Multiple Sclerosis and Vision

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IMG_4109Multiple Sclerosis (MS) is a disease of the central nervous system. It affects the brain, optic nerves, and spinal cord, which is why vision problems are often the first symptom of the disease. Inflammation — where parts of the body become reddened, swollen, and painful — is the main issue with MS, as it causes damage to the nerves. MS is characterized by flare-ups of inflammation that typically go away after some time or will need to be treated with steroids. (For more information please see the Multiple Sclerosis Association of America’s website.) Stress, fatigue, infection, and elevated temperature can all affect vision in people with MS, so reducing those factors is an important part of managing the disease.

How MS Affects Vision

Optic Neuritis

The most common symptom is optic neuritis, which is an inflammation of the optic nerve. According to the National Multiple Sclerosis Society, most times, it happens in one eye only. The good news is, it usually goes away on its own after a couple of weeks or more and vision returns to normal. Here’s what optic neuritis looks like:

  • Pain with eye movement.
  • Blurred vision.
  • Dimmed vision.
  • Loss of being able to see colors accurately.
  • Difficulty seeing at night.

In some cases of blurred and/or dimmed vision, the center of the visual field can be blocked out. Side, or peripheral vision, usually isn’t affected. This is called central scotoma.


Another common symptom is called diplopia, or double vision. This occurs due to nerve damage or inflammation as well. Diplopia may resolve on its own. If not, using an eye patch can help to retrain the affected eye. As with many symptoms of MS, a course of corticosteroids may be helpful in relieving the symptoms.


Not as common, nystagmus — also known as “dancing eyes” — is caused by muscle weakness. It is an involuntary rapid eye movement to where eyes may go from side-to-side or up-and-down rapidly. Mild cases may not cause any change in vision, but severe cases will affect vision to where things don’t seem to stay still. Treatment is usually to wait and see if it resolves on its own as the overall MS symptoms resolve, and again, steroids may be necessary to help with the symptoms.

If you have any concerns about your vision, or suspect you may have MS, please consult with your health care provider and eye-care provider for an accurate diagnosis.

Anisocoria: One Pupil Larger Than the Other

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In last month’s blog post on how a concussion affects vision, we discussed that having one pupil larger than the other is a cause for concern if you’ve recently suffered a concussion. This month, we’re going to take a deeper dive into that condition, known as Anisocoria.


Anisocoria naturally affects about one-fifth of the population without any problems in vision. Outside of being born with the condition, most people who are affected by it usually have had an eye disorder of some sort or an issue with their nervous system.


Photo from The Express UK Article on David Bowie

According to the Merk Manual, eye disorders include birth defects, injuries to the eye, drugs, inflammation of the pupil itself, or are glaucoma-related. The late David Bowie, a well-known British musician and icon, is an excellent example of anisocoria. Most people think he had different colored eyes, a condition known as heterochromia, but he did, in fact, have anisocoria as a result of being hit in the eye as a teenager. To learn more about that story, here’s the link to The Express UK article on David Bowie.

Sometimes there are issues with the nervous system that result in one pupil being larger than the other. Those issues include pressure on the 3rd cranial nerve (nerve affecting the movement of the eye), stroke, injury, tumors, infections, or problems with the autonomic nervous system that result in drooping eyelids and misaligned eyes.

Symptoms to Watch For

See a medical professional if you experience any of the following and your pupils suddenly appear to be different sizes:

    • Drooping eyelid 
    • Double vision
    • Loss of vision
    • Headache or neck pain
    • Eye pain with bright light
    • Recent injury to the head or eye



Eye-care professionals will first take a look at your history — and even perhaps an old photograph or your driver’s license — to see if anisocoria has been present all along. Then they will perform a series of examinations to make sure that both of your eyes are tracking correctly, responding to light and dark appropriately, and will use a slit lamp to magnify your eye for further examination.

While there isn’t anything that can be done to treat the condition itself, there may be a need and/or opportunities to treat the underlying condition that is resulting in anisocoria.

For more information on this condition, check out All About Vision, the Merk Manual for Professionals, and the American Academy of Ophthalmology.

How a Concussion Affects Vision

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A concussion, also known as a mild Traumatic Brain Injury (mTBI), happens when you get hit in the head hard enough that it bruises the brain. While not typically life-threatening, a blow to the head can leave you with headaches, dizziness, fatigue, vomiting (in more severe cases), and vision problems.

Causes of Concussions

The Centers for Disease Control says that the majority of concussions — around 47 percent — happen after a fall (off a bike, missteps, etc.). Being struck by an object (baseballs, football tackle, etc.) account for around 15 percent of mTBIs. While 14 percent happen as a result of a motor vehicle accident.

Symptoms of a Concussion

Common symptoms of a concussion are headaches, dizziness, vomiting, and at least initially, blurred vision and light sensitivity. Unlike the other symptoms, which can happen shortly after the blow, vision problems, as noted by All About Vision, can actually show up later and may not present themselves right away. So, you need to be on the lookout for them throughout the healing process.

For further reading, the Brain Injury Association of America has provided information on this condition.

Red CrossPlease note: It is a medical emergency and a strong indicator of severe trauma if one pupil (dark dot in the center of the eye) appears larger than the other. You must go to the Emergency Room straight away to be seen by a medical professional.

Vision Problems to Watch For

According to and the Neuro-Optometric Rehabilitation Association, concussions can trigger many vision issues. They are:


Graphic Provided by Neuro-Optometric Rehabilitation Association

    • Blurred or fuzzy vision
    • Light sensitivity
    • Reading difficulties
    • Comprehension problems
    • Double vision
    • Aching eyes
    • Headaches when tending to visual tasks
    • Visual-field loss
    • Eye movement issues such as tracking, shifting focus, and binocular focusing

If left untreated, the concussed patient may begin to have trouble making sense of visual information, so it is important to remain vigilant for at least a month after getting an mTBI to watch for these other symptoms.


The single best thing you can do after receiving a concussion is to rest and avoid environments where you may re-injure yourself while you are healing. The brain takes a few weeks to recover. If it is determined that your vision has been affected, there are various optometric vision therapies and vision rehabilitation therapies that can help. Talk with your eye-care professional for recommendations on which therapy would work best for you.

New Year, New Glasses!

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The annual flipping of the calendar to the new year inevitably leads people to think about fresh starts, overhauling their old ways for better ways … out with the old, in with the new! So what better time than now to revisit the frame style for your eyeglasses and sunglasses? It’s a great way to spruce up your style and give your appearance a boost. New Year, new glasses!

To see how different frames can really change a look, check out Gentlemen’s Quarterly (GQ) article this past summer on the many frame types worn by actor Jeff Goldblum over the course of his 40+ years in the limelight. The photographs show his hits and misses and more importantly, why they work … or don’t.

The biggest consideration when choosing a new style is shape — both for the glasses themselves and for your face. Esquire’s online magazine has a great blog post using video snippets that show the various face shapes and types of frames that look good with them. The face shapes include oblong, triangle, diamond, square, round, heart, and oval. Esquire overlays those shapes onto actual people to demonstrate what a square-shaped face, for example, looks like in real life. As for the frame types, those terms include cat eye, round, oval, rectangle, and square. Familiarizing yourself with these terms can be useful for when talking with your optician.

So if you’re ready for a new you, come to All About Eyes to see for yourself which frames flatter your face. We have a variety of styles to choose from and experts on hand to help you pick the best ones for you. Here’s a sample of what we have on offer:

Happy New Year from all of us at All About Eyes!

Playing it Safe this Holiday Season

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Projectile Toy ExampleGift-giving holidays are right around the corner and, as fun and exciting as new toys are, playing it safe is important, too. Here’s a not-so-fun statistic to consider: One in ten eye injuries for children at emergency rooms in the United States are from toys, primarily from projectile ones such as crossbows, darts, BB guns, air-soft guns, Nerf guns, and slingshots. While those toys are fairly obvious that they may cause an eye injury, there are other toys that shoot small projectiles as part of the overall play experience that can also be a problem (i.e., Legos, Paw Patrol) too. A good rule of thumb for those kinds of toys is that parents should be able to explain the risks to their children to help them to avoid eye injuries. If the child can’t understand what they’re being told, they’re probably too young or too immature to play with it just yet.

The Food and Drug Administration (FDA) also adds laser toys to the list, saying in their bulletin that the highly concentrated light can cause serious vision issues if pointed directly at eyes.

Avoiding those kinds of toys, especially for children under the age of 6, is but one way to prevent eye injuries. Here are several other things to look for in choosing toys for your children:

  • Well-constructed toys (check for flimsy plastics that may break and cause sharp edges).
  • Toys with rounded edges (eliminates potential hazards).
  • Age-appropriate toys (if in doubt, follow the recommended age guidelines for the toys).
  • Developmentally appropriate toys (you know your child best, choose toys that you know they are ready for).

Let’s all help to keep toys fun, by keeping them safe to enjoy as well. Merry Christmas, Happy Holidays, and Happy New Year from all of us at All About Eyes!

The Gift of Sight: Eye Donation

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November marks the inaugural Eye Donation Month!

Organ donation after death can include the gift of sight: eye donation. Last year, according to the Eye Bank Association of America, over 84,000 corneas were donated. The very first cornea transplant was performed in 1905, and since 1961, over 1.7 million transplants have been done.

Corneal Transplant (with stitches) courtesy of National Eye InstituteUnlike other human organs, cornea transplants have a 95 percent success rate. This success is due in part, to the fact that there doesn’t need to be an “exact match” in race, blood type, or even eye color for the cornea — the transparent cover over the iris and pupil — to be attached.

Additionally, unlike other organs like the heart, lungs, or kidneys, corneas can be transplanted up to 3-5 days after the passing of the donor, so they remain viable for longer periods of time.

Anyone can sign up in advance to have their eyes donated upon death at which is operated by the United States Department of Health and Human Services or the Eye Bank Association of America. The whole eye can be donated; however, only the cornea can be transplanted. The sclera tissue (white part of the eye) can be used to rebuild the eye of donor recipients. The remainder of the eye itself can be used for research into treatment and cures for future generations.

Benefits of Daily Disposable Contact Lenses

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When faced with how best to correct vision issues, your main options are wearing glasses or contact lenses (surgery is physically invasive and costly). While the variety of glasses are primarily fashion-oriented or purposed-oriented (i.e., sports, sunglasses, etc.), contact lens options tend to be time-oriented, as in, how long you can wear them before changing them out and cleaning them.

The American Optometric Association identifies five different types of contact lenses:

  • Rigid gas-permeable (RGP): Made of slightly flexible plastic that allows oxygen to pass through to the eyes. Corrects most vision problems but debris can sometimes get under the lenses, causing infection or injury.
  • Daily wear soft: Made of soft, flexible plastic that also allows oxygen to pass through to the eyes. Available in lenses that do not need to be cleaned (disposable). They don’t correct all vision issues, however.
  • Extended-wear: Available for overnight wear in soft or RGP lenses. Can be worn up to seven days without removal. May cause infection.
  • Extended-wear disposable: Soft lenses worn for extended periods of time (usually one to six days), then discarded. May cause infection.
  • Planned replacement: Soft daily wear lenses replaced on a planned schedule, most often either every two weeks, monthly, or quarterly. 
CDC - How to wear contact lenses

CDC – Contact Lenses

“Daily disposable contacts are healthier/better for your eyes than the two-week or monthly lenses,” says Dr. Cheryl Roell, optometrist and co-owner of All About Eyes. “We try to prescribe dailies for everyone, but especially all the kids/teens in our practice, for the health benefit as well as the ease of care. There is a higher percentage of eye infections and irritations with longer-wear contacts.”

Eye infection, known as keratitis, is an inflammation of the cornea (the clear dome that covers the colored part of the eye), notes the Centers for Disease Control (CDC) on their website. Keratitis happens when contact lens wearers don’t clean their lenses as instructed and germs get on the lenses — and are then transferred onto the cornea — causing the infection.

Disposed of after each use, daily wear contact lenses reduce the chances of infection. Note that disposable lenses should be thrown away in the trash, not flushed down the toilet or washed down the sink, as that causes environmental problems.

Other benefits to wearing daily wear contact lenses include feeling better about your appearance, they’re excellent for participating in sporting activities, and they don’t fog up in sudden temperature changes or get smudged. And because the lenses move with your eyes, side vision tends to improve, and there aren’t any frames getting in the way of your vision. In other words, they offer a more natural vision experience to wearing glasses.

If you are interested in trying out daily wear contact lenses, please contact either Dr. Cheryl or Dr. David Roell for an appointment to learn more about this option.


Disposing of the Disposable Contact Lens

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When Leonardo da Vinci first sketched out the concept of a glass lens to correct vision that would cover the eye in 1508, it is unlikely that even he could have visualized the impact that the disposing of disposable contact lenses would have on the environment over 500 years later. Now that over 45 million wearers in the United States alone are using them, researchers at Arizona State University have begun investigating how wearers are disposing of their lenses.

Contact Lens Evolution
Contact lens being inserted onto eyeball.

Photo by CDC

At first, contact lenses were crafted out of glass and covered the entire eye. The heavy, thick lenses, fashioned in Germany in the late 1880s*, could only be worn for a few hours at a time. Contact lenses evolved from there in 1936, when New York optician William Feinbloom used a combination of glass and hard plastic to construct a more wearable lens. A dozen years later, the lenses switched to all hard plastic until the next evolution came in 1971 when Bausch and Lomb developed soft plastic lenses.

The first disposable lens became available in the United States in 1987, but lenses didn’t become truly disposable as we know them today, until 1995, when one-use lenses were introduced into the market.

Contact Lens Pollution

With millions of users tossing out their soft plastic lenses every day, Arizona State University researchers set out to discover where those lenses end up in the ecosystem in the first-ever study of its kind this year. According to the researchers, they “found that 15 to 20 percent of contact-lens wearers are flushing the lenses down the sink or toilet. This is a pretty large number, considering about 45 million people in the United States alone wear contact lenses, amounting to 1.8-3.36 billion lenses flushed per year, or about 20-23 metric tons of wastewater-borne plastics annually.”

The study goes on to explain that once put down the drain, lenses are then conveyed to wastewater-treatment plants, which then fragment them into microplastics that accumulate in sewage sludge. Researchers noted for that for every two pounds of sludge, a pair of contact lenses can be found.

The short-term solution: throw away your lenses in the trash. Researchers hope that with enough education and awareness paid to this issue, that in the long-term, manufacturers will develop a lens that will biodegrade on its own.

*For a complete history of the contact lens, check out Eye Topics.

Effects of Smoking on the Eyes

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smoking-infographic-580x2218Smoking. It’s not just bad for your lungs, heart, and pretty much every organ in your body according to the Centers for Disease Control, but it’s detrimental for your eyes, too. In addition to increased risks of heart and lung cancer, stroke, and type 2 diabetes, smoking can dramatically increase your chances of vision loss as you age.

Eye diseases such as age-related macular degeneration (AMD) skyrocket by 25 percent for smokers. And it doesn’t end there: nonsmokers will double their risk of getting AMD just by living with a smoker and being exposed to second-hand smoke. AMD is an incurable vision disease that attacks the center part of the retina causing a dark spot in the center of your field of vision. Cataracts, a white, cloudy film that forms over the lens, are two times more likely to develop in a heavy smoker (15 or more cigarettes a day) than to a nonsmoker.

Smokers are twice as prone to uveitis (an inflammation of the iris area of the eye) and dry eye syndrome (where there aren’t enough tears to lubricate the eye).

And if all that wasn’t bad enough, the risk of developing diabetes is 30–40 percent higher for smokers, which can trigger eye diseases like glaucoma and diabetic retinopathy.

Traditional cigarettes are not the only cause for concern amongst smokers either. According to Vaping Daily, an online trade magazine covering the latest trends in e-cigarettes (smoking e-liquids via an electronic cigarette), the vapor clouds that are created in exhalation are being studied for their effects on vision as well.

To increase your chances of slowing down or halting the onset of these diseases the solution is simple: stop smoking and limit your exposure to people who do in your environment.

Get Your Sunnies On! National Sunglasses Day

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National Sunglasses Day will be on Wednesday, June 27, and it is a perfect day to celebrate protecting your vision with your sunglasses!

Why Sunglasses?

Sunglasses — not just any sunglasses but specifically those with Ultra Violet (UV) protection — can help to protect your eyes against sunburn (yes, your eyes can get sunburnt), pterygium (abnormal growths on your eyes), potential cataracts, age-related macular degeneration, and squamous cell carcinoma (cancer).

What Are Symptoms of Sun Damage?

If you have been outside without sunglasses for a prolonged period of time or around highly reflective surfaces like lakes, the ocean, sand, or snow, you may find that your eyes are affected. The cornea, the outer layer of the eyeball, is like the top layer of skin on your body and can get sunburnt just as easily.

How do you know if your eyes are sunburnt? If you find they are red, swollen, and/or you have blurry vision and light sensitivity, your cornea may have been sunburnt. This is called photokeratitis. Your eyes may water and you may feel like you’ve got sand or grit in them. See your eye-care practitioner for eye drops and stay in a darkened room for at least a day to allow your eyes time to heal. The cornea will usually heal quickly.

How to Protect Your Eyes

IMG_2525It’s easy to protect your eyes, and stylish, too! All About Eyes has a variety of sunglasses to choose from and they are all UV protected.

And it’s okay to go all “Hollywood” and wear your sunglasses on cloudy days, as the sun’s UV rays are present then, too.

Join the fun, share your #SunglassesSelfie on #NationalSunglassesDay and wear your sunnies!