Monday, April 30, 2012

Skyvision honored as an Accredited Dry Eye Center!

Skyvision is one of just a few eye practices in the U. S. who have
earned this honor!  

The TearLab corporation has awarded this honor to Skyvision as a premier
eye center focused on the treatment of Dry Eye Syndrome, a common
and often uncomfortable eye condition.

For more on Dry Eye and how it is diagnosed and treated by our very
skilled Skyvision Docs, watch for some more blogs in the near future!
Or visit the Skyvision YouTube channel SkyvisionCenters105 for the Dr. Whiteboard
video series by Dr. Darrell White on Dry Eye.

Monday, April 23, 2012

RevitalVision: How Does It Work?

So how exactly does RevitalVision work? How do we train our brain to see better? It turns out the RevitalVision takes advantage of something called "neural plasticity", and the concept of neural plasticity was actually proven in the science of vision. We once thought that our brains were "hardwired" sometime around the age of 20 or 25. It turns out that we can actually open or create new pathways in our brains once we figure out the best way to stimulate those pathways.

Think of every activity that you do as being controlled by a "highway" of nerve cells in your brain. Each pathway is almost like a 6 Lane Hwy. with only one lane open. RevitalVision, actually any kind of training that opens up new pathways, does one of either two things: either we open up to more lanes on the highway right next to our original lane, or we increase the speed limit on our 1st Lane. from, say, 55 to 110!

Maybe even both! Improvement that we have seen with RevitalVision on the eye chart and contrast sensitivity, how sharp images appear to us, suggests that we may actually not only open up new neural pathways, but we may also make our original pathway faster!

So in a sense RevitalVision is ramping up the highway to vision.

Dr. White will be testing out his "highway" of nerve cells over the next few months, so stay tuned for his feedback on this.

Friday, April 20, 2012

No Longer Struggling to See! A Satisfied Cataract Patient's story . . . .

Thank you for your kind words Dr. Palma!

I went to Skyvision this past fall for what I believed to be a routine eye exam to update my prescription for glasses and contact lenses. I definitely couldn't see as well as I used to. The staff was professional and friendly as always (my kids go there too).

Initially I saw Dr. Kaye who was concerned about my vision and ordered further tests. After lengthy testing, Dr. White made the comment that I was really "struggling to see". It turned out I had a cataract.... not something I wanted to hear being less than 50 yrs old. During my evaluation for cataract surgery I met with Dr. Schlegel who explained every aspect of surgery. He answered all of my questions, reassured me everything would be ok, and that they had done the intraocular lens implant surgery frequently.

I chose the multifocal intraocular lens so I would not need glasses to see up close. The day of the surgery I went to the outpatient surgery center. The staff there was just as professional and friendly as at Skyvision. The surgery took just a few minutes and I left 1/2 hr after surgery. Two weeks later, the other eye was done.

Today I am NOT "struggling to see". Dr. White gave me the incredible gift of sight! I cannot thank the doctors and staff at Skyvision enough for my special care. Recently my husband told me that he was so impressed with the care I received that he was going to switch to Skyvision!

Gabriella Palma, M.D.

Wednesday, April 18, 2012

RevitalVision and Dr. White

Our own Dr. Darrell White is about to embark on his own RevitalVision training! "I've been having just a little bit of blurriness when driving, especially at night," said Dr. White. "After my LASIK in 1999 I've really only had to wear reading glasses after turning 45 or so (Dr. White is now 52). My corneas were so thin that I was only going to be able to have LASIK done once so the little distance prescription I now have needs to be taken care of some other way."

Enter RevitalVision! Most of what Dr. White has in the way of a distance vision problem is due to a little bit of astigmatism. The perfect solution for him is the RevitalVision Sportsvision program. We are awaiting delivery of the module right now.

Dr. White: "I"ll report on my progress and the experience right here! I can't wait to get this permanent improvement and stop wearing my driving glasses again."

Tuesday, April 17, 2012

RevitalVision and the Hubble Space Telescope

Train your brain to see better! How does this work actually? Well, we think a very good example that helps to explain how RevitalVision works is the Hubble space telescope. Remember when the telescope was initially launched and it was a big problem with focusing the telescope? It turns out that the mirror, the focusing element in most big telescopes, was very poorly focused. The mirror not only had some astigmatism but also had something called "higher order aberrations". It took five visits to the Hubble from the Space Shuttle to finally get the optics of the mirror right.

1990 Hubble image.

The last Space Shuttle mission was in 1999 so the last time the mirror was "focused" was 11 years ago. But every year since we've been getting better and better images from the Hubble space telescope. Absolutely brilliant views of distant solar systems and galaxies, each year bringing a clearer view of the rest of our universe. How can this be if we are using 1999 vintage optics?

2009 Hubble image.

Once the optics were optimized on the Hubble space telescope images that were captured were sent back to Earth in exactly the same way. However, here on earth, we have been using better, faster, and stronger computers to evaluate those images. In other words, we have been bringing better processing to bare upon those images. Hence, better views!

In a nutshell that's how RevitalVision works. Once we've done everything that we possibly can do to get a better image from our eyes, we can now use RevitalVision to make our brain process that image better! We can train our brain to see better!

How cool is that?!

Friday, April 13, 2012

All Laser LASIK

We've been examining our results and outcomes since we made the switch to All Laser LASIK and we have just one thing to say:


Laser Vision Correction has undergone many changes since Dr. Darrell White did the first VISX laser procedure in Cleveland in the early 1990's. The excimer lasers themselves, the lasers that actually put the prescription on your eye, are now able to correct very complex prescriptions, and they track your eyes during the procedure in every conceivable direction! The accuracy of the treatment is nothing short of amazing.

In the last several years a move has been underway to increast the amount of the procedure that can be performed using lasers, including the creation of the LASIK flap in your cornea (the "window" to the eye). Modern mechanical keratomes are excellent, and we should note that Dr. White's own LASIK was done using a mechanical keratome. We have made the move to using a Femptosecond laser, specifically the IntraLase, to make our flaps after Dr. White conferred with trusted colleagues like Dr. Stephan Coleman in New Mexico, one of the true LASIK pioneers.

And now? WOW!

Are you interested in great vision without glasses or contact lenses? Come visit us here in Cleveland at Skyvision Centers. See What's Next (R) with Dr. White!

Thursday, April 12, 2012


Written By:  Healthy Aging Admin  10-4-2008
Categorized in: Health News

It's your birthday soon and in many states that means your driver's license might be up for renewal.

When was the last time you had an eye exam? Don't be vain or shy. Not knowing if you will pass or not is stressful. Go into your next exam armed with the knowlege that your eye sight is good or that you have taken the corrective measures to make your sight "driving safe".

During driving, the eyes are constantly on the move -- looking at vehicles ahead and to the side;
reading road traffic signs; checking the rear and side view mirrors, and shifting their gaze between external and internal environments in order to check the speedometer, read a map on a global navigation system, change a radio station, or search for a dropped item in the car.

During darkness, these tasks can become more difficult for some drivers. A driver with 20/20 vision during the day can experience a reduction of visual acuity to 20/40 at night.

Research findings from the Pennsylvania Department of Motor Vehicles indicate that over half of those who fail a DMV vision exam are unaware that they have a vision problem. One in four (25 percent) Americans said it has been more than two years since their last eye exam, according to Americans’ Attitudes & Perceptions About Vision Care survey, conducted by Harris Interactive® on behalf of The Vision Care InstituteTM, LLC, a Johnson & Johnson Company.

“Getting behind the wheel of a car with an uncorrected or improperly corrected vision problem can have tragic consequences,” says California-based optometrist Dr. Elise Brisco. “A comprehensive eye exam will include testing to diagnose potential problems and determine the correct form of treatment.”

In the Harris survey, 80 percent of respondents said they believe that correcting vision problems can improve their driving a great deal.

Having a regular eye exam is all part of the Healthy Aging® prevention checklist.

Below are some common vision problems and how they can impact driving.

Distance vision

Poor distance vision and excessive speed can have disastrous results. If your distance vision is poor, you may not see hazards until it's too late to react safely. The faster you travel, the less time you have to see things and react to them.

Depth Perception

You need to be able to judge distances well to pass other vehicles and change lanes, especially in busy traffic. The inability to judge distance can result in the driver stopping too short of the limit line or inside the intersection, turning too wide or too short, and/or failing to maintain speed and/or following distance appropriate for prevailing driving conditions. Poor depth perception also can result in “fender benders” and make parking more difficult.

Accommodation (near vision focusing)

When you're driving, you need to look from the road to the dashboard and back again quite often. This ability to change focus from far to near is called accommodation or near vision focusing. Over the age of 45, most people have increasing difficulty with near vision, and may need bifocal or progressive lenses or contact lenses to help see at all distances from far to near.

Field of vision (peripheral)

In driving, peripheral or side vision is used in part to detect information that may be important for safe driving, such as road signs, appearances of hazards, and changes in the flow of traffic. The ability to see to both sides is important. You need to be able to see cross traffic, pedestrians, and animals at the roadside, without having to look away from the road ahead.

Peripheral vision is also used in controlling the vehicle. When the driver looks in the rear view mirror, peripheral vision is used to monitor traffic in front of the vehicle. In keeping the vehicle centered in the lane, peripheral vision is used to monitor the lane boundaries. Peripheral vision impaired by one or more vision conditions can result in the driver failing to react to a hazard coming from the driver's far left or far right, failing to heed a stop light suspended over an intersection, weaving while negotiating a curve, and/or driving too close to parked cars. Additionally, due to the frame, some eyeglasses also can block peripheral vision so that when looking sideways, upwards or downwards, the wearer is looking outside the perimeter of the lens.


Astigmatism is a vision condition that occurs when surfaces of the eye, such as the cornea, have an oval shape -- like an egg. This shape prevents light from focusing properly on the back of the eye, the retina. People with uncorrected astigmatism will usually have blurred vision, and in some cases may also experience headaches, eyestrain, or fatigue.

Night vision

The visual ability of two drivers may be about the same during the daylight hours and be markedly different during night or other low-light situations. For example, twilight is one of the most difficult times to drive, because eyes are constantly changing to adapt to the growing darkness.

Drivers need to be able to see in low and variable light conditions, and recover quickly from the glare of oncoming headlights. Glare recovery is best in drivers under the age of 30, and night vision can deteriorate after the age of 40.

Driving safely at night requires seeing well not only under low illumination, it also requires one to see low contrast objects. Someone wearing dark clothes and crossing the street in front of the driver is much harder to detect at night than during the day because there is much less contrast at night between darkly clothed pedestrians and a dark background.

Night vision impaired by one or more vision conditions can result in a driver at night failing to react to hazards located directly in front of the vehicle, tailgating, and/or failing to steer when necessary because the driver is unable to see low contrast features of the roadway such as its edges and irregularities in the road surface.

Color vision

Color plays an important part in road safety. Drivers must instantly recognize traffic lights, indicator signs, hazard warning lights and stoplights, and people with color vision defects may react slower to them.


Wednesday, April 11, 2012

Women, Vitamin D, and Macular Degeneration

This article appeared in the online edition of the LA Times. It quotes a study from the April issue of the Archives of Ophthalmology.

"Getting enough vitamin D may help prevent women from losing their vision in old age. That's the quick and easy conclusion from a new study, just perhaps not one that will require you to change your diet.

In a study of 1,313 women ages 50 to 79, researchers from the University of Buffalo in New York found that women with adequate levels of vitamin D were at 48% decreased odds for developing age-related macular degeneration (AMD) compared with women with insufficient levels of the vitamin. The work was published in the April Archives of Ophthalmology.

The team writes in its abstract:

“… Among women younger than 75 years, intake of vitamin D from foods and supplements was related to decreased odds of early AMD in multivariate models.”

Seems straightforward: Women under 75 who get enough vitamin D have a reduced risk of going blind, which other studies have suggested.

But hold on. The individual risk of developing AMD is relatively low if you're young. Only about 2 out of 100 middle-aged adults will develop the blindness. But that risk increases to nearly 30 in 100 for those over age 75. So in a study of women 50 to 79, most of whom are getting reasonable amounts of vitamin D, the big risk factor is age, not diet.

Other factors are related to AMD as well, such as race (whites are more likely than African Americans to lose vision through AMD) and family history, which the study didn't control for. Still, there's no predicting precisely who will develop the disease — as with most diseases.

Besides, people get vitamin D through vitamin supplements, eating foods such as fish and fortified milk and orange juice or by spending time in the sun. In fact, most people are getting an adequate supply of the vitamin, a survey last month found.

Reality check: Vitamin D is of course good for us, and there are plenty of good reasons to make sure you're getting enough. You don't need to obsess about this one study."

At Skyvision we think it's important to eat a healthy diet. We are impressed with the number of studies that have come out recently that show the benefit of increasing your vitamin D intake. Despite the disclaimers in the LA Times article we think you should consider Vitamin D supplements if your family doctor approves.

Monday, April 9, 2012

Monday Morning Comics

Samuel is lying on his deathbed, his extended family gathered around him. He's lived a good and long life, and in general he is satisfied and comfortable. But still, something is wrong...

"What is it, Samuel?" the family asks. "You are restless. Do you need something? Is there something we can do?"

After some prompting Samuel admits that he does, indeed, want something. "Bring me my optometrist, Dr. Walter."

Now, Walter has cared for Samuel and his eyes for 40 years, and he is terribly flattered to be called to his sickbed. "What can I do for you, Samuel my friend?"

"Walter, after all of these years, there's something that I must know, something that only you can tell me."

"Anything Samuel. Ask me anything."

Walter, so that I may die in peace, tell me...finally...what is the answer. Which one IS better, number one, or number two?"

Wednesday, April 4, 2012

Astigmatism 101

What is Astigmatism? It's a funny word, isn't it? Lots of people think the word is "stigmatism" and that you have "a stigmatism". That of course means that you could have one or more "stigmatisms", but that's not really how it works!

Astigmatism is an optical term that relates to how an optical system focuses, or doesn't focus, light. In our situation the optical system is the eye! There are three different parts of the eye that make up the focusing elements of our vision system: the TEAR FILM that sits on the very surface of the eye (that's why Dry Eye causes vision problems!), the CORNEA or window to the eye, and the LENS that sits in back of the pupil. Astigmatism is present when the combination of these pieces parts creates two or more focused images from a beam of light.

Most of the time astigmatism is caused by the shape of the CORNEA. In a normal eye, one without astigmatism, the cornea is like the front of a sphere; it's round like a basketball or a soccer ball. A cornea that has astigmatism is longer in one direction than the other. It's STEEPER in one direction and FLATTER in the other. In other words the astigmatic cornea is shaped like a football instead of a basketball.

Whether you are nearsighted or farsighted, if you have astigmatism you will have at least two images focused in the eye. There are lots of ways to correct this, and we'll talk about all of them as time goes on. Be sure to check here, and watch for the videos on the Dr. Whiteboard over on Youtube for more info on ASTIGMATISM.

Tuesday, April 3, 2012

Vision Insurance News

More on Vision Insurance

Why Are Visually Impaired Americans Not Getting Eye Care?

Mainly It's Cost, Lack of Insurance and No Perception of Need

May 2011 — If you were visually impaired or had an age-related eye disease, would you get regular eye care? Many Americans aged 40 and over with these problems don't, says the government's Centers for Disease Control and Prevention (CDC).

Eye care cost or lack of health insurance (39.8 percent) and perception of no need or not having thought of it (34.6 percent) were the most common reasons cited when people were asked why they hadn't visited an eye care provider in the last year. And while 21.1 percent chose the "other" response, more specific reasons were "do not have/know an eye doctor," "too far, no transportation" and "could not get appointments."

Men were more likely than women to report no need for eye care (41.7 percent vs. 28.7 percent). Also, those 65 or older reported this more than those aged 40-64 (43.8 percent vs. 32.9 percent). "A possible reason for this is that older adults might regard impairment as a normal part of aging," wrote the study authors.

The authors also noted that a previous study had shown that primary-care providers were not adequately highlighting the need for eye care to their patients.

Regarding cost and lack of insurance, only 21.6 percent of Massachusetts respondents aged 40-64 chose that reason for not getting eye exams. But in Tennessee it was 60.4 percent. For those 65 and older, in Massachusetts it was 8.9 percent, but in West Virginia it was 48.0 percent. As the study authors noted, Massachusetts is the state with the smallest percentage of residents with no health insurance.

The CDC's analysis used data from Behavioral Risk Factor Surveillance System surveys, a series of annual, state-based phone surveys, conducted from 2006 to 2009. Data from 21 states were used in the analysis, with a sample of 11,503 adults aged 40 or over with self-reported moderate to severe visual impairment who had not visited an eye care provider in the previous year.  The definition of "visual impairment" was difficulty in recognizing a friend across the street and in reading various types of printed material.

The study report appeared on May 20 in the CDC's Morbidity and Mortality Weekly Report.