CONTACT LENSES-DOCTORS ADVICE

Advancements in contact lens technology offer the potential for successful contact lens wear to most of our patients.
Contact lenses not only enhance visual acuity and appearance, but also improve performance in visual tasks and sports.Because contact lenses are medical devices placed on the eyes, they require expert fitting and careful instruction, as well as conscientious care and compliance with recommended follow-up examinations to maintain the healthy functioning of your eyes.
Computerized Contact Lens Fitting

The goal of contact lens fitting is to find the most appropriate contact lens for your optimal comfort and vision. An enormous variety of types, styles, materials, sizes and colors are offered.We are committed to taking the time and making the effort to fit you properly.Although many patients need only one fitting session, some require several appointments.

Q
What is the difference between an ophthalmologist, an optometrist and an optician?
A
An ophthalmologist is a medical doctor who specializes in the eye, detecting and treating eye diseases with medications and surgery. An optometrist examines eyes, detects vision problems and prescribes the appropriate treatment. An optician interprets the optometrist's prescription and dispenses eyeglasses or contact lenses. An optician is to an optometrist, as a pharmacist is to a doctor.
Q
Does wearing glasses make my eye sight worse?
A
Most eye practitioners believe that glasses do not have any physical effect on changing your eyes. Glasses focus light at the distant that is needed and will not make your eyes better or worse.

Q
My child likes to sit very close to the television. Is this harmful?
A
Children have a much better ability to focus close at a younger age than adults. They get a much bigger picture at this distance. In general viewing anything close will not have any effect on physically changing the eyes on anyone. The only concern with viewing the television close is the possible effect from electromagnetic energy that is released from the television. This energy, however, has not been shown to be harmful in most recent studies.

Q
My child likes to read in the dark or near dark. Is this harmful?
A
No. Reading or working under low light does not have a physical effect though it may lead to eye fatigue, in general it is not harmful.

Q
What is Astigmatism?
A
A visual defect caused by an eye surface that is irregularly shaped. People with astigmatism see less clearly at any distance.

Q
What is nearsightedness?
A
It is also called myopia. You can see clearly up close, but not at a distance.

Q
What is farsightedness?
A
It is also called hypermetropia. The opposite of nearsightedness. You can see clearly at a distance, but not up close.

Q
Will wearing eyeglasses make me dependent on them?
A
No. Glasses and contact lenses allow you to see comfortably. When you remove them, you see less comfortably. This contrast is what makes some people believe their vision is worse for wearing glasses. Corrective lenses won't make your vision problems go away, nor will they worsen them. They only correct the symptoms.


Q
What are bifocals? Who needs to wear them?
A
Bifocals use two different powers in one lens. Typically, the upper portion of the lens if used for distance vision and the lower portion is used for viewing objects up close. Bifocals correct for a decreasing ability to focus a problem that sneaks up on just about everybody as they age. It is likely that most people will need bifocals, or what is known as progressive lenses, at some point in their lives.

Q
Can eye exercises improve my vision?
A
You can train your eye muscles to work better together and correct problems like strabismus crossed eyes which involves training the muscles that align the eye.

Q
At what age should children have their first eye exam?
A
Some ophthalmologists suggest children should have their first eye exam at about age three. Always have a child's vision checked if there is any doubt about how well he or she sees. Early detection of eye problems can sometimes prevent significant damage to the eye or to vision.


Q
Can my eyes get sunburned?
A
Yes! "snow blindness" and a welder's flash are examples of "sun burned" eyes. Outdoor enthusiasts and those with sensitive eyes should invest in sunglasses with an ultraviolet filter to block harmful UV radiation from the sun. Contact lens wearers are especially sensitive to bright light, they should always wear a good pair of nonprescription sunglasses with their contacts when they are outside.

VISION INSURANCE PLAN

How To Choose a Vision Insurance(Benefits) Plan

If you are among the more than 50 percent of U.S. citizens who already wear prescription glasses or contact lenses, you might consider taking advantage of a plan offering vision benefits either through your employer or directly from an insurance or vision benefits company.
Company owners looking for an affordable way to attract and retain good employees also might think about adding vision coverage to employee benefits packages.
What Kinds of Vision Insurance Plans Are Available?
Vision insurance comes in the form of either a:
1.vision benefits package or a
2.vision discount plan.
A vision benefits package provides coverage for services including eye exams in different ways, such as requiring a co-payment from you at the time of service with the balance to be paid by your plan. In a vision discount plan, you pay fully for services but at a lower price that the network provider has agreed to charge.
When you purchase vision insurance, whether it is a benefits package or a discount plan, you buy two products:
Access to a network of eye care providers who have agreed to give service at lower than retail prices, including optometrists and ophthalmologists, eyeglass and contact lens manufacturers, optical laboratories, and (possibly) LASIK and other refractive surgeons.
Specific eye care services, such as eye exams and prescription lenses.
Therefore, when choosing a vision insurance plan, you need to evaluate both the eye care provider network and the services being offered.
How To Evaluate Vision Benefits and Vision Discount Plans
To evaluate vision benefits packages and vision discount plans, ask yourself these questions:
1.Which vision plan provides services that best meet my needs?
2.Which vision plan saves me the most money? (Individuals and company representatives will, of course, have different criteria when answering this question.)
3.Are quality assurance mechanisms and easy-to-follow grievance procedures in place?
To analyze different vision plans for coverage as an individual, you first need to estimate your present and future eye care needs.
Begin by reviewing one or two years in your personal records to find out what kinds of eye care services you and your family members have used in the past and how many times these services were used by each family member. This information will give you an idea of what your future needs will be.
Basic services typically include an eye examination with dilation, an eyeglass frame, a pair of eyeglass lenses (single, bifocal, and trifocal, or other certain special designs), contact lenses, and LASIK or PRK refractive surgery.
A list of value-added services that might be covered under vision benefits could include progressive lenses, high-index lenses, polarized lenses, polycarbonate lenses, plastic photosensitive lenses, blended segment lenses, ultraviolet coating, and scratch-resistant coating. [Read more about types of eyeglasses and lens coatings.]
Once you have estimated your future eye care needs, analyze the services offered by a variety of vision plans.
Do this by creating and completing a worksheet like the one we've provided in a Word document here (108 kb). Expand the list of services offered or that you are interested in accordingly.
When you have completed the worksheet, you will be able to decide which vision plan best meets your coverage needs.
To figure out which vision plan will save you the most money, create two worksheets. One is for assessing the costs of a vision benefits package, and the other is for assessing the costs of a vision discount plan. (See sample worksheets in the Word document mentioned above.) Expand the list of services for each vision plan as you see fit.
Note: In the retail price category, you can determine prices either by requesting estimates from each provider you want to consider or by reviewing your eye care receipts for the previous two years.
When you have finished completing the cost assessment worksheets, you will know which vision plan will save you the most money.
The final step in the process is to select the vision insurance plan that best meets your provider, service, and cost requirements.

CARING FOR SOFT CONTACT LENSES

Caring for Soft Contact Lenses

On this page
Basic cleaning instructions
Products
Store brand considerations
Must-knows
Enter the contact lens care aisle of most supermarkets and drugstores, and you'll find a confusing array of products. Though daunting, it's essential to understand contact lens care: not caring for your lenses properly can lead to a variety of eye infections, including some that cause blindness.
Actually, contact lens care is easier than ever. One-bottle care systems and disposable contact lenses mean that proper lens care involves much less time, expense and trouble than it did years ago.
Before we get started, understand that you should not switch care regimens without asking your eye doctor first. Some products are not compatible with each other, or with certain contact lenses. Using incompatible products can ruin your contact lenses or harm your eyes.
To make sense of all the bottles and boxes, it helps to know what steps are required to care for soft contacts.
It's particularly important to follow guidelines for safe handling of soft contact lenses in light of recent outbreaks of serious fungal eye infections that appear associated with Bausch & Lomb's ReNu with MoistureLoc contact lens cleaning/disinfecting solution.
The Basics of Soft Contact Lens Care: Clean, Rinse and Disinfect
1.Wash your hands so that you don't transfer dirt and germs to your eye. Try to avoid moisturizing soaps, as they are not good for contact lenses. Dry your hands with a lint-free towel.
2.Remove one lens and clean it with the recommended solution. Cleaning removes eye-produced buildup, cosmetics and other debris that impairs lens comfort. The FDA recommends that you rub the lens in the palm of your hand with a few drops of solution, even if you are using a "no-rub" product.
3.Rinse the lens again to remove the loosened debris, making sure to take as long as the package directs: rinsing is an important step.
4.Place the lens in your clean lens case or lens holder and fill with fresh solution; don't "top off" your old solution. Disinfecting kills microorganisms on the lens. Disinfection time varies from product to product; check the package for details.
5.Repeat steps two through four for your other lens.
Beyond Clean, Rinse and Disinfect
Protein. Depending on what kind of contact lenses you wear and how much protein your eyes deposit on your contacts, your doctor may recommend you use a product for protein removal.
Multipurpose solutions make caring for your lenses easier than ever.
While cleaning them does remove some protein, it can still build up on your lenses and make them uncomfortable. That's why the longer you wear lenses before replacing them, the more likely you are to need a protein remover.
For example, if you wear disposables, you probably won't need one; but if you wear the kind of lenses that are replaced only once or twice a year, you definitely will. Products for removing protein include enzymatic cleaner and daily protein removal liquids.
Eye dryness and irritation. Use contact lens eyedrops to lubricate your eyes and rewet your lenses.
Eye sensitivity and allergies. A small percentage of lens wearers develop an eye allergy to the chemicals present in contact lens solutions. If this is the case with you, you don't need an additional product: you just need to switch products to those marked "preservative-free."
The Products: Cleaning, Rinsing and Disinfecting Solutions
Saline solution is for rinsing and storing contact lenses, when you're using a heat or UV disinfection system. You may also need it for use with enzymatic cleaning tablets or cleaning/disinfecting devices. Never use saline products for cleaning and disinfection.
Daily cleaner is for cleaning your contact lenses. You place a few drops in the palm of your hand and carefully rub the lens for as long as directed, usually around 20 seconds, making sure to clean both sides. Use other products for rinsing and disinfection.
Multipurpose solution is for cleaning, rinsing, disinfecting, and storing your contact lenses. Clean your lenses as you would with daily cleaner, then rinse (as long as directed) and disinfect, all with the same solution; or rinse the lenses twice, then place them in the clean lens case with solution to clean and disinfect. When you're ready to wear the lenses, rinse them again. As with regular multipurpose solutions, no other products are necessary.
Hydrogen peroxide systems may help wearers who are sensitive to the preservatives in multipurpose solutions.
Hydrogen peroxide solution is for cleaning, disinfecting, rinsing and storing your contact lenses. With this product, you place your lenses in the provided basket and rinse them, then place the basket in its cup and fill the cup with solution to clean and disinfect your lenses.
Some lens holders for hydrogen peroxide systems have a built-in neutralizer (to convert the hydrogen peroxide to water, so it doesn't sting your eyes), but with others you need to add a neutralizing tablet.
Rinse your contacts (with another product) before placing them in your eyes.
Cleaning/disinfecting devices will, as you would expect, both clean and disinfect your contact lenses. Depending on how the brand is designed, cleaning is accomplished with either ultrasonic waves or subsonic agitation, whereas disinfection occurs via multipurpose solution or ultraviolet light.
The instructions for the devices are all a little different. In general, you first rinse the lenses, using either saline or multipurpose solution as directed. One brand requires rubbing with the saline, but most are no-rub.
Then, put your contact lenses in the device and fill it with the same type of solution as for the rinse. Place the lid on the device and plug it in to clean and disinfect your lenses.
The Products: Protein Removers, Eyedrops and Options for Sensitive Eyes
Enzymatic cleaner is for removing protein from your contact lenses, usually on a weekly basis. You use the tablets with saline solution or disinfecting solution (multipurpose or hydrogen peroxide), as directed.
Before using enzymatic cleaner, clean and rinse your contacts using other products. Fill your lens case or vials (as directed) with solution, then drop an enzymatic tablet in each lens well or vial. Wait for them to dissolve, then add your contacts. Leave them in for the required time, usually 15 minutes.
Afterward, disinfect with another product if necessary (certain enzymatic cleaners allow you to skip the disinfection step if you use disinfecting solution rather than saline, but that's not always the case; check the enzymatic cleaner packaging to find out).
Daily protein remover also removes protein from your lenses, but it's in liquid form and you use it daily. You use it during disinfection with multipurpose solution.
Before using a daily protein remover, you clean and rinse your contacts using other products. Fill both wells of your lens case with multipurpose solution, then add a drop of daily protein remover to each. Disinfect your lenses as usual.
If your eyes feel dry, you may want to re-wet your contact lenses with lubricating drops.
Eyedrops for contact lenses are for lubricating your eye and rewetting your contacts. Make sure to choose a brand that is safe for contact lenses. Eyedrops that aren't mean for contact lenses can temporarily alter how a lens fits your eye, or discolor the lens.
Products for sensitive eyes help people who have allergic reactions to contact lens solutions. These allergies can crop up even you've been using the same products for years without difficulty. Symptoms may include itching, tearing, foreign body sensation, burning, redness and discharge. It's important to see your eye doctor if you're experiencing these symptoms, as they can have many causes.
A preservative called thimerosal was found to cause problems in about 10 percent of patients, so most brands do not use it nowadays. Thimerosal-free saline is usually marked "for sensitive eyes."
However, people do have reactions to other preservatives as well and need to switch to preservative-free care products. Some of these have what's called a "disappearing" preservative that's gone before the solution comes in contact with your eyes. Hydrogen peroxide, for example, is a preservative, but the neutralizing step in hydrogen peroxide disinfection makes the solution eye-friendly.
Other products are actually free of preservatives and may have expiration dates. Non-aerosol preservative-free saline, for example, will generally last about two weeks after you open it.
What's Most Popular? Ease of Use
Nowadays, most people don't go for the multi-bottle cleaning conglomerate unless they have to. Instead, they choose a multipurpose solution for the clean, disinfect and rinse steps. Then, if they experience any discomfort, or are not satisfied with the product, they look into the other options.
Store Brands
You may have noticed that stores like your pharmacy and grocer sell store-branded contact lens care products, also known as "private label" products. Often they are considerably cheaper than name-brand products. Should you use them?
These products are safe and FDA-approved, or they couldn't be sold. But there are potential problems. Sometimes private label products are made from older formulations, which don't offer the same advantages as newer products.
But here's a bigger problem: As you know, you shouldn't switch products without consulting your doctor to make sure the new solution is compatible with your lenses. Let's say that you buy a bottle of Store-brand X, bring it to your doctor, and he gives you the OK. You use the product, and everything is dandy.
Next time you buy Store-brand X, it may not be the same product. That's because the store doesn't, of course, make its own solution. They buy it from a supplier. If a better deal comes along, they might switch suppliers — and even formulations — but still sell the revised product under the "Store-brand X" name. And the revised formulation may or may not be right for your eyes or your particular contact lenses.

Contact Lens Care Must-Knows
Once you've decided which product you'd like to try, discuss your plans with your eye doctor. Don't switch brands until you determine that the new brand is compatible with your other products and with your contact lenses.
Regardless of which care regimen or brands you use, remember:
1.Never touch solution bottle tips to any surface, including your body: the solution can become contaminated.
2.Avoid getting tap water on your contact lenses and accessories, as it can carry a microorganism called Acanthamoeba that causes serious eye infections. While regular contact lens disinfection procedures do kill Acanthamoeba, they typically don't kill its cysts.
3.Remember to clean your contact lens accessories (lens case, cleaning/disinfecting devices, enzymatic cleaner vials and so on) as directed.
4.Lens cases can be rinsed with hot tap water and dried when not in use.
5.Throw out your contact lens case once a month, or as directed, to reduce your risk of infection.
Most importantly, clean and disinfect your contact lenses once a day (those with extended wear contacts should clean and disinfect them when they take them out, unless the lenses are scheduled to be discarded). Not only will your eyes be safer and healthier, but your contact lenses be more comfortable to wear, too.

DISCOMFORT LENSES-REMEDIES

Are Your Contact LensesUncomfortable? What to Do About It
Ever feel like something's not quite right with your contact lenses? You're not alone. Half of former wearers say they dropped out of contact lenses because of discomfort.
But there's no reason to stop wearing contacts, or to suffer in silence. There are many remedies for contact lens discomfort, including a host of new contact lenses and other products designed to make your wearing experience more comfortable.
Before we review your options, remember that contact lens discomfort takes many forms. The only way to determine the causes of your particular discomfort, and the appropriate remedies, is with an in-person exam by an eye care professional who is experienced in contact lenses.
This will also rule out the possibility that the discomfort means a more serious underlying problem.
Keep in mind:
If your eyes don't feel good, look good, or see well, you need a checkup.
Don't be afraid to bring up problems with your doctor because you think it might mean the end of your contact lens wear. Problems can usually be fixed!
Sometimes a minor irritation, if left untreated, can develop into a more serious problem — occasionally one that can be sight-threatening.
We have great preparatory information for your doctor visit. Choose a statement below that describes you, or go directly to discomfort remedies.
You don't have to live with uncomfortable contact lenses! Your eye doctor can help.
Situation:
My eyes are red, painful, swollen and/or produce discharge
When wearing contacts, I always feel like something is in my eye
I drink a lot of coffee and/or alcohol, and/or I smoke
I'm taking over-the-counter or prescription medications
When wearing contacts, my eyes occasionally feel dry
I can't wear my contacts as long each day as I'd like
I have allergies
I have other medical problems
I don't follow my doctor's contact lens care instructions
I spend time in dry or dusty environments
I use my computer a lot.

ULTRAVIOLET RAYS and YOUR EYES

Fashion aside, sunglasses serve an important purpose: protecting eyes from the harmful rays produced by the sun. You're probably well aware of the need to protect your skin from the sun, but it's equally important to protect your eyes.
Ultraviolet Light's Dangers
Ultraviolet (UV) radiation consists of invisible rays from the sun. The three bands of UV light are: UVA, UVB and UVC. UVC rays are of little concern as they are absorbed by the upper atmosphere and do not reach the earth's surface.
UVB rays are the ones that burn the skin and can damage the eyes. Combined with cold wind and snow, UVB has the potential to cause snow blindness (photokeratitis), a temporary (lasting 12 to 48 hours) but painful problem in the cornea of the eye.
Although not all scientists agree, there is some research that suggests that daily exposure to UVB in very bright sunlight over a period of many years may cause cataracts, a gradual clouding of the lens of the eye.
Experts also suspect that the primary cause of eye growths such as pingueculae or pterygia is exposure to UVB rays. [Read more about pingueculae and pterygia.]
UVA rays are primarily absorbed within the lens of the human eye, though there are no documented disorders of the human eye from UVA. This, however, remains a much debated and researched topic, says the Sunglass Association of America (SAA).
Measuring Ultraviolet Rays
A globally used index measures the amount of solar ultraviolet rays that are reaching the surface of the earth. Scientists use a scale of 1 to 11 to indicate how much threat exists at a particular time and place from sun exposure, and to permit the news media to warn people when UV levels are high. Usually such warnings include advice to wear hats and other protective clothing, sunglasses, and sunscreen. Avoiding the sun around midday is also important.
What to Look for When You're Buying Sunglasses
Sunglass standards for lenses place limits solely on UVB and UVA rays, butbear in mind that both the standards and labeling are voluntary, not mandatory. According to these standards, sunglasses must block at least 70 percent of UVB and at least 60 percent of UVA.
To best protect your eyes, look for sunglasses that provide at least 98 percent protection from both UVA and UVB rays. UVC rays are blocked automatically since they are absorbed in the atmosphere and do not reach the earth. Some of the higher-priced products with polycarbonate, glass or plastic (CR-39) lenses can claim to block 100 percent of the UV rays.
For more protection, wear a visor that attaches to your sunglasses, like this one from speXshade.
Is It True That ... ?
One question people ask frequently is whether pupil dilation from wearing sunglasses can cause problems for the eyes.
The answer to this is that there is a very minimal dilation of the eyes when wearing sun protection and that the protection received from wearing sunglasses is greater even than simply standing in the shade.
According to the SAA, sunglasses "reduce the UV more than if you were to stand in the shade, since the shade more or less evenly attenuates all wavelengths, visible and UV, while sunglasses preferentially attenuate shorter wavelengths (i.e., UV wavelengths)." Thus, sunglasses provide more protection than shade alone.
Another question people ask is whether it's necessary to wear sunglasses in the winter. While the sun's rays feel less intense during wintertime, they are still strong enough to worry about eye damage, including the snow blindness mentioned above. New snow can reflect up to 80 percent of ultraviolet rays, according to the World Health Organization, while normal ground surfaces and bodies of water tend to reflect less than 10 percent. (The numbers for beach sand and sea foam are estimated at 15 percent and 25 percent.) [Read more about winter sunglasses and ski goggles.]
Finally, what if you're wearing contact lenses that have UV protection? This is a good idea, because such lenses can decrease the amount of UV rays that enter the cornea and affect the eye structures beneath. But you still need to wear sunglasses over the contact lenses, because UV rays will affect the eye tissue that is not covered by the contacts. Your eyes will be more comfortable, too, with the light and glare reduction that sunglasses provide.

About LASIK

LASIK is a surgical procedure that uses a laser to correct nearsightedness, farsightedness, and/or astigmatism. In LASIK, a thin flap in the cornea is created using either a microkeratome blade or a femtosecond laser. The surgeon folds back the flap, then removes some corneal tissue underneath using an excimer laser. The flap is then laid back in place, covering the area where the corneal tissue was removed.
With nearsighted people, the goal of LASIK is to flatten the too-steep cornea; with farsighted people, a steeper cornea is desired. LASIK can also correct astigmatism by smoothing an irregular cornea into a more normal shape.
If you are considering LASIK eye surgery, your first step is to choose a good LASIK surgeon who can evaluate whether LASIK is right for you. Your LASIK surgeon will examine your eyes to determine their health, what kind of vision correction you need, and how much laser ablation (corneal tissue removal) is required. The doctor will also ask about any health conditions that may disqualify you altogether for LASIK surgery.
If you're not a candidate for LASIK, you may qualify for another laser eye surgery such as PRK (similar to LASIK but without the flap), LASEK, or epi-LASIK. There are also non-laser vision correction procedures. Your prescription and eye structure will be considered to help determine which procedure is best for you.
LASIK is an outpatient procedure. The LASIK surgeon uses a computer to adjust the laser for your particular prescription. You will be asked to look at a target light for a short time while the laser sends pulses of light to painlessly reshape your cornea. The actual LASIK surgery usually takes less than five minutes.

Why Isn't My Vision Sharper After Refractive Surgery?

Despite high refractive surgery success rates, LASIK, PRK and other laser vision correction procedures don't produce perfect vision for everyone. Your results depend a great deal on the unique way your corneas respond to laser energy and how they heal after surgery.
Glare, halos and starbursts around headlights and street lights can sometimes be a problem after refractive surgery. LASIK and other procedures can also sometimes cause irregular astigmatism, with accompanying blurred and/or distorted vision.
For most people who have less-than-perfect vision after refractive surgery, problems are quite mild and usually tolerable. But for others, post-surgery vision problems can decrease overall quality of life with side effects such as eyestrain, headaches and difficulty driving at night.
When Would I Need Post-Surgery Contact Lenses?
LASIK and other laser vision correction procedures reshape your eye's front surface by removing microscopic amounts of tissue from the cornea. Occasionally, this can cause irregularities in the shape of the cornea that can make your vision less distinct after surgery than it was when you wore glasses or contact lenses before the procedure.
These irregularities sometimes can be corrected with a follow-up laser procedure called an enhancement. But if your cornea is too thin for a second surgery, or other problems rule out an enhancement procedure, GP or hybrid contact lenses may be your best solution.
Post-Surgery Gas Permeable Contact Lenses
Because gas permeable contacts are rigid, they maintain their shape on the eye — unlike soft lenses that drape the cornea, losing their shape.
That's significant because the space between the cornea and the back surface of a GP lens is filled with tears. This "lake" of tears covers all the tiny irregularities (aberrations) on the cornea's surface. The smooth front surface of the GP lens then optically replaces the irregular corneal surface, eliminating blur and visual distortions.
In comparison, soft contact lenses are pliable and conform to the surface of the cornea. This means soft lenses can't achieve the same aberration-cancelling effect that GP lenses provide.
And conventional eyeglasses, which do nothing to change corneal irregularities, cannot correct the vision problems those irregularities cause. These glasses can correct only the basic refractive errors — nearsightedness, farsightedness, and regular astigmatism.
Special Contact Lens Designs for Post-Surgery Fittings
Because LASIK and other laser refractive surgery can significantly alter the shape of the cornea, fitting contact lenses on a post-surgery eye is more challenging than fitting lenses on a normally

shaped cornea. Instead, special GP lens designs are usually required in these circumstances.
These modified designs may include a larger lens diameter, aspheric optics or a design where the center of the lens is significantly flatter than the periphery (called a reverse geometry design), similar to the gas permeable lens design used for orthokeratology to correct nearsightedness without surgery.
Special computerized instruments (not needed for regular contact fitting) are usually required to obtain highly accurate, point-to-point measurements of the post-surgery corneal surface to obtain the best possible fit for vision correction. These instruments, called corneal topographers or aberrometers, use the same LASIK technology that measures the cornea before laser vision correction.
Because of these added complexities, contact lens fittings after refractive surgery are typically more time-consuming and involve a higher fee than regular contact lens fittings. Also, if you've never worn GP lenses before, be aware that it takes longer to adapt to them than to soft contacts. You may have to wear the lenses at least part-time every day for several weeks before they feel completely comfortable.
Fitting GP contacts on an eye that has undergone refractive surgery requires special skills similar to those needed to fit lenses on an eye with an irregular cornea, such as an eye with keratoconus or one that has had a cornea transplant procedure called a penetrating keratoplasty. Several lens modifications may be required to achieve the optimum fit, comfort and visual acuity. For best results, you may need to ask your eye doctor to refer you to a colleague who specializes in this area.
SynergEyes hybrid contact lenses have a rigid GP lens in the middle with a soft skirt for comfort.
New Technologies: Hybrid Contact Lenses and Wavefront Glasses
Recently, two new eyewear technologies were introduced that offer an alternative to GP contact lenses for correcting irregular astigmatism and higher-order aberrations after eye surgery.
One technology involves a type of contact lens that has a rigid gas permeable optic zone in the center and a soft outer skirt. Called SynergEyes, these new "hybrid" lenses may offer the best of both worlds: the aberration-correcting optics of a rigid GP lens, combined with comfort that often rivals that of soft contact lenses. Early reports indicate SynergEyes lenses may be equally as effective as GP lenses in correcting aberrations after surgery, but may be easier to adapt to and wear.
The second new technology is a type of eyeglass lens that uses LASIK-style wavefront measurements to create a custom lens design for each person. In addition to correcting common refractive errors like nearsightedness, these new eyeglass lenses can also correct some degree of irregular astigmatism and higher order aberrations (HOAs) caused by corneal irregularities.
Studies suggest that these new wavefront lenses, called iZon High Resolution Lenses, provide sharper vision at night than conventional eyeglass lenses and may be an acceptable alternative to GP or hybrid GP/soft contact lenses for the correction of post-surgical vision problems.

EYE EXAMS

Preparing for an Eye Exam

Eyecare experts recommend that everyone have a complete eye exam every one to three years, depending on age, risk factors, and physical condition.
Children: Some experts estimate that approximately one in 20 preschool children and one in four school-aged children have an eye problem that could cause permanent vision loss if left untreated. Children without symptoms and who are at low risk for eye problems should have their eyes screened by six months of age, then examined at age three and again at the start of school. Risk-free children should then continue to have their eyes examined at least every two years throughout school.
Any child who does have risk factors for vision problems may need to have more frequent eye exams. Some examples of common risk factors include:
prematurity
developmental delays
turned or crossed eyes
family history of eye disease
history of eye injury
other physical illness or disease
According to the American Optometric Association (AOA), children who wear eyeglasses or contact lenses need to be seen annually to keep their prescriptions current.
Adults: The AOA also recommends an annual eye exam for any adult who wears eyeglasses or contacts. If you don't normally need vision correction, you still need an eye exam every two to three years up to the age of 40, depending on your rate of visual change and overall health. Doctors often recommend more frequent examinations for adults with diabetes, high blood pressure and other disorders, because many diseases can have an impact on the health of your eyes.
If you are over 40, it's a good idea to have your eyes examined every one to two years to check for common age-related eye problems such as presbyopia, cataracts and macular degeneration.
Because the risk of eye disease continues to increase with advancing age, everyone over the age of 60 should be examined annually. The American Optometric Association provides the general guidelines shown below.

Who Should I See for My Eye Exam?
There are three different kinds of eyecare professionals: ophthalmologists, optometrists and opticians. Who you should see depends on your needs.
Ophthalmologists are medical doctors (MDs or DOs) who specialize in eyecare. Not only do they prescribe eyeglasses and contacts, but they also perform eye surgery and treat medical conditions of the eye. Ophthalmologists are doctors who have received 12 or more years of training.
Optometrists (ODs) are eye doctors who can prescribe glasses and contacts and treat medical conditions of the eye with eyedrops and other medicines. Optometrists generally receive eight or more years of training. Optometrists prescribe glasses, contacts, low vision aids, vision therapy and medication to treat eye diseases, as well as perform certain minor surgical procedures.
Opticians are not doctors, but eyecare professionals who adjust and repair glasses, instruct patients in contact-lens use and grind and assemble spectacles. In some cases, specially trained opticians can determine your prescription and fit contact lenses. Opticians generally receive their training either "on the job" by apprenticeship or from technical schools.

COMPUTER EYE STRAIN: 10 Steps for Relief

With so many of us using computers at work, computer eye strain has become one of the major office-related health complaints. Studies show that eye strain and other bothersome visual symptoms occur in 50 percent to 90 percent of computer workers.
These problems can cause physical fatigue, decreased productivity and increased numbers of work errors.
Here are steps both workers and employers can take to reduce computer eye strain and the other common symptoms of computer vision syndrome(CVS):

1. Get a computer eye exam.
This is the most important thing you can do to prevent or treat computer vision problems. According to the National Institute of Occupational Safety and Health (NIOSH), computer users should have an eye exam before they start working on a computer and once a year thereafter. Be sure to tell your eye doctor how often you use a computer at work and at home.
2. Use proper lighting.
Eye strain is often caused by excessively bright light either from outdoor sunlight coming in through a window or from harsh interior lighting. When you use a computer, your ambient lighting should be about half that found in most offices.
Eliminate exterior light by closing drapes, shades or blinds. Reduce interior lighting by using fewer light bulbs or fluorescent tubes, or use lower intensity bulbs and tubes. If possible, position your monitor so that windows are to the side of it, instead of in front or back.
3. Minimize glare.
Glare on walls and finished surfaces, as well as reflections on the computer screen can also cause computer eye strain. You may want to install an anti-glare screen on your monitor and, if possible, paint bright white walls a darker color with a matte finish.
Again, cover the windows. When outside light cannot be reduced, consider using a computer hood.
If you wear glasses, have an anti-reflective (AR) coating applied to your lenses. AR coating reduces glare by minimizing the amount of light reflecting off the front and back surfaces of your eyeglass lenses.
4. Upgrade your display.
If you have not already done so, replace your old tube-style monitor (called a cathode ray tube or CRT) with a flat-panel liquid crystal display (LCD), like those on laptop computers.
If your older monitor is causing computer eye strain, try one of the newer flat-panel LCD screens, which are easier on the eyes.
LCD screens are easier on the eyes and usually have an anti-reflective surface. Old-fashioned CRT screens can cause a noticeable "flicker" of images on the screen, a major source of computer eye strain. Even if this flicker is imperceptible, it can still contribute to eye strain and fatigue during computer work.
Complications due to flicker are even more likely if the refresh rate of the monitor is less than 75 hertz (Hz). If you must use a CRT at work, adjust the display settings to the highest possible refresh rate.
When choosing a new flat panel display, select a screen with the highest resolution possible. Resolution is related to the "dot pitch" of the display. Generally, displays with a lower dot pitch have sharper images. Choose a display with a dot pitch of .28 mm or smaller.
Finally, choose a relatively large display. For a desktop computer, select a display that has a diagonal screen size of at least 19 inches.
5. Adjust the brightness and contrast of your computer screen.
Adjust the display settings on your computer so the brightness of the screen is about the same as your work environment.
As a test, try looking at the white background of this web page. If it looks like a light source, it's too bright. If it seems dull and gray, it may be too dark.
Also, adjust the screen settings to make sure the contrast between the screen background and the on-screen characters is high. And make sure that the text size and color are optimized for the most comfort — read the tips in the sidebar.
Text Size And Color On Your Computer Screen :
Adjusting how your monitor displays text can provide welcome eyestrain relief. Ideally, your text size should be three times the smallest text size you can read from your normal viewing position.
Doctors also recommend black text on a white background as the best color combination for your eyes; other high-contrast, dark-on-light combinations are also acceptable.
To adjust the text size and color settings in the Windows operating system, use the Display Properties dialog box, which is available from the Control Panel. Depending on which version of Windows you have, font size will either be on the Settings tab or the Appearance tab. Color choices are on Appearance.
If you're online and using the Internet Explorer browser, you can click on View, then choose the Text Size that is most comfortable for you. Most other browsers and email programs also let you change the text size and color, but you may have to do some exploring through the Help menus to find those controls.
6. Blink more often.
Blinking is very important when working at a computer; it rewets your eyes to avoid dryness and irritation.
When working at a computer, people blink less frequently — about five times less than normally, according to studies.
Tears coating the eye evaporate more rapidly during long non-blinking phases and cause dry eyes. Also, the air in many office environments is dry, which can increase the evaporation rate of your tears, placing you at greater risk for dry eye problems.
If you experience dry eye symptoms, ask your eye doctor about artificial tears for use during the day. By the way, don't confuse lubricating drops with the drops that only "get the red out." The latter can indeed make your eyes look better. They contain ingredients that reduce the size of the blood vessels on the surface of your eyes to "whiten" them. But they are not necessarily formulated to reduce dryness and irritation.
Try this exercise: Every 20 minutes, blink 10 times by closing your eyes as if falling asleep (very slowly). This will help rewet your eyes.
7. Exercise your eyes.
A component of computer eye strain is focusing fatigue. To reduce your risk of tiring your eyes by constantly focusing on your screen, look away from your computer every 20 minutes and gaze at a distant object outside or down the hallway. Looking far away relaxes the focusing muscles inside the eye to reduce fatigue.
Another exercise is to look far away at an object for 10-15 seconds, then gaze at something up close for 10-15 seconds. Then look back at the distant object. Do this 10 times. This exercise reduces the risk of your eyes' focusing ability to "lock up" (a condition called accommodative spasm) after prolonged computer work.
Both of these exercises will reduce your risk of computer eye strain. Remember also to blink frequently during the exercises to reduce your risk of computer-related dry eye.
To ease eye strain, make sure you use good lighting and sit at a proper distance from the computer screen.
8. Take frequent breaks.
To reduce your risk for computer vision syndrome and neck, back and shoulder pain, take frequent breaks during your computer work day.
Many workers take only two 15-minute breaks from their computer throughout their work day. According to a recent study conducted by the National Institute of Occupational Safety and Health (NIOSH), discomfort and eye strain were significantly lower when computer workers took four additional five-minute "mini-breaks" throughout their work day.
And these supplementary breaks did not reduce the workers' productivity. Data entry speed was significantly faster as a result of the extra breaks, so work output was maintained even though the workers had 20 extra minutes of break time each day.
During your computer breaks, stand up, move about and stretch your arms, legs, back, neck and shoulders.
Check your local bookstore or consult your fitness club for suggestions on developing a quick sequence of exercises you can perform during your breaks and after work, to reduce tension in your arms, neck, shoulders and back.
Position your desk lamp so it doesn't shine on the computer screen or into your eyes.
9. Modify your workstation.
If you need to look back and forth between a printed page and your computer screen, this can cause eye strain. Place written pages on a copy stand adjacent to the monitor. Light the copy stand properly. You may want to use a desk lamp, but make sure it doesn't shine into your eyes or onto the computer screen.
Improper posture during computer work also contributes to computer vision syndrome. Adjust your workstation and chair to the correct height.
Purchase ergonomic furniture to enable you to position your computer screen 20 to 24 inches from your eyes. The center of your screen should be about 10 to 15 degrees below your eyes for comfortable positioning of your head and neck.
10. Consider computer eyewear.
For the greatest comfort at your computer, you may benefit from having a customized eye glasses prescription for your computer work. This is especially true if you normally wear contact lenses, which may become dry and uncomfortable during sustained computer work.
Computer glasses are also a good choice if you wear bifocals or progressive lenses, because these lenses are generally not optimal for the distance to your computer screen.

NUTRITION & VITAMINS FOR YOUR EYES

Herbs, Nutrition & Cataracts

Can you stave off cataracts by using herbs or changing your diet? This article explores the links that may exist between eye disease and what we eat.
Fat You Can Use: EFAs: You're getting too much fat in your diet ... and not enough: the average American consumes way too much omega-6 fatty acid and not nearly enough omega-3. These fatty acids affect the eyes in a wide variety of ways. Find out how, and learn which foods to avoid and which to add to your diet.
Lutein and zeaxanthin: Lutein and zeaxanthin are antioxidants found in many vegetables. Read about their effect on the eyes, with information on the best sources (and possible side effects of consuming too much).
Flaxseed Oil's Benefits for Dry Eyes: Research has found that flaxseed oil can help relieve the effects of dry eye syndrome. Read about how it compares with other dry eye medications, recommended dosage, how to store flaxseed oil, and more.
Nutrition and Your Eyes: In a Nutshell: Whether you've read all the articles in this section and want a condensed recap, or you just want to cut to the chase about what foods you should be eating to protect your eyes, this summary is the place to go!

Try these foods to make sure you get enough eye-protecting nutrients:
Vitamin A: cod liver oil, liver, carrots, sweet potatoes, butternut squash.
Lutein and zeaxanthin: spinach, kale, collard greens.
Vitamin C: sweet peppers (red or green), kale, strawberries, broccoli, oranges, cantaloupe.
Bioflavonoids: citrus fruits, cherries, grapes, plums.
Vitamin E: sunflower seeds, almonds, hazelnuts.
Selenium: brazil nuts, yeast, seafood.
Zinc: oysters, hamburgers, wheat, nuts.
Fatty acids: cold-water fish (salmon, mackerel, trout).
In general, you should eat plenty of green, leafy vegetables, two servings of fish per week, some nuts and some yellow or orange fruits and vegetables.

Vitamin A and Carotenoids: Antioxidants for Sight: Carotenoids give carrots their orange color. You can find them in many red, yellow and orange fruits and vegetables, as well as in green, leafy vegetables (which are a great source of the carotenoid lutein).

Vitamin C and Bioflavonoids: The Batman and Robin of Eye Health: Ever-popular vitamin C may reduce your risk of glaucoma, cataracts and macular degeneration. Bioflavonoids help your body to absorb vitamin C and sometimes work as antioxidants themselves.

Vitamin E and Minerals: Nutrition from Nuts: Like vitamins A and C, vitamin E may reduce your risk of cataracts and macular degeneration. The minerals selenium and zinc help your body to absorb antioxidant vitamins and may have their own protective effects as well.

TIPS FOR CONTACT LENS WEARERS

On this page

Is my lens inside-out?

Applying your contact lenses

Removing your contact lenses

Cosmetics and contacts

Many people new to contact lenses, and even some experienced wearers, have practical questions about contacts.
These tips can help you deal with everyday contact lens concerns.

Which Way Is the Right Way?

A question many newbie wearers have is: "How can I tell if my contact lens is inside-out?"
The difference can be subtle, but before placing a contact lens on your eye, make sure it looks like half a ball, not a soup bowl with a rim.
The trick is to place the lens on your finger so that a cup is formed. Then hold the lens up directly in front of your eyes so you're looking at the side of the cup.
If the lens forms a "U" with the top edges flared out, it's inside out. If it forms just a "U," it's in the correct position.
If you're wearing lenses with a handling tint, another way is to place the lens on your fingertip and then look down at it. The edge of a tinted lens should look very blue (or green, depending on the tint); that won't be the case if the lens is inverted.
Some contact lenses also have a laser marking, such as the brand name, on the edge to help you. If you can read it properly, the lens is not inside out. Don't worry if you place a contact lens in your eye inside out. The lens will feel uncomfortable, but it can't do any damage.

Applying Your Contact Lenses

Make sure you wash your hands thoroughly before applying your contact lenses, but avoid overly scented or oily soaps that might adhere to the lens surface. Especially avoid using products containing lanolin.
Some eye doctors say to always apply the first contact lens in the same eye, so you'll avoid the possibility of mixing up lenses for the right eye and left eye.
Other basic guidelines for contact lens application include:
Gently shake your lens case containing the storage solution, to loosen the contact lens should it be stuck. (Don't try pulling at the lens with your finger, or you might damage it.)
Slide the lens out of its case and into the palm of your hand. Rinse thoroughly with the appropriate contact lens solution.
Place the contact lens on the tip of your index or middle finger, which should be dry or mostly dry.
With the fingers and thumb of your other hand, simultaneously pull up on your upper eyelid and down on your lower eyelid.
Position the lens on your eye while looking upward or forward, whichever you find to be easier. You also can apply the contact lens by placing it on the white of the eye closest to your ear.
Roll your eyes in a complete circle to help the lens settle, then blink.
Applying contact lenses is easy.

Removing Your Contact Lenses

Always wash your hands before removing contact lenses. If you are standing in front of a sink, make sure you use a clean paper towel to cover the drain where the contact lens might accidentally fall.
To remove soft contact lenses, look upward or sideways while you pull down on your lower eyelid. With a finger, gently maneuver the lens onto the white of your eye. There, you can very gently pinch the lens together with your index finger and thumb and lift it off the eye. Until you master contact lens removal, you might consider keeping your fingernails clipped to avoid accidentally scratching and damaging your eye.
Rigid contact lenses can be removed by holding out the palm of your hand, bending over, and then opening your eye wide. With one finger of your other hand, pull on the skin of your eye's outside corner straight out toward your ear with your eye wide open. Then blink. The contact lens should pop right out and into your open palm.
Devices for removing contact lenses, known as "plungers," also are available from your eye doctor, and can be used to touch and directly remove a lens from your eye. Just make sure you touch only the lens and not your eye's surface with this device.
While you might hear a myth or two about someone "losing" a contact lens in the back of the eye, this is actually impossible because of a membrane that connects your eye to the back of your eyelid.
Contact Lenses and UV Light
Researchers have linked ultraviolet (UV) to the formation of cataracts. Exposure to excessive UV light also may result in a condition called photokeratitis. That's why some lenses now incorporate a UV-blocking agent. You can't tell if a contact lens has a UV blocker just by looking at it — the blocker is provided in clear form, so as not to disturb vision. The contact lens packaging will specify if the product has a UV blocker, or you can ask your eye doctor.
Very important: UV-blocking contacts are not meant to replace sunglasses. A contact lens covers only your cornea, not your entire eye.
However, UV-blocking contact lenses do help protect the portion of the white of your eye that is covered from formation of growths such as pingueculae and pterygia.

Sunglasses with UV protection can cover more of your eye and the parts of your face that surround the eye, depending on the size of the sunglass lens. That's why contacts with UV blockers are designed to complement sunglass use as an added protection.
Eye Makeup and Contact Lenses
Getting makeup in your eye is annoying. But it's even worse with contacts, because it can stick to the lenses instead of flushing right out. Follow these tips to keep your eyes looking and feeling good:
Put in your contact lenses before applying makeup. And always wash your hands thoroughly before touching your contacts, so you won't transfer any oils, creams, or lotions to the lenses.
Use only non-allergenic makeup. Almay and Clinique have eye-friendly products, but there are other brands as well.
Cream eye shadow is less likely to get in your eye than powder. However, creams can also irritate your eyes more if they do make it into your eyes. Choose water-based rather than oil-based creams.
If you prefer powder, keep your eyes closed during application. Then, brush off any excess powder before opening your eye.
Never apply eyeliner between your lashes and your eye. Apply eyeliner only on the portion of your lashes that is well away from your eye.
To remove eye makeup, wash and dry your hands. Then remove your contacts, being careful not to bump them into any makeup. Finally, use your eye makeup remover.

PATIENT EDUCATION

Eye care, conditions and diseases – What is it? What are the symptoms? Who does it affect? How can it be prevented? How is it treated?

CATARACTS
Cataracts occur when there is a buildup of protein in the lens that makes it cloudy. This prevents light from passing through a normally clear lens, causing some loss of vision. Cataract surgery, which is now relatively routine and safe, involves replacing the clouded lens with an intraocular lens implant. As the leading cause of blindness worldwide today, it's imperative to seek early detection for cataracts.
CONTACT LENS WEAR CONDITIONS
Contact lens wearers can experience a range of conditions that range from allergic reactions to potentially dangerous infections. Sufferers often experience red, swollen, stinging sensations in the eye. It's also common for contact lens wearers to experience dry eye, a condition that is equally uncomfortable causing irritated dry eyes. Recent advances have been made in contact lens solutions to help contact lens wearers maintain eye hydration.

DETACHED RETINA
Retinal detachment occurs when the two layers of the retina become separated from each other and from the wall of the eye. The cause is most often attributed to the vitreous gel, the thick fluid that fills the center of the eye, shrinking and separating from the retina. The results can range from mild to severe vision loss in the affected area of the retina. Surgical treatment is available to repair the retina and is usually successful.

DIABETIC RETINOPATHY

Diabetic retinopathy is experienced by those who suffer diabetes, type I and type II, which damages the small blood vessels in the retina and leads to poor vision and even blindness. Preventative measures can be taken to slow the progression of the disease.

DRY EYE SYNDROME

Dry eye is as it sounds – a condition that results in red, itchy, dry eyes as the result of a dry cornea. It's a common eye condition often affecting contact lens wearers, people who focus long periods of time on a computer screen or reading material, or people exposed to environmental pollutants. It was once common for artificial tear treatments to cause blurry vision, but recent advances have been made to minimize or alleviate this side effect while still effectively relieving the symptoms of dry eye.

EYE ALLERGIES

An allergy is the body's overreaction to a substance it believes is harmful. Allergies of the eye often manifest as red, itchy, swollen eyes, but prevention is sometimes possible and pharmaceutical treatments are available to help with symptoms.

EYE INFECTIONS

Eye infections can range from conjunctivitis to blepharitis or styes. Symptoms range from a swollen, red, irritated eye that discharges liquid to an inflamed eye lid or eye lid with a red, swollen bump, as is the case with a stye. An eye infection is usually a condition that is caused by bacteria, virus or other microbiological agent, but eye surgery is another common way to contract an eye infection. Treatments are available to protect against infection in cases of surgery, or treat eye infections once they have occurred.

EYE INFLAMMATION

Often painful and requiring attention by an eye care specialist, inflammation of tissue associated with the eye is generally related to trauma or surgery, but can also be caused by bacterial, viral or environmental factors. It's important to treat eye inflammation early to avoid the threat of infection and possible scarring, which may lead to permanent vision loss. Anti-inflammatory agents are available to treat eye inflammations.

GLAUCOMA

Glaucoma is an eye condition that develops when too much fluid pressure builds up inside of the eye. It tends to be inherited, have few symptoms and may not show up until later in life. Fortunately, advanced treatment is available for glaucoma, but early detection is needed for greater success.

MACULAR DEGENERATION

Macular degeneration occurs when the small central portion of the retina, known as the macula, deteriorates, which results in an increasing loss of central vision. As the leading cause of blindness in individuals over the age of 60 in the developed world, aggressive treatments are underway to slow the progression and ultimately cure the disease.

MYOPIA, HYPEROPIA, ASTIGMATISM & PRESBYOPIA

Commonly referred to as refractive disorders, these conditions are among the most common eye conditions and may require corrective eye wear to improve blurred vision. Also known as near or short-sightedness or far or long-sightedness, myopia and hyperopia symptoms manifests as blurred vision due to the retina's inability to focus at varying distances. The same symptoms occur as a result of astigmatism and presbyopia. Significant advances in LASIK surgery have occurred in the last decade, and the results often mean a life free from eye glasses or contact lenses.