Vision Problems and Eye Health

How Do the Eyes Work?

To understand how the eyes work, it's helpful to compare the eyes to a camera. Cameras use a lens and film to produce an image, and in a way, so do the eyes.

Light comes in through the cornea, a clear tissue that covers the front of your eye. The pupil is the dark spot in the middle of your eye. It works like a camera shutter, controlling the amount of light that enters our eyes. When it's dark, the pupil dilates, or widens. When it's bright, the pupil gets smaller. Surrounding the pupil is the iris. This is the colored ring of muscle fibers that help the pupil change size.

When you look at an object, light rays enter your eyes. These light rays are bent and focused by the cornea, lens, and vitreous. The vitreous is a clear jelly-like fluid that fills the inside of your eye. The lens' job is to make sure the rays come to a sharp focus on the retina at the back of the eye. Think of the retina as the film in the camera. It's lined with light-sensitive cells, called photoreceptors, that capture, upside-down, the images in our visual field. The sensitive macula, critical for sharp focus, is the most active part of the retina. A healthy macula helps us read small print and see the images in our direct line of vision. When light rays reach the retina, they're converted into electrical pulses that travel through the optic nerve to your brain. It is there that the image gets flipped right-side up.

Vision Screening Guidelines

Guidelines for Adults

• At least one test between ages 20 and 29 and at least two between ages 30 and 39
• Vision tests every two to four years between ages 40 and 65 and every one to two years after age 65.

Guidelines for Children

• Children five years and younger should have their eyes checked each time they see their pediatrician. Teens should be examined once a year.

If you are experiencing any vision problems, it's a good idea to get checked more often.

Protecting the Eyes & Vision

While we can't control the risk factors that make us more vulnerable to vision problems, it's important to exercise caution:

• Know your family's medical history;
• Protect your eyes with sunglasses that absorb 100 percent of damaging ultra violet rays;
• Stay away from cigarettes which contain chemicals that can damage the eyes; and
• Eat a healthful diet.

Types of Vision Problems

It's normal for our vision to deteriorate as we age. Here are some very common vision problems that can usually be corrected with glasses or contacts:

• Farsightedness. This occurs when you can see well at a distance, but not close up.
• Nearsightedness. This is also called myopia. It occurs when you can see well close up, but not at a distance.

There are some vision problems that are much more serious and can even lead to blindness.

If you have a family history of eye disease, you'll have a higher risk of developing vision problems. You may also have other risk factors like previous eye injury, premature birth, diseases that affect the whole body, like diabetes, high blood pressure, heart disease, or AIDS. The only way for you to know for sure if you have serious eye problem is by having an eye exam given by an Optometrist (O.D.) or an Ophthalmologist (M.D.).

• Glaucoma. This occurs when the pressure of the fluid inside your eyes damages the fibers in your optic nerve, and causes vision loss. If left untreated, you can lose your eyesight altogether.
• Cataracts. A cataract means a 'clouding' of all or part of the normally clear lens within your eye, which results in blurred or distorted vision.
• Conjunctivis. This is commonly known as Pink Eye. It is caused by an inflammation of the conjunctiva. This is the thin, transparent layer that lines the inner eyelid and covers the white part of the eye. The inflammation is usually caused by a virus, and will resolve without any treatment. But, sometimes pink eye is caused by a bacterial infection and will require antibiotics.
• Eye Floaters. These may look like small dots or lines moving through your field of vision. They're actually tiny clumps of gel or cells inside the vitreous fluid in the eye. They may be a sign of retinal detachment and you should call your doctor right away.
• Macular Degeneration. This results from changes to the macula portion of the retina. The macula is responsible for clear, sharp vision. This condition can cause a blind spot in the middle of your sight line.
• Retinal Tears and Detachment. These affect the thin layer of blood vessels that supplies oxygen and nutrients to your retina. Initial symptoms are eye floaters. This condition must be treated immediately. If it isn't, it can lead to permanent vision loss.

Early detection is key to fixing problems with your sight. Don't take your eyes for granted. Get them checked regularly, and tell your doctor if you notice anything unusual.

Sources

Age Related Macular Degeneration. Bethesda, MD.: National Institute of Health, 2009. (Accessed October 18, 2009 at http://www.nei.nih.gov/health/maculardegen/index.asp.)

Vision Not Improved By Surgery for Complications of Age Related Macular Degeneration. Bethesda, MD.: National Institute of Health, 2008. (Accessed October 18, 2009 athttp://www.nei.nih.gov/news/statements/surgery_amd.asp.)

Vision Problems. Atlanta, GA.: A.D.A.M., 2008. (Accessed October 18, 2009 athttp://www.nlm.nih.gov/medlineplus/ency/article/003029.htm.)

HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.

Reviewed by: Dr. Supriya Jain, Dr. Preeti Parikh and Dr. Holly Atkinson

Last Review Date: 08/29/2012

Host Reviewer: Dr. Roshini Raj

Author: Ms. Audra Epstein

Copyright © 2013-2014 HealthiNation, Inc. All rights reserved.

What Are Those Spots In Front Of My Eyes?!

They're kinda like little bugs flying around, except there are no bugs there! Lots and lots of little spots in front of your eyes all of a sudden, and it seems like they are always RIGHT in front of your vision when you are trying to read. Or it feels like there's a spot just outside your field of view--is that the bug? You just can't shoo it away.





They're floaters!

Wait...what the heck's a floater, anyway? Well, a floater is a little speck of protein debris in the vitreous jelly, the jell that fills up the middle of the eye. The vitreous jelly (you may have heard it called vitreous humor in school) is very important for the development of the eye until we're about 2 years old. After that point it's really just there to cause mischief. One of the mischievious things it does is shrink.

The thing that make the vitreous a gel is the same thing that makes Jello a gel. There's a microscopic protein skeleton and as we get older that skeleton collapses upon itself. Little areas that used to be just barely microscopic are now just dense enough to be macroscopic. They form a little clump and VOILA...a floater.

So you've got floaters, what do you do about them? In time your brain will learn to ignore them. They become like background visual noise and your brain just ignores them, just like the old fashion elevator operator who didn't hear the elevator music any more because it was always there!

For some more information check out this Eyemaginations video here. If you DO have floaters make sure to get them evaluated at Skyvsion Centers.

Who Made That Eye Chart?

Buying eyeglasses in the 1700s was tricky: 

you had to diagnose the problem yourself and then pick the correct lenses. Some vendors  helped customers along by scratching ages onto their spectacles, so that a 40-year-old would be steered to “40” lenses­ — the assumption being that everyone’s vision deteriorated at a similar rate as they grew older

But these shortcuts no longer sufficed in the mid-19th century, as doctors began to understand that patients needed bespoke lenses.

At a hospital in the Netherlands, Dr. Franciscus Donders devised a method for diagnosing vision problems: he would ask people to gaze at a chart on a distant wall and report what they could see. Apparently too busy to make the chart 

himself, he enlisted the help of a colleague, Herman Snellen.

Snellen first printed up a chart with dingbats — squares, circles,

 plus signs — of various sizes, but that proved to be a bad idea. 

“When you look at a symbol, how do you describe it?” says 

August Colenbrander, a scientist at the Smith-Kettlewell Eye

 Research Institute who has researched the history of the eye

 chart. (It was probably easy to cheat, too.) In the end, Snellen 

realized that letters would work best.

The chart spread all across Europe, an instant hit. “The first big 

order was from the British Army, in 1863 or so,” Colenbrander

 says. “Obviously the soldiers who fired their muskets had to be 

able to see.” Soon after that, printers everywhere copied it. A

 low-tech solution to a complex problem, the chart has remained

 popular because it was cheap and easy to use. But widespread 

reproduction and success are two different things. The EFPTOZ 

chart (pictured here) has practically become iconic, undermining

 its medical value, Colenbrander says. A recognizable eye chart is

 not a very useful one.

By PAGAN KENNEDY

May 24, 2013

The Meibomian Gland Dysfunction Epidemic

Our Meibomian glands are just inside our eyelashes. They produce the oil or lipid part of our tears. The oil in our tears stabilizes the surface or the tears and prevents rapid evaporation. An abnormality in this layer cause a type of Dry Eye.

A video about your meibomian glands Video Link Click Here

Most of the eye doctors, and especially our own Cleveland Dry Eye experts here at Skyvision Centers, believe that we are now having an epidemic of Dry Eye and especially Meibomian gland disease. This is due at least in part to major changes in the U.S. populations intake of Omega-3 fatty acids over the last 50 years. These changes came about from government subsidies of corn, which is now the feed of choice for everything from cows to fish! This change in the diet of livestock and fish from grass and algae to corn is contributing to the frequency and severity of Dry Eye.

What can we do to reverse this? Well, we probably can't change U.S. farm policy overnight, but the doctors at Skyvision are convinced that everyone, especially anyone with Dry Eye, should be taking a high quality Omega-3 fatty acid nutritional supplement. For example, Doctors Advantage brand names "Eye Relief" or "Omega Shield" have the right combination of ingredients to help. Our doctors can advise you of what may be best for you.

Our vision, comfort, and even quality of life starts on the surface of the eye with our tear film and we would like to help you enjoy and feel your very best!

Glucosamine Supplements Tied to Risk of Eye Condition

By Denise Mann
HealthDay Reporter

THURSDAY, May 23 (HealthDay News) — Glucosamine supplements 

that millions of Americans take to help treat hip and knee osteoarthritis 

may have an unexpected side effect: They may increase risk for

 developing glaucoma, a small new study of older adults suggests.

Glaucoma occurs when there is an increase of intraocular pressure 

(IOP) or pressure inside the eye. Left untreated, glaucoma is one 

of the leading causes of blindness.

In the new study of 17 people, whose average age was 76 years, 

11 participants had their eye pressure measured before, during and 

after taking glucosamine supplements. The other six had their eye 

pressure measured while and after they took the supplements.

Overall, pressure inside the eye was higher when participants were 

taking glucosamine, but did return to normal after they stopped taking 

these supplements, the study showed.

“This study shows a reversible effect of these changes, which is 

reassuring,” wrote researchers led by Dr. Ryan Murphy at the 

University of New England College of Osteopathic Medicine in 

Biddeford, Maine. “However, the possibility that permanent damage 

can result from prolonged use of glucosamine supplementation 

is not eliminated. Monitoring IOP in patients choosing to supplement 

with glucosamine may be indicated.”

Exactly how glucosamine supplements could affect pressure inside the

 eye is not fully understood, but several theories exist. For example, 

glucosamine is a precursor for molecules called glycosaminoglycans,

 which may elevate eye pressure.

The findings are published online May 23 as a research letter in 

JAMA Ophthalmology.

The study had some shortcomings. Researchers did not have 

information on the dose or brand of glucosamine used, and they did 

not know how long some participants were taking the supplements.

Duffy MacKay, vice president for scientific and regulatory affairs at

 the Council for Responsible Nutrition, a Washington, D.C.-based

 trade group representing supplement manufacturers, said the findings 

don’t mean that people should stop taking the supplements.

“This research letter raises questions and introduces a hypothesis 

that should be explored further, but the small number of cases

 investigated and the [fact that] researchers did not count capsules or control 

for dose or intake or duration of use of glucosamine provide extremely limited 

evidence of harm,” MacKay said.

“This study should not change consumer habits; however, individuals

 with glaucoma or ocular hypertension who are taking glucosamine 

should let their doctor know so that the appropriate monitoring of 

intraocular pressure measurements can be done to identify any 

changes,” he said.

MacKay concluded: “The good news is that increased IOP was 

reversible. So if you take the product, and your IOP goes up, then you 

can stop taking the product to see if it returns to normal.”

However, previous studies have raised questions about whether 

glucosamine supplements provide any health benefit to consumers. 

A large recent study concluded it had no healing effect on arthritic pain.

The potential relationship between glucosamine and glaucoma is new

to Dr. Scott Fudemberg, a glaucoma surgeon at Wills Eye Institute, 

in Philadelphia. “The mechanism about how people can develop 

glaucoma isn’t completely understood, so how the supplements 

may play a role isn’t completely understood either,” he said.

While the study found an association between taking glucosamine 

and increased eye pressure, it didn’t establish a cause-and-effect 

relationship.

The best thing that anyone can do to preserve their vision is to get

regular eye exams, Fudemberg advised. “Glaucoma can be treated 

with medications, lasers and/or surgery,” he said. “These findings 

pose a question about whether oral glucosamine can raise intraocular 

eye pressure, but it doesn’t provide an answer. More research is 

now needed before any conclusions can be drawn.”

FYI: Can A Bionic Eye See As Well As A Human Eye?

It's the difference between a grainy black-and-white film and HD.

By Alyssa Brewer

What's New in Eye Care . . . . 

Previously blind patients who receive the recently FDA-approved Argus II bionic eye system will regain some degree of functional sight. The retinal implant technology, developed and distributed by Second Sight, can improve quality of life for patients who have lost functional vision due to retinitis pigmentosa, a disease that causes retinal cells to die. But the implant doesn’t facilitate a sudden recovery of 20/20 vision.

Just as cochlear implants don’t have the sensitivity to accurately relay the complex mix of frequencies in music, bionic vision through the Argus II will be closer to a very grainy black-and-white film than an HD movie.

The multi-piece system starts with a digital camera mounted in eyeglasses. Images from the camera get translated into data through a miniature computer and sent via wireless transmitter to a computer chip on the side of the eyeball. From there, the chip activates an eyelash-thin electrode array implanted behind the retina, which then stimulates retinal cells to send visual information to the brain.

Bionic vision will be closer to a very grainy black-and-white film than an HD movie.

First Bionic Eye Second Sight

While the prosthesis sounds complex, it doesn’t compare to the intricacy of the natural human eye. Shawn Kelly, a scientist at Carnegie Mellon University, is currently working on his own retina implant system that includes the same basic technology as the Argus II. He explains that, with the technology available now, the electrode array isn’t finely tuned enough to produce the same detail and clarity of a fully functional human retina.

“It’s not going to be anything like normal vision,” Kelly says, describing the expected results of his implant. “It’s going to be very difficult to convey colors, and it’s going to be difficult to convey the type of visual resolution that we have in the center of our vision.”

The eye’s retinal cells, commonly known as rods and cones, are split up into six types of receptors that detect contrast between light and dark, red and green, and blue and yellow. Electrical signals from the retinal cells travel through the optic nerve to the brain to form a complete picture of what the eye is looking at.

Instead of trying to imitate the activity of all six receptor types, Second Sight’s Argus II implant focuses on stimulating retinal cells to show light and dark contrast. For a blind patient using an artificial retina, being able to detect the relative darkness of a hole or an approaching wall is a lot more important to independently navigating than knowing whether that wall is painted red or blue.

Brian Mech, vice president of business development at Second Sight, reports that in clinical trials, all of the company's 30 patients had some degree of vision improvement after receiving the retinal implant. “Basically they see black and white, shades of gray and they’re getting somewhere between 50 and 60 pixels of information on average,” Mech says.

In terms of acuity, the patient with the best result went from no useful sight to 20/1260 vision. This ratio means that to get the same amount of information a healthy human eye can discern from 1,260 feet, this patient would need to be standing 20 feet away.

Mech admits this level of acuity is limited. “[It] is still pretty poor considering normal vision is 20/20, but it’s pretty amazing when you’re completely blind to begin with,” he says. But he explains that as research and testing continues, there is plenty of room to improve the system’s performance just by working on the external technology. Even color vision is a possibility with improvements to the video processor and wireless transmitter. “I don’t want to make it sound too easy,” Mech says. “There’s a lot of work to be done before we can do color vision, but the good news is that they won’t need a new implant for it.”

Second Sight is currently developing more advanced retinal implants, but the timeline is still unclear. Mech says it will be five to seven years or more before the next generation of implants becomes a reality.

This story was produced in partnership with Northwestern University's Medill School of Journalism.

Do Women Have a Better Sense of Color?

We at SkyVision Centers, the premier ophthalmology practice in Westlake, Ohio would like you to weigh in on this!

Take the quiz and then post your color number and gender on the SkyVision Facebook Page!

What is your color sense- Your Color IQ

Itchy Eyes . . . . Spring Allergies?

Spring is the time of year that we normally think of when it comes to seasonal allergies. As the trees start to bloom and the pollen gets airborne, allergy sufferers begin their annual ritual of sniffling and sneezing. Each year, 35 million Americans fall prey to seasonal allergic rhinitis, more commonly known as hay fever.

Although there is no magical cure for spring allergies, there are a number of ways to combat them, from medication to household habits.

What Causes Spring Allergies?

The biggest spring allergy trigger is pollen -- tiny grains released into the air by trees, grasses, and weeds for the purpose of fertilizing other plants. When pollen grains get into the nose of someone who’s allergic, they send the immune system into overdrive.

The immune system, mistakenly seeing the pollen as foreign invaders, releases antibodies -- substances that normally identify and attack bacteria, viruses, and other illness-causing organisms. The antibodies attack the allergens, which leads to the release of chemicals called histamines into the blood. Histamines trigger the runny nose, itchy eyes, and other symptoms of allergies.

Pollen can travel for miles, spreading a path of misery for allergy sufferers along the way. The higher the pollen count, the greater the misery. The pollen count measures the amount of allergens in the air in grains per cubic meter. You can find out the daily pollen count in your area by watching your local weather forecast or by visiting the NAB: Pollen & Mold Counts page on the American Academy of Allergy, Asthma and Immunology’s web site.

Here are some of the biggest spring allergy offenders:

Trees

Alder
Ash
Aspen
Beech
Box elder
Cedar
Cottonwood
Cypress
Elm
Hickory
Juniper
Maple
Mulberry
Oak
Olive
Palm
Pine
Poplar
Sycamore
Willow

Grasses and weeds

Bermuda
Fescue
Johnson
June
Orchard
Perennial rye
Redtop
Saltgrass
Sweet vernal
Timothy

Allergy symptoms tend to be particularly high on breezy days when the wind picks up pollen and carries it through the air. Rainy days, on the other hand, cause a drop in the pollen counts because the rain washes away the allergens.

What are the symptoms of spring allergies?

The symptoms of spring allergies include:

• Runny nose
• Watery eyes
• Sneezing
• Coughing
• Itchy eyes and nose
• Dark circles under the eyes

Airborne allergens also can trigger asthma, a condition in which the airways narrow, making breathing difficult and leading to coughing, wheezing, and shortness of breath.

How are spring allergies diagnosed?

If you’ve never been formally diagnosed with spring allergies but you notice that your eyes and nose are itchy and runny during the spring months, see your doctor. Your doctor may refer you to an allergist for tests.

The allergy specialist may do a skin test, which involves injecting a tiny sample of a diluted allergen just under the skin of your arm or back. If you’re allergic to the substance, a small red bump (called a wheal or hive) will form. Another diagnostic option is the radioallergosorbent test or RAST. RAST is a blood test that detects antibody levels to a particular allergen. Just because you are sensitive to a particular allergen on a test, though, doesn’t mean that you’ll necessarily start sneezing and coughing when you come into contact with it.

What's the treatment for spring allergies?

Doctors treat spring allergies with a number of over-the-counter and prescription drugs. Over-the-counter allergy drugs are effective for many people and include the following:

• Antihistamines reduce sneezing, sniffling, and itching by lowering the amount of histamine (the substance produced during an allergic reaction) in the body.
• Decongestants clear mucus out of the nasal passageways to relieve congestion and swelling.
• Antihistamine/decongestants combine the effects of both drugs.
• Nasal spray decongestants relieve congestion and may clear clogged nasal passages faster than oral decongestants.
• Cromolyn sodium nasal spray can help prevent hay fever by stopping the release of histamine before it can trigger allergy symptoms.
• Eye drops relieve itchy, watery eyes.

Even though you can buy these allergy drugs without a prescription, it’s a good idea to talk to your doctor first to make sure you choose the right medication. Some antihistamines can make you feel sleepy, so you need to be careful when taking them during the day (although non-drowsy formulations are also available). Don’t use over-the-counter antihistamines and decongestants for more than a few days without talking to your doctor.

If over-the-counter remedies don’t help allergies, your doctor may recommend a prescription medication, allergy shots, or even oral/sublingual immunotherapy. Prescription nasal sprays with corticosteroids reduce inflammation in the nose. Allergy shots expose your body to gradually increasing doses of the allergen until you become tolerant of it. They can relieve your symptoms for a longer period of time than oral and nasal allergy medications. Although they don’t work for everyone, in people who do see a response, allergy shots can stave off symptoms for a few years.

Some allergy sufferers turn to natural therapies for relief, although the research is mixed on their effectiveness:

• Butterbur. The herb butterbur (Petasites hybridus), which comes from a European shrub, shows potential for relieving seasonal allergy symptoms. In one Swiss study, butterbur was just as effective as the antihistamine Allegra for reducing allergy symptoms.
• Quercetin. This flavonoid, which is found naturally in onions, apples, and black tea, has anti-inflammatory properties and has been shown in research to block histamines.
• Stinging nettle. The roots and leaves of the stinging nettle plant (Urtica dioica) have been used to treat everything from joint pain to prostate problems. Although some people use freeze-dried stinging nettle leaves to treat allergy symptoms, there isn’t much research to show that it works.
• Nasal irrigation. Nasal irrigation with a combination of warm water, about a quarter-teaspoon of salt, and a quarter-teaspoon of baking soda may help clear out mucus and open sinus passages. You can administer the solution through a squeeze bottle or a neti pot -- a device that looks like a small teapot. Use distilled, sterile, or previously boiled water to make up the irrigation solution. It’s also important to rinse the irrigation device after each use and leave open to air dry.

Just because a spring allergy treatment says “natural” doesn’t mean that it is safe. Some herbal remedies can cause side effects or can react with medications you’re taking. Talk to your doctor before you start taking any herb or supplement.

How to manage spring allergies

It’s nearly impossible to completely avoid spring allergies if you live in an area where plants grow. However, you can ease sniffling, sneezing, and watery eyes by avoiding your main allergy triggers. Here are a few tips.

• Try to stay indoors whenever the pollen count is very high (pollen counts usually peak in the mornings). 
• Keep your doors and windows closed whenever possible during the spring months to keep allergens out. An air purifier may also help. 
• Clean the air filters in your home often. Also, clean bookshelves, vents, and other places where pollen can collect. 
• Wash your hair after going outside, because pollen can collect there.
• Vacuum twice a week. Wear a mask because vacuuming can kick up pollen, mold, and dust that were trapped in your carpet

Reviewed by Kimball Johnson, MD on June 16, 2012

© 2012 WebMD, LLC. All rights reserved.

What Are Bifocals and How Do They Work?

OK...you'r over 40 years old and you can't read things up close. Maybe you have to take your glasses off and you can read. Maybe you need those $3.00 cheapo glasses from the pharmacy, even putting them on over your contact lenses. But you're starting to get cranky because of all the on-and-off with the glasses stuff. What to do? It's time to talk about bifocals.

Bifocals are glasses that have both a correction for your distance vision on the top of the lens, and a correction to help you read on the bottom. The first bifocal was actually invented by Benjamin Franklin. Yup...the same guy who did the whole kite and key thing to discover electricity! Ol' Ben just glued the top half of one lens to the bottom half of another and created what we now call an "Executive" bifocal.





This very simple type of lens has evolved into into more modern bifocal lenses. The most direct descendant of the Franklin lens is the Flat-top bifocal. These lenses have a very large area devoted to your distance vision, with a smallish insert or segment that allows you to focus on objects up close. The working distance, how far away you can hold something and still be in focus, is fixed with this type of bifocal.

What about seeing things a little further away, say a computer screen? And by the way, I think those bifocals where I can see the lines make me look older. Isn't there some kind of newer lens?




Absolutely! The most modern bifocal lenses are called "No-line" or "Progressive" lenses. These lenses have a smooth change in focus from the topo of the lens (distance), through the middle (arm's length), to the bottom of the lens (reading distance). We say that there's a "column of clarity", a sweet spot for each working distance for our vision. This column is usually shaped somewhat like an hourglass.

Our favorite Progressive lenses at Skyvision are Varilux products like the Varilux Comfort or the Varilux Physio. We always try to match the strengths of a particular lens to your special visual needs. Our doctors and opticians are experts on making this match. If you are having trouble with reading come on in and learn all about bifocals!

I Have Pinkeye...Can I Wear My Makeup?

Can I wear makeup if I have Pink Eye? Do I have to throw out my old makeup? And HEY, just what IS pinkeye, anyway?

Pink Eye, or Conjunctivitis, is one of the most frequent caused of emergency visits at Skyvision Centers. Dr. White, Dr. Schlegel, and Dr. Kaye are all experts in treating all of the causes of conjunctivitis. True Pink Eye is an infection caused by either a bacteria or a virus. A majority of Pink Eye in young children is caused by bacteria, but as we get older most of it is actually from viruses. You catch viral Pink Eye like you catch a cold through coughing, sneezing, or coming in contact with tears. Bacterial Pink Eye is usually from contact with tears. Both are VERY contagious.

What to do about your makeup if you have Pink Eye? Well, there's actually not a whole lot of very good research here so our advice is good, solid, Cleveland medical common sense! Don't wear makeup until your eyes look and feel better, and YES, you should throw away your mascara and your eyeliner.

And don't forget, your cousin's or your neighbor's or your BFF's eyedrops for THEIR Pink Eye may not be right for YOU. Come see us at Skyvision for your diagnosis and treatment!

A PHARMACY IN THE OFFICE?

Have you ever received a prescription from your doctor and had a pharmacist ask you to change to a generic when you went to fill the prescription?  Or how about this experience:  you have been receiving a branded drug from a mail order pharmacy for many years and all of a sudden your co-pay goes up by a factor of 5 or even 10, but a generic is less expensive.  What do you do?

Even more importantly, what if your doctor has told you that there truly is a difference between the generic version of a medicine, or medicine that a pharmacy wants to substitute, and the very specific medicine your doctor has prescribed?  How can you get the medicine your doctor wants you to have?

The doctors at Skyvision, indeed all of the staff at Skyvision Centers deal with this question every single day.  A recent example is patients who have been on a branded glaucoma medication who are switched to the generic of an older medicine in the same class who then go on to have a very serious complication in their retina, one that is a well-known complication of the older medicine, but generally not seen with the branded medicine. 

One interesting option has been presented to Skyvision Centers.  There is a company that will set up an in-office mini-pharmacy to dispense the medication that your doctors want you to take.  What is interesting about this particular service is that they make sure that any discounts, coupons, or co-pay assistance is factored into the price of the medicine.  In other words, any and all discount programs available would be applied to your price.  There might still be a less expensive generic version of your prescription, or a generic version of a similar prescription, but in those instances where your doctor felt the branded medicine was a better choice for you it would be made available with no “hassle factor”. 

What are your feelings about doctors dispensing medicine in the office?  Would you find this more convenient?  What kinds of concerns might you have?  We would love to hear your thoughts.  

A NEW STEROID EYE DROP FORMULATION

Steroid eye drops were first introduced in eye care in the 1970’s and 1980’s.  They were truly revolutionary!  For people with chronic inflammation of any type the creation of steroid eye drops was truly a sight-saving development.

With this benefit came some side effects and complications, however.  The original steroid, prednisolone, has been shown to cause an elevation in eye pressure in as many as 30% of people who take it.  In addition, long-term use often leads to the development of cataracts.  All of the steroid eye drops to date have been suspensions; you had to shake them vigorously in order to make sure you got the right amount of steroid in your eye. 

Bausch & Lomb recently introduced a new gel formulation of the steroid Loteprednol which has been provided under the brand name Lotemax.  The physics behind this gel are truly extraordinary!  Shaking it just once permanently suspends the steroid medicine.  There is no settling of the medicine in the bottle!  The other very cool thing about this new drop is that the gel is re-liquified within one or two blinks after inserting the medicine.  Not only do you get the exact amount of steroids that is desired from a single drop, but this nearly instant liquefaction means less discomfort and less blurriness. 

Lotemax was found in its FDA trial to be effective in reducing the inflammation following cataract surgery.  In addition, Lotemax has been known to cause a much less frequent rise in pressure than other steroid eye drops.  For these reasons the doctors at Skyvision Centers are very excited to have this new steroid eye drop as an option to treat you.  

DemandForce is alive and well at SkyVision! Thank You to our patients for our 5 Star reviews!

"What does that mean, you ask?  As you know, the global online community becomes more robust with each passing day. It’s hard to imagine life without cell phones and computers because communicating has become so easy, efficient, and effective."    source:   DemandForce Dish Newsletter, August 2012. 

SkyVision  adopted the new online system about one year ago to help improve the quality and timeliness of communication to its patients.   The staff and patients have responded to it very well.   On a daily basis Demandforce notifies patients of upcoming appointments and patients can confirm via their cell phone or computer.  After a patient visits they also receive a thank you for visiting and are asked to complete an online review if they wish.   In addition, they can also submit a survey where their opinions are polled.

Our patients have responded with such enthusiasm to this that we have received well over 450 reviews in less than a year.  In addition, we have received over 475 surveys.   For our reviews, we have achieved the highest overall rating of 5 Star  ***** over the long haul.   We have received many comments, opinions, suggestions, etc through the surveys.    We appreciate the patients taking the time to respond to either the surveys and reviews and they can be done anonymously or with their names.    

SkyVision not only is at the top of its class in its practice of the very best eye care by highly experienced doctors and staff, it is also committed to the advancement of communication with the patient and by keeping pace with the latest in current trends and lifestyles.

Find out more about SkyVision by liking our Facebook page and Click on the link here:

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Do I Need Prescription Sunglasses?

Do you need prescription sunglasses? It depends on your prescription, of course, but it also depends in part on what you are doing while you are wearing your sunglasses. If you wear contact lenses you are set--the contacts cover your distance vision, and all you have to do is get the perfect sunglass lens for your activity. But if you wear glasses on a daily basis you might consider putting a prescription into a high-quality pair of sunglasses.

At Skyvision Centers we make it a point to carry sunwear that can be "Rx'ed". Our Maui Jim, Kaenon, Nike, and Oakley lines can all be made with your regular prescription. Even your bifocal prescription! There are some other options, too. We have the entire spectrum of Transitions lenses available, including the revolutionary "Drivewear" lens that changes color in the car! On top of all that, you can add a magnetic clip-on to many of our highest high fashion frames when it gets sunny.

Whether its' golf, biking, tennis, or just reading this summer's blockbuster on the beach, we can outfit you with a pair of high-quality, hi-def sunglasses with YOUR prescription to maximize your vision outdoors. It's just one more way that we are changing the face of vision care. Vision Redesigned!

Kaenon Sunglasses Go To The Movies!

The movie "Monte Carlo" has been out about a year and it stars Kaenon Sunglasses! Well, not really, but the actresses starring in the movie wear some of the coolest Kaenon fashions you've ever seen.

The movie stars are Selena Gomez and Katie Cassidy. Selena wears the Kaenon DELITE as she plays a wealthy, fashion conscious heiress. Co-star Katie is seen romping on Monte Carlo's beaches in the Kaenon GEORGIA.

The Kaenon high-fashion sunwear has the same super high-quality optics with polarization and anti-glare in every pair. Come visit our optical and take a look at them in person in our flagship office in Westlake, Ohio, just across the street from Crocker Park!

Drivewear, Transitions Lenses That Darken in a Car!!

Dr. White keeps saying wonderful things about his "Drivewear", but what exactly is it? Well, Drivewear is one of the newest lenses to come out of the genius labs at Transitions, the company famous for making suglasses that darken outside and become clear lenses indoors. Transitions lenses are rightly celebrated for being the best and easiest to use photochromic sunglass lenses made. The only problem is that they didn't really get all that dark in a car.

Until now!!

Drivewear lenses are just killer technology. They have pretty much everything you would want in a pair of glasses for driving. First of all, they are polarized (remember our post on polarization and cutting down glare?). They utilize one of the most advanced methods for this, the "Nupolar" process. Less glare in all viewing situations.

The Transitions Photochromic technology does the rest. In dim light, in or out of a car, the lenses are a high contrast green-yellow. This minimizes glare and maximizes the amount of light information that enters the eye.

While other photochromic lenses don't change color in a car, the Drivewear lenses will darken even behind a windshield. The lenses become a copper color in the car on a sunny day. This highlights reds and greens...you know, like the ones in street lights! They reduce glare and cut down excess visible light.

Outside, especially on bright days, the Drivewear lenses become a dark reddish-brown color. This gives maximum comfort and protection from excess light, and of course blocks out 100% of harmful Ultraviolet rays.

So see what Dr. White is so excited about! Come on over to Skyvision Centers and ask us about Transitions Drivewear!

What Color Sunglass Lens For Driving?

For many of us the most frequent use of sunglasses is while we are driving. Polarization is a big help here since using polarized lenses of any color will dramatically reduce the glare that comes off the hood of the car and from other cars. Most of the better sunglass manufacturers like Maui Jim, Oakley, Kaenon, and Nike offer polarized options.

The color you use to drive depends on your personal preference more than anything else. Lenses that have brown tints will preserve your color appreciation to a greater degree than any of the other colors so we will typically suggest brown for driving and general purpose wear. Dr. White wears his Maui Jim Brown HD's all the time! (By the way, these are NOT Dr. White's!)

How about Transition lenses, lenses that change color to become darker when you are outside? For most of these lenses the change occurs when they are exposed to UV light. Your windshield and your car windows effectively block out all of the UV light so regular Transitions will NOT get dark inside the car.

Stay tuned for more scoop on Sunglass Lens colors!

What's The Deal With Polarization?

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 are 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 Centers Optical to see our polarized sunglasses from Oakley, Nike, and Maui Jim!

What Does 20-20 Vision Mean?

Vision is very important to us. Everyone desires 20/20 vision. Some patients say that they don't want 20/15 vision but prefer 20/20. This statement will appear hilarious when you have read and understood this article.

We all want great vision. Why? So that we can have a competitive advantage. In prehistoric times it gave us the edge to see the wild animals earlier. As society became more organized a method of comparing vision was needed. The credit for the most commonly used method goes to Snellen. Hence the chart which displays the letters or numbers bears his name. It compares a person's vision to the that of the average for the population.

20/20 means that the person whose vision is being tested is normal. If the vision is 20/40 it means that a normal person can see the object at 40 feet away whereas the patient being tested has to go much closer than this to 20 feet before he can see as well. That implies that the test subject has poorer vision. If it is 20/200 than the vision is even worse. Conversely 20/15 means that the test subject can see an object from even further than a normal person. He can see at 20 feet what a normal would see at only 15 feet. 20/10 vision is even better. Lots of professional athletes have vision that is better than 20/15!

What's YOUR vision? Come on in for a vision exam at Skyvision Centers and find out!

Eyedrops For Cataract Surgery

Dr. White is our cataract surgeon at Skyvision Centers. He is one of the most experienced cataract surgeons in Cleveland, and indeed in the entire country! He, along with Drs. Schlegel and Kaye, form our cataract team of doctors. They choose which eyedrops are the best available for use before and after cataract surgery. In addition the doctors have chosen a group of medicines that are easier to take (most times you only need to use the drops twice per day), and eyedrops that are comfortable so you don't avoid using them!


There are typically three types of eyedrops used around the time of your cataract surgery. An antibiotic is prescribed which is to be used starting 5 days BEFORE cataract surgery. The antibiotic typically is continued for a week after the surgery. The doctors have chosen an antibiotic drop from the strongest class of antibiotics now in existence in order to prevent infections. There are three choices in this class of medicines, two of which can be used twice per day.

A non-steroidal anti-inflammatory drop (NSAID), kind of like Motrin in a drop form, is also prescribed to start 5 days prior to the surgery. This medicine is then continued for 4 weeks after the surgery. It is used to prevent a type of swelling in the back of the eye. The doctors have chosen a medicine that is easy to take (twice per day), doesn't hurt when you put it in, and doesn't have any dangerous side effects. There are NO TRUE GENERIC EQUIVALENTS for this medicine. The generic medicines on the market must be used 4 times per day. They can be very uncomfortable; most people complain bitterly that they sting. Most importantly, the generic option has a 30% complication rate. That's right, 3 out of 10 people have swelling and inflammation in their cornea caused by this drop and this causes pain and a big drop in vision.

Finally, a steroid eyedrop is prescribed to be used after the surgery, beginning on the 1st day after the surgery. This drop treats the normal post-op inflammation in the eye. Like the other eyedrops it is used twice per day, and you continue to use it for 4 weeks after the surgery. There are NO TRUE GENERIC EQUIVALENTS for this medicine. The generic medicines must all be used at least 4 times per day and they are not as strong or as effective.

We understand that medicines can be expensive, especially when an important medicine is not fully covered by your health insurance. But we are talking about YOUR EYES and eye surgery. Your Skyvision doctors have chosen what they feel are the best medicines possible to do every thing possible for you to have a great surgical result.

What could be more important?!