Category Archives: eye

Surprising Conditions That Eye Doctors Find First

People often think of an eye exam as how you update your eye glass or contact lens prescription. More importantly, it is a very effective way to provide early detection of systemic conditions. Readers Digest recently published this article on conditions that are often first diagnosed by an eye doctor.

New Video on the Importance of Yearly Eye Exams

I came across this video from the American Optometric Association about the importance of yearly eye exams.  We also filmed our own video about the importance of yearly eye exams at the new Colleyville office .  With back to school eye exams being an important part summer it is important for us to safeguard our children’s vision.

Video Games May Help Your Vision?

Snellen-Eye-Chart, Copyright 2009 The Eye Doc BlogA new study found that first person action games improved the vision of adult video game players.   Two groups of patients were tested.  The first group of patients played Call of Duty and experienced a significant increase in their ability to distinguish different shades of gray (contrast sensitivity function).  The second group used The Sims, which was similar in it’s graphic detail however it is a non action game that does not require precise visual activities such as aiming.

Contrast sensitivity function is a measure of visual acuity (the chart on the wall that uses progressively smaller numbers is another, more common method, shown to the right) uses different shades of gray to evaluate a person’s vision rather than how small of a letter a person can read (the latter is called Snellen visual acuity.  Contrast sensitivity is a much more precise way of evaluating a person’s visual acuity and is more often used in clinical research.

The exciting part of this study is that it has been previously thought that it was difficult to improve the vision in adults.   This study paves the way for possible new treatments of amblyopia in children and the hope of retraining patients that may have lost vision due to some retinal conditions.  The study showed that not all games are created equal in producing this affect and advised caution in recommending games to recommend to patients.  The entire study was published online by the journal Nature Neuroscience.

FDA Approves Latisse for the Treatment of Hypotrichosis of the Eyelashes

It’s official, as we reported a little over 2 weeks ago about pending approval of LATISSE(TM) to increase the length, number and darkness of a patient’s eyelashes Allergan made the announcement today that the FDA approved LATISSE(TM) (bimatoprost ophthalmic solution 0.03%), allowing it to be prescribed by doctors.

Available only through a doctor, LATISSE(TM) is a once-daily prescription treatment applied to the base of the upper eyelashes with a sterile, single-use-per-eye disposable applicator. LATISSE(TM) users can expect to experience longer, fuller and darker eyelashes in as little as eight weeks, with full results in 16 weeks. To maintain effect, continued treatment with LATISSE(TM) is required. If use of LATISSE(TM) is discontinued, eyelashes will gradually return to where they were prior to treatment over a period of weeks to months (average eyelash hair cycle).

LATISSE(TM) will be available in the United States by prescription only and is subject to all U.S. guidelines applicable to dispensing a prescription product. Based on today’s FDA approval, Allergan expects to launch the product nationwide in the first quarter of 2009.

In studies LATISSE(TM) was well tolerated with the most commonly reported adverse events being non-serious and cosmetic in nature. Common adverse events observed in the clinical trial included eye redness (3.6%), itchy eyes (3.6%) and skin hyperpigmentation (2.9%).  LATISSE(TM) use may cause darkening of the eyelid skin which may be reversible. Although not reported in clinical studies, LATISSE(TM) use may also cause increased brown pigmentation of the colored part of the eye which is likely to be permanent.

Protecting Your Eyes While playing Sports

If you have ever played sports and worn glasses, you know the limitations in doing so. Glasses present obvious mobility and peripheral vision issues. In addition, glasses offer little protection and actually can contribute to damage to the eyes if glass lenses are shattered.

Contact lenses offer a safe, clear and comfortable alternative for the athlete on any field or court. Peripheral vision is not an issue with contact lenses. However, contact lenses don’t protect the eyes other than offer some protection for the cornea.

Winter and indoor sports like ice hockey, basketball, football, and gymnastics, along with water and pool activities, baseball, softball, racquet sports and golf contribute the greatest number of eye injuries.  Read more here.

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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Glaucoma Gene Found By Alcon and University of Iowa Researchers

Research funded by Fort Worth based Alcon has found that the over expression of the gene sFRP1 elevates the pressure in an eye, thus greatly increasing a patient’s risk for developing glaucoma. Discovery of a gene responsible for causing glaucoma is great news! Glaucoma is the second leading cause of irreversible blindness in the United States. Making the diagnosis of glaucoma in its early stage is often difficult. Early diagnosis is very important to prevent loss of a patient’s peripheral vision. New technology such as scanning laser ophthalmoscopes have made early diagnosis much more reliable, however, a gene test would be great. I hope we will be able to use this technology in our offices soon. If you would like to see the entire article you can find it here.

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