Friday, June 29, 2012

Family History and Glaucoma Screening

You've seen them at the mall or at a health fair, the Glaucoma screening booths. The dreaded "air puff" to check your eye pressure to see if you might have Glaucoma. There are actually lots of different ways to screen for Glaucoma risk, and this is a very active area of research for eye doctors. What's the best way to screen for Glaucoma?

First, a couple of thoughts on what a screening test should do and not do. When you have a disease that is sneaky, like Glaucoma, and it doesn't have any outward symptoms to let you know it is there, sometimes it makes sense to have some kind of test that will let you know that you DO either have the disease or at a high risk to get it. Glaucoma is like this; there are no symptoms in early Glaucoma, and by the time your vision is affected to a point where you know something is wrong it's too late.

A screening test should be easy to do. It should be relatively inexpensive. It shouldn't hurt! The test should be able to identify pretty much anyone who MIGHT have the disease, and it definitely shouldn't miss anyone who actually HAS the disease (a false negative result). In a perfect world the screening test would not falsely find that healthy people have a the test (a false positive result), but we usually accept less accuracy here because we don't want to miss anyone who is at risk.

So how about Glaucoma screening? Well, high pressure is a risk factor for Glaucoma, so identifying people with high pressure will get them referred to an eye doctor which is what we want. There is something called a "nerve fiber analyzer" which will also do the same thing but with a little higher accuracy. Both of these screenings suffer from the expense of the equipment and the need to have trained people doing the test.

It turns out that for Glaucoma there is a really effective screening test that identifies one of the top two risk factors for developing the disease and losing vision: ask someone if they have a family member who has or had Glaucoma! Research has shown that a family history of Glaucoma, especially vision loss from Glaucoma, is the most important risk factor, and that if you DO have a family history you should have a complete Glaucoma examination at the eye doctor's office. Like Skyvision in Cleveland!

Do you have Glaucoma? Tell all of your relatives to have a complete eye exam.

Wednesday, June 27, 2012

When Should My Child Have A First Eye Exam?

Everyone at Skyvision Centers gets asked this question, both in the office and outside in the regular world: when should my child have a first eye exam?   Lots of kids, maybe even most kids, get a screening exam as part of their school experience, but even with that, is there an age when a child should have a complete eye exam?

There are two very definite answers to that question. If you have a family history of Amblyopia (lazy eye) or Strabismus (an eye that turns), then children in your family should have a complete eye exam at age 3. This is especially important if a brother or sister is the one with the eye problem.
Even if your child has had an exam at age 3, the doctors at Skyvision Centers think that EVERY child should have a complete eye exam just before starting kidnergarten or 1st grade. This exam is much more extensive than any eye screening exam and will find even small problems that might need to be solved. In addition, a potential problem might be found that would make the doctor suggest an earlier follow-up exam.

Vision is important for everyone, but it is especially important for your children as they enter their school years. A complete eye exam is part of a healthy approach to life!

Monday, June 25, 2012

When Should I Use Teardrops?

There are many degrees of Dry Eye so there are many answers to this question! For some people it's perfectly OK to just use an artificial tear when there is a little bit of discomfort. Feel a little dry? A tiny bit of scratchiness? Go ahead and put a drop in. 

Other people have Dry Eye symptoms all the time. The doctors at Skyvision like to tell these folks that they should use their tears just like they were a prescription medicine. 2, 3, sometimes 4-6 times a day on a schedule is sometimes what it takes to be comfortable with your Dry Eye.

It turns out that it is usually easier to prevent the Dry Eye symptoms from starting than it is to stop them once they start! In other words, the time to take your eye drops is when you DON'T have any symptoms. If you wait until your eyes feel badly it's already too late. 

Think of an image of a well with a bucket that hangs down into the water. If the well slowly drains all day long pretty soon the rope won't be long enough to reach the water. In order for the bucket to get to the water you first have to FILL UP THE WELL! Same thing with dry eye; if you don't keep the well full all day you won't get the benefit of the tears until you fill the well (your eye) back up! 

Ask one of the SkyVision Centers docs (Dr. White, Dr. Schlegel, or Dr. Kaye) what kind of artificial tear is best for you, and how much to use them.  There are many types of over-the-counter eye drops available.  If you need something more than artificial tears, there are ways to determine what is the best solution and the SkyVision Docs will work with you until you are comforable once again.

Thursday, June 21, 2012

Choosing a Cataract Implant

You've just been told that you have a cataract and that changing your glasses will not make you see any better. The only way you can get better vision is by having cataract surgery. At this point there are two very important questions that you must answer. Number one: when do I wish to see better? As soon as the answer is NOW it's time schedule cataract surgery!

Now you have to answer question number two. Do I want to have to wear glasses? If I DO have to wear glasses after my cataract surgery, WHEN do I want to need to wear glasses? If you really think about it, this is actually pretty cool! You've probably worn glasses for something for many, many years. Either you need to wear glasses to read, or you need to wear glasses to see things far away, like for driving, or you need to wear glasses ALL THE TIME. Now you are about to have cataract surgery and guess what? You can choose NOT to have to wear glasses! How cool is that?!

At Skyvision Centers you have three general choices. A modern, High–Tech BASIC implant will give you fantastic vision, typically much better than you saw prior to your cataract surgery. With this Basic implant you'll need to wear glasses for most, if not all of your vision needs. Our Advanced Distance Vision LIFESTYLE lens implant typically gives you fantastic vision for faraway like driving or watching television. The Advanced Far–Away and Up–Close LIFESTYLE lens implant can make it possible for you to see EVERYTHING without wearing glasses!

So, having a cataract and needing cataract surgery can actually be something very exciting. Especially if you live in Cleveland and you are a Skyvision Centers Patient!

Wednesday, June 20, 2012

RevitalVision Re-Boot for Dr. White

He's back at it! Dr. White changed his RevitalVision program from the Sports Vision module to Low Myopia. His goal is to reduce the amount of time he is wearing the small distance prescription left over from his LASIK 13 years ago.

"Session 0 went just fine. This is the session where the program sets itself to me, where I am and what my vision is today. It's a little long--it took me about 34 minutes, but I scored a 94 so it looks like I'm off to a good start again. I'm sure the  8 or so sessions I did on the Sports Vision module helped."

The Science Behind Revitalvision

We'll keep you posted on Dr. White's progress. Everyone is very excited about this, especially Dr. White. He is even going to give an internet seminar on the subject for other eye doctors in August so he is VERY motivated to do well!

Monday, June 18, 2012

Over 40? Things to Remember for LASIK

LASIK is becoming more and more popular for people who are over the age of 40! There are some very important things to be thinking about before surgery, though. When a person starts to get into their 40's the near vision focusing begins to decline, a process called "Presbyopia". This can be a set-up for an unpleasant surprise after surgery if you don't think about it prior to your LASIK.

"Many people who are near-sighted don't realize how frequently they are removing their distance glasses to see things up close," said the SkyVision Centers surgeon Dr. Darrell White. "If they are around 45 or so we will sometimes put a contact lens on them and give them a chance to see what their reading vision will be like right after LASIK. This way there's no surprise when they can't read the newspaper the next day!"

Just like with contact lenses a patient can choose to do Mono-vision with LASIK. One eye is set for distance vision as usual, and one eye is slightly undercorrected leaving it near-sighted enough to be able to read. We will typically target a prescription that lets our patients read a menu and see their computer screens without wearing reading glasses.

It's almost never too late to think about LASIK! Even if you are over 40 it can still be a ton of fun to have great distance vision without wearing glasses or contact lenses. Dr. White always says the "LASIK is still one of the nicest things I've ever done for myself, even though I wear reading glasses a lot now." At SkyVision we will make sure you know what to expect after your LASIK!

Friday, June 15, 2012

100% Satisfied

How about that?! 100% of our new patients at SkyVision in the month of May were satisfied with their SkyVision experience. In fact, 99.5% were either very satisfied or EXTREMELY satisfied!

We survey all of our new patients every day to see how their SkyVision Centers experience went. It's very important to us that we not only provide the very best eye care possible, but we also want our patients to have a wonderful experience in the process. We ask each new patient if they would refer friends and family to see us for all of their eyecare needs. In May 90% of our new patients said that they would look for opprotunities to bring up their SkyVision experience so that they could send friends and family to see us!

From the very outset Dr. Darrell White, Dr. Scott Schlegel, and Dr. Gregory Kaye have been striving to create a real, true patient-centered experience. Most medical practices of all kinds are actually built around the needs of the doctors. At SkyVision Centers we think that might be backwards--everything should be centered on our patients. Each of us spends time every day monitoring your experience, from waiting time to inusurance processing, to making sure that you are getting exactly the right care for your particular needs.

So thank you for all of your kind words and your wonderful reviews. We DO want to hear from you directly, not only to tell us how nice your experience was, but definitely also when you think there might be something that we can do better! Here's hoping June is just as successful!

Wednesday, June 13, 2012

We are OK With Our Patients Talking Behind Our Backs!

We have been told growing up that it is not nice to talk behind someone's back.   Well, here at SkyVision,  it would not have grown so well if people had not done just that!

So, we are thankful that we have been able to give great eye care to individuals and families and that people are talking about it. 

A big thank you to those of you have done the talking!

Tuesday, June 12, 2012

Vitamins For Macular Degeneration: FAQ

Here are our answers to some of the Frequently Asked Questions about vitamins and Macular Degeneration (AMD):

1) Do I HAVE to take special vitamins?

Of course not! However, taking high doses of anti-oxidant vitamins per the AREDS1 and 2 studies is thus far the only known way to prevent progression and vision loss from AMD

2) If I don't take the vitamins will I go blind?

There is no way to know if any one individual person will lose vision from AMD. Everyone is different, and we can only tell you what the odds are from the research available.

3) If I take the vitamins am I guaranteed to not lose my vision?

Unfortunately the same answer applies here: we can only say that taking the antioxidant vitamins in the AREDS doses will reduce the number of people who lose vision, and the amount of vision lost, when we look at a large group of people.

4) Are there side effects from the vitamins?

Some people have some stomach issues from taking any vitamins, and AMD vitamins are no different. In addition, the pills are rather big, and if you have trouble swallowing pills you may have trouble taking the AMD vitamins.

5) Who SHOULDN'T take AMD vitamins?

Smokers should not take high dosed of beta-carotene, the vitamin A form used in the AREDS vitamins.

6) Any other risks from taking these vitamins?

There are conflicting studies with results that don't agree about the risk of reduced bone density from taking high doses of beta-carotene. You should check with your family doctor if this is a concern.

7) What brand names should I look for?

This is one of the hard questions to answer because there are quite a few name brands, and within those brands there are some confusing choices. In general, if you plan to buy your vitamins at a store, "Preservision", "ICaps", and IVites" are good choices. SkyVision docs have chosen to provide Doctor's Advantage vitamins here in the office.  Look for info regarding these vitamins in upcoming blogs. 
8) What if I am taking a multivitamin? Should/can I keep taking it?

Another very hard question to answer because we are fans of multivitamins for people of all ages. You need to be careful not to over-do the anti-oxidants with AREDS vitamins + multivitamins. The math (adding up the doses and dividing between vitamins) can be complex, too complex for any doctor's office to do for you with store-bought vitamins. (Again, look for the upcoming post about vitamins from Skyvision). Aim for a total of the AREDS doses of Vitamin C, E, beta-carotene, Zinc and Copper between all your vitamins.

We hope that's helpful!

Wednesday, June 6, 2012

New Dyslexia Findings

Many children are referred to SkyVision Centers with a diagnosis of dyslexia. Both parents and physicians wonder if the dyslexia is either caused by a vision problem, or if spectacles might be able to help the dyslexic child read better. On occasion we will see a child who does have a need for reading glasses, and like all children with this need wearing a pair of glasses will help. However, the need to wear reading glasses is not the cause of the dyslexia, nor will the glasses cure the problem.

Our eyes "collect" images and then send them to the back of the brain where we actually "see". Most of what happens in the eye doctors office is trying to make the images that are collected as clear as possible. Glasses, contact lenses, LASIK and cataract surgery are all part of this effort. Healthy eyes will send a clear image to the vision center in our brain. It's very rare for children to not have a healthy vision center, and even a child with dyslexia will "see" an image correctly.

The problem in dyslexia occurs then the image is "processed", when what is seen must be interpreted. For example the figures in "CAT" must be interpreted as a C, an A, and a T, and they must then be put together and interpreted as "cat". In the simplest of terms this is where things go off the rail when a child with dyslexia is reading.

New research findings both confirm this understanding of dyslexia and provide a strategy to help a dyslexic child read better and faster. It turns out that children with dyslexia can read faster and with greater accuracy if the letters in text are more widely spaced. The improvement is immediate and is equal to what you would see from a full year of school.

Standard spacing that works for accomplished readers may seem crowded to the dyslexic reader. This will in turn cause them to take longer to translate or interpret the letters, and make more mistakes because the characters blend together. When you increase the spacing the reading speed increases "on the fly" according to the researchers. These findings could have immediate practical implications since it is so easy to alter the font size, type size, and spacing in any electronic media. You can search for a free app on Apple products called "DYS".

Tuesday, June 5, 2012

Ophthalmic Migraines

"I see these wavy lines in front of my vision; kinda like heat waves. Sometimes they're like jagged lightening bolts off to the side. It lasts about 10 minutes and then I feel like I just ran a mile. What the heck is going on?"

We hear something like this almost every day at Skyvision Centers. This is called an "Ophthalmic or Ocular Migraine", or a migraine without the headache. A "Classic Migraine" (that's what it's really called!) is a terrible headache that has some sort of warning symptoms or aura that come first. In an eye center these warning symptoms always involve vision, of course, but they can be things like an unusual smell, deja vu, or a sense that something bad is about to happen. But in an Ophthalmic or Ocular Migraine once the vision symptoms go away the episode is over.

Why and how does this happen? Migraines are felt to have some sort of vascular or blood vessel part in their cause. The vision symptoms are caused when the blood vessels constrict or close down. The blood vessels  then dilate or open up wide, and if they just go back to their normal opening the whole thing is done. Something about over-dilating is felt to trigger the headache part (the lining of blood vessels has pain fibers but the brain does not).

Ophthalmic or Ocular migraines, like classic migraines, can be triggered by things such as foods (aged cheese, chocolate, caffeine), too little sleep, and extra stress on top of our normal every day stress. If you get one you should just stop what you are doing, sit down, and wait for it to pass. Ophthalmic or Ocular migraines (and regular migraines for that matter) are only signs of more serious problems in the very rarest of cases.

If you get something like this feel free to call us for an appointment at any time. You don't need to be seen WHILE you are having your symptoms.

Friday, June 1, 2012

Cataract Surgery - We Love To Hear From Our Patients!

"Dear Dr. White,

Am I Happy with my new Crystalens? They’ve changed my life. I feel like I have new eyes. I didn’t think that was possible.

My Mother lost vision in one eye due to glaucoma along with a cataract. I was hesitant to have ANY eye surgery done. My cataracts were beginning to obstruct my nighttime driving so I knew that it was time for some type of eye correction.

Never did I realize that I would get my vision back. Every morning I get out of bed with good vision. No fumbling for glasses. No daily routine of inserting one contact lens for near vision and one for far vision.

I can drive at night, see movies in the theater, read a newspaper, read books, and work on my computer, all without difficulty. It’s like a miracle happened or else new eyes transplanted.

Thank you to the research department that developed the Crystalens.


Kathy Gregory R.N.,R.D.H., B.S.,M.S.&E.D.
Registered Nurse, Registered Dental Hygienist, Bachelor of Science, Master of Science and Education"
Thank you Kathy for sharing your experience with us!
The doctors and staff from Skyvision