Category Archives: Eye Care

Scleral Lenses – An Old Dog With New Tricks

Eye with keratoconusScleral lenses have been around for over 100 years. Until the new gas permeable lens materials were developed patients could only wear scleral lenses for a few hours a day. With the highly oxygen permeable lens materials now in use, patients can comfortably wear these lenses all day. Scleral lenses are most commonly used to treat eyes with irregular corneas such as keratoconus and post surgical eyes (usually following corneal transplant surgery or related to complications from refractive surgery). Another common use for scleral lenses is in the special effects industry where they are used to protect the cornea and/or to give the eye an exotic appearance.

What Is A Scleral Lens?

Scleral lenses are large contact lenses that rest on the sclera (white part of the eye) with the remainder of the lens vaulting over the cornea. Tears are trapped between the lens and the cornea allowing sclerals to treat irregular corneas. The average soft contact lens has a diameter of about 14 mm whereas scleral lenses typically have a diameter exceeding 14.5 mm. 

How Are Scleral Lenses used?

At Total Eye Care Dr. Driscoll has  used scleral lenses to treat many conditions such as irregular astigmatism, keratoconus, high myopia, dry eye syndrome, and complications related to LASIK and PRK. Because of their size, sclerals are quite comfortable. Patients often report the comfort being similar to that of a soft contact lens. Most patients with irregular corneas will see better with a scleral lens than with glasses. 

Below is a good video that shows how scleral lenses are cared for and how to insert and remove them.

Say It With Your Eyes This Valentine’s Day

Some say the eyes are the window to your soul, but did you know they are also a window to your overall health?  Signs of high blood pressure and other conditions which can indicate an increased risk of heart disease and stroke can be seen with an eye exam.

 As February is American Heart Month, Drs. Richard Driscoll and Alycia Green of Total Eye Care are encouraging residents of Keller and Colleyville to take this opportunity to protect their vision and heart health by having an eye exam and an optomap retinal exam.

Dr. Driscoll comments: “Cardiovascular disease is the leading cause of death in the United States; one in every three deaths is from heart disease and stroke, equal to 2,200 deaths per day.”*

Most people don’t realize that by visiting their optometrist for an eye examination, and in particular by having a simple optomap,  signs of hypertension can be detected, which if left untreated, can lead to heart problems and stroke.

An optomap is one of the most advanced technologies in eye care technology. It is the only technology currently available that provides an ultra-wide 82% view of the retina (the back of the eye) in one image – including the all-important periphery for successful diagnostics of both eye and non-eye related conditions and diseases.

“Viewing the retina during an eye examination allows  me to see the retinal blood vessels and detect any changes to their size and pattern,” Says Dr. Green. “Such changes can be indicative of changes in blood vessels in other parts of the body, such as the heart, and they highlight that further medical investigation and treatment may be required.”

To book an eye examination and optomap call 817.416.0333 or schedule an appointment online.

For more details on American Heart Month 2013 and further information about heart disease visit the Centers for Disease Control and Prevention – www.cdc.gov/features/heartmonth/

* Source: www.cdc.gov/features/heartmonth/ (online, 2013)

What’s on Doc’s iPad Part 2

Tablets are becoming an increasingly bigger part of how we entertain ourselves and even conduct business. I have found some of the most useful apps via recommendations of friends, colleagues, patients, and articles like this one. I hope you find a must have app or two. This article is the second of a series of articles on useful iPad apps. Part one of the iPad app series was published a few months ago.

Google Earth iPad App Logo

Google Earth is a great way to see what your iPad is capable of. Pick a destination on the globe and you can then view it in 3D. It doesn’t matter if your desired location is your childhood home or the Pyramids of Egypt, virtually the entire earth is available. The resolution is great. If you can imagine having the ability to fly, you get an idea of the viewing perspective available with Google Earth. Most popular destinations and cities are available to view in 3D. You can zoom in or out on your desired location and hover above it from any altitude. A fun and interesting way to kill a few hours. Google Earth is free.

When I was looking for an office productivity suite I first checked out the Apple products, Keynote, Pages and Numbers, however I wanted better Microsoft Office compatibility and settled on Quick Office Pro HD. It allows for basic formatting of Word, Powerpoint and Excel documents and overall works pretty well. It is clearly not a replacement for MS Office, but it takes care of most of your needs when advanced formatting is not required. What I do like best about it is that it integrates well with numerous cloud storage providers such as Google Drive, SugarSync, DropBox, and Evernote. Quick Office Pro HD is $14.99.

LastPass-Tab-BrowserLastPass is a password management tool and consequently a very important app for me. I use it multiple times a day and can not recommend it highly enough. When you set up your account, LastPass encrypts your passwords on your PC, and uploads the encrypted passwords to their servers, giving you an encrypted offsite back up of this critical information. You can then opt to only store encrypted passwords on your PC, further enhancing your passwords security. I usually use the desktop version which smoothly incorporates password management into your internet browser. The LastPass iPad app gives you access to all of your passwords via its own internet browser. LastPass uses its own browser since iPad’s Safari browser does not allow plugins or app integration. LastPass works very well and provides a safe, secure way to store  passwords and other confidential information. LastPass offers free and paid options.

desktoponliveiconOnlive Desktop gives you a virtual Microsoft Desktop. This is great when you need to make a 100% Microsoft compatible document. The only drawback is that it requires an internet connection. When you log in it looks like you just logged into a windows PC. You can share your OnLive files with your desktop PC or Mac by logging into files.onlive.com. I can’t believe this service is free.

itunesu ipad App LogoDo you want to learn about a particular subject? iTunes U has hundreds, possibly thousands, of free courses available on nearly every topic you could want. There are college level courses offered by major universities in addition to K-12 classes. There is also a section where private or non-profit organizations offer courses. The courses are very well done with class notes, audio and video material. iTunes U is an incredible resources. You can download the complete courses to your iPad for later use or pull them off the internet as needed. The iTunes U app and access to the library of classes is free.

skype_for_ipad_iconWho doesn’t love Skype? Do you remember seeing the Jetson’s as a kid? I remember seeing Jane Jetson talk on the video phone, and if she wasn’t “presentable” she would cover her face with a mask of herself while she talked. I thought how cool would it be to be able to see the person you are talking with on the phone, just like on the Jetsons. Skype now gives us that ability. The free version allows you to video-teleconference with one other person. If you want to make calls to ordinary telephones or video-teleconference with more than one person there is a modest monthly charge. Skype is a must have, making it easy to stay in touch with family members that are far away.

wordpress-iconThe Eye Doc Blog is powered by WordPress I often use this app to manage comments, check statistics, and read other blogs. If you do any blogging this is a great app. The WordPress app lets you manage your blogs, and functions as a good blog reader. This app is free.

Gmail iconIf you have a Gmail account then this app is a must have. I use it daily. It allows me to do everything on the app that I can do when I log into my Gmail account via the web.  This app is a freebie.

logmein-ios-app-icon-225x225Have you ever been at home and wished you could log into your office computer? LogMeIn let’s you do just that. Most often, you will navigate to the Logmein (Log Me In) website and gain remote access to your registered PCs. The iPad app is very well done and easy to use. It’s a handy app when there is something you must do or have access to on a remote PC. I do miss the lack of a mouse while using the app; however the advantage of using the app versus logging into Logmein via Safari is they have incorporated various finger gestures into the app to simulate mouse functionality. While not quite as efficient as using a mouse it will allow you to do what you need to do and beats having to drive to the office to get that must have file. Logmein is free for basic access to 6 PCs, a subscription service is available for more advanced options.

That will do it for now. Nine more iPad apps I have found helpful. I’m sure you have some winners as well. I would love to hear your recommendations on iPad Apps that you have found helpful. You can read part one of the iPad App series here.

Visual Evoked Potential – New Technology Available at Total Eye Care

We have added a new service here at Total Eye Care. It is called the Visual Evoked Potential or VEP. Until recently this technology was only available to large institutions and teach hospitals. We are now able to provide this service for our patients at the Colleyville office.

What is the VEP?

The VEP, or Visual Evoked Potential, measures how well you visual system is working. Testing the integrity of your visual system is done by showing you a series of checkerboard patterns and then measuring the electrical activity between your eye and the visual cortex of your brain.

Your eye converts what you see into very low voltage electrical signals that travel along the optic nerve between your eye and the visual cortex. The computer inside the VEP compares the strength and speed of signal to a database of normal results and then the doctor uses that information to guide his or her diagnosis.

How is the VEP Done?

Two sticky pieces of tape are placed on your forehead and another on the back of your head. A patch is then placed over one eye and you look at a computer monitor that shows you the checkerboard pattern. When the testing is complete the process is reversed for the other eye. That’s all there is to it.

What Does the VEP Tell the Doctor?

The VEP evaluates how well the entire visual system is working. A visual field (peripheral vision test) gives the doctor similar information. In this way the VEP  helps the doctor diagnose and manage patients with glaucoma. The VEP is also used in the diagnosis and treatment of patients with amblyopia, multiple sclerosis, myasthenia gravis, optic atrophy, and concussion to name a few.

OrthoKeratology in the News

Here is a mainstream media article in Gizmag talking about an upcoming meeting of the Optical Society where David Troilo, PhD, who is the Vice President and Dean for Academic Affairs from SUNY College of Optometry, will give a lecture on Optical Approaches for Controlling Myopia Progression: Evidence from Experimental Models.

It is good to see this excellent and effective technology getting its due. Virtually every time we fit a child or adult with myopia regulating orthokeratology lenses the parents and the patient seem amazed and can’t believe that they can actually see well during the day without a contact lens by merely sleeping in these specially designed vision retainer. It’s not magic or snake oil, it really does work.

On The Eye Doc Blog we have written extensively about the benefits of orthokeratology in preventing the progression of nearsightedness in children. We should not overlook the benefits of orthoK in adults. I am glad to see some mainstream media coverage about orthokeratology.

Win An iPad From Total Eye Care

It’s easy, you can enter our contest in two steps.*

  1. Purchase a complete pair of eyeglasses or sunglasses from Total Eye Care before November 30, 2012,
  2. “Like” either office on Facebook and you are entered into our contest, and
  3. Fill out an entry form and drop it in the box at either office.

The contest ends November 30, 2012.  We will announce the winner on Facebook December 1st.  Good luck.

Colleyville Facebook

Keller Facebook
      *No purchase required to enter the contest. Alternate form of entry stop by the office and fill out an entry form.

Contact Lens Travel Suggestions

With Summer upon us a common question in the office is “what is the best way to travel with contact lenses.”

Daily disposable contact lenses are easily the most convenient travel option. With daily disposables all you have to worry about are lenses, no extra contact lens solutions are needed. Now, there are many new, convenient options available for daily disposable contact lens wearers. Numerous contact lens companies now make daily disposable contacts in both toric, spherical and bifocal versions. With the expanded parameters now available, over 80% of contact lens wearers can now find a daily disposable contact lens that will fulfill their needs.

The biggest hassle for traveling contact lens wearers is how to transport the contact lens cleaners and solutions. After all, the TSA limits each bottle of liquid, aerosol, or gel to 3.4oz (100 ml) or less and all of the bottles in your carry-on luggage must fit into a clear, 1 qt. zip lock bag. There are exceptions; however, for prescription, OTC medications, and people with special needs. You are not limited in the amount or volume however if an item is over 3.4 oz or it is not in a 1 qt. zip lock bag then you must declare it.

Safe travels

Rub and Rinse Contact Lens Cleaning Method Shown to be More Effective Than No Rub Technique

A study out of Australia has confirmed what eye doctors have long suspected. Rubbing your contact lenses and briefly rinsing them prior to overnight storage and disinfection is more effective at removing bacteria from the lens surface than merely placing the contacts in the case (no rub technique). Numerous multipurpose no rub contact lens solutions have been approved by the FDA  and shown to be an effective method of disinfecting contact lenses however this study shows that applying a few drops of the multipurpose solution, rubbing and then rinsing the lenses is much more effect at removing bacteria from the lens surface.

This study was done “in-vitro” meaning that it was a lab study where patients did not actually wear these lenses but the lenses were seeded with bacteria and then after the lenses were cleaned and disinfected the lenses were then testing to see how much bacteria was removed.

So the moral of the story is after removing your soft contact lenses add a few drops of the multipurpose contact lens solution, rub both sides of the lens then rinse the lens and place it in the case to disinfect overnight.

Reference Data: Zhu H, Bandara MB, Vijay AK, Masoudi S, Wu D, Willcox MD. Importance of rub and rinse in use of multipurpose contact lens solution. Optom Vis Sci. 2011 Aug;88(8):967-72.

Total Eye Care has a YouTube Channel

Total Eye Care’s YouTube Channel is up check it out and let us know what you think.

Total Eye Care to Conduct CCSVI Study

We are very pleased to announce that Total Eye Care will start its first clinical study next month. The title of the study is Vascular Fundus Changes in Patients With High Probability of Chronic Cerebrospinal Venous Insufficiency (CCSVI). Check out the video below for more information. We are recruiting patients with either Ehlers-Danlos Syndrome or Multiple Sclerosis so please spread the word. The video has a lot of good information on the study so please do check it out.