after treatment is completed. Retinoblastoma is never something we want to see but if caught early much can be done to help.

So now you have a better understanding of retinoblastoma. If you have any questions always feel free to contact us on Twitter, Facebook, Google + or via our website or phone us at (403) 474-6744.

For more information follow the links below!

Canadian Cancer Society

Ask a Doctor of Optometry - Retinoblastoma

Part 2: So, eye doctors do exams on babies? How does that even work? Why bother?

In this continuation from Part 1 of our two part blog about children's eye exams we talk more about how our eye work together, eye health and how we check these areas out on young children.

We often don’t think about it, but it’s pretty amazing that we don’t see double all the time. Our eyes have to line up perfectly all the time and work together well to allow us to see properly. It’s perhaps not surprising to hear that sometimes the system breaks down. It’s very obvious when someone has a big eye turn in or out and most parents would notice that. What is trickier is when the eye only turns sometimes, only turns when reading or there’s a muscle problem that doesn’t result in any eye turns at all! Many people have a muscle alignment problem that causes a lot of symptoms  but the eyes themselves don’t actually visibly turn in or out when both eyes are open. For a child trying to learn how to read this is a big deal! Kids may skip words, confuse letters, say letters are moving or have any other number of problems that people think is a learning problem but is actually an eye problem. A simple test to confirm the alignment of the eyes, standard on all eye exams, can help to prevent or solve a whole host of problems.

The thing about eyes is we only get two. It’s important to take care of them right from the start. We encourage our kids to take care of their first set of teeth even though they’re going to get more! We want a dentist to make sure they have healthy mouths. If something goes wrong with our eyes we don’t get to have a replacement! The majority of kids are, again, very healthy. Unfortunately though eye health problems in kids are either extremely serious and require early detection and treatment or are very minor like pink eye that just require drops. Most eye cancer, for example, strikes young kids under the age of five. It’s very rare but very serious.  There are many eye diseases that can affect children and by looking inside the eye and out optometrists can detect them early.

80% of learning is visual. I see so many kids that are being treated for attention problems or are getting special tutoring because they’re falling behind in school but their only problem is that they can’t see or their eyes aren’t working together. I don’t know about you, but I would probably act out too if I couldn’t see what was going on all day! Kids 18 and under are 100% covered by Alberta Health Care so you don’t have to pay a dime! You really don’t have an excuse not to bring your kids in and get them checked!

If you have more questions about this, or any other topic, always feel welcome to contact us on Twitter, Facebook, Google + or via our website.

For more information about children's eye exams check out the links below:

Eye Exams for Infants

Eye Exams for Preschoolers

Eye Exams for School Age Children

Part 1: So, eye doctors do exams on babies? How does that even work? Why bother?

People love their kids, that’s pretty much a given fact. Everyone wants to make sure they do the best they can to help their kids be everything they want to be! You take them in for their shots and check ups, make sure their teeth are healthy with the dentist and keep them busy with sports or music or any number of things! What many parents forget is to have their child’s eyes checked by an Optometrist.

I completely understand how this happens: People don’t think we can do eye exams on young kids; they think that little Timmy sees just fine thank you very much; they just don’t think it’s necessary!  The thing is the consequences of assuming everything is fine can be quite serious. It's much better to check and know everything is fine than to not check and hope for the best.

Optometrists are fully trained to do eye exams on just about anyone including small children. We actually start seeing kids as young as 6 months (and we really only wait that long because the eyes are still learning how to work together properly before then). I know you’re thinking “But, what on earth are you going to do with my 6 month old!” Don’t worry. We don’t require that our patients answer all those questions to get the information we need. Without any questions we can still assess the three major areas all optometrists check: how well the eyes focus, how well the eyes work together and how healthy the eyes are inside and out.

To check how well the eyes focus, especially on kids or people who are non-verbal, optometrists use a tool called a retinoscope. When we shine it back and forth at someone’s eyes we see a light reflex. Depending on how that reflex moves we can tell if someone is near-sighted, far-sighted or has astigmatism. We use lenses to ‘neutralize’ that reflex and that tells us  what the prescription is. We can do this on anyone of any age but it only gives us an estimate of the prescription so we still ask adults all those darn questions. Most kids don’t have a significant prescription, even if they may develop one later in life. Some children though have very extreme prescriptions. If the prescription isn’t corrected it can lead to amblyopia, a condition that prevents someone from having  clear vision even with glasses on.  

A lot of parents assume that if their child hasn’t complained they must not have a problem. This isn’t accurate for a couple reasons. If only one eye is affected your little guy can see just fine… it’s just only out of one eye. Since most kids don’t walk around with one eye closed they don’t usually notice the problem! The other issue is that kids don’t really know what they should be seeing, especially when they’re very young. If both eyes are affected he or she may not realize there’s a problem and assume that this is just how everyone sees. It’s not until they’re much older, 7 or 8, that they start to realize something isn’t quite right at which point it’s almost too late to treat.

Our next blog will continue to explore kids eye exams and talk a bit more about how our eyes work together, eye health and how we check those out on young kids.

If you have more questions about this, or any other topic, always feel welcome to contact us on Twitter, Facebook, Google + or via our website.

For more information about children's eye exams check out the links below:

Eye Exams for Infants

Eye Exams for Preschoolers

Eye Exams for School Age Children
 

UV and you: Why sunscreen isn’t all you need to protect yourself from the sun

Everyone knows how important it is to wear sunscreen, especially if you’re going to be spending the day outside. Sunscreen has become a part of many of our daily routines and is in most skin creams. Enjoying our short summers here in Calgary usually means spending as much time as possible outside while the weather is nice and we all know we need to wear sunscreen when we’re outside all day. Protecting your eyes from the sun though is just as important.

In my last blog I talked about cataracts and how UV light increases your risk of getting cataracts sooner. Several blogs ago I talked about macular degeneration and how one of the main preventable risk factors in the disease is exposure to UV light! If you’ve been reading my blogs you already know how important protecting your eyes from the sun is. UV light also increases your risk of certain eye and eyelid cancers as well as wrinkles, lumpy fleshy elevations on the white of your eye called pingueculae or even fleshy growths over the clear part of your eye called pterygia!

So I’ve convinced you how important sun protection is (I hope!) and you get it now. Even though sun protection is really important did you know that almost one third of people don’t wear sunglasses at all? When we talk about kids that number increases to almost 50%! While it is definitely important for people of all ages to wear sun protection it is extra important for kids. A combination of very large pupils, a more transparent lens inside of their eye that allows far more UV to penetrate inside and spending more time outside than most adults leads to 80% of lifetime UV exposure to the eye to happen before the age of 18!

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UV light is sneaky and may be getting to your skin and your eyes in situations you might not expect such as underwater, on cloudy days or getting a double dose from light reflected off of snow or water!

All sunglasses are the same though, right? Wrong. Not all sunglasses block all UV light rays. All sunglasses sold in Canada have some degree of UV protection but not all block 99% of UVB rays which is what is recommended to best protect your eyes! If you have sunglasses and want to know how much UV they block feel free to bring them in to our office and we can measure how much UV is blocked at no cost to you.

So you’re saying to yourself alright, I get it, I need to wear good sunglasses: I have more news. Sunglasses are often not enough. Even nice big sunglasses still let some light in around the edges and especially some of the extremely cool aviator frames are flat (they don't 'wrap' around your face) and don’t offer much protection from the side. You have some options to help protect yourself further. A good hat with a wide brim helps prevent as much sunlight from getting around your sunglasses. Another option though is to wear contacts!

I know you’re wondering how on Earth contact lenses could help. It’s a fair question since most do not. All contact lenses offered by Acuvue though have some degree of UV protection. They have many that will block over 99% of UVB!  This is a great option for protecting your eyes from the sun and at Eye Spy Optometry we carry a wide variety of Acuvue products.

So which is best? Sunglasses? A hat? UV blocking contact lenses? The answer is all of them together. All these options will work together to give you comprehensive UV protection for your eyes. It’s important to remember as well that UV exposure doesn’t decrease  very much on cloudy days, under water, in the winter or at dawn or dusk. If you think you only need sun protection from 10:00am-4:00pm on sunny days in the summer you’re going to still get a heavy dose of UV the rest of the time! Think about all those times on the ski hill when you’ve ended up with a burn on the few exposed areas of skin you had.

Remember to protect your eyes, protect your skin and protect your health with as many UV blocking options as you can find. Your body will thank you for it!

If you have more questions about this or anything else always feel free to contact us on Twitter, Facebook, Google + or via our website. For more information feel free to follow the links below:

The Vision Care Institute

Doctors of Optometry Canada - Risks Associated with Sun Exposure

Doctors of Optometry Canada - Children and Risks Associated with Sun Exposure

Cataracts: They're not what you might think they are!

Often when I talk with my patients about cataracts they’re very unclear about what a cataract really is! Lots of people seem to think it’s something affecting the front of the eye and can be peeled off. Others think it can just be lasered off. Others think cataracts only happen in older people. None of these things are strictly true. Cataracts are one of the most common eye disorders in the world and so of course lots of myths have sprung up around them. Let’s figure out what cataracts are, who they affect and what you can do to prevent or treat them.

To fully understand cataracts you need to know a very little bit about the anatomy of the eye. The biggest thing to absorb here is that the pupil, the dark central part of your eye, is not an actual thing. The pupil is actually nothing! It’s just a hole. Behind that hole though is a very cool structure called the crystalline lens. The lens in your eye not only provides some of the focusing ability of your eye so you can see far away it also flexes and changes shape to allow you to see clearly when you look at things that are close to you as well. Overtime that lens can become cloudy. This prevents as much light from getting to your retina and also causes light to scatter. This leads to a combination of blurred vision and night glare. This is a cataract.

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This is an example of an extremely dense cataract. They almost never get this bad in Canada as people usually seek treatment before their vision is this bad.

So now that we know what a cataract is, what causes it? There are actually a lot of different causes so today I’ll go over just a few. One of the most important causes of cataracts is exposure to UV light. Over the long term UV light causes the lens inside of our eye to cloud up. Your best protection against this is to wear sunglasses as much as possible when outside, even on cloudy days or as the sun is going up or down. Many people think there is a much lower risk of UV exposure when it’s cloudy or during sunrise or sunset but while the UV exposure is somewhat reduced UV is still getting through to your eyes and skin.

An impact or other types of injury (such as electric shock) can also cause cataracts in otherwise young and healthy people. The trauma to the eye and to the lens can cause the lens itself to rupture or crack. These cracks allow fluid to enter into the rigidly organized lens and allows a cataract to form. The most obvious way to prevent this is to protect yourself against injury! Wear safety glasses if you’re doing work where something might hit you in the eye and definitely while participating in sports like squash that carry a high risk of getting hit in the eye.

The last type of cataract I’ll go over today is congenital. Congenital is fancy word for ‘you’re born with it’. Roughly ⅓ of congenital cataracts are genetic, ⅓  are caused by a disorder or disease and ⅓ are idiopathic… another fancy word that means we don’t really know where they come from. Hospitals do typically check newborns to make sure they don’t have an obvious or significant congenital cataract that requires treatment . That said I have a lot of patients that have minor congenital cataracts that aren’t really an issue but they had no idea were there.

So cataracts are inside the eye and are the clouding of the lens behind our pupil. They can affect anyone from newborns to seniors depending on a lot of different factors. These facts probably fly in the face of what you thought cataracts really were! The good news is that cataracts can be easily removed with a relatively quick and easy surgery. That’s a topic for another blog though! For now, if you have any questions you can always contact us on Twitter, Facebook, Google + or via our website. For more information check out the following links.

Doctors of Optometry Canada - Cataracts

CNIB - Cataracts