comprehensive eye exam

Seeing Signs: Teen Driving

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Photo of a blurry stop sign.The beginning of the new school year for high schoolers often means the start of driver’s education courses and getting permits for most teenagers. While most kids focus on passing the written portion exam for their permit, there’s another, equally important exam to pass: the vision test. As part of the permitting process, eye exams are given at the state’s motor vehicle facility to ensure that peripheral (side) and distance vision are up to the task of driving.

It can also be a time when teens and their parents first learn about myopia, or “nearsightedness.”

As children grow into their teenage years, their eyes grow as well, and this can change the shape of the eye. This, according to the Mayo Clinic, causes light rays to bend (refract) incorrectly, focusing images in front of your retina instead of on your retina. Thus, making objects farther away, blurry. Objects like road signs and license plates in the car ahead.

Nearsightedness is a rapidly growing concern in the United States. From 1972 to 2004, myopia in people ages 12-54 increased from just 25 percent of the population to nearly 42 percent, according to the National Eye Institute. Why? Computers and hand-held devices are the culprits. The Nielsen Report, which monitors media usage, says that Americans are now spending upwards of 11 hours a day on their devices, up from 10 hours a day last year. All this time spent on computers and smartphones is causing problems for people in their distance vision.

Myopia, for some people, can be associated with other eye disorders like cataracts, glaucoma, and retinal detachment. Signs of the condition include squinting, eye strain, headaches, and feeling tired when driving. Nearsightedness can be corrected with prescription eyeglasses, contact lenses, and in some cases, refractive surgery.

Schedule a comprehensive eye exam today!


Eyelid Cancers – Shade Your Eyes in Summer!

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SunWith the summer months stretching out before us, there will be plenty of opportunities to be outside. And that means exposure to the sun will increase along with those opportunities. Most people think to apply suncream to protect their skin but they don’t always think about protecting their eyelids from the sun. The eyelid area, according to SkinCancer.org is where up to 10 percent of all skin cancers happen. Most of those, 90 percent, are basal cell carcinomas (benign), just over 5 percent are squamous cell carcinomas, and 1-2 percent are malignant melanomas.

Symptoms

Since most of the tumors grow undetected at first, there are several things to look for — and note that most eyelid cancers happen on the lower lid:

  • Change in appearance
  • Bleeding lump or bump
  • Swelling
  • Sudden loss of eyelashes
  • Chronic infection that doesn’t respond to treatment
  • Wound that won’t heal
  • Spreading, colored mass
  • Flat, irregularly shaped, pigmented lesions

 

Treatment

Once a biopsy has been performed (where they remove a portion of the affected area to test it) and cancer has been diagnosed, a team of doctors will help you. The team usually consists of an ophthalmologist, dermatologist, surgeon, radiation oncologist and/or a medical oncologist.

Surgery can remove the cancerous tissue. In some severe cases, the eye will need to be removed and a prosthetic added, and radiation/chemotherapy treatment may be necessary to prevent cancer from causing tissue damage or spreading to the nasal and orbital cavities behind the eyes.

Prevention

Sunglasses with UVA and UVB protection, along with a wide-brimmed hat will go a long way toward preventing eyelid cancers. There is also suncream available for the eyelid with an SPF15 that can help, too. As always, regular comprehensive eye exams with your eye-care professional can help to detect cancers early, leading to faster treatment.

Next month celebrates #NationalSunglassesDay and All About Eyes has a wide-array of sunglasses to choose from! Come see us to get a head-start on prevention!


Seeing Double, Double Vision

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double visionAs the name suggests, double vision, called diplopia, is when you see two images of a single object. Double vision can happen in one eye (monocular) or both (binocular). The treatment for diplopia will largely depend on the type you have, and the underlying cause.

Diagnosis

To detect if diplopia is in one eye or both, your eye-care professional will cover one eye at a time during their exam and may use prisms to see what the level of double vision is. Not surprisingly, it is easier to detect in adults, as they can describe what they’re seeing. With children who are unable to talk about their vision, parents may need to watch for various behaviors: squinting, covering one eye to look at things, head tilting, or looking at things sideways.

Monocular Diplopia

According to Harvard Health, the causes of double vision in one eye can be cataracts, astigmatism, keratoconus (where the cornea becomes cone-shaped), pterygium (a growth of tissue on the eyeball), dislocated lens, swelling or mass in the eyelid, or dry eyes (Sjogren’s disease, etc.).

Binocular Diplopia

The causes of double vision in both eyes can be strabismus (crossed eyes), nerve damage, diabetes, myasthenia gravis (neuromuscular/autoimmune illness), Grave’s disease (hyperthyroidism), multiple sclerosis, migraines, stroke, or trauma (black eye).

Treatment

As mentioned above, treatment of diplopia largely depends on what is causing it. If other diseases such as diabetes, Sjogren’s, Grave’s, etc., are at the root of the problem, those conditions will need to be treated independently, and then the double vision problem can be revisited with your eye-care professional. For other issues — such as trauma, cataracts, or astigmatism — surgery or lens correction may resolve the double vision.


General Info on Age-Related Macular Degeneration

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Image Credit: National Eye Institute

Image Credit: National Eye Institute

For 10 million Americans ages 50 and over, macular degeneration looms on the horizon of age-related concerns. Macular degeneration is an incurable vision disease that attacks the center part of the retina (at the back of the eye) where “millions of light-sensing cells that provide the sharp, central vision” reside (National Eye Institute). The macula records the images we see and relays them to the optic nerve, which then passes the information to the brain.

These cells are responsible for our ability to read, to recognize faces, for driving, and for doing any close-up, detail work such as needlepoint. If these cells become damaged, the central field of view can become blurry, distorted, or form dark splotches.

Detection of Macular Degeneration

Comprehensive eye exams are the first line of detection for macular degeneration. During the visual acuity and eye dilation portion of the exam, eye-care professionals are able to look for yellowish deposits called drusen and for any pigment changes in the retina. The size of the drusen deposits will determine how advanced the macular degeneration (if any) has become.

Stages of Macular Degeneration

There are three distinct stages of this disease:

  • Early:  In this stage, the drusen deposits are medium-sized. There typically is no change in vision for the patient.
  • Intermediate:  At this point, the drusen will be large, and there may also be changes in the retina’s pigment.
  • Late:  Drusen deposits will be large, pigment changes will be present, and there will be vision loss at this stage. According to the American Macular Degeneration Foundation, the degeneration will be classified as either atrophic (dry) or exudative (wet).
    • Atrophic cases tend to be age-related, and 85-90 percent of macular degeneration falls into this classification. There is no leakage of blood or serum into the eye. Vision may still be good but may be fluctuating. Patients may have limited reading ability in dim lighting (such as in restaurants at night).
    • Exudative cases make up the remaining 10-15 percent. Exudative – or wet – macular degeneration occurs when abnormal blood vessels grow under the retina and bleed or leak fluid. This distorts vision.
Prevention and Treatment 

While there is no cure for macular degeneration, there is strong evidence that leading a lifestyle that promotes wellness will go a long way toward staving off the advancement of the disease. Not smoking, exercising regularly, eating a healthy diet with plenty of green leafy vegetables, and maintaining normal blood pressure levels, will all go a long way toward overall good health as well as preserving vision.

For intermediate- and late-stage atrophic (dry) macular degeneration, studies have shown that high doses of vitamins C and E, along with zinc and copper, can reduce the disease by up to 25 percent. For the exudative (wet) cases, anti-VEGF treatment (periodic injections in the eye of Avastin or Eylea) allows patients to remain stable instead of getting progressively worse.

The National Eye Institute has more comprehensive information available on the studies.


An Overview: Comprehensive Eye Exams

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We have a lot of blog posts here at All About Eyes that mention and/or encourage our visitors to get a comprehensive eye exam. So we thought we take this opportunity to talk about what it is and why it’s important to not just your eye health, but your overall health as well.

The first phase of the comprehensive eye exam focuses on your vision and any issues you may have there. The second phase of the exam evaluates your eye health.

What is a Comprehensive Eye Exam?

At the start of the visit, a technician will have a medical history conversation with you and will perform a pre-test using an autorefraction machine that measures the eyes for the preliminary prescription and also does keratometry, an examination of the curvature of the eye itself. This is useful in determining astigmatism. Then they perform what’s called tonometry with the non-contact tonometer (no drops needed). A tonometer is used to apply a puff of air onto the eye to measure eye pressure and is used to determine if you have glaucoma.

If the results from that test are high, then the doctor will apply numbing drops in the eyes and a further check of the intraocular pressure with an applanation tonometer will happen. Applanation tonometry uses a small lens to rest on the tear film/cornea to check the pressure. This test is usually painless and quick.

The other tests offered during pretesting are the Optomap digital retinal imaging which gives a wider, more complete picture of the retina and can detect problems not seen with the other tests. All About Eyes also uses an ocular coherence tomographer (OCT) which is a non-invasive imaging machine used to check the layers of the retina. It is beneficial for early glaucoma detection and in diagnosing macular problems.

Classic Eye Chart: Comprehensive Eye Exam

A visual acuity test will be given, where you will be asked to read off rows of random letters that gradually decrease in size until you reach a point to where you can no longer read with certainty. Also in included in the visual acuity testing are checking your vision for color blindness (if any) and 3-D testing to check your depth perception.

In the visual mobility tests, your practitioner will use various instruments (lights, eye covers) to see how your eyes are working. They will watch for eye muscle movements, check your peripheral (side) vision, and for your pupils’ response to light. Phoropter: Comprehensive Eye Exam

A phoropter is a refractor machine that determines the lens power needed for glasses (nearsighted, farsighted, and/or astigmatism). The doctor will give you an option of which lens looks clearer (“one or two”) and this helps to set your prescription for glasses or contact lenses if needed.

Slit Lamp: Comprehensive Eye ExamTo look at the back of the eye, the doctor will use a small, high magnification lens in addition to a biomicroscope. The biomicroscope, also called a slit lamp, is used to shine a light onto the eye so that its structure can be examined up close. This binocular microscope looks at all the areas towards the front of the eyes: eyelids, cornea, conjunctiva, iris (colored area), and the lens itself. This test can detect many diseases including cataracts, macular degeneration, corneal ulcers, and diabetic retinopathy. Sometimes dilating drops are necessary during this exam if the patient has tiny pupils, is very light sensitive, or they have retinal problems.

Why are Comprehensive Eye Exams Important?

First and foremost, as the American Optometric Association says, annual comprehensive eye exams can help with early diagnosis of vision issues which can help to prevent vision loss. Quite simply, they help to save your sight.

But, as we talked about in our article, Eye Checkup = Health Checkup, a comprehensive eye exam can also go a long way toward early detection of other major health issues such as stroke, heart disease, and sexually transmitted diseases, to name a few.

So schedule an appointment with either Dr. Dave Roell or Dr. Cheryl Roell today!


Melanoma in Your Eyes

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Eye Graphic - Melanoma

Graphic courtesy of National Cancer Institute

When people generally think of melanoma, they usually think of skin cancer. And while it is rare, melanoma can develop in the eyes. It is called ocular melanoma and, according to the Ocular Melanoma Foundation, up to 2,500 Americans are diagnosed with this form of cancer each year.

“Melanomas are a type of cancer that develop in the cells that produce pigment. Pigment is the substance that gives your skin, hair and eyes color,” explains the American Academy of Ophalmology’s website. Melonaomas tend to develop in the uveal part of the eye, which is one of the three layers of the eye, the other two being the sclera (outer layer) and retina (innermost layer).

The problem with ocular melanoma is that it typically doesn’t have symptoms and is usually only detected during a routine, comprehensive eye dilation exam.

Who is at Risk?

Research suggests that there is a strong genetic component for people who develop eye cancer and that it tends to affect those with lighter skin tones who have blue or green eyes and of that group, it tends to affect people ages 50 and above. Another major factor, not surprisingly, is overexposure sunlight or ultraviolet light from tanning beds. The simple act of wearing sunglasses can go a long way toward reducing the risk of developing ocular melanoma.

How is it Detected?

As mentioned above, a routine eye exam where eyes are dilated is the best detection method, given that the cancer is relatively symptom-free. That said, if you notice dark spots on your iris (colored part of your eye), a change in the shape of your pupil, blurred vision, or a loss of vision, you should see your eye care professional. These issues can also be present for other eye problems, so further assessment will be needed.

If eye cancer is suspected during the routine eye exam, the next step may be to see a specialist for an ultrasound of the eye, a fluorescine angiography (where dye is injected into your body and a special camera takes pictures of the contrast image), or a biopsy (where eye tissue is removed and examined).

How is it Treated?

Depending on the severity of the ocular melanoma, radiation and/or surgery are the traditional treatments. In the last few years, medical oncologists at Memorial Sloan Kettering Cancer Center have been testing experimental drug therapies and are having promising results.


Eye Checkup = Health Checkup

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Your eyes are more than the windows to your soul – with a comprehensive eye checkup – they are a doorway to your overall health

eye dropReasons to visit your eye-care professional for a checkup usually center on getting corrective lenses for your eyes when you notice your vision has changed. But did you know that there are many general health benefits to having a regular checkup as well?

As we discussed in last month’s blog post, Your Eyes and Diabetes, getting an annual comprehensive eye exam performed will shed light not only on your vision issues, but overall health issues as well. In addition to detecting diseases like diabetes, your eye-care professional will be able to tell if you have hypertension, high cholesterol, thyroid issues, tumors, sexually transmitted diseases, autoimmune disorders, and even cancer.

According to the American Academy of Ophthalmology, “The eye is the only place in the body where a doctor can have an unobstructed view of our blood vessels, nerves, and connecting tissue — without any need for surgery. Because the eye has the same microscopic tissue as our other major organs, and is an important part of our larger nervous system, abnormalities spotted in the eye may signal the same changes in other parts of the body.”

So, it’s a good idea to have your eyes checked regularly, as a visit to your eye-care professional could literally save your life through early detection of some serious health issues! You can schedule an appointment by calling 609-653-9933 or using our online scheduler.

Don’t forget that now is a good time to use any remaining eye care benefits or flex spending before the end of the year!


Learn About Your Eyes and Diabetes

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November is National Diabetes Month

Did you know that this disease can be detected through a routine, comprehensive eye exam? The American Optometric Association says that diabetes is the leading cause of vision loss for Americans under the age of 74. If left untreated, it may lead to blindness, so it is important to keep diabetes under control through dietary choices, exercise, not smoking, and if needed, medicine.

DEDInfographic

What is diabetes?

The Diabetes Research Institute describes this condition as, “A group of diseases where there is too much sugar (glucose) in the blood. Sugar comes from the foods we eat, like bread, cereals, pasta, rice, fruit, starchy vegetables and dairy items. Sugar is used by the body for energy. Insulin is a hormone that is made in the pancreas and works like a key to a door – insulin opens the door of the cells of our body allowing the sugar to go from the bloodstream into the cells where it is then used for energy. If there is not enough insulin or if the insulin can’t open the door to the cell, the sugar levels rise in the blood and diabetes occurs.”

The most common type of the disease is type 2 diabetes (a chronic condition that affects the way the body processes glucose), type 1 diabetes (also a chronic condition where the pancreas produces little or no insulin), prediabetes (where blood sugar is high, but not high enough to trigger type 2 diabetes), and gestational diabetes (which affects pregnant women).

The primary effects of diabetes are high blood pressure, high cholesterol, and a lack of blood glucose control.

What are the symptoms of diabetes?

Typically, people with diabetes will feel thirsty, hungry, tired, have to urinate frequently, and have blurry vision.

How does diabetes affect the eyes?

Because diabetes increases blood sugars in blood vessels, causing them to swell and leak, it can affect the blood vessels in the eyes as well. This can lead to several eye conditions, most noticeably in the retina, the light-sensitive tissue at the back of the eye.

A major complication of the disease is diabetic retinopathy, which is a condition causing progressive damage to the tiny blood vessels in the retina.

According to the American Diabetes Association, having diabetes may increase your chances of having additional eye-related complications as well: a 60 percent increased risk for cataracts, a 40 percent increased risk for glaucoma.

How can comprehensive eye exams help?

During the comprehensive eye exam, eyes are dilated with eye drops, allowing a clear view of the blood vessels at the back of the eye. By having yearly exams, an eye-care professional can detect retinopathy, cataracts, and glaucoma early and start treatment programs.

 

 

 


Glaucoma: Closed-Angle – Part two

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closedangleglaudoma

Graphic: Glaucoma Research Foundation

This is part two of a two-part series on glaucoma that includes the main types of the disease, the symptoms and risk factors, and treatments available to combat the disease.

In last week’s post, the focus was on the most common form of glaucoma, open-angle, which affects about three million Americans and accounts for 90 percent of all glaucoma cases. The next most common type is called closed-angle glaucoma (also known as narrow-angle glaucoma and/or angle-closure glaucoma).

Closed-Angle Glaucoma

While the drainage canals are also blocked as with open-angle glaucoma and this causes eye pressure, in this form of the disease, the angles are narrow or closed, which can result in sudden, severe pain, requiring immediate medical attention.

Risk Factors

According to the American Academy of Ophthalmology, people with a family history of closed-angle glaucoma, those of Asian descent, and people with hyperopia (farsightedness) tend to be at risk of developing this type of glaucoma. As with glaucoma in general, age is also a factor. 

Symptoms and Treatment

Typically, closed-angle glaucoma is a medical emergency with an onset of severe eye pain, blurry vision, a headache, nausea, and seeing halos around lights. People at risk for developing this form of glaucoma often have no symptoms ahead of an acute attack. Once an acute attack happens, the patient will need to seek medical care straight away, otherwise, they risk permanent vision loss in that eye.

However, yearly eye exams can help in detecting this form of the disease, which can allow the patient the opportunity to have an iridectomy performed in a non-emergency situation. An iridectomy is a procedure whereby a laser beam is used to create a drainage hole in the iris, which provides relief of eye pressure. The procedure is done on an out-patient basis and has minimal recovery time.

Don’t let glaucoma steal your vision, contact All About Eyes and get your eyes examined today!


Glaucoma – A two-part series

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This will be a two-part series on glaucoma that will include the main types of the disease, the symptoms and risk factors, and treatments available to combat the disease.  

What is Glaucoma? 7544734516_bc4180a6f4_z

Glaucoma is a group of eye diseases which produces increased pressure within the eye, due to a fluid build-up. Over time, according to the Glaucoma Foundation, this pressure can cause damage to the optic nerve and cause vision loss. The optic nerve is part of the central nervous system and carries the visual information from the eye to the brain. Once pressure builds on this nerve, it can start to die, and may lead to blindness.

There are several types of glaucoma, but the two most common are open-angle and closed-angle, with open-angle being far more common of the two. In fact, it is estimated that at least 90 percent of all glaucoma cases are this type, affecting about three million Americans.

Open-Angle Glaucoma

Open-angle glaucoma tends to develop slowly over time and does not present with noticeable symptoms until well into the disease. The Glaucoma Research Foundation says, “Glaucoma is an eye disease that gradually steals vision.” By the time the patient is aware of vision loss, it is often too late to prevent it. Vision loss due to glaucoma is permanent. Open-angle glaucoma is caused by the slow clogging of drainage canals within the eye structure, which results in increased eye pressure. The aspect of “open angle” refers to the angle where the iris meets the cornea is as wide and open as it can be.

Risk Factors 

So the question begs, if you don’t know it’s happening, how can you prevent it or stop it? One way is to understand common risk factors. Knowing your family medical history is an excellent place to start since glaucoma tends to be hereditary. Those of African-American or Latino descent are also at risk. And those who are diabetic, obese, or have cardiovascular disease may also be at higher risk of developing glaucoma. Of course, age plays a factor as well.

Prevention

Knowing if you are at risk is just one part of the equation, however. The best line of defense is getting annual check-ups with your eye-care professional. They will perform a comprehensive dilated eye exam, which will help to diagnose early signs of glaucoma.

Treatment

If it is determined that you have open-angle glaucoma, medications are available to help reduce eye pressure, and several different types of surgery are available as well, including selective laser trabeculoplasty and argon laser trabeculoplasty.

Part two of this series will focus on closed-angle glaucoma and will be posted on Monday, October 10.