Scleral Lenses – An Old Dog With New Tricks

scleral lensesScleral 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 contacts 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 contact 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 contacts 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 scleral contacts to treat irregular corneas. Scleral contact lenses are also used to treat dry eye syndrome by preventing the cornea from drying out. The average soft contact lens has a diameter of about 14 mm whereas scleral contacts typically have a diameter exceeding 14.5 mm. The larger diameter is one of the biggest reasons why scleral contacts are so comfortable. 

How Are Scleral Lenses used?

At Total Eye Care, Dr. Driscoll has used scleral contact 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 contacts are cared for and how to insert and remove them.

Computer Glasses – What Are They, How Will They Help, Are They Worth it?

Computer glasses are an under used component of a comfortable office environment. As a person approaches their 50’s it becomes more difficult to see things not only at near but at an intermediate range as well. Normal progressive lenses let you see objects clearly at this distance but only by lifting your head up to look through the intermediate portion of the glasses. Using regular glasses while working at the computer leads to neck pain, back pain and eye strain. This is where computer glasses come in.

Progressive lenses allow a person over 40 to view objects clearly at all distances, even computer distance. Progressive lenses let us view intermediate objects by looking half way down the lens. With computer glasses; however, you can view an intermediate object by looking straight ahead (most computer monitors are at eye level), and the bottom of the computer lens lets you focus an object at normal reading distance. Computer glasses allow for a natural eye position so you can comfortably view your computer.

If your computer monitor is at eye level, you are in your late forties or older, and spend more than 30 minutes at the computer a day then computer glasses are definitely a worthwhile investment.

Computer glasses are an important part of making your workstation a comfortable place to work. See this article on visual ergonomics for more information on setting up your workstation.

FDA Approves First Bionic Eye

The FDA approved Second Sight’s “bionic” eye. While actually more of a retinal prosthesis, the implant is designed to assist patients with retinitis pigmentosa. The Argus II Retinal Prosthesis System has a resolution of 60 pixels. The device will not provide the HD type of vision that our eyes are capable of; however, more importantly, this technology will greatly aid a blind patient’s mobility and is a revolutionary step forward.

The system consists of a wireless retinal implant that rests on the retina. The patient will wear special glasses that see the image. The image will be sent to a visual processing unit that is worn on the patient’s hip. Once the data is processed it is sent back to the glasses which wirelessly transmit this data to the retinal implant. The implant electrically stimulates the photoreceptors simulating a coarse image. The patient learns how to interpret these light and dark images allowing them to navigate around and among obstacles.

The device was approved for use in Europe last year. Check out the video below from the European branch of the medical device company.

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)

Leading Causes of Contact Lens Discomfort are . . .

I came across some good information from our friends at Bausch & Lomb on the common causes of contact lens discomfort (used with permission). Soft contact lenses are generally very comfortable. When contact lens discomfort occurs it can usually be easily remedied.

What Causes Contact Lens Discomfort?

inserting a soft contact lensContact lens discomfort can occur for a variety of reasons. In order for contact lenses to work the way they’re supposed to, it’s important to care for them properly, following the maintenance and replacement schedule. These guidelines help to keep your eyes healthy and comfortable in contact lenses. If they’re not followed, problems with vision, comfort and other safety issues can occur.

You should be aware that the following problems may occur:

  • Eyes stinging, burning, itching (irritation), or other eye pain
  • Comfort is less than when lens was first placed on eye
  • Abnormal feeling of something in the eye (foreign body, scratched area)
  • Excessive watering (tearing) of the eyes
  • Unusual eye secretions
  • Redness of the eyes
  • Reduced sharpness of vision (poor visual acuity)
  • Blurred vision, rainbows, or halos around objects
  • Sensitivity to light (photophobia)
  • Dry eyes

If you notice any of the above symptoms:

Immediately remove your lenses.

If the discomfort or problem stops, then look closely at the lens. If the lens is damaged in any way, do not put the lens back on your eye. Place the lens in the storage case and contact your eye care professional. If the lens has dirt, an eyelash, or other foreign body on it, or the problem stops and the lens appears undamaged, you should thoroughly clean, rinse, and disinfect the lenses; then reinsert them. After reinsertion, if the problem continues, you should immediately remove the lenses and consult your eye care professional.

When any of the above problems occur, a serious condition such as infection, corneal ulcer, neovascularization, or iritis may be present. You should keep the lens off your eye and seek immediate professional identification of the problem and prompt treatment to avoid serious eye damage.

Be sure to follow the manufacturer’s recommendations, cleaning your lenses with each use, and replacing them on the schedule your eye care professional recommended for you. This is the best way to ensure your lenses stay comfortable and your eyes stay healthy.

Poor Fit

Your eye’s size and shape are unique to you, and your contact lenses should be too. Your eye care professional performs a variety of measurements to make sure the fit of your contact lens is well-fitting, but sometimes, it may be a little off.

Symptoms: Feeling a foreign object in the eye, slight pain or irritation, redness, fluctuations in vision

Treatment: Tell your eye care professional – they will reexamine your eyes and lens selection to give you a better fit. This is important, as improperly fit lenses may cause surface abrasions to the cornea.

Contact Lens Associated Dry Eyes

People with dry eyes may not produce enough tears to keep eyes moist and lubricated. This creates discomfort when they wear contact lenses. Dry eyes may be inherent (associated with a number of medical conditions), or acquired (linked with risk factors such as smoking, computer use, caffeine, certain medications, and more).

Symptoms: Tired eyes, dry eyes, and discomfort

Treatments: Your eye care professional may recommend a lubricating/rewetting solution for your use. Moisturize your soft contact lenses to soothe your eyes and minimize lens dryness and discomfort while wearing them with a lubricating and rewetting drop. It’s important to find a drop that’s compatible with your contact lenses.

Environmental Allergens

Your eyes may become irritated when there are large amounts of environmental allergens such as dust or dander. These allergens can stick to the surface of lenses, causing irritation for the wearer.

Symptoms: Redness, irritation, dryness

Treatments: Frequent cleaning is crucial to remove any buildup that may occur on lenses. If problems persist, switching to a daily disposable modality can provide a fresh pair of lenses every day. If it’s seasonal allergies that are affecting your eyes, be sure to remove your contact lenses before using an eye drop that isn’t specifically intended for use with contact lenses and wait 15-20 minutes before inserting your lenses.

Underlying Conditions

Irritation in your eyes may not come from your contact lenses at all. If your eyes become red, swollen, or if you experience discharge, you should contact an eye care professional immediately. Your symptoms may be a result of infection, or underlying disease and should be diagnosed and treated as soon as possible. You should not wear contact lenses if you have an eye infection or while using certain topical eye medications.

The original article can be found here.

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.

Total Eye Care Welcomes A New Eye Doctor

We are happy to announce that Total Eye Care is growing and Dr. Thuy Tran has joined our practice. Dr. Tran is an honor graduate of the University of Houston College of Optometry.  A native of Arlington, Dr. Tran will hold office hours at both the Colleyville and Keller locations.

Invisible Illness: Searching for a Cure

What’s on Doc’s iPad Part 1

I used to be one of those that thought I didn’t need an iPad . . . OK few of us really NEED an iPad, but I’ve come to the conclusion that my iPad is a wonderfully handy tool and I use it almost daily. The iPad has not replaced my Kindle as my favorite way to read books. I find both the Kindle and the iPad helpful for different purposes.

Some of my favorite apps were recommendations from friends or articles I’ve read.  This article is the first of a series of three articles where I will review my favorite, most used iPad Apps.

The first app I installed was Evernote which is essentially a digital filing system. Evernote is a must have. It works across all platforms, allowing you to save something on your desktop PC and have it automatically sync with all of your other devices.

See the book on Amazon.com

It is excellent service and obviously not just for iPad users. When I was doing research for my book An Eye Doctor Answers: Explanations To Hundreds Of The Most Common Questions Patients Wish They Had Asked all of my data was saved to Evernote, thus no trees were harmed in the making of this book. Evernote has a free starter program and if you need more storage or expanded options there is a paid program.

SugarSync is another must have which syncs your saved data among all of your devices. SugarSync will automatically back up anything you designate and then allow it to be accessed by all of your devices. SugarSync has many other nice features, too many to list here; however, one of the features I particularly like is that it  automatically backs up the photos on your phone and makes them accessible to all of your devices. SugarSync  has a free 5 GB introductory account with paid accounts starting at $5 per month.

Many people. myself included, like to work with music in the background. Numerous apps do this. I like Pandora. It lets you enter a song or an artist and builds a play list with similar songs. When a song you like is played Pandora will then let you buy it within the app. Pandor has both free and paid options.

There are many apps that let you organize your Todo list. I like Remember The Milk. I use it frequently every day. It is free for use on your PC, however if you want to share your Todo list across mobile devices, such as an iPad, Kindle or your cell phone it’s $24 per year.

So far we’ve covered productivity apps. The iPad is a great device for entertainment though. If you hit writer’s block or need to blow off some steam, logging a little bit of air time flying a paper airplane or a foam biplane might loosen things up. Air Wings lets you sit in a five different airplanes or a quadracopter and dogfight with your friends or people all over the world. Games are quick, lasting only a couple of minutes. A word of caution though, it can be addictive. Air Wings is free. Upgrades are available for different airplanes and new maps.

Gmail has rapidly become one of the most popular cloud-based email providers. Gmail’s iPad app gives an excellent user experience and gives you fool access to your email, just like using the browser interface.  Given that email has become such an integral part of our work and personal life I this is easily one of my top 5 most used apps. The Gmail service, as well as the Gmail app are free. This app is easily a must have for all Gmail users.

Flipboard board is beautiful on the iPad. During set up you tell it what feeds you want it to include, such as Twitter, Facebook, or numerous other social media services. You can also include online news services such as CNN and FoxNews. Also available, is the option to include your interests or hobbies and it will go out and find relevant content. Flipboard then formats the data into your very own personalized news magazine. Flipboard is free.

Alarm CLock HD is just what it says, however it will wake you up in the morning by reading the news, your tweets or Facebook  or even wake you to music. It also has a flashlight mode should you need some light in the middle of the night. In addition to giving you the time, Alarm Clock HD also has the current temperature and weather for the day. Alarm Clock HD has a free ad-supported version or for $.99 you can go advertising free.

There you have it, in no particular order, nine of the apps on my iPad . I’ll post part two of this series very soon. Like I said, some of the best app recommendations I’ve received have been from people like you so I’d love to hear your thoughts. Let me know what iPad apps you can’t do without.