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Do's and Don'ts of Contact Lens Wear

Contact lenses are great medical devices that help over 30 million people in the world improve their vision. However up to 90% of contact lens wearers do not follow the proper care instructions for their lenses. And that can lead to bad news for your comfort and vision. Here are some tips on good lens care and hygiene. Replacement Schedule: Depending on the brand, soft contact lenses come in monthly, biweekly, or daily replacement schedules. It is important to adhere to the recommended schedule. Extending the life of your lenses can cause excess build up of protein, allergens, pollutants, or mircoorganisms that can irritate your eyes causing dryness and discomfort or worse an eye infection. Daily disposables are trending more these days since they eliminate the build up of debris allowing for better comfort. Daily lenses also result in better compliance for patients who forget when it is time to replace their lenses after several weeks. I recommend daily disposables especially to my younger patients who have very active lives. Contact lens solution and how to clean your lenses: Always wash your hands with soap and water before handling your contacts and eyes. This is how microorganisms contaminate your eyes and lead to irritation or infection. When removing your lenses at the end of the day make sure to rub with multipurpose solution with your fingers for 20 seconds and then rinse them before placing them into the case overnight. Be sure to only use contact solution to clean your lenses. Multipurpose solution is designed to disinfect lenses unlike water, saline, and/or rewetting drops. Never reuse old solution and never top off old solution in your case. It is just as important to clean the case and allow them to air dry during the day. Remember to replace your case every 3 months as it can be another source of microbial contamination. Conveniently, companies usually include a new case in the package of each bottle of solution. There are various types of contact solutions on the market these days. Multipurpose solutions can be used to rinse, clean, condition, and store contacts. Examples of multipurpose solutions are Bausch and Lomb's Biotrue and Alcon's Opti-Free. Also available are products such as Clear Care by Alcon which uses hydrogen peroxide to clean and remove debris from lenses. They require a specialized case and takes 6 hours to neutralize the peroxide into saline. Beware that if you place the solution directly into your eyes it will result in redness and stinging - a painful mistake! However, once the peroxide is neutralized after 6 hours it is perfectly safe to directly place the lenses onto your eyes. Hydrogen peroxide solutions are also preservative-free which is great for patients who experience sensitivity to other products. Do not sleep in your lenses! I always stress to my patients the dangers of sleeping in contact lenses. The cornea is the top layer of the eye on which the contact lens sits on. Wearing contacts normally reduces oxygen transmission to the cornea from the open air. By closing your eyes and sleeping you deprive them of oxygen even further. The cornea can swell thereby causing blurry vision. You are also more likely to get an infection from any bacteria harboring on your lenses and then sitting on your eyes overnight. I tell my patients to remove their lenses earlier in the evening before they get tired to avoid accidently falling asleep in them. Update your contact lens prescription annually Lastly, contact lenses require a prescription. Your eye doctor will exam your eyes to make sure they are in good health as well as check if your glasses and contact lens prescription have changed. Many times corneal issues are detected during routine exams.Visiting your doctor annually and following these simple rules of contact lens care will keep you and your eyes looking sharp!

Sources: Centers for Disease Control and Prevention.

What's trending for contact lens patients with dry eyes?

Contact lenses have come a long way in a short amount of time.  The largest trend I've seen in the past few years has been a shift to daily disposable lenses.  These days every contact lens manufacturer has their own stockpile of daily disposable lenses, each with their own strengths.

There are many benefits to wearing a daily disposable lens.  We get build up on our lenses everyday such as microorganisms, allergens, pollutants, and tear film protein.  A daily lens eliminates re-inserting those potentially harmful agents and prevents infections.  Additionally, the debris collected on a contact lens over time can cause discomfort which is why you feel the need to throw away your monthly lens before the 30 days is up.  Another advantage to daily disposables is the convenience factor.  Most patients do not like to bother with rubbing, rinsing, and storing their lenses every single night.  Some patients even find irritation with certain cleansing solutions.  Many of my patients frequently travel for business and they have found it a relief to do away with carrying solution on their journey.  Thus health, comfort, and convenience are the chief reasons I prescribe dailies.

While many of my patients are happy in their current monthly and biweekly contact lenses, there are times when someone will complain about dryness and comfort.  These may be middle aged patients who suffer from dry eyes or professionals who work on a computer all day.  It is also possible that the patient has already converted into a daily lens but still does not find significant relief.  In these cases there is a lens that comes to mind where I have found success in providing all day comfort.  Last year Alcon debuted Dailies Total 1.  The lens contains the latest in comfort evolution called Water Gradient technology.  This mean that the lens has an increased amount of water content on the front and back surface which gives a cushion of moisture on the eye.  Patients respond extremely well to the product and love wearing contacts lenses again. The best part of Dailies Total 1 is that it doesn't sacrifice health benefits such as oxygen permeability.  According to Alcon it is six times more breathable than the other daily disposables.  This makes prescribing Total 1 a win for both patients and doctors.

If you would like to try Dailies Total 1 and see how much better your  contact lens wearing experience can be then make an appointment with us at your convenience.  We look forward to taking care of you and your eye care needs!

Guarding Against Glaucoma

Regular Eye Exams Are Key in Fighting a Disease That Can Rob You of Your Sight

Called the "silent thief of the night,” glaucoma can creep up unnoticed, especially in its early stages. In fact, people who have glaucoma - the name given to a group of diseases that damage the eye's optic nerve - might not even know they have it until it's too late. The disease starts with imperceptible blind spots at the edges of the field of vision, progresses to tunnel vision, and then ultimately leads to blindness if left untreated. In fact, glaucoma creates at least some vision loss in more than half of the approximately 2.5 million Americans with the disease and is the second leading cause of blindness.

While anyone can develop glaucoma, some people are at higher risk: African Americans over the age of 40, people with a family history of glaucoma, and everyone over age 60. The best way to prevent against damage caused by glaucoma is by following the tips suggested below:

  • Get regular eye exams. Regular comprehensive eye exams can help detect glaucoma in its early stages before irreversible damage occurs. As a general rule, have an eye exam every three years up to the age of age 40, and every two years for those ages 40 to 65, and every one to two years for those over 65. You will probably need more frequent screening if you are at risk.
  • Treat elevated eye pressure. An elevation of the pressure inside the eye, called intraocular pressure (IOP), has traditionally been blamed for damaging the optic nerve and creating the loss of vision that occurs in glaucoma. Glaucoma eye drops can significantly reduce the risk that elevated eye pressure will progress to glaucoma. However, these drops must be taken regularly to be effective.
  • Eat healthily and exercise regularly. While maintaining a healthy diet won't prevent glaucoma, it can help you keep your weight down and control high blood pressure (a risk factor for developing the disease). In addition, a regular program of moderate exercise, such as walking or jogging three or more times every week, can lower your IOP and benefit your overall health.
  • Wear eye protection. Serious eye injuries can also lead to glaucoma. Wearing eye protection when engaged in high-impact sports activities (such as racket sports on enclosed courts) and home improvement projects. Hats and sunglasses to protect your eyes are highly recommended if you spend time outdoors.
Why an Eye Exam Should Be on Your Back-to-School List

Kids with undiagnosed vision problems can be mistaken for having learning disabilities. Make sure your back-to-school list includes an annual eye exam.

Now’s the time when parents start making lists of what has to be done before their children go back to school. Along with notebooks, binders, pencils, and pens, I hope you won't forget one of the most important things that will help your child perform at his or her best in class: an annual eye exam.

In the United States, some 10 million children suffer from undetected vision problems that may cause them to struggle in school. In addition, 60 percent of children labeled as “problem” learners actually have undiagnosed vision problems. It's very common for a vision problem to be mistaken for a learning disability. Undetected vision conditions can lead to frustrated students, poor grades, and behavioral issues.

Most parents are unaware that American Academy of Ophthamology recommendations call for infants at high risk for eye disease to have a comprehensive examination by an ophthalmologist as soon as medically feasible. All children should have an assessment for eye problems in the newborn period and then at all subsequent routine health supervision visits. School-age children should be evaluated regularly for visual acuity and ocular alignment (approximately every 1 to 2 years).

Since children’s eyes develop so rapidly, and they continue to develop until about the age of seven, early detection is essential to correcting potentially permanent vision issues. I'd also like to point out that if a child waits too long to have an eye exam, a correctable visual problem may become permanent.

Furthermore, many in-school screenings are limited in scope, while comprehensive eye exams in an ophthalmologist's office test for visual acuity, color vision, eye alignment, eye health, and chronic diseases.

Please call our office to schedule your child's back-to-school eye exam and help ensure that vision impairment will not adversely affect his or her schoolwork.

Dr. Ameet Goyal, M.D. General Ophthalmologist and Oculoplastic Surgeon

Seven Tips to Protect Your Eyes from the Sun This Summer

Most people think of shading their eyes during the summer months. But it's important to protect your eyes from the sun's harmful ultraviolet (UV) rays year round. These rays can burn the skin around your eyes and damage your corneas. Prolonged exposure to the sun also plays a major role in the development of cataracts and macular degeneration. Following are some tips to keep your eyes safe this summer and for the rest of the year:

1. Apply your sunscreen around the eye area (make sure it's waterproof so it doesn't drip into your eyes). An SPF of 30 will block out about 97 percent of UV rays.

2. Wear a baseball cap, or even better, a wide-brimmed hat with a two- to three- inch brim. They are very helpful in blocking harmful rays from reaching your eyes.

3. Make sure your sunglasses have 100 percent UV protection. You want to prevent ultraviolet light from reaching the retina. The best filters against these rays are in the amber-orange-brown range.

4. Choose sunglasses that fit close to your face and, if possible, wrap all the way around the temples as you should protect your eyes from all angles.

5. Even if you have contact lenses that offer UV protection, you should still wear sunglasses. Sunglasses help to prevent the drying effect caused by warm wind that most contact lens-wearers experience.

6. Wear sunglasses whenever you're outside, even on cloudy days – and not just in summer. Wear sunglasses anytime you are in high glare areas, around snow or water.

7. Don't forget the kids! Opt for sunglasses with UV protection for your children, and remember that the eyes of small infants should always be shaded from direct exposure to the sun. Dr. Ameet Goyal, M.D.
General Ophthalmologist and Oculoplastic Surgeon

The Case for Contact Lenses

With all the heat, you may find that your glasses are fogging up, sliding down your nose, or trapping sweat that can irritate your skin. If so, contact lenses, worn full time or even just occasionally, may prove to be a liberating experience.

Contact lenses can come in handy during this time of year, especially when you engage in sports activities such as tennis, softball, soccer and lacrosse. When you wear contact lenses you don't have to worry about your field of vision being obstructed or distorted as it would when wearing glasses. In addition, wearing contact lenses can reduce your risk of eye injury, should your face be hit.

Contact lenses can correct vision for those who have nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. Even people who require bifocal glasses can enjoy the benefits of a multifocal contact lens.

Speaking about contact − please give us a call if you would like to discuss how contact lenses could improve your lifestyle.

Iva Yalkowsky, O.D. Optometrist

A Remedy for Wrinkled Foreheads

A very effective advertising campaign by a popular fried chicken restaurant chain is promoting boneless fried chicken by showing the panicked expressions of people who believe they have eaten the bones of the chicken when they see their empty plate. One particularly gentleman sports a deeply wrinkled forehead that rivals that of a Shar-Pei to make the point.

While having a wrinkled forehead may be great for humorous ads, it can be a negative in our everyday social interactions. Wrinkles can convey a sense of worry, and that can be interpreted as a person lacking confidence. Or, they can communicate a general sense of unease.

People often try to mitigate forehead lines with Botox treatments. Yet, they may be missing the root cause: droopy eyelids. Think of it: When someone has lids that droop enough to interfere with their vision, he will subconsciously raise his brows, and in the process wrinkle his forehead in order to help keep the upper eyelids from blocking his view.

If you find that you are frequently raising your brows and wrinkling your forehead, consider that this may be a sign of serious eyelid droop. The easiest way to test this hypothesis is to close your eyes and hold your fingers firmly above your eyebrows. After you open your eyes again, if you feel a strong urge to push up your brows, or if your lids appear droopy as you hold your brows in place, this could be a sign of a significant droopy upper eyelid condition.

If you are plagued by droopy upper lids and would like to address forehead wrinkling, please contact us.

Dr. Jerry Lai, MD General Ophthalmologist and Oculoplastic Surgeon

Eliminate Angry Face: Your Botox and Surgery Options

Recently, a popular local radio station hosted a contest for the angriest looking face at rest. I immediately thought of an old acquaintance of mine who had the heaviest, most angled brows of anyone I knew. Even when he was happy, he looked angry. In fact, rumor had it that he could not get the blessing of his girlfriend's parents to get married because they thought he looked so mean.

As we discussed in a previous blog, people are greatly influenced by first impressions, and those impressions often come from facial expressions influenced by your eyes and brows. Angled furrowed brows are seen as signs of anger or displeasure. The persistence of this look can, unfortunately, have a negative impact on one’s relationships.

Fortunately, small adjustments can be made to the eyelids and brows that can alter these mistaken perceptions. Botox injections and surgical procedures can be used to shape the lids and brows, resulting in a friendlier appearance.

Please contact us if you would like to schedule a consultation to restore the harmony between your outward expression and your inner beauty.

Dr. Jerry Lai, MD General Ophthalmologist and Oculoplastic Surgeon

A Better Way: Bladeless Laser Cataract Surgery

One of the more exciting advancements in treating cataracts is laser technology that eliminates the traditional method of using a physical blade. With laser cataract surgery, the computer-assisted incisions are executed with precise depth into the cornea. The laser also can accurately correct for astigmatism, which is curvature of the cornea.

Everyone who has cataract surgery receives a lens implant after the cataract is removed. With the laser procedure, a precisely positioned "manhole" is made into the cataract that allows the implant to stay in the proper position. By using this cutting-edge laser technology, the patient enjoys better vision and a higher probability of not needing glasses. In addition, there is less likelihood of any surgical complications.

If you are interested in finding out more about bladeless laser surgery for cataracts, please feel free to contact our office.

Dr. Ameet Goyal, M.D. General Ophthalmologist and Oculoplastic Surgeon

No More Drooping Eyelids

I recently visited a friend who was watching the movie Stand and Deliver, one of the prototypical inner city schoolteacher movies. It reminded me of one of my first patients, a schoolteacher trying to make a difference in the lives of struggling urban youth. Although the patient was tall, eloquent, and otherwise commanding in his presence, he had developed drooping upper eyelids. When I first met him, I could hear the frustration in his voice as he described how his students did not respect him because they always thought he was asleep. At a follow-up appointment, several months after a simple procedure to lift his lids, he elatedly told me how his relationships with his students had blossomed as if a curtain had been lifted.

This goes to show, that our personal relationships are often heavily influenced by what we look like and our facial expressions. The eyes, in particular, convey emotions, alertness, and interest. When someone develops drooping upper lids, the eyes can mistakenly convey disinterest or fatigue. Fortunately, there are simple procedures that can be performed to raise the lids.

If you suffer from drooping eyelids and would like to discuss your options to restore a refreshed, healthy appearance, please contact us to set up a consultation.

Dr. Jerry Lai, MD General Ophthalmologist and Oculoplastic Surgeon