More on Sunglasses--Visible Light Transmission

It's a beautiful, bright sunny day in Cleveland, Ohio! We don't get too many of these for most of the year, but Spring and Summer around here can be magnificent. Let's talk about another thing that you should think about when you are choosing what sunglasses to wear, how dark should your sunglasses be.

The technical term for this choice is "Visible Light Transmission". When Eye Doctors and Opticians think about sunglasses we think about how much light actually gets through, the VLT. It's funny because when we talk about UV protection we talk about how much UV light DOESN'T get through. With VLT the darker the lens the lower the VLT in general. But sunglass lens technology has become so advanced that some relatively light lenses actually block out lots of visible light!

Your activity and your environment will help you choose your sunwear. Let's think about Cleveland for a minute. Right now it's pretty sunny. We're a lake community with Lake Erie just to the north of everyone and everything. Lake activities make you want POLARIZED sunglasses, and today you would look for something that has around 20% VLT. Two super examples would be the Nike Brown (16% VLT) or Grey (17% VLT) Max Tint Polarized lenses.


Now, it IS Cleveland, and we get lots and lots of cloudy, overcast days around here. On days like that it's not so important that you wear polarized sunglasses, but you could if you wanted. On cloudy days you want UV protection, decreased transmission of blue light waves, and a slightly higher VLT, usually around 40%. Good choices from Nike would be the Max Tint Orange (60% VLT) or Smoke (50% VLT). We often see Dr. White with his Max Tint Orange Nikes on cloudy days.

Why a Bowtie?

We recently asked Dr. White why he wears a bowtie. Here’s what he said (after he stopped laughing!):

“Why a bowtie? Wow...it’s been so long I haven’t given all that much thought to that. When I was in medical school my wife and I cleaned out the bargain tie bin at a local department store that was going out of business. Silk ties for 2 and 3 bucks! When we got home we noticed two bowties in the mix. I happened to be on call the next night so Beth tied one for me to wear—bowties stay out of the way of all kinds of icky stuff you encounter in a hospital.

Well, as luck would have it, the most popular show on TV was “Hill Street Blues”, and one of the detectives wore a bowtie. Whenever Henry Goldblum got stressed his bowtie came undone. Of course, my wiseguy fellow med students thought it would be fun to untie MINE...and I didn’t know how to tie it yet! Sooo, three hours in front of a mirror later and I was an expert on bowtie tying.

I must have gotten good feedback about the bowtie as a resident because I found myself wearing it more and more. Not everyone at NYU knew Dr. White the ophthalmology resident, but everyone knew Dr. Bowtie the eye doctor! Now if I go someplace without a bowtie I’m almost invisible.”

So there you have it, why Dr. White wears a bowtie. If you’re interested Dr. White gets his bowties from Beau Ties Ltd. in Vermont, and leeallison.com in Chicago. 

It's Sunglass Season!

Hey! Even in Cleveland  the sun comes out. It's springtime… almost summer, and it's time to think about sunglasses. At Skyvision we have everything to meet your sunglasses needs. We have high fashion names like Fendi and Coach, and we have some of the most high-tech offerings from companies like Oakley, Maui Jim, and Nike.

So why would you want to wear sunglasses? Well, there are two very important reasons to think about wearing sunglasses, even when it's not terribly sunny out. The first, and most important reason, is to protect your eyes from ultraviolet light. UV light is actually toxic to many of the structures in the eye including the lens and the retina. There is some very good research that shows that prolonged exposure to UV light causes cataracts, and in people with light colored eyes there seems to be an association between ultraviolet light exposure and macular degeneration.

Why else might you wear sunglasses? Lens technology has advanced so far in sunglasses that it's actually possible to ENHANCE your vision for a particular activity by wearing the appropriate type of sunglasses. For instance, the Nike Speed lens is dynamite for baseball. Nike also makes the very best lens for golf with lenses that enhance your ability to see contour and multiple shades of green on the golf course.

And who hasn't seen a photo of Lance Armstrong in his Oakley Jawbones careening around the corner in the Tour de France?! Oakley has pioneered the technology of “swappable” lenses, and the Jawbone is a great example of how one frame can accommodate many different activities simply by swapping out the lenses.

Skyvision centers is your headquarters for all of your sunglasses needs!

Over 40 Eyes...Why Can't I Read?

We know what you're thinking...who shrunk my arms? It's happening a lot around the office at Skyvision Centers, too. We're all getting a little older  around here and it seems like there are a bunch of reading glasses lying around everywhere now. As a matter of fact, the only person in the office who can't seem to find Dr. White's readers is DR. WHITE!

Why do we start to have trouble reading when we get older? To answer that we have to go all the way back to age 2 or so. Almost all of us is born a little farsighted or hyperopic. We focus our eyes to overcome this little bit of farsightedness using the same muscles that we use to focus on objects up close. This muscular process is called ACCOMMODATION. When we look at things up close three things happen: our eyes come closer together, our pupils get smaller, and the lens inside our eyes gets fatter. We have massive powers of accommodation at age two and then we gradually lose those powers as wel get older.

The medical term for "Over 40 Eyes" is PRESBYOPIA. When we lose enough of our power of accommodation that we can no longer see things up close we become presbyopic. Of course your kids will just say you got old! Here's a LINK to the Eyemaginations video on presbyopia.

So what can we do? Well, there are a bunch of options, actually. If your eyes are health you can just buy reading glasses at the pharmacy. You might have a different prescription in each of your eyes, and if so your Skyvision Centers eye doctor can prescribe a pair of reading glasses that are specific to you. Many of us need to wear glasses to see things far away--a pair of bifocals takes care of the up-close problem. Bifocal contact lenses are available, and you can even correct your vision with something called MONOVISION, with one eye corrected for near and one eye corrected for far vision.

Whew! That's a lot of options! Don't worry...we'll have lots of answers for you in future posts, and of course, we bet we'll see an "At the Dr. Whiteboard" video or two on this subject, too!

Let's Talk About Tears!

Before we get to the topic of how to treat Dry Eye let's take a couple of minutes to learn about tears. We have two kinds of tears lubricating the front of our eyes. We have our reflex, or emotional tears. These tears are created by the lacrimal gland that sits up and above our eyes. The lacrimal gland  makes the tears that we cry when we watch a sad movie, or if something gets in our eye.

It's the tears that lubricate our eyes from minute to minute that we are more interested in when we are talking about dry eye. These tears are made by different types of microscopic glands on the surface of our eyes, as well as deep within our eyelids. These tiny glands can be affected by all kinds of medical problems like arthritis, lupus, and the hormonal changes that come with getting older.

Normal tears consist of three different, separate substances. We  have mucin which is created by the goblet cells on the front surface of our eyes. We also have a salt water or aqueous component created by the glands of moll and zeiss. Lastly, we have an oily substance called meibum which is created by the tiny glands that sit just inside our eyelashes on the upper and lower eyelids. These three substances are mixed together, kind of like Italian salad dressing, to form a lubricating layer between our eye and the air.

Shake up a bottle of salad dressing and let it sit for a minute or two. Notice how there is a little bit more oil on the top surface, a thicker middle layer that is a mixture of everything in the salad dressing, and then a layer on the bottom that is really thick. This is a good way to visualize our tears. We have more mucin close to the eye, a mixture or emulsion of mucin and aqueous in the thicker middle, and then a layer which is mostly oil sitting on the surface and preventing evaporation of our tears.

When our tears are healthy we have just the right amount, and we have just the right proportion of the three different components. We start to have problems with dry eye when we either have too few tears, or when the three components do not mix well. Next, we'll talk about the different types of dry. See you soon!

How We Diagnose Dry Eye

So you've come to Skyvision Centers with red, burning or tearing eyes. Your vision gets blurry when you look at a computer. You always feels like there's something in your eyes. How do we know it's from Dry Eye? How do we make the diagnosis?

Well, the very first thing we do is LISTEN to you! We try very hard to hear what it is that's bothering you. After that there are several tests that the technicians and doctors do to evaluate your tears, like examining your tears themselves. Both the doctors and the technicians look at your tears. Do you have a normal amount present just on viewing? Are they clear? Is there any debris, stuff like mucous or clumps of white blood cells present?

Before we put anything into your eyes we will often use a special instrument called an osmometer to check your tear OSMOLARITY, how salty your tears are. This is a very new, fully FDA approved test to evaluate whether you have a normal amount of salt in your tears. Normal is below 300 and abnormal is above 308, with the 300-308 range being relatively non-diagnostic. This test is very helpful in determining whether or not you have the most common type of Dry Eye, especially when other signs are hard to see.

The doctor will then put a vegetable-base dye called FLUORESCEIN into your tears to evaluate their function. How long does it take before they "break up"? Tears should remain smooth over the front of the eye for at least 8-10 seconds. Does any part of the front of the eye become stained by the flourescein? Dye staining is a sign that your tears do not work well enough. Finally, tiny strips of filter paper may be placed just inside your eyelids for a test of your tear production called a SCHIRMER test. This helps us know the volume of tear production.

That's how we do it! Lots of work to make the diagnosis, but heck...you're worth it! Tune in for lots of information on how we TREAT Dry Eye, coming soon.

How Does The Eye Work?

How does the eye Work?

Over on our YouTube channel  we have a new series called "At the Dr. Whiteboard." Check it out! Pretty soon there'll be a video up that explains how our eyes work, and how it is that we actually see. Let's introduce that topic here and do a little review

Vision is kind of like filming a TV show. Our eyes act like the television camera, gathering images. The optic nerve works like the fiber optic cable that carries information from the television camera back to the computers in the production room. Those computers are very much like the back of our brain, the occipital cortex, where vision actually occurs.

So vision is actually a combination of three separate processes: focusing and capturing an image, changing that image into a series of electrical impulses that are then transmitted to the brain, and then processing those electrical impulses to re-create the image that we "see." Historically the majority of eye care has been dedicated to improving focusing, improving our ability to capture images. Cataract surgery, LASIK surgery, even something as simple as a pair of glasses allows us to create a sharp image.

Over time will talk a lot about these and other topics, as well as the exciting new vision processing programs like RevitalVision.