Friday, July 27, 2012

Diabetes Control and Eye Exams

The occurrence of Diabetes is rapidly increasing in the United States. It has been estimated that there will be more than 30 Million diabetics in the U.S. by 2030, and there are presently 23 Million. In addition, another 57 million people are considered to have prediabetes, meaning that their blood sugar is not normal but not quite abnormal enough to make a diagnosis. Diabetes has many complications associated with it like increased heart disease, stroke risk, and a loss of sensation in your limbs causing difficulty walking. Here at Skyvision, of course, we are engaged every day in the fight against blindness caused by Diabetes.

Diabetes remains a major cause of blindness in all age groups. Diabetic retinopathy consists of abnormal blood vessels which occur where they do not belong. In time these blood vessels can leak causing swelling. The also break and bleed, sometimes filling the eye up with blood. The bleeding often causes a kind of scarring which can lead to a retinal detachment. The most effective treatment is to PREVENT DIABETIC RETINOPATHY from ever happening. Once it occurs, the treatment of all types of diabetic retinopathy is much more successful if it starts early.

Do you have diabetes? If so, what can you do to prevent yourself from going blind? There are two well-studied things you should do. First, and this is really easy, make sure you have an eye exam every year. This exam should include eyedrops that dilate your pupil. Your eye doctor should then explain any findings, and a letter should be sent to your diabetes doctor.

The other thing you can do is keep your diabetes under control! The measurements that are the most important are your morning fasting sugar level, and your Hemoglobin A1c (HbA1c). The safest levels according to the most recent research are a fasting sugar of 100 or below, and an HbA1c or 6.0 or lower. Your risk of diabetic retinopathy goes up by a factor of 2.5--it more than doubles--if your fasting sugars are over 108. The same holds true for your HbA1c: your risk more than doubles with a value of 6.5 rather than 6.0.

Do you have diabetes? Get an annual eye exam. Know your morning fasting sugar levels. Ask your doctor what your Hemoglobin A1c is. You CAN prevent diabetic retinopathy!

Tuesday, July 24, 2012

No Left Turns! An great article/story by Michael Gartner, Pulitzer Prize Winner

This is a wonderful piece by Michael Gartner, editor of newspapers large and small and president of NBC News. In 1997, he won the Pulitzer Prize for editorial writing. It is well worth reading, and a few good chuckles are guaranteed. Here goes...

My father never drove a car. Well, that's not quite right. I should say I never saw him drive a car.

He quit driving in 1927, when he was 25 years old, and the last car he drove was a 1926 Whippet.

"In those days," he told me when he was in his 90s, "to drive a car you had to do things with your hands, and do things with your feet, and look every which way, and I decided you could walk through life and enjoy it or drive through life and miss it."

At which point my mother, a sometimes salty Irishwoman, chimed in:

"Oh, bull shit!" she said. "He hit a horse.."

"Well," my father said, "there was that, too."

So my brother and I grew up in a household without a car. The neighbors all had cars -- the Kollingses next door had a green 1941 Dodge, the VanLaninghams across the street a gray 1936 Plymouth, the Hopsons two doors down a black 1941 Ford -- but we had none.

My father, a newspaperman in Des Moines, would take the streetcar to work and, often as not, walk the 3 miles home. If he took the streetcar home, my mother and brother and I would walk the three blocks to the streetcar stop, meet him and walk home together.

My brother, David, was born in 1935, and I was born in 1938, and sometimes, at dinner, we'd ask how come all the neighbors had cars but we had none. "No one in the family drives," my mother would explain, and that was that.

But, sometimes, my father would say, "But as soon as one of you boys turns 16, we'll get one." It was as if he wasn't sure which one of us would turn 16 first.

But, sure enough , my brother turned 16 before I did, so in 1951 my parents bought a used 1950 Chevrolet from a friend who ran the parts department at a Chevy dealership downtown.

It was a four-door, white model, stick shift, fender skirts, loaded with everything, and, since my parents didn't drive, it more or less became my brother's car.

Having a car but not being able to drive didn't bother my father, but it didn't make sense to my mother.

So in 1952, when she was 43 years old, she asked a friend to teach her to drive. She learned in a nearby cemetery, the place where I learned to drive the following year and where, a generation later, I took my two sons to practice driving.. The cemetery probably was my father's idea. "Who can your mother hurt in the cemetery?" I remember him saying more than once.

For the next 45 years or so, until she was 90, my mother was the driver in the family. Neither she nor my father had any sense of direction, but he loaded up on maps -- though they seldom left the city limits -- and appointed himself navigator. It seemed to work.

Still, they both continued to walk a lot. My mother was a devout Catholic, and my father an equally devout agnostic, an arrangement that didn't seem to bother either of them through their 75 years of marriage.

(Yes, 75 years, and they were deeply in love the entire time.)

After he retired (at 70), my father almost always accompanied my mother whenever she drove anywhere, even if he had no reason to go along. If she were going to the beauty parlor, he'd sit in the car and read, or go take a stroll or, if it was summer, have her keep the engine running so he could listen to the Cubs game on the radio. In the evening, then, when I'd stop by, he'd explain: "The Cubs lost again. The millionaire on second base made a bad throw to the millionaire on first base, so the multimillionaire on third base scored."

If she were going to the grocery store, he would go along to carry the bags out -- and to make sure she loaded up on ice cream. As I said, he was always the navigator, and once, when he was 95 and she was 88 and still driving, he said to me, "Do you want to know the secret of a long life?"

"I guess so," I said, knowing it probably would be something bizarre.

"No left turns," he said.

"What?" I asked

"No left turns," he repeated. "Several years ago, your mother and I read an article that said most accidents that old people are in happen when they turn left in front of oncoming traffic..

As you get older, your eyesight worsens, and you can lose your depth perception, it said. So your mother and I decided never again to make a left turn."

"What?" I said again.

"No left turns," he said. "Think about it.. Three rights are the same as a left, and that's a lot safer. So we always make three rights."

"You're kidding!" I said, and I turned to my mother for support.

"No," she said, "your father is right. We make three rights. It works."
But then she added: "Except when your father loses count."

I was driving at the time, and I almost drove off the road as I started laughing.

"Loses count?" I asked.

"Yes," my father admitted, "that sometimes happens. But it's not a problem. You just make seven rights, and you're okay again."

I couldn't resist. "Do you ever go for 11?" I asked.

"No," he said " If we miss it at seven, we just come home and call it a bad day. Besides, nothing in life is so important it can't be put off another day or another week."

My mother was never in an accident, but one evening she handed me her car keys and said she had decided to quit driving. That was in 1999, when she was 90.

She lived four more years, until 2003.. My father died the next year, at 102.

Thursday, July 19, 2012

5 Reasons Never to Leave Home Without Your Sunglasses

This is an article found in the recent Oprah magazine.   Enjoy . . . .

By Emma Haak.

Looking cool is just one of many excellent reasons to wear sunglasses.

You slather on SPF 50 to shield your skin from the sun. But what about your naked eyes? In a 2012 survey, less than half of 10,000 Americans polled recognized the health benefits of sunglasses, and 27 percent of respondents reported never wearing them. Yet this simple and stylish accessory* can protect your eyes from a host of conditions caused by ultraviolet rays:

1. Skin Cancer

Up to 10 percent of all skin cancers are found on the eyelid.

2. Cataracts

The World Health Organization reports that, worldwide, approximately 900,000 people are blind because of cataracts—cloudiness in the lens of the eye—triggered by UV exposure.

3. Macular Degeneration

Over time UV light may play a role in damaging the macula lutea (an area of the eye with millions of light-sensing cells, which allow us to see fine details clearly), potentially leading to blurriness and vision loss.

4. Pterygium

This abnormal growth of tissue—also called surfer's eye—may progress slowly from either corner across the white part of the eye, possibly leading to inflammation or disturbance of vision.

5. Photokeratitis

Essentially a sunburn of the eye, it's temporary (healing within 48 hours) but can be painful, causing blurred vision, light sensitivity, and the sensation of having sand in your eye.

*Just not the $5 pair for sale on the corner. Those can do you more harm than good. Our pupils dilate behind dark lenses, meaning cheap shades will actually let more damaging rays into your eyes than if you weren't wearing any sunglasses at all. Shop for a pair that's designed to block 99 to 100 percent of UVA and UVB light.

Read more:

What are polarized sunglasses?

What exactly is polarization? Are all sunglasses polarized? Should they be?

Let's talk a little bit about what polarization is first. When light comes out of a single source, or point source, the light rays come out in an infinite number of directions. Kind of like the light coming from a star or street light. Polarized light is light that is traveling in only one direction or plane.

There are lots of times when polarized light is created naturally. Think of sunlight bouncing off of a snow-covered field or the surface of a pond. There are also lots of times when reflected light is NOT polarized, like the reflection off the chrome bumper of that car that was in front of you this morning on the highway! We can use polarized lenses in our sunglasses to choose exactly which type of light we see.

We can minimize glare while driving by wearing polarized sunglasses. Most reflected light is parallel to the ground; polarized sunglasses will block out these rays, allowing vertical rays to come through the lenses. The same thing is true on the water. When you are boating or fishing you can reduce glare by wearing polarized sunglasses.

Not all sunglasses are polarized. In fact, there times when you DON'T want to have your sunglasses polarized. On the golf course polarization will make everything seem flat. Imagine how hard it would be to putt if you couldn't see the break on the greens!

Come visit us at the sky vision sensors optical to see our polarized sunglasses from Oakley, Nike, Kaenon, and Maui Jim!

Wednesday, July 18, 2012

Sunglasses For Overcast Or Flat Light

Every daytime lighting condition can provide an opprotunity to enhance your vision by choosing the right kind of sunglasses. Overcast days, whether it's bright or dim, still require UV protection, especially if you are enjoying an outdoor activity like running, biking, skiing, or water sports. Since the amount of light is decreased when it is overcast or cloudy be sure to have a pair of sunglasses that allow a bit more light to come through. The Visible Light Transmission (VLT) should be anywhere from 25 to 50% under these conditions.

The classic sunglass lens color for these conditions is in the YELLOW family. True yellow, amber, orange, and yellow-green all tend to brighten objects in so-called "flat light" circumstances. These colors enhance contrast when bright sunlight is not available, increasing your perception of the environment. All of these lenses are great for Sporting Clays and hunting, and goggles with these colors work great if you are skiing or boarding in overcast conditions.

One of our favorite lenses is the Nike HD Orange. Dr. White likes to wear this one when it's raining. Since we all live in Cleveland he wears this one a lot!!

Tuesday, July 10, 2012

What Color Lenses For Golf?

Dr. Greg Kaye and Dr. Scott Schlegel represented SkyVision Centers yesterday at the 1st Annual Ken Lee Golf Outing. You may recall that Dr. Lee, was a very close friend of one of our founder's Dr. White and Dr. Lee passed away last year after a battle with pancreatic cancer. The outing raises money for a lecture series in Dr. Lee's honor. SkyVision was a major sponsor of this year's event and Drs. Kay and Schlegel WON! What a great way to introduce our first sunglass color for golf.

All three of our doctors have been lifelong golfers and they have tried pretty much every type of sunglass lens ever made for golf. One important thing to remember before we even start on color is that polarized lenses may NOT be best for golf. Dr. White has noted that typical polarization will make contours appear to be flatter than they really are. This is particularly of concern on the green when you are trying to read the break on a putt.

The optimal color for a golf lens is one that will make the white golf ball stand out against a green background. The lens should also enhance a golfer's ability to tell the difference between different shades of green, and most importantly the lens should increase the recogition of contour changes all over the golf course. The color that best accomplishes this is lavender or purple, a combination of red and blue nearer to blue.

NikeVision makes the golf lens that all of our doctors have been wearing for at least 7 years. The Nike golf tint is a lavender lens with 28% Visible Light Transmission (medium darkening) that can be worn on sunny and bright overcast days alike. Wearing the Nike golf tint make the white golf ball POP against the green background of the course. All of the doctors have found that it significantly enhances their ability to recognize contour while playing. And of course, the Nike lens essentially blocks all harmful UV rays in order to protect your eyes.

So congratulations to our victorious doctors and the very best of luck to the organizers of the Ken Lee Lecture Series!

Monday, July 9, 2012

Sunglasses? What Color Lens Should I Get?

It's Summer time! We are in the full swing of sunglasses season. We've talked in the past about the importance of protecting your eyes from Ultraviolet light, and we've discussed what polarization is. Let's talk a little bit in general about the color of sunglass lenses, and then over a few posts we can break down some of the specifics of lens color.

All sunglasses limit some part of the natural light that surrounds us from getting into the eye. Visible Light Transmission (VLT) is a measure of how much light gets through in general. The darker the lens the smaller the VLT, and the smaller the VLT the less light gets through. The first thing to think about when you buy sunglasses is how much dimming do you want from your lenses. The brighter your environment (beach, snowfield) the lower you want your VLT.

The next consideration is color. More specifically, what color of light do you wish to filter out with your sunglasses, or what color to you wish to let in? The color of light is determined by its wavelength. A lens can be designed to filter out all wavelengths, or you can choose specific wavelengths or colors to filter out. If you do this you will make the un-filtered colors stand out more.

Most people will do best with general purpose sunglasses that simply decrease all of the wavelenths or colors that come through. Grey or Brown lenses are suggested for this. Grey will be darker, dimming everything. Brown lenses tend to let you keep your sense of colors better than grey. If you are choosing sunglasses for very common tasks like driving you can't go wrong with either Grey or Brown lenses.

Stay tuned for discussions about special use lens colors, coming soon on the SkyVision blog!

Friday, July 6, 2012

My Child Just Failed A School Vision Test!

Uh oh...your child just failed a school vision screening test. Just what IS a vision screening test? What are they looking for? What does it mean to fail the test? Now what should I do?

First things first: take a deep breath! Take your own pulse. Relax! Vision screening tests are meant to find children who have a vision problem that might not be uncovered without testing. Like ALL screening tests for anything, the vision screening test is designed to pick up anything that MIGHT BE abnormal. These tests are meant to not miss any abnormalities, so they often will "find" something abnormal where everything is really just fine.

Your child was likely tested for near vision, far vision, color vision, and some kind of eye muscle function. Vision screening is done by volunteers who are only trained in how to administer the test itself. Very few people who are doing the screening work in eye care, so most of these volunteers will not be comfortable answering any questions you might have. Don't worry if they don't have answers!

What do you do if your child fails the screening? Easy! Bring them to Skyvision Centers! ALL of our doctors are qualified to examine and treat children and children's vision problems. Kids who fail a screening test simply need to be seen by an eye doctor. We were VERY surprised when friends were recently told to take their child to a University specialist for a simple failed school screening--totally unnecessary referral!

Most visits to the eye doctor uncover a simple vision problem that can be fixed with a pair of glasses, or a finding of nothing at all! A perfectly normal eye exam! So RELAX. Just give us at call at Skyvision Centers (440-892-3931), or contact us through our website (, or through Demand Force at and schedule a visit.

Thursday, July 5, 2012

Generic Medicine and Cataract Surgery

"These eye drops are SO expensive."

"My insurance says I have to take this generic drop."

Every day our doctors, technicians, and surgical counselors hear some version of these two sentences. We hear it from almost everyone! It's funny how viewpoints have changed over the years. The fee that your insurance company pays a doctor and his staff to do everything that is necessary for cataract surgery in about 60% LESS than it was in the year 1990, and that's WITHOUT  taking into account any inflation. That means in 1990 the co-pay for cataract surgery was greater than what it costs in 2012 to buy the very best eyedrops that protect you from infection and inflammation.

Sometimes newer medicines really are better. They might work better, or have fewer side effects, or need to be taken less frequently. All of these things are important because you will have a better outcome from your cataract surgery if you take your medicine as our doctors have prescribed. Better vision. A lower risk of infection. Dramatically lower chances of swelling and inflammation. We have chosen the best medicines, the ones with the fewest side effects that are the easiest to take.

Here are two examples. SkyVision cataract patients receive a prescription for Besivance, a 4th generation antibiotic in its class. Many insurance companies try to make a switch to generic Cipro, a 3rd generation medicine that is available for perhaps 1/4 the cost. Sounds OK, right? It's only one previous generation? Well, good studies have shown that using a 3rd generation medicine instead of a 4th can increase the risk of infection by a factor of 10. 10 times the risk! Ciprofloxin must also be used 4 times each day and Besivance only twice which makes it easier to actually use the Besivance.

The other very important example is the Non-Steroidal Anti-inflammatory Drug or NSAID. If you don't take one you have a 10 times greater risk of vision threatening swelling in your retina. Both older, generic forms of NSAID's and newer branded ones reduce this risk. However, all of the older generic versions cause swelling and inflammation on the cornea, the front of the eye, in 3-4 out of 10 people. This results in pain, decreased vision, and the need to take more medicine for a longer period of time. On top of that, all of the generics HURT when you put them in, and you have to use them 4 times each day, and this makes people avoid using them at all.

You have two eyes. You will have cataract surgery on each eye once in your lifetime. Which is actually more expensive, the cost of the eyedrops your surgeon has chosen for you after careful studying of all the options, or the cost of using generic eyedrops that must be used more frequently, have more side effects, and may in some cases be less effective?

Tuesday, July 3, 2012

A Patient-Centered Approach to Emergency Visits

We all have an occasional medical emergency. What happens in Cleveland when you have an eye emergency? What does "same day appointments" mean, the ones that you see on the big billboards around our town? Well, here's what it means if you are a Skyvision Centers patient: you are seen by a Skyvision Centers doctor in the Skyvision Center office you know and love RIGHT AWAY!

It's very hard to know as a patient what is and what really isn't a true emergency. The staff members who answer our phones have been trained to ask you important questions to determine if you have the kind of emergency that requires you to come in on the day you have called. Curtains or shades coming over your vision? Come right in. Pain in the eye that is new and just won't go away? How fast can you get here?

How about nights and weekends? Yup...then too! If you have an eye emergency an eye doctor will see you even then.

If it seems like your problem is urgent but not an emergency our staff will discuss the timing of your visit, especially if we are very busy that day and we are trying to avoid a big wait for you. But in the end, a patient-centered approach to eye emergencies, the SKYVISION CENTERS APPROACH, is that if you are very concerned about your new eye problem we will find a way to see you that day. That's what Patient-Centered Medicine means at Skyvision.

Do you think that's what they mean on all those billboards around Cleveland?