Category Archives: FAQ

Frequently Asked Questions

World Glaucoma Awareness Week is March 7 to March 13

FOR IMMEDIATE RELEASE

COLLEYVILLE, TEXAS – March 6, 2010 – In honor of World Glaucoma Awareness Week (March 7 to March 13, 2010), Total Eye Care will be offering free Glaucoma Screenings on World Glaucoma Day, March 12, 2010 at the Colleyville office located at 6114 Colleyville Blvd. from Noon to 2pm.

“Early detection and awareness are crucial to limiting vision loss from glaucoma.  The purpose of Glaucoma Awareness Week is to get the word out and prompt patients to seek an evaluation from their eye doctor.  At Total Eye Care we would like to make it easier for patients to learn about glaucoma by offering a free screening ” says Dr. Richard Driscoll, clinical director at Total Eye Care.  Glaucoma is the second leading cause of blindness worldwide, not because of lack of effective methods for diagnosis and treatment, but due to insufficient information available to the public and low awareness of the implications of the disease.  Glaucoma is asymptomatic in its early stages, while the patient’s vision suffers irreversible and cumulative damage. Visual disturbances are noted by the patient during the later stages on the way to blindness, whereas timely diagnosis and therapy could have prevented this degradation.

“We have so many advanced medications and diagnostic instruments available to us that the detection and treatment of glaucoma has been greatly advanced in the last 10 to 15 years” says Dr. Alycia Green.  A glaucoma awareness questionnaire is available on the Total Eye Care website along with detailed handouts for patients on glaucoma and many other eye diseases such as macular degeneration and keratoconus.

Total Eye Care participates in Glaucoma Awareness Week, the complete press release.

About Total Eye Care

Therapeutic Optometrist and Optometric Glaucoma Specialist Dr. Richard Driscoll has been serving the eye care needs of Colleyville, Texas since 1995.  Dr. Alycia Green brings over 10 years of experience to Total Eye Care, specializing in pediatrics.  The Colleyville office is located at 6114 Colleyville Blvd.  Total Eye Care’s Keller office is located at 1834 Keller Parkway. More information can be found on The Eye Doc Blog or the Total Eye Care website at www.TotalEyeCare.com

Contact Information

Dr. Richard Driscoll
Total Eye Care
6114 Colleyville Blvd.
Colleyville, TX 76034
817.416.0333

How are Soft Contact Lenses Made?

Have you ever wondered how soft contact lenses are made?  We found this Discovery Channel video from the show How Do they do it? showing how custom soft contact lenses are made.  

Top Ten Reasons to Buy Your Contact Lenses from Your Eye Doctor

1. You are guaranteed to get the correct lenses in the correct parameters

2. You are guaranteed to get unexpired lenses

3. If your lenses are not performing properly you don’t have to worry about exchanging your old lenses

4. You can exchange unopened, unexpired, unmarked boxes in new condition at your yearly eye exam

5. If you have a defective lens, we will replace it free of charge

6. We have the latest manufacturer’s rebates available to save you money

7. Competitive pricing

8. FREE shipping

9. You will be getting the lenses from an authorized distributor of the brand you wear

10. You will have the satisfaction of supporting a local business that cares about you and your eyes

Image courtesy of Flickr user Malkav.

How do 3D Movies Work

3D Glasses, image courtesy of Flicker user Phillip CasablancaThis weekend Taylor and I went with a group of dads and daughters to see A Christmas Carol in 3D.  A popular question was, “so how do they do the 3D effect?”

We can judge depth because our eyes are about 2 1/2 inches apart, allowing each eye to have a slightly different view of an object.  The brain interprets these differing views, allowing us to note that the objects are at varying distances.

In a movie theater, the image is projected onto a flat screen, therefore we must show each eye a slightly different image, this is accomplished by using either polarized lenses (the better method) or red and green lenses (think headache).  Polarized lenses are, by far, the preferred method.  Typically, light radiates in all directions, polarized lenses filter the light so that it radiates in only one direction, with all of the light waves parallel to each other.

The 3D movie glasses use polarized lenses that filter the light 90 degrees apart for each eye, thus allowing each eye to see a different image.  Two movie projectors are then used to show the movie.   Each projector’s image is slightly offset on the screen simulating the distance between our eyes.  While wearing your polarized 3D glasses the movie looks clear and sharp.  If you take your glasses off the movie looks fuzzy with a shadow off to the left.  Your brain will fuse these views giving depth to the image.

An Interesting Experiment

If you take a friend’s 3D movie glasses and hold their left lens in front of your right lens you will see that no light gets through, turn the lenses perpendicular to each other and once again you can see through both lenses.

So How Was The Movie

A Christmas Carol 3D 2009 The last 3D movie I saw used red and green glasses so it was great seeing a 3D movie that did not give me a headache.  The picture looked great and the 3D effects were well done, however that’s about it.  The chase scenes were way to long and really done mostly to show off the movie’s 3d effects.  Jim Carrey was good in his role as Ebenezer Scrooge and the movie stuck to the original book.  So the bottom line, it’s not a bad movie as a matter of fact they did a good job, however the only reason to see this movie, is to see the 3D effects.

10 Must Have FireFox Browser Addons

Occasionally I depart from the usual eye care related topics and branch into something that I feel people might find useful.  My internet browser of choice is Firefox. I only use Internet Explorer when absolutely necessary, which is a very rare event indeed.  What I like about Firefox is that you can customize it with addons.  There are thousands of addons available for Firefox.  Here are a few of my must have favorites.  I use everyone of these daily.

  • Tab Mix Plus – Adds increased options and functionality to Firefox’s current tab system
  • Unites States English Dictionary – a spell checker
  • Google Toolbar for Firefox – search Google from the browser without going to the website, includes other helpful items as well
  • Adblock Plus – gets rid of pop ups and advertisements, you can tell it which pages you want the ads removed
  • Delicious Bookmarks –  Store your bookmarks online and categorize them.  Decline the option to install Yahoo’s Toolbar, Google’s is better
  • ForecastFox – gives you weather in the bottom right corner of the browser
  • Gmail Manager – Much better way to access your Gmail, especially if you have multiple accounts
  • IE Tab – sometimes only Internet Explorer works, usually only needed for an E-Commerce site
  • Remember the Milk for Gmail – My todo list integrated with Gmail
  • Sxipper – Gives me the option to enter my passwords at logon screens

That’s it those are my must have Firefox Browser Extensions/Addons.  You can search for other Firefox addons at the Firefox Addon Website.  I have also reviewed addons that are available to patients with impaired vision.

How Does Glaucoma Damage the Eye?

We are frequently asked to explain how glaucoma causes blindness. Glaucomatous damage to the eye is caused when the pressure within the eye is greater than the optic nerve can tolerate. How does the pressure cause blindess? The simple answer is we don’t know exactly, however there are two main theories as to why the damage occurs. Neither theory fully explains how the optic nerve damage occurs in the different types of glaucoma.

The Vascular Theory of Glaucoma

The premise of the vascular theory is that high pressure inside the eye restricts blood flow to the optic nerve causing the optic nerve to slowly die from lack of oxygen and nutrients.

The Mechanical Theory of Glaucoma

Physical damage is the underlying hypothesis of the mechanical theory of glaucoma. It is thought that the high pressure damages the optic nerve fibers.

So Which One Is It?

That’s a good question the leading researchers can make a convincing case for both theories and neither theory, by itself can completely explain how glaucoma damages the eye. In reality both probably play a role in how an eye is damaged by glaucoma.

Stumble It!

Treating Dry Eyes with Punctal Plugs: Silicone Plugs vs the SmartPLUG®

Are you sensitive to light? Do your eyes often feel gritty? Does your vision fluctuate? Does blinking improve your vision? Do you use artificial tear more than 3 times a day? Find your contact lenses uncomfortable?Graphic of Odyssey Silicone Punctal Plug for the treatment of dry eye syndrome These are just a few of the most common symptoms we hear when patients tell us their eyes feel dry and irritated. Dry eye syndrome is very common, especially in women. Treatment of dry eye syndrome is very beneficial with very little risk of complications. Punctal occlusion with silicone plugs is one of the most common modes of treatment.

We often use punctal plugs to increase the amount of tears present in a patient’s eyes. A recent study compared the two most common types of punctal plugs, silicone punctal plugs and the SmartPLUG®. Essentially the study found that they both were relatively equally effective in reducing a patient’s symptoms (over 55% of the patients reduced the use of artificial tears). The study evaluated only 36 eyes for less than 12 weeks which really was not enough patients over too little time. However, one would likely expect that as long as the punctal plugs remained in the eyes the patients would continue to do well. The study does show that treatment of dry eye syndrome with punctal plugs is an effective solution.

Interestingly, 33% of the eyes treated had a plug fall out during the 12 weeks, which is very high. In our practice we see approximately 5% of our patients per year lose a plug, a rate much more in line with other ophthalmic practices. A 33% loss makes me want to look for a problem with punctal plug sizes.

We use both types of punctal plugs used in the study, silicone plugs (made out of a rigid type of silicone) and the SmartPLUG® (made out of a thermodynamic gel). We find both to be very effective and helpful in different situations. I like the silicone plugs for most patients, it is easy to insert and verify that it is still in place doing its job. The SmartPLUG® is helpful in patients that find the silicone plugs irritating.

If you think you are experiencing the symptoms of dry eyes see your eye doctor and get some help. There are numerous treatments available, which we will cover in another article. At a minimum, patients typically note a significant decrease in symptoms with treatment.

If you would like to read a summary of the article it’s available here “SmartPlug versus silicone punctal plug therapy for dry eye: a prospective randomized trial”.

UPDATE: Check out this video on treating Dry Eye Syndrome with punctal plugs at Total Eye Care.

FDA Listens to LASIK Patients

On Friday, the Food and Drug Administration heard testimony from LASIK patients dissatisfied with the outcome of their surgeries. The ophthalmic devices panel heard testimony that approximately 1/4 of all patients that wished to have LASIK were poor candidates and 95% of LASIK patients were satisfied with the outcome of their surgery. Expert testimony before the panel concluded that the FDA should provide clearer warnings about the risks and possible complications of LASIK. Next year the FDA and the National Eye Institute will begin a landmark study to better identify which patients are more likely to encounter post surgical LASIK complications and how those complications affect quality of life. We compared the incidence of complications for patients having LASIK vs contact lens related complications in a prior blog entry.

I find that the FDA is not the only one that could improve their modus operandi here but that some of the marketing/advertising for refractive surgery is irresponsible. This over promise of results does not apply to just refractive surgery but also the bifocal lens implants promising to give your back your ability to see near and far without bifocals.

At Total Eye Care our role as optometrists is to provide the patient with an objective assessment, finding the best method of vision correction available for each patients situation. Today there are many refractive options available such as contact lenses, glasses, orthokeratology, PRK, LASIK and refractive lensectomies just to name a few. If a refractive option is selected it is our job to work with the patient to find the best surgeon and procedure for each patient to get the best, safest result. The Associated Press had good coverage regarding the ophthalmic devices hearing, if you would like to read it it’s available here.

Q: If My Blood Pressure is High Does That Mean the Pressure in My Eye is High Too?

A: This is a great question that gets asked a lot. The pressure inside your eye is completely unrelated to your blood pressure. The intra-ocular pressure system and the blood pressure are completely separate systems and fluid is not exchanged between them. Therefore, if you have high blood pressure you won’t necessarily have glaucoma.

LASIK – Is It Safer Than Contact Lenses?

It’s all over the radio these days a LASIK surgeon touts “some experts believe LASIK is safer than contact lenses”. In reality this is a difficult statement to backup properly, given that we are really comparing apples to oranges. Why is this comparison difficult? Comparing LASIK to another refractive surgery procedure, such as PRK, is rather straight forward because the complications are similar for both procedures and the opportunity for complications is essentially nil after the patient is stable, typically 6 months to a year after surgery. A contact lens wearer, on the other hand, has a lower complication rate. When compared to LASIK or PRK contact lens complications are less severe and less frequent, however, a contact lens wearer’s potential for complications will last as long as the patient is wearing their lenses, often for decades.

Both LASIK and contact lenses are safe and in our office we utilize both techniques, choosing which is best for the patient. It is our practice to discuss all of the refractive options with our patients. We weigh the risks and benefits of each option before proceeding.

As a practical matter the incidence of vision threatening problems in compliant contact lens wearers is very small. When a patient does have a problem, it typically manifests itself as a red eye usually resulting from poor care or not replacing their contacts as often as recommended. It is exceedingly rare for a contact lens related red eye to cause a patient to require surgery to resolve the problem.

This prompts me to ask “what does the research say”. In my mind that’s what matters. Let the studies show us which is safer. The most important contact lens and LASIK complications are those that have resulted in a loss of vision and therefore that is the best criteria to compare LASIK versus extended wear contact lenses. A 2005 study including almost 5,000 patients followed over a 1 year period showed that 30 day Ciba Night & Day contact lens wearers, experienced an overall rate of presumed infiltrative keratitis (a type of corneal ulcer) of 0.18%. Of those experiencing keratitis 0.036% resulted in a loss of vision and 0.144% experienced keratitis without vision loss.

Numerous studies published in 2005 and 2006 indicated a complication rate for LASIK, resulting in a loss of best corrected vision, ranging from 0.6% to 7.0%.

Given the facts outlined above, I feel it is doing patients a disservice to state or imply that refractive surgery is as safe or safer than silicone hydrogel contact lenses. Both LASIK/PRK and silicone hydrogel contact lenses have come a long way in reducing both the rate and severity of complications and in looking at the numbers both are safe.

I still believe LASIK and PRK are good options for patients. I, in fact, have had LASIK and at our office it is still one of the refractive options we present to our patients. However, the research does not support the statement that refractive surgery is as safe as contact lens wear nor should it be promoted as such.

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