“C” is for Cataract

July 24, 2017

Cataract, which is clouding of the eye lens, affects more than half of Americans aged 65 years and older. This age-related cause of vision loss can occur much earlier due to exposure to the sun’s ultraviolet (UV) rays and a host of other causes (including smoking, use of corticosteroids, and a family history). It is also thought that cataract formation is linked to oxidative changes in the human eye lens, which makes the case for consuming fruits and vegetables containing high amounts of antioxidants. In fact, recent research involving 324 pairs of twins over a decade showed there was a 33 percent lower risk of developing cataracts among women whose diets were rich in foods containing vitamin C.

The symptoms of early cataracts may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. To learn more, please call the Legarreta Eye Center at 716-633-2203. Our practice is based on the philosophy of providing high-quality comprehensive eye care. We have served the community for over 35 years. We have office locations in Williamsville, Cheektowaga and Lockport.

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Diagnosing Glaucoma

April 5, 2016

Because glaucoma is an eye disease that leads to permanent vision loss without first presenting symptoms that might warn of its potential danger, it is very important to undergo regular comprehensive eye tests. Bearing in mind that more than 2.2 million Americans have glaucoma and only half of them know it, people ages 40 to 60 should be examined by the ophthalmologist every three to five years. Anyone over the age of 60 should have his or her eyes examined every one to two years. These examinations will screen for the disease with “tonometry,” which measures eye pressure. In addition to measuring intraocular pressure, the exam will also likely include an“ophthalmoscopy,” which involves examination of the optic nerve. Glaucoma typically affects your peripheral vision first. Depending on the severity of the disease, treatment for glaucoma can involve the use of medications, conventional surgery, laser surgery or a combination of these treatments. To schedule and exam, please call us today 716-633-2203.

P.S. The most common treatment for glaucoma involves the use of eye drops known as “prostaglandin analogs,” which lower eye pressure.


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Stunning Sunglasses

March 11, 2016

The most popular sunglasses lately are so bold and stylish that they have the ability to transform the wearer’s entire look. One of the biggest trends involves mirrored lenses in a variety of colors and shapes that draw stares and return reflections. Also popular are round sunglass lenses that take the look of the 70s two steps further with bold retro frames.Those with round faces may also be interested in flat-top frames that contrast a severe top line with a rounded bottom, which help elongate the face. Their look is similar to the classic “wayfarers,” the definition of cool.Last, but hardly least, color-blocked shades mix up bold blocks of color that add an element of fun to sunglasses.

Whether or not you require vision correction, sunglasses can add an element of comfort and enhanced performance to your activities, while helping you look great. For clear, comfortable vision outdoors or when driving, prescription sunglasses can eliminate glare which can reduce vision and cause eye strain. For more information, please callus at 716-633-2203. 

Quick Tip: Color-blocked sunglasses with high contrast black and white frames are destined to become classics.

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The Myopia Epidemic

February 16, 2016

With rates of “myopia” (nearsightedness) increasing worldwide, many are labeling it a “myopia epidemic.” When trying to attach a specific cause to this pervasive problem, cell-phone use comes to mind. It may seem to make sense that spending more time squinting into the screen of a handheld digital device may make users more prone to nearsightedness, but there is another, more likely cause.Research indicates that, as children spend less time outdoors than peering into computer screens, they are depriving themselves of the sunlight needed to preserve good eyesight. Scientists speculate that natural light stimulates the normal release of dopamine (a major neurotransmitter in the retina) that guards against nearsightedness. If so, more time spent outdoors may help avert myopia.

P.S. In the United States and Europe, about one-half of children and young adults are thought to be nearsighted, which is double the prevalence of myopia a half century ago.


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Ptosis

January 23, 2014

Ptosis is a drooping of the eyelid; it can be mild to severe and can easily affect the quality of life in affected patients.

In children, ptosis can contribute to more severe conditions like amblyopia (Lazy eye), which can limit visual capabilities. In adults, ptosis may be the result of Bell’s Palsy, brain injury, aging, drug use, injuries, or it may be present since birth; ptosis may also develop based on other medical conditions not listed above.

Treatment for ptosis may range based on its etiology (cause), the age of affected patient, and the severity of  the condition. If you are concerned about a presentation of ptosis, please contact our office to schedule an appointment at your earliest convenience.


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Use it or Lose it! FSA Spending

December 19, 2013

We’re coming to the end of the year so swiftly! Remember that any money you contributed to your Flexible Spending Account will likely expire as soon as 2013 does! This money can be used for qualified medical purchases, even some over-the-counter products, provided certain guidelines are adhered to. Just as a reminder, here are some brief tips on FSA spending for your eyes!

Your FSA can be used for our products and service in office including, but not limited to:

Prescription glasses and prescription sunglassesContact lensesCopaymentsExam feesPrescription medicationsCertain over-the-counter medications (artificial tears, contact solution, eye patches, lid scrubs, vitamins), provided a prescription from a doctor can be given for them

What your FSA CAN’T be used for:

Nonprescription sunglassesCosmetic treatments and medicationsMultiple vitaminsLotions and skin moisturizers

Call & set up an appointment at one of our offices before time runs out!!! Don’t miss out on using your FSA!

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The Gift of Good Vision

December 12, 2013

If you can read this sentence, your vision is better than the estimated 39 million people worldwide who are blind. Vision is something that we all can take for granted; seeing is not a voluntary action…we open our eyes, some of us throw on some glasses or contacts, and there the world is. One of the best ways you can celebrate this amazing gift is by taking care of it!

Ways to care for your eyes:

1. Keep your diet eye-friendly!

Focus on fruits and veggies! Get your daily doses of leafy greens, citrus fruits, and colorful vegetables.Add omega-3 rich foods like salmon, walnuts, and enriched eggs.Limit your intake of sugars and saturated fats.

2. Protect your eyes!

Wear proper safety glasses.Wear UV protective glasses when exposed to sunlight.Wear corrective (and/or protective) glasses as directed, especially if you’re monocular!

3. Get routine examinations, especially if you have other medical conditions.

Diabetics should follow advisement for frequency of dilated examinations; some may require annual or biannual visits (or more  frequently, especially if blood sugar is in poor control).Any ocular condition (glaucoma, cataracts, macular degeneration, etc) may require multiple visits annually; while this may be somewhat inconvenient, it is a necessary and vital part of ensuring the best care is given to your eyes!Concerns about eye health should be addressed with immediacy in many cases; if you’re concerned about your eye health, contact our office today to schedule an exam!

4. Practice good hygiene, especially in cold and flu season!

Wash your hands and keep your hands away from your eyes!Use a quality artificial tear as needed.Take precautions when a family member, coworker, or friend is actively ill; limit contact and keep shared surfaces clean!Take precautions when you’re ill! Wash your hands, avoid using tissues repeatedly or transferring use from nose or mouth to the eyes.

This information is solely for informational purposes and is not intended to provide medical advice. If you are concerned about any medical condition or your eye health, please visit and speak with your primary or eye care service provider.


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Eyelid Twitching

December 3, 2013

Eyelid twitching can be annoying, uncomfortable, and can limit one’s ability to perform daily activities with ease. Eyelid spasms differ from full facial spasms, which can be cause for more concern (if you are concerned about a full facial spasm, contact your primary medical doctor). Eyelid twitching can have various etiologies; two common types of spasms, blepharospasms and myokymia, will be discussed below. As always, if you are concerned about your eyes or general health, contact your primary or ocular specialist.

Myokymia:

Myokymia is generally characterized by an involuntary quivering or twitching in the eye lids, often the lower lid(s). It often will occur and resolve spontaneously. Possible contributing factors are excessive amounts of caffeine, stress, exhaustion, alcohol or drug use, and anxiety. Because this condition will often resolve of its own volition, treatment is often used to make the condition more bearable for its duration. Treatments may include reduction of caffeine, warm compresses, oral antihistamines, and/or rest and relaxation.

Blepharospasm:

Blepharospasms can be caused by a variety of conditions from dryness and irritation to benign essential blepharospasm, wherein the particular cause of twitching is unknown. Blepharospasms may involve one eye, both eyes, or the full face; it can be difficult to tolerate and may be uncomfortable/activity limiting. Blepharospasms may self-resolve or may require treatment to cease; treatments may include BOTOX injection, drug therapy, surgical intervention, and stress management.


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Giving Thanks!

November 26, 2013

It’s easy to take our vision and our accessibility to quality healthcare for granted. Thanksgiving gives us a rare opportunity to take a day to focus on the positives of our lives; we are functional, we have the ability in our country to much more easily access assistance, clean water, and food than do many others in our world. If we can see, even if our abilities are encumbered by glasses, glaucoma drops, or itchy eyelids, we are better than the millions worldwide who cannot see the sun rise or snow fall.

We can try to be thankful for the snow, but, in Western New York, that may be a tall order.

Here at Legarreta Eye Center, we are thankful for our wonderful staff, and of course, our great patients & optical customers! Thank you so much for all of your support, business & recommendations. We greatly appreciate it & we are glad to serve you!

Happy Thanksgiving to you and yours from your family at Legarreta Eye Center.


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Diabetes and Eye Health

November 22, 2013

Diabetes is often a lifelong condition which requires active maintenance and monitoring. Checking blood sugar daily (or as frequently as your doctor advises) can become routine. What should also become routine is maintaining a healthy diet and attempting to exercise within your body’s limitations. A diabetic diet can be seen as restrictive; this is certainly not the case, provided you make an effort to incorporate the wide range of healthy, advisable foods! A diabetic diet (which emphasizes fruits, vegetables, and whole grains) is beneficial for almost everyone, even people who do not have a current diabetic diagnosis.

Diabetes can greatly affect the eyes; it can cause permanent damage, damage to the back of the eye (via hemorrhages, active bleeding, and/or blood vessel growth), and fuzzy vision, especially with blood sugar fluctuations. Diabetes can increase the risk for blindness, glaucoma, and early cataract development. Diabetic retinopathy, an unfortunate and somewhat common occurrence in patients with diabetes, can range from mild to severe and can vary from nonproliferative to proliferative (the main distinction being the latter’s presentation of actively regrowing blood vessels which are extremely volatile, abnormal, and fragile). Your eye care professional monitors the health of your macula and retina with dilated examinations; while dilation can be somewhat time consuming and annoying for a few hours, it is vitally important to the health of the eye for diabetics to adhere to their advised regimen of dilated examinations.

With excess calorie and fat comes a rise in blood glucose; this can be devastating to patients with troubled endocrine systems. Severe or recurrent fluctuations can lead to stroke, blindness, and death.   Weight loss can bridge the gap between a healthy adult and an unhealthy adult; often, the difference between an active diagnosis of diabetes and no diagnosis is a few pounds. Though it can be difficult to lose weight, it is not an impossible task for anyone, provided they are willing to commit to being an active part of their own health.

If you have diabetes or you have a risk factor for diabetes (obesity, familial history, etc), a dilated eye exam can be beneficial to your overall and ocular health. Scheduling an annual exam (at least) for dilation is a good habit; diabetics may require more frequent monitoring, especially if the health of the retina is compromised or blood sugar control is especially poor. Our eye care professionals are skilled in diabetic care and are available for appointments!


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Keratoconus

November 5, 2013

Vigorous eye rubbing is generally discouraged by eye care professionals. It can lead to abrasions on the eye, bruising of the ocular area (if rubbing is especially forceful), temporary eye pressure increase, and even a reduction of the elasticity of the eye lids! While most eye rubbing among the general populations is accepted as relatively benign, unfortunately, a more severe condition can stem from this discouraged habit: keratoconus.

Keratoconus presents as a thinning and gradual conical bulging of the cornea, the clear “cap” of the eye. This condition is progressive and can lead to significant enough damage to the ocular surface that surgical treatments may be advised; these surgical treatments may include a corneal transplant. Vision may decrease and blur and light sensitivity can increase as keratoconus progresses. Because keratoconus is volatile and progressive, symptoms may range in occurrence and severity; they include: blurred/distorted vision, light sensitivity, decreased night vision, sudden decrease or clouding of vision, and frequent refractive prescription changes.

An optometrist or ophthalmologist can ascertain and diagnose keratoconus through a routine eye exam, though the severity of the irregular astigmatic curvature of the eye may be tested with additional tests not performed on routine examinations. Monitoring for progression is important for patients with keratoconus as there are options for treatment that are not as invasive as a corneal transplant (examples include Intacs corneal implants and riboflavin crosslinking; though, note that the latter treatment is still in clinical trials in the US).

Habitual eye rubbing alone may not be the sole factor in the development of keratoconus; even so, avoiding habits associated with increased risk of a degenerative disorder’s development can be your best method for decreasing your likelihood of developing said disorder. While the exact cause of keratoconus is unknown, risk factors for the disorder include excessive eye rubbing, prolonged contact lens wear, other conditions (including retinitis pigmentosa, retinopathy of prematurity, Leber’s congenital amaurosis, and Down Syndrome), and a familial history of keratoconus.

An excellent resource for information on keratoconus and its treatment is: http://www.nkcf.org/. This site provides informational videos and updates on keratoconus.

If you are concerned about the health of your cornea and/or if you have noticed a significant decrease in your visual capabilities, an eye examination with your eye care professional is advisable. While keratoconus is not an incredibly common disorder in the general population, it is estimated to occur to some degree in about 1 out of every 2,000 people. Any of our four qualified eye care professionals can evaluate your corneas for keratoconus during your annual eye examination. Call for an appointment today if you have any concerns or would like an evaluation!


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October is Eye Injury Prevention Month

October 24, 2013

Over 2 million people in the United States suffer eye injuries annually. While some injuries are unavoidable or resultant from accidental occurrences in out-of-the-ordinary situations (eg. car accidents, falls, etc), many of these injuries occur due to negligence in wearing the proper protective eye wear. By and large, men have a higher risk for eye injuries than women (be careful, guys). Nearly half of eye injuries occur at home; a portion of these occur during projects dedicated to home upkeep (like yard maintenance, home repairs, cooking, and cleaning).

Protective eye wear is vitally important; it’s estimated by the American Academy of Ophthalmology that up to 90% of eye injuries could have been prevented or mitigated by safety glasses! Wearing protective eye wear that bears the label ANSI Z87.1 is an excellent step in reducing the risk of permanent damage from injuries sustained to the eyes. While no safety measures are inherently infallible, taking steps to decrease the risk of injury can make the difference between a life-altering injury and minor (or no) damage. Many companies will contribute to, or pay for in total, the cost of safety eye wear.

At Legarreta Eye Center, we have many options for safety and sport eye wear available at all three of our locations; if you would like to make an investment in your eye health, consider purchasing a reliable pair of safety glasses! As always, UV Protection is also important for optimum ocular health. Ensuring that the exposure of the eye to harmful UV radiation is as limited as possible is equally as important as wearing protective glasses during risky activities. Sunglasses may be covered under your insurance care provider (especially if they are dispensed with your current prescription). If you have any questions or concerns or would like to schedule an appointment for an eye examination, call any of our three locations today!


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October is Blindness Awareness Month

October 12, 2013

October is World Blindness Awareness Month. 180 million people worldwide (according to the World Health Organization) suffer from blindness or some form of impaired vision. Gaining understanding of the magnitude of visual impairment is important at any time of year, but especially during the month of October. October 11th is World Sight Day, an observation that helps shed light on the importance of vision.

EyeCare America is an organization that raises awareness of ocular disorders, health management, and provides a wealth of amazing information about the eye, its diseases, and what you can do to help those that are visually impaired. We often take our good vision for granted; what better way to give back to your community than by assisting someone who may have functional limitations due to visual impairments? For information on EyeCare America, visit: http://www.eyecareamerica.org/

If it has been a while since your last eye exam, an exam during Blindness Awareness month could be a great idea! If you need to schedule an exam, give any of our three locations a call! We even offer some evening and Saturday hours!


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Bell’s Palsy

October 3, 2013

Bell’s palsy is often characterized by a weakness or paralysis of the muscles on one side of the face. While similar in appearance to the results of a stroke, Bell’s palsy is not normally linked to a stroke or transient ischemic attack (TIA). If you notice a sudden weakness on one side of your face, or are concerned for your health at all, visit an emergency room or your primary doctor immediately. Bell’s Palsy can affect the eyes, especially the ability to produce sufficient lubrication for the surface and a difficulty keeping the eye on affected side open.

While the exact cause of Bell’s palsy is unclear, it is thought that many cases are related to the herpes simplex one virus. Bell’s palsy often presents with an inflammation of the nerve that controls unilateral facial muscles. Symptoms of Bell’s palsy include sudden weakness/drooping/paralysis of one side of the face; a difficulty closing eye on affected side; inability to control drooling; tearing; decreased or total loss of ability to taste; ear pain; phonophobia (sensitivity to sound); numbness of affected side of face. Testing for Bell’s palsy may include an in-office exam, MRI, CT scan, and/or blood testing. Treatment may range from monitoring to corticosteroid and/or antiviral medications.

If you are concerned that you or a loved one may have Bell’s Palsy, set up an appointment with your primary care physician, ophthalmologist, or emergent care center. Because symptoms of Bell’s Palsy can be similar to the symptoms of a stroke, early diagnosis is important.


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Computers and Your Eyes

September 25, 2013

While they can certainly be convenient, entertaining, and a source for reading wonderfully informative ophthalmic blogs, computers can be detrimental to the eyes. It’s actually become so prevalent that it has a name of its own: Computer Vision Syndrome! Taking breaks from excessive use, using artificial tears intermittently during use, and wearing your correct refractive prescription are some of the methods which can reduce the severity of complications from computer use.

 Computers, or, more accurately, the staring we do while using computers, can contribute to dry eye. Dry eye can cause any number of complications from discomfort to an increased risk for infection (for an extensive description of dry eye, check out our January blog on the topic). One easy way to reduce this effect is to keep a bottle or vials of artificial tears next to your computer; this can help as a reminder to use them on occasion, especially while using the computer for extended periods of time. Remember, a preservative-free artificial tear is the best option if artificial tears are used in excess of four times daily; many quality brands are available in preservative-free form (Theratears, Optive, and Systane to name just a few). If you are concerned your dryness may be more than just a result of overuse of the computer, or it continues without significant reduction of symptoms, call us to schedule an evaluation.

 Headaches and eyestrain are common complications of Computer Vision Syndrome; again, taking consistent breaks can contribute to a reduction of these symptoms. Where you sit and how you look at the computer can also factor into your ocular comfort; ensuring that you’re wearing the proper prescription for computer range vision and you are seated the appropriate distance away from the screen can decrease your risks for symptoms of Computer Vision Syndrome. If your headaches or eyestrain are frequent, severe, or concerning, an evaluation with an eye care professional or your primary doctor is warranted.


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Eating For Your Eyes

September 25, 2013

While changing dietary habits can be difficult and should be supervised by your primary care physician, making healthy choices in your daily regimen is always a good choice! There are many, many diets out there, from juicing to low-carb to low-fat to all grapefruit! What is most important to keep in mind is that a balanced diet is very important. Keeping a diet which contains a variety of fresh fruits and vegetables, one that focuses mainly on healthy alternatives and less on simple carbohydrates and saturated fats, can be easier to maintain and tolerate than “crash” diets which focus on deprivation and may result in severe depletion of vital nutrients.

Eating for your eyes does not have to differ from an overall healthy dietary approach; certain healthy foods can not only benefit your eyes, but your entire system! Because the eyes are vascular organs, a heart-healthy diet (one low in trans/saturated fat) can aide in protecting blood vessels from undue damage. Eating foods high in antioxidants can further benefit your overall and ocular health. Below is a list of eye-healthy foods that most anyone can healthfully tolerate! As always, check with your primary physician before any drastic dietary changes.

Vitamin C: citrus fruit, berries, tomatoes, and broccoliVitamin E: vegetable oils, wheat germ, nuts, and legumesZinc: nuts and seeds, legumes, wheat germ, and shellfishLutein and zeaxanthin: kale, spinach, broccoli, peas, whole eggs, and Brussels sproutsOmega-3 fatty acids: cold water oily fish (salmon and tuna), walnuts, and flaxseedBeta-carotene: carrots, pumpkin, sweet potatoes, and spinach

Adding any of these foods into your diet can be simple: have our AMD shake in the morning (see our AMD blog for the Green Shake recipe); have salmon on the grill instead of a beef steak; have spinach in your salad and top it with flaxseeds; instead of cookies or cake, have fresh fruit for dessert (diabetics may be able to tolerate lower glycemic fruits; consult your primary doctor).


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How Does Pepper Spray Work?

September 12, 2013

First off, NEVER experiment with pepper spray. It is for use in emergency situations only, meaning you should not use it unless you are in mortal peril; it’s not a toy to be used for fun or while under the influence of drugs or alcohol. Though it mostly has limited long-term complications, pepper spray can contribute to sudden death. The sprayed individual is not the only one who will suffer the ill-effects of pepper spray. When you spray pepper spray at another person, you may notice some of the adverse effects; this is important to note when you’re using it for its intended purpose: as a method of self-protection. If you ever find yourself in a situation where pepper spray needs to be used, the most effective way you can save yourself by using pepper spray is to use it as directed and then RUN. Get as far away from the situation as you can because you’re going to feel its effects and it very likely will impair your ability to get away effectively. 

To understand what pepper spray can do to the eyes, we should first understand what it is. Pepper spray is derived from a chili pepper extract called capsaicin. If you’ve ever eaten an exceptionally hot pepper, you should be aware of the intense burning sensation that accompanies very hot peppers. Imagine that same sensation in the eye. When exposed to the eye, pepper spray causes involuntary closure, tearing, burning, and temporary vision loss. Further, sinuses will drain and there is a distinct possibility that breathing will become difficult and labored. The symptoms which occur after being sprayed with pepper spray generally dissipate after approximately one hour.

If you’re ever sprayed with pepper spray, regardless of how it happened, getting to an emergency care facility is important. Flushing the eyes with water may reduce the amount of pepper spray on the lids, but may have little long-term effect on the actual eyes. Pepper spray is oil-derived; as oil and water separate, rinsing out the eyes with just water may be ineffective. Emergency services will be a


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Sports Glasses

September 5, 2013

Avid athletes, with or without refractive errors, may well benefit from wearing protective sports eye wear. Not only can sports glasses provide ample increases to vision, they can decrease the risk of ocular trauma during sports activities.  Even if you only casually engage in sports, sports glasses may be an excellent option for you!

Poor vision can lead to an increased risk in normal daily activities; this risk increases with certain activities, sports included. Failure to have clear vision during sports activities can result in any number of injuries, from misjudging distances to facial/eye trauma from wayward sports equipment. Results can be painful and potentially permanently damaging.

Many prescription sports glasses are designed to handle impact while providing clear vision. Not only can they protect the eye from damages from a fly ball or running into another player, they can allow a wider range of peripheral vision when compared to traditional glasses. Protecting the eyes during sporting activities is not only important for adults, but for children as well.

We have many options for prescription sports glasses available at any of our three locations. Call or stop in today to check out our available sports glasses!


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Blepharitis

August 28, 2013

Blepharitis is an eyelid inflammation; it can cause red, irritated, itchy eyelids which may or may not exhibit dandruff-like scaling on the eyelashes. It can be annoying or uncomfortable, but generally does not cause any permanent damage to eyesight. There are two main types of blepharitis: anterior blepharitis (occurring at the outer edge of the lid where eyelashes connect) and posterior blepharitis (occurring at the inner edge of the lid which comes into contact with the eyeball).

Symptoms of Blepharitis

Gritty/burning sensation in the eyesExcessive tearingItchiness of the lidsRedness/swelling of the lidsDry eyesCrusting of the eyelidsBlurring vision 

What causes blepharitis?

The cause of blepharitis can vary from bacteria or general dandruff to an influx of oil gland production or even mites!

How is blepharitis treated?

In many cases, a regular cleaning routine can reduce or even resolve symptoms. Good lid hygiene is important; this may include warm compresses, face washing, cleaning the eyelids, and avoiding overuse/sleeping in makeup and contact lenses. If the cause of blepharitis is bacterial in nature, topical treatments may be added to alleviate symptoms.

A tip for warm compresses: fill a coffee mug with water that is as hot as you can tolerate. Bring a clean washcloth and the mug with you and sit down and relax. Dip the washcloth into the hot water in the mug, then hold across closed eyes; rewet washcloth in the mug to reheat as needed. This allows for a reduced need to get up and reheat the washcloth!


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Back to School!

August 21, 2013

Can it be that time already?! Back to school examinations can get your child ready for the school year ahead. Nothing is quite as beneficial for kids as going back to school relaxed from their summer vacation with clear vision! A large percentage of children under 8 have never had a comprehensive eye exam (some estimate at 50%!). Making sure your child’s vision and eye health are in working order is a great way to prepare them for the school year ahead. New frames for kids are lightweight, versatile, and comfortable, in addition to the benefits corrective lenses give them!

Because a child’s vision adapts and compensates for low qualities, your child may not even complain of poor vision! As we discussed earlier this month, that can be a big problem if their vision is compromised by an “invisible” condition like amblyopia (lazy eye) or a sometimes visible condition like strabismus (eye turn). While in-school vision checks may be sufficient for the very basic vision testing, a comprehensive eye examination is recommended to give your child the most expert level of care.


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Color Vision Deficiency and Stereovision

August 14, 2013

Color Vision Deficiency

Color vision is the ability to distinguish objects based on the wavelengths of light that are reflected, emitted, or transmitted. Human color perception is a brain response to stimuli produced and reacted with by cone photoreceptors in the eye. Color vision deficiency, or “color blindness,” manifests as a loss of color perception to one or many color wavelengths. Often, color vision deficiency is a congenital disorder, though it may be produced by physical or chemical damage to the eye, optic nerve, or brain. Color vision deficiency affects a large portion of individuals, occurring with much greater frequency in men than in women. Deficiencies in the red-green fields are most common. While color vision deficiencies are not treatable, people with the disability generally do not notice a significant negative impact in their daily activities. Examinations in childhood will often pick up on these deficiencies.

Want to test your color vision?! Follow the link below!http://www.toledo-bend.com/colorblind/Ishihara.asp

 

Stereovision

Do you know that there are some people who can’t see 3D? Stereoscopic vision in humans gives us our ability to see depth; under normal conditions, the eyes work together to provide vision of an image, along with its depth. In people with limited or no stereoscopic vision (ex: those affected by amlyopia (lazy eye), strabismus (eye turn), or patients with a blind or only one eye), depth perception may be limited or nonexistent. In patients with limited stereoscopic vision due to strabismus or amblyopia, treatments may be available to correct vision in the impaired eye, possibly providing some development of stereoscopic vision, though treatment as early as possible is desirable to ensure that possibility.

Want to test your stereovision?! Follow the link below!

http://www.vision3d.com/frame.html


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Childhood Eye Disorders

August 7, 2013

Disorders of the eye can be detrimental at any age, but can be especially devastating in childhood. Many of these conditions can be terrifying, especially to a nervous parent; thankfully, many congenital disorders and/or disorders developed in childhood can be treated and kept in check, even if they are not “curable.” In April, we discussed one such childhood disorder, retinoblastoma (http://www.legarretaeyecenter.com/blog/news-and-updates/cancer). This week, we’ll dive into some less frightening disorders of childhood: amblyopia, strabismus, and refractive errors.

Amblyopia

Developmental problems in the brain causing delayed or stunted visual development are most often the cause of amblyopia, or “lazy eye.” Within childhood visual development, there is a period of critical development which, if treatment for amblyopia is not adhered to, can cause lifelong visual limitations. What makes determination and treatment difficult is the ability of the brain to compensate for poor vision, out of one eye especially; children affected by amblyopia may not even realize that they have limitations. Amblyopia is usually congenital and can be secondary to other eye conditions, including congenital cataracts, strabismus (misaligned eyes), and anisometropia (unequal refractive error between the two eyes).

Treatment, often in the form of patching or blocking the vision of the better seeing eye, can be integral to increasing the visual capabilities. Difficulties arise in compliance, especially with children adhering to advised treatments. Parents are urged to be vigilant in recommended treatments; vision not developed within the fundamental visual development period is lost forever. After the visual developmental period is over, no further treatments have significant effects on vision in amblyopic eyes, and children may be excluded from certain careers (and are more at risk for limited capabilities if better seeing eye is damaged).

Strabismus

Strabismus is a condition where the eyes are misaligned; this may be a constant or may be intermittent, somewhat controllable or completely uncontrollable. While it is a relatively rare condition, it is estimated that it is present in approximately 4% of children. Advised treatments should be begun as soon as possible to ensure the best possible visual outcome; treatments include surgery on the muscles of the eyes, prisms in refractive spectacles, and monitoring. Symptoms include an eye that turns out, in, up, or down; this may switch between either eye, or may be only affecting one eye; further, constant or intermittent misalignment may be noted. During your child’s examination, testing may be performed to attempt to cause the affected eye(s) to deviate if it is not immediately apparent.

Refractive Errors

Refractive errors are simply the visual disorders many of us are born with or develop; nearsightedness, astigmatism, and farsightedness are common refractive errors. It is important to treat these in childhood with glasses, if deemed necessary by your eye care professional. Some symptoms of refractive errors include sitting more closely to the television, holding books closer while reading, squinting, and complaining of poor vision. Teachers and parents may notice a decrease in performance in school or difficulties reading the chalk/smartboard or books. Determination of refractive error is often a simple, non-invasive eye examination.


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Obesity

July 31, 2013

Obesity has become an epidemic in the US; it has progressed to the point where it is an acceptable medical diagnosis! Not only can obesity shorten your lifespan, decrease your quality of life, and increase your risk for heart disease, cancer, liver disease, polycystic ovarian syndrome, and diabetes, it can increase your risk for ocular disorders, including cataracts, diabetic retinopathy, retinal vein occlusion, and pseudotumor cerebri, which we’ll focus more acutely on below.

Definitive Diagnosis of obesity can be somewhat difficult; BMI calculators alone are insufficient as they do not make allowances for muscular body weight or skeletal frame. It is important to follow closely with your primary doctor, especially if you are concerned that you are overweight or obese. Losing weight can be difficult, but it is by no means impossible! Reducing simple carbohydrates and sugars, increasing exercise within your capabilities, and adhering to an overall healthy diet can aide in helping you achieve a healthy weight!

Pseudotumor cerebri is an idiopathic increase in your intracranial pressure, giving the symptoms of a tumor, without actual tumor presence. While it can occur in people of any age, weight, or nationality, it is most commonly noted in obese women of childbearing age (obese women under the age of 40 are about 40 times more likely to develop pseudotumor cerebri than the general public). Symptoms include moderate to severe headaches, ringing in the ears (pulsing in time with heartbeat), nausea, vomiting, dizziness, blurred vision, temporary and brief episodes of blindness (may be unilateral or bilateral), decreased peripheral vision, double vision, flashes of light, and neck, back, and/or shoulder pain. While pseudotumor cerebri is relatively uncommon, it is a serious condition which bears treatment and close monitoring; as many as 10% of affected people will experience progressively worsening visual symptoms which can lead to eventual blindness. This can occur years after initial onset or diagnosis; weight loss is essential for obese or overweight patients with the condition, and regular eye exams are vastly important for the most quality care. Treatments include the use of glaucoma drugs, diuretics, migraine medications, and surgical intervention (often at optic nerve or spine).

As with any treatment, following closely with your primary medical doctor is advised prior to beginning any weight loss treatment. Adhering to an overall healthy diet and including moderate amounts of exercise can be easy and beneficial to just about anyone! While weight loss is no guarantee of ocular or even overall health, prolonged obesity can increase your risk for complications in the eyes and the rest of your body. If you’re worried about your weight, or would like more information on how to control your weight in a healthy manner, speak to your primary doctor.


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Corneal Ulcers

July 24, 2013

A corneal ulcer is a severe condition which requires IMMEDIATE treatment from your eye care provider. Untreated (and, unfortunately, even with treatment), corneal ulcers can permanently scar the eye, rob vision, and can even cause loss of the eye itself. If a concern for a corneal ulcer is raised, through your primary doctor, acquaintance, or even by self estimation, evaluation and treatment by an eye care professional is essential to treating the condition and providing you the best prognosis available.

What is a corneal ulcer?

Corneal ulcers are inflammatory or infective conditions of the cornea. They are often caused by bacterial infection following contact lens overuse or misuse, eye injury or trauma, severe dry eye, chlamydia infection (trachoma), or herpetic eye infections; they may also be caused by viral infection, fungi, or parasitic infection of acanthamoeba (parasite found in tap water, swimming pools, hot tubs, and other bodies of water).  Ulcers may occur in any portion of the cornea (the clear cap of the eye); they can be much more vision-threatening, however, when they occur in the central cornea, often over the pupil.

Symptoms of a corneal ulcer include, but are not limited to:

Blurry/hazy visionA red or bloodshot eyeA visible white or discolored spot on the eye.Sensitivity to lightItching and dischargePainful eyesTearing

 

How can I avoid corneal ulcers?

When your optometrist, ophthalmologist, optician, or primary doctor tell you not to sleep in your contacts, they mean it!! Contact lenses are a very common cause of corneal ulcers; sleeping in contacts, poor contact hygiene, and over-wearing contact lenses are habits which can lead to this very severe, possibly vision-destroying condition. Extended wear contacts (those that are approved for overnight wear) still need to be taken out on occasion; if you can tolerate “daily wear” lenses (lenses which you use only once and discard afterwards) provide less risk of complications from over-wear, provided you adhere to the restrictions given on the lenses.

How are corneal ulcers treated?

Treatment depends on the severity of the ulcer. Topical antibiotics are usually advised and the area may be cultured for evaluation; follow-up appointments range depending on the aggressiveness of the ulcer, some specialists may recommend daily follow-ups, while others may suggest visits every other day or every three days. Unfortunately, severe corneal ulcers, even with treatment, may lead to permanent corneal scarring. While immediacy in treatment gives the best chance for avoiding severe complications from ulcers, ulcers may still cause severe and sometimes irreparable damages. Even with the best care and management of this condition, some patients with corneal ulcers may require a corneal transplant to achieve any amount of vision after this severe infection. Corneal transplants, while a very significant and serious surgical treatment, can be very effective in allowing compromised eyes to regain some semblance of usefulness; transplants replace affected corneas with healthy, cadaver donations.


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Toxoplasmosis

July 17, 2013

What is Toxoplasmosis?

Toxoplasmosis is a parasitic disease that can affect warm-blooded animals, including humans. The primary hosts are members of the feline family; often, transmission from cat to human occurs with the handling of unsanitary feline waste. Symptoms of the illness can differ depending on the phase of toxoplasmosis; typically, the first few weeks after exposure are characterized by a mild, flu-like illness. Initial symptoms may include swollen lymph nodes in the neck, under the chin, in the armpits, and/or in the groin area.

Fatalities, though uncommon, may occur in any infected host, but are more common in those with susceptible or weakened immune systems (young children, fetuses, patients with AIDS, patients on chemotherapy, or pregnant women). Serious illnesses, such as encephalitis (brain inflammation), necrotizing chorioretinitis (choroidal inflammation), disorders of the liver, heart, and ears, learning disabilities, epilepsy, and neurological diseases may be caused by this parasite. Further, studies indicate that toxoplasmosis may cause or contribute to psychiatric disorders, including depression, anxiety, and schizophrenia. 

How is Toxoplasmosis Transmitted and Treated?

Transmission may occur via ingestion of raw or undercooked meat (especially pork, lamb, or venison) or ingestion of contaminated cat feces (possible via hand-to-mouth contact after gardening, cleaning a litter box, contact with sandboxes, or touching a leech); the toxoplasmosis parasite can survive in the environment for over one year. Pregnant women are advised not to be exposed to cats during the course of their pregnancy, avoiding fecal exposure if this is not feasible.

Diagnosis of toxoplasmosis can be difficult and often is made by therapeutic drug trials, followed by a brain biopsy if no clinical improvement is noted with repeat imaging. Blood samples can aide in definitive diagnosis. Treatments include antibiotics, steroids, and/or antimalarial drugs. Treatment is especially important for pregnant women, as this is an important preventative measure to avoid fetal infection.

 How Does Toxoplasmosis Affect the Eyes?

This parasite can be severely detrimental to fetal visual development. While a possibility, new development of ocular toxoplasmosis is relatively rare in adults. In fetuses, the most common part of the eye to become affected by toxoplasmosis is the retina, more specifically, the choroid. This can lead to retinal scarring, vision impairment, and even blindness; these impairments may be unilateral (affecting one eye only) or bilateral (affecting both eyes). Other ocular conditions caused by toxoplasmosis include nystagmus (uncontrollable, fast ocular movements), congenital cataract, microphthalmia (one eye smaller than the other), optic atrophy, and cerebral visual impairment. Scarring and retinal damage from toxoplasmosis cannot be repaired; however, it usually does not worsen, though relapse from dormancy may occur later in life, causing a new active infection and further damage, if not treated accordingly.


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Allergies and Your Eyes

July 10, 2013

Do you feel like your eyes burn every time you walk outside during the spring or summer? Are your eyes itchy, watery, or otherwise irritated? You may be suffering from ocular allergies. Ocular allergies can cause the eye to be itchy, irritated, swollen, and may cause significant tearing. Swollen eyelids are also a possible result of eye allergies.

The causes of ocular allergies are as varied as the causes for systemic allergies, but may include: dust, mold, pollen, mold, and pet dander. In addition, the preservatives found in artificial tears may cause rebound inflammation, especially in patients who overuse the drops. Ocular allergies can have a severely negative impact on your daily life; they can be so severe that you avoid activities you enjoy, including: gardening or yardwork, walking or biking outdoors, swimming, having pets, or cleaning (though that last one I think we all may wish we could avoid!). 

Treatments for ocular allergies include topical drops (such as anti-inflammatory drops, steroid drops, and/or antihistamine drops), specifically allergy-related drops like Pataday, Alaway, Lastacaft, Bepreve, or over-the-counter Zatidor, oral allergy medications, and/or using a preservative-free artificial tear, as needed. If you notice that your eyes are irritated, tearing, uncomfortable, or if you feel you have to avoid activities you love to avoid eye irritation, any of our caring medical professionals would be happy to evaluate your condition and determine the most effective treatment for you!


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Fireworks and Eye Injuries

July 3, 2013

Celebrating our nation’s independence should not come with an added trip to your primary or ophthalmic doctor! Every year, 9,300 serious injuries are sustained from fireworks; of that number, up to 2,000 people on average suffer some form of eye injury.

Of the injuries sustained by fireworks annually in the United States, eye injuries can be some of the most life-changing. Approximately one quarter of the eye injuries sustained from fireworks (averaging about 500 of the 2,000 reported) cause permanent loss of vision, blindness, or loss of the eye completely. Other complications to the eyes include torn irises, corneal ruptures, hyphema (blood in the front of the eye), eyelid lacerations, subconjunctival hemorrhages, and severe burns to the ocular surface.

While the majority of fireworks injuries seem to stem from firecrackers and “bottle rockets,” seemingly harmless sparklers can be potentially dangerous to the eyes and your overall health as well. Children should NEVER be allowed to handle any type of pyrotechnic equipment, nor should any individual under the influence of drugs or alcohol. Safety glasses and gloves should be worn by the adult setting off fireworks and the entire group watching the display should be an adequate distance away from the “launch” site; ideally at least 40 feet for consumer products, 500 feet for professional products. Professional fireworks are provided by your county of residence in New York State; there are many wonderful, free showings annually, especially in the period surrounding the Fourth of July. Check your local listings for dates and times in your county!

Remember, consumer fireworks are illegal in New York State, unless you have a permit. Do not, under any circumstances, use fireworks if you are not licensed to do so, or it is legal in your state of residence.


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Myasthenia Gravis Awareness

June 23, 2013

Myasthenia Gravis is a chronic neuromuscular/autoimmune disorder; its hallmarks are increased and varying degrees of weakness in the voluntary muscles in  the body. Myasthenia Gravis is often characterized by weakness in the muscles that control eye movements, eyelids, arm and leg movements, breathing, coughing, facial expressions, swallowing, and chewing. It often presents as eyelid drooping (ptosis), double vision, difficulties in breathing, speaking, or eating, and generalized fatigue, even with minimally exertive activities. While there is no cure for this disease, treatments are available which can increase quality of life and decrease symptom significance.

Myasthenia Gravis is caused by a communication breakdown between the nervous system and muscles due to damage from the autoimmune nature of the disease; muscle contractions are prevented from successful occurrence by this disease, leading to complications and annoyance on part of the affected person. In Myasthenia Gravis, the thymus gland does not decrease in size as it does in a person without the disease; sometimes, thymomas (tumors of the thymus) can occur. While generally benign, caution must be taken as tumors have the capacity for malignancy. While Myasthenia Gravis can occur in any ethnicity or age group, it is most common in women under 40 and men over 60.

Often, the first symptom subjectively noted in Myasthenia Gravis is eye muscle weakness; any presentation of a unilateral or bilateral eyelid droop is cause for evaluation by your eye care provider. Further, this disease may cause double vision or blurred vision; as with abnormal presentation of eyelid droop, any double vision or sudden presentation of blurred vision warrants a visit to your eye doctor!

The diagnostic testing for Myasthenia Gravis can be varied, but often includes a medical history review, testing of eye movement capabilities, an ice test in patients with ptosis (testing is done to ascertain if ptosis reduces with ice), bloodwork, and a chest CT or MRI to monitor for thymoma presence. Treatment for this disease can be a compilation of approaches, from medication to surgical removal of the thymus gland to dietary and activity changes. Patients with Myasthenia Gravis may especially benefit from solid sleep every night, an increase in daily levels of Vitamin D, Calcium, and fiber, and an increase in aerobic exercise (within fatigue limitations).


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Miniblog: My Cataract Grew Back!!!

June 20, 2013

As a busy ophthalmic practice, we will often hear many of the same complaints or questions from different patients. One of the most common we hear is about cataracts. Cataracts, a topic we will discuss in depth later this year in our blog, are a clouding of the natural intraocular lens. Cataract surgery removes this clouded lens, replacing it, instead, with a clear, plastic, artificial lens. Patients will often question if the cataract grew back because they have a family member or friend who said it happened to them; a condition known as posterior capsular opacity, or an “after-cataract,” can and often does develop months or even years after successful cataract surgery. This opacity affects the capsule in which the natural lens once sat, and in which the artificial lens is placed. Symptoms can include blurred vision, glare, halos, and poor night vision. If treatment is advised, it is in the form of a simple, in-office laser procedure.


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Pinguecula and Pterygium

June 19, 2013

Pingueculae and pterygia are growths which can affect vision and the comfort of the eyes. They are often indicators of a patient who enjoys outdoor activities as UV light, wind, and dust exposure can instigate the development of either condition. While neither of these conditions are usually indicative of malignancy, any growth on the surface of the eye should be investigated properly by a medical eye care professional.

PINGUECULA

A pinguecula is a yellowish patch or bump on the conjunctiva (the “white” of the eye) near the cornea (the clear cap of the eye). Most often pingueculae will appear on the side of the eye closest to the nose (the nasal portion of the eye). They may appear similar to a callus on the skin of the eye. Pingueculae can progress into a pterygium.

PTERYGIUM

A pterygium is an often triangle-shaped growth of fleshy tissue of the conjunctiva that eventually extends over the cornea. Pterygia may encroach on the center of the eye, obstructing vision significantly. Pterygia often develop from pingueculae. Pterygia may be significant enough to change astigmatic prescription, as well.

SYMPTOMS

Both pingueculae and pterygia can be irritating to the ocular surface, causing itching, burning, foreign body sensations, and grittiness; vision may be distorted; finally, aesthetic dissatisfaction is a common result of both conditions.

TREATMENT

Treatment for both pingueculae and pterygia include surgical removal, monitoring, and topical steroid drops. Surgical removal may be effective, but both conditions have a degree of recurrence likelihood.

PREVENTION

While no factors can fully prevent pterygia or pingueculae development, wearing wraparound sunglasses when outdoors, wearing safety eyewear in dry, dusty conditions, and using artificial tears in dry conditions can aide in reducing risks for either condition.


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Smoking and Your Eyes

June 13, 2013

Nearly every medical professional decries the adverse effects of smoking to your overall health. Smoking can increase your risks for cancer, emphysema, chronic bronchitis, heart attacks, strokes, cognitive dysfunction, female infertility, and Parkinson’s disease. In addition, smoking can severely decrease or even destroy ocular function.

WHAT SMOKING DOES

Smoking decreases blood flow, can harden arteries, and can reduce antioxidant supply. These factors can instigate or worsen already developed ocular conditions. Smoking can topically irritate the eyes, leading to allergic conjunctivitis and/or dry eye, but can permanently damage the retina, macula, intraocular lens, and other portions of the eyes. If you are a smoker, routine eye exams are important to monitor potential ocular damage.

WHAT CAN SMOKING DO TO THE EYES?

Smoking can cause numerous complications to the eyes, but a list of the most common complications is below.

Macular Degeneration (this condition can permanently destroy central vision)Early Cataract Development (while cataracts progress normally with age, smoking can expedite development)Dry Eye and Allergic Conjunctivitis (smoking can irritate the surface of the eye, causing inflammation)Uveitis (inflammation in the middle layer of the eye, leading potentially to eye pain, floaters, and loss of vision, among other complications)Graves’ Disease in patients with active thyroid disordersOptic Neuropathy (damage to the optic nerve, which can lead to irreparable blindness)Retinopathy of Prematurity in infants born to smoking mothers (this condition is an abnormal growth of blood vessels in the retina, leading to complicated vision)

HOW TO QUIT

There are many methods through which you can quit smoking, varying from medication to support groups to quitting “cold turkey.” Whichever method you choose, know that your decision to quit smoking can have very beneficial results for your eye health and your overall health. For assistance in quitting smoking, please visithttp://www.smokefree.gov/ . Good luck! We know you can do it!


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Cataracts

June 5, 2013

Cataracts are a very common eye condition which can reduce vision and quality of life with their progression. Responsible for up to 51% of the world’s blindness, cataracts often develop slowly over the course of years. Thankfully, in the United States we have lower rates of vision complications due to cataracts (when compared to more prevalently affected areas like Africa, Indonesia, the Middle East, India, and Burma) because of our medical advances and availability of care.

WHAT ARE CATARACTS?

Cataracts are a clouding of the natural intraocular lens of the eye; this clouding can lead to visual distortions and decreased quality of life, especially if left untreated. Cataracts reduce vision by lens opacification, meaning that the lens can become so dense that it limits the eye’s ability to pass light through to the retina, where the majority of our vision occurs. The term cataract is derived from the latin cataracta, meaning waterfall; comparing the cloudiness of a cataract-affected lens to the frothy white waters produced by Niagara Falls is an apt comparison.

WHAT CAUSES CATARACTS?

Age-related cataracts are a natural progression, but certain lifestyle factors can expedite the rate of progression and increase the significance of cataract severity. Smoking, steroid use, and exposure to UV-B light can increase how quickly cataracts are developed. Cataracts can also be related to trauma or can be congenital. Age-related cataracts often begin much earlier than we would like to think; approximately 42% of people in the US between the ages of 52-64 have some semblance of cataract. This percentage increases with age; 91% of US adults between the ages of 75-85 will have developed cataracts.

WHAT ARE SYMPTOMS OF CATARACTS?

The most common symptoms of cataracts include blurred vision, distorted vision, decreased color perception, glare, halos around lights, and decreased visual acuity in poor lighting conditions. Because age-related cataracts develop over many years, patients may not notice the severity of their condition because their vision has been slowly decreasing over time. This is one reason why it is integral to have routine eye examinations with your eye care provider. Cataracts, especially advanced cataracts, can increase your risk for injuries at home, while driving, and at work; when your vision is decreased, your ability to react quickly and appropriately for certain situations may also be decreased.

HOW ARE CATARACTS TREATED?

Depending on your degree of cataract severity, your eye care specialist may recommend monitoring your eyes for progression or cataract surgery. Surgery in the United States is most commonly done through a procedure called phacoemulsification; this procedure uses ultrasonic waves to break up the cloudy lens before it is removed through a small incision in the eye. The cloudy lens is replaced with a clear, plastic lens which can often provide significant vision improvements, even without glasses! There are many types of lenses used for cataract surgery, but the most common lens is a monofocal intraocular lens, which corrects for one range of vision, usually distance vision. Post-operatively, patients will need to use eye drops, an eye shield for sleeping for a period of time, and will need to limit their exertive activities and avoid exposure to dusty, dirty environments.


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Optical Fashion

May 29, 2013

Optical trends follow a similar lifecycle as clothing trends; there are many styles which will always be available and popular, while there are simultaneously fashions that will come about on a less frequent basis. While buying a pair of cat-eye frames similar to what your parents or grandparents wore in the 1950s might not be the best fashion choice, frames that are evocative of those styles are contemporary enough to avoid appearing ironic or dated. We have frames available in our optical departments in a wide array of colors, shapes, and styles that can fit any budget!

Choosing the Right Frame

Many patients will ask how they can determine the type of frame best suited to their facial structure. There’s also almost always some confusion on what shape face they even have! Below are some tips on determining your facial shape and the frames which should be avoided. 

Measuring your face shape is not as daunting a task as it may seem; all you need is a steady hand, a flexible measuring tape, and a mirror. AClens.com has provided an easy step-by-step instruction manual for shaping your face at home.

Read four measurements:

The width from the top of one cheek bone to the otherThe height of the middle of your forehead (between brow and hair lines)The base of one side of your jaw to the tip of your chin, multiplied by two.The length from your chin to your hair line

Face shapes

Round: facial width is similar to facial height, forehead and jaw are typically more narrow than the cheeks; avoid circular or curved frames and stick to geometric and rectangular frames.Oblong: height of the face is greater than 1.5 times the width. Cheeks, forehead, and chin are similar in width; avoid wide glasses with a lower overall height.Oval: facial height is close or slightly lower than 1.5 times the width. Forehead, cheeks, and chin are similar in width. Oval faces can tolerate any type of frame!Heart: forehead is wider than cheek bones and significantly wider than chin; avoid teardrop and lower-rimless frames.Square: height and width are nearly identical with the jaw and forehead close to cheek measurements;  avoid boxy or tall frames and choose round or curved frames.Diamond: cheek measurement is significantly wider than forehead and jaw; avoid angular frames and shop for curved frames.

Style Trends

Optical fashions are gleaning from the past and updating their looks; cat-eye frames, bold colors, and larger frames are all making a distinct presence in current optical styles. Glasses are upbeat, quirky, and taller this season. Eyefunk is an increasingly popular brand that reflects these changes, while traditional brands like Dolce & Gabbana, Ray Ban, and Coach are reflecting a similar stylistic change. While some frames are becoming  thinner and more streamlined, many are increasing in bulk of frame while still maintaining a sleek appearance.

What ever style of frame you choose, our optical departments will have a fashionable, affordable option that will suit your needs and keep you up-to-date with the current fashion trends.


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Lupus

May 22, 2013

Lupus can be a devastating disease for the whole body, but can detrimentally affect the eyes as well. May is Lupus awareness month, so it’s important for us to focus on just how it can affect the eyes and what we can do to combat it.

Lupus is a chronic autoimmune disease; it affects the eyes, skin, kidneys, joints, blood vessels, nervous system, and heart. Lupus attacks healthy tissue, resulting in flare-ups, inflammation, swelling, pain, fatigue, and tissue damage. Some of the most common eye diseases associated with lupus are: erythematosus (thickened rash over the eyelids), dry eye (if coupled with arthritis and dry mouth, it is called Sjogren’s Syndrome), retinal vasculitis (where blood supply to the retina is reduced and vision may be lost), scleritis (which can cause pain, light sensitivity, blurred vision, and red or dark spots on the eye), and optic neuritis (which is an inflammation of the area around the optic nerve, causing profound vision loss).Plaquenil and Methotrexate are immunosuppressive drugs used in treating lupus; they can adversely affect the eye by increasing the risk of infections, damaging the retina, and decreasing color vision perception. While these aren’t reasons to immediately stop these drugs, discussing your options with your primary doctor and your eye care specialist may best serve your ocular and overall health.

Many of the conditions described above can be treated or reduced effectively, especially with expedited treatment. It is important, if you have lupus, that you routinely follow with both a primary and an eye doctor to ensure your best chances of avoiding possibly blinding complications.


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Flashes and Floaters

May 15, 2013

Occasionally we can notice a squiggly line, a black dot, or a few minor flashes of light. When these occur, it can be very concerning and annoying. Often, floaters are a normal part of vision, especially as we age and in patients with high myopia. Though floaters and flashes can be a benign annoyance, they can signify conditions of grave concern, including uncontrolled hypertension and retinal detachments or tears. Because it is difficult for a patient to ascertain if a floater or flash of light is a signal of a more serious condition, evaluation is important for the most thorough and safest approach.

FLOATERS

What are floaters?

Floaters are often specks, spots, lines, cobwebs, or squiggles which appear to be viewed in front of the eyes. In actuality, they occur in the vitreous jelly which fills the back of the eye. The vitreous will become stringy, forming floating threads or spots which can become visible, especially in certain lighting conditions. Often, patients are able to adapt to these annoyances and can see “around” them without issue.

Floaters will occasionally signify significant damage to the eye; floaters can signal many conditions from retinal hemorrhages to Posterior Vitreous Detachments (PVDs). PVDs are most often noted in patients over 70, though can rarely occur in much younger patients. A rapid onset of large andnumerous floaters, especially when combined with flashes of light, can signal an in-progress or impending retinal tear or detachment.

When to get checked:Any time you notice a change in vision, even a few floaters, it is a good idea to have an evaluation with your eyecare professional. However, it is especially important to be evaluated fully if you notice any of the following:

Floaters which occur suddenly or increase quickly over minutes to hoursFloaters coupled with flashes of lightFloaters that are especially large or numerousFloaters following trauma or injuries to the head or eyeA painless loss of vision, often described as a curtain coming across vision

FLASHES

What are flashes?

Flashes are the visualization of lights when no flashes of light are actually present. These may look like a camera flash, fireworks, flashes of lightning, or many tiny bright sparkling lights; these will often last for an instant to a few seconds, but may recur. Conversely, some patients will notice jagged, shimmering lights which remain a constant for fifteen minutes or more, often coupled with a headache; this is more often a symptom of an ocular migraine, but should also be evaluated by an eye care or neurological professional.Flashes of light are a medical emergency, especially if coupled with a loss of vision and/or an increase in floaters. While flashes may be benign, they are often noted with severe retinal complications, including retinal detachments and tears; both detachments and tears of the retina occur treatment immediately as any efforts to save vision may be worthless if the complication is left without treatment for an extended period of time. As with floaters, it is vital to be checked out if there is any sudden or distinct change or increase noted. It is important to be evaluated fully if you notice any of the following:

Flashes which occur suddenly or increase quickly over minutes to hoursFlashes of light accompanied by new floatersFlashes of light following trauma or injuries to the head or eyeFlashes of light that are especially numerousFlashes of light accompanied by a headacheA painless loss of vision, often described as a curtain coming across vision

Risk factors for both flashes and floaters are:Myopia (nearsightedness)Eye traumaDiabetesCataract surgery and YAG Laser Capsulotomy

A note about myopia: with the benefits of laser surgery (like LASIK), patients who were once highly myopic may forget that they remain at risk as they no longer require glasses; while laser vision correction does provide glasses-free vision, it treats the cornea, not the at-risk retina. While laser vision correction does not put patients at a higher risk for retinal detachments, it does nothing to change or reduce the risks the eye had prior to laser enhancement. This is why it is important to continue routine exams, including dilation, even if your vision is otherwise perfect.


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Miniblog: Sodium

May 10, 2013

Sodium is delicious. It’s flavorful, aides in food preservation, and is readily found in many of our foods. The typical American diet is laden with sodium. Unfortunately, excessive sodium can also vastly increase your risk for heart disease, obesity, and stroke. It can raise blood pressure and cause water retention, both factors in the increased rate of coronary complications. In addition, it can increase your risk of ocular complications including vision loss. It is advisable to reduce sodium consumption, limiting it to no more than 1500mg daily for adults with diagnosed heart conditions and 2300mg for otherwise healthy adults.


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Exercise, Diet, and Your Eyes!

May 8, 2013

We all need to make healthy approaches to our daily lives. While we, as a general rule, have a vast amount of nutritious foods available, our approach to our dietary health is not what it should be. In our busy lives it is very easy to be undernourished in vital minerals and vitamins while simultaneously being over-nourished in fats, carbohydrates, and sugars. While it is advisable to discuss any dietary or exercise changes with your primary doctor, most people can benefit from reducing dietary fats and sugars.

Promoting your eye health begins with your diet. Diets with adequate amounts of Omega-3s, Lutein, Zinc, and Vitamins C and E may reduce macular degeneration and early cataract development. Diets high in green, leafy vegetables and low-glycemic fruits can be especially beneficial, not only for diabetics, but also for the majority of people seeking to approach their health proactively. Taking a Mediterranean approach to eating (one where olive oil, natural fruits, vegetables, and whole grains are promoted) can not only be healthy for your eyes, it can be healthy for your heart! In the coming months, we’ll look at the Mediterranean diet in depth; stay tuned!

Making the choice to keep active is the first step in keeping healthy. While many patients have limitations on what type of exercise they can safely do, almost everyone is able to do some form of exercise. Often, the difference between a healthy adult and an unhealthy adult is 30 minutes of daily exercise. While checking with a medical professional prior to beginning a new exercise regimen is advised, most people can safely add any number of mild to moderately exertive exercises into their daily routine. Exercise doesn’t need to be especially excessive or strenuous and, above all, you should enjoy it! Mild stretching, walking or running, and lifting within your physical limitations can aide in keeping muscles from atrophy, increases your cognitive function, decreases the symptoms of certain diseases, can reduce your likelihood of developing certain diseases, and helps to keep you limber and functional well into old age!

What if someone told you that a moderate amount of daily exercise could improve your cognitive function? A new study has shown significant results in both animal and human test subjects; a moderate amount of exercise training has been linked with increased memory capabilities. Women who walked briskly multiple times a week have been shown to increase both spatial and verbal memory; women who focused on weight training showed an increase in spatial memory. Brain-derived neurotrophic factor (or BDNF) increased during testing after six weeks in lab animals adhering to an endurance-training regimen; while weight-training lab animals did not show a similar increase, they did show an increased level of another protein, one which aided in the promotion of cell division and growth. This is great news for people who are concerned about their memory; while exercise alone won’t reverse the effects of age-based memory loss, it can aide in the reduction of its significance.

Examples of Endurance Exercises:

RunningPilates/yogaSwimmingAbdominal crunches on an exercise ballSit-ups/crunches with weighted medicine ballCyclingWalking

Examples of Weight Training Exercises:

Knee extensionsBicep curlsAbdominal crunches on an exercise ballSit-ups/crunches with weighted medicine ball


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Sunglasses and UV Awareness

May 1, 2013

Sunglasses can provide UV Protection for your eyes, reduce eyestrain in bright conditions, and protect you from flying debris and other hazards from outdoor conditions. Sunglasses can also provide visual comfort and clarity, depending on the lens you purchase. Having a quality pair of sunglasses can be vital to your overall ocular health in addition to providing clarity of vision and reducing glare. Ocular conditions like pinguecula, pterygium, cataracts, and ocular melanoma can be caused or made more severe by extensive unprotected exposure to sunlight.

UV Rays

UV rays can penetrate cells and cause mild to severe damage; UVA, UVB, and UVC rays can all be harmful, especially when no protection methods are adhered to. The amount of sunlight exposure and skin sensitivity will affect the redness of the skin; DNA damage can be directly caused by UVB light y causing aberrant covalent bonds (an abnormality) between DNA molecules in the skin cells. DNA then replicates with a mutation in it which can then result in cancerous growth. The DNA replication damage has a signature on it that points to UV light as the cause. Sunscreen blocks UVB, an important factor in reducing skin cancers, including skin cancers around the ocular area.

UVB light can be hazardous to the health of the eye itself, in addition to causing complications to the skin surrounding the eye. Photokeratitis, or arc eye, is frequently noted in welders; this condition is highly preventable condition caused by intense UV exposure without adequate protection. Pterygia and pingueculae may form from prolonged, unprotected exposure to sunlight, wind, and other outdoor conditions. Cataracts and certain ocular melanomas may be caused or expedited in development by long-term exposure to UV light.

Prevention is key in the fight against conditions and diseases related to UV exposure. Quality UV-protecting eyewear is vital for providing a barrier through which harmful rays cannot pass, or through which they have a difficult time passing. Investing in a quality pair of sunglasses (and protective eyewear if you do welding work) is an investment in your eye health; while they may be more costly than an inexpensive pair, quality lenses last longer and provide more protection for your eye health and eyesight


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Cancer

April 23, 2013

We have all been touched by cancer; we all have a friend, coworker, family member, or personal experience with cancer and the havoc it can bring to our lives. There are over one hundred types of cancer, many of which can be devastating in the damage they cause. Cancer is characterized by an abnormal growth of cells. Many cancers are detected through routine self-examinations, but often are not noted until a medical professional’s examination or screening. Treatments can include chemotherapy, radiation, and surgical intervention. While we all may be aware of more common systemic cancers (like breast, colon, prostate, and skin cancers), we would like to focus on two types of eye cancers: retinoblastoma and melanoma.

While eye cancers may be less common, but they are no less potentially deadly; routine eye examinations are a key factor in the screening for many eye conditions, including ocular cancers. The American Cancer Society estimates that there are 2,800 new cases of cancers (primarily melanoma) of the eye and orbit annually: 1,490 in men and 1,310 in women; 320 people with an active ocular cancer will die annually.

MELANOMA

The most common type of ocular cancer in adults is melanoma (followed closely by lymphoma). Ocular melanoma may begin on the lid, the brow, the iris (the colored part of the eye), or, most often, in the choroid, a vascular area of the eyeball which sits between the retina and the sclera. While cancers of the iris, lids, and brow are often very easy for patients to visibly see (many times they will start as a pigmented spot, bump, or lesion that grows over time), choroidal cancers require a medical examination to be fully viewed.Signs of cancers of the skin surrounding the eye (lids, brow, etc) are often very easy to note as they are frequently visible to the naked eye. Lid cancers may begin as a discoloration on the lid and progress to a raised bump or active lesion, or they may remain as a discolored area of the lid. In either case, evaluation and treatment is required; evaluation of the affected area should occur as soon as you notice a change, have a concern, or are referred by another doctor, friend, or family member for ophthalmic evaluation. Cancers of the skin surrounding the eye are highly treatable, especially when caught early on in the disease.

Signs of intraocular melanoma include a pigmented spot on the eye, blurred vision, a change in vision, loss of vision, headaches, and a change in the shape of the pupil. Intraocular tumors may cause glaucoma as they can cause tension and separation on the retina; patients with active glaucoma caused by a tumor (not “normal” glaucoma) may note eye pain, redness, nausea, headaches, and blurred vision. If you notice any of the above symptoms, an examination with your ocular medical professional is essential. Your exam may consist of: dilation of the pupil (this gives the doctor a better view of your eye), ultrasound exam of the eye (which uses sound waves to provide a picture of the inside of the eye), and transillumination of the eye (wherein a light is used to examine the eye).

There are many factors which increase the risk of developing intraocular melanoma, but the most common are age and extensive sun exposure. Further risk factors include having fair skin, having blue, green, or light-colored eyes, and being caucasian. Patients with a previous history of skin cancer are also at a higher risk. Understanding the signs and symptoms of ocular cancers is a crucial factor in the cancer’s treatment and resolution; treating ocular cancers early may save your vision and your life. Treatments for ocular melanoma include: surgery, watchful waiting, and radiation therapy.

Surgical method may vary depending on the type and severity of eye cancer present. Removal of the tumor and a small amount of the healthy tissue surrounding it is often performed in eye cancers which haven’t spread significantly. In larger, more aggressive tumors, unfortunately the eye is not able to be saved and aggressive surgical intervention is required; this can include either enucleation or exenteration. Enucleation removes the affected eye and part of the optic nerve; patients may be fitted for an artificial eye after this procedure. Exenteration removes the eye, the lid, muscles, nerves, and fat of the eye socket; patients may be fitted for a facial prosthesis or artificial eye after this procedure.

RETINOBLASTOMA

Retinoblastoma is an almost predominantly childhood cancer; it will usually occur in children younger than five and is a rapidly developing cancer affecting the retina. The most obvious sign of retinoblastoma is an abnormal pupil, often visibly noted as a “white eye” reflection. Children with retinoblastoma may also present with a strabismus (crossed eye), proptosis (bulging eye), and a red, irritated eye. Often, parents will note a defect in “red eye” noticed in photographs; an affected eye will continue to show a whitish appearance while an unaffected eye will react normally with a reddened appearance.

Caught early, retinoblastoma is highly treatable; treatments can include chemotherapy, radiation, and/or enucleation (removal) of the affected eye. Left untreated, retinoblastoma is vision and life-threatening. Almost all untreated patients die of intracranial extension and disseminated disease within two years.

While any type of cancer is serious and potentially deadly, cancers of the eye are, fortunately, relatively rare. Routine examinations with your eyecare professional and being an active part of monitoring changes in your vision and eye appearance are the best methods for continued eye health and early treatment if a concern is noted. If you suspect or are concerned about any of the above conditions, please make the earliest appointment with an eye care professional.


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Alcohol Awareness

April 17, 2013

April is Alcohol Awareness Month; it’s estimated that over half of Americans over the age of twelve are active drinkers of alcohol (2008 National Survey of Drug Use and Health by the US Dept of Health and Human Services). Alcohol is the third leading cause of preventable deaths in the United States. While a healthy diet can and often does include some alcohol consumption (namely, one glass of red wine per day with dinner has been accepted by many dietitians as appropriate), understanding and adhering to alcohol use in moderation is integral to avoiding its abuse. Raising awareness of alcohol abuse and providing education on appropriate approaches to alcohol are important year round, but are a great topic on which to focus this week’s blog!

Alcohol, in appropriate moderation, has a relatively low risk for ocular and systemic complications in otherwise healthy adults; a glass of red wine with dinner has long been accepted as a heart-healthy alcohol use and has even been included in the Mediterranean diet. In excess binge drinking or habitual alcohol abuse, we begin to see many health complications. While we all should be aware of the systemic damage alcohol abuse can cause (including cancers, liver disease, obesity, diabetes, brain damage, heart disease, and death), many people are unaware of the risks to eye health that are posed by habitual overindulgence in alcohol.

* Short term eye effects: dilated pupils, temporary decreased peripheral vision, blurred vision, and increased risk for ocular trauma (secondary to decreased hand-eye coordination and an increased propensity for “risky” behavior).

* Long term eye effects: optic neuropathy, decreased peripheral vision, reduced sense of color palette, increased risk of trauma, and increased risk of diabetic retinopathy, a potentially vision-threatening condition which can result in permanent blindness.

Although we do not specialize in substance abuse, we urge you to seek out a professional if you feel you are unable to set appropriate boundaries for yourself in regards to any substance.


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Styes and Chalazia

April 10, 2013

Styes and chalazia are similar, but distinctly different, eyelid conditions which can be painful and recurrent. Both will often affect the lid margins, the area where the inner lid meets the outer lid, but chalazia can often occur seemingly “underneath” the eyelid farther away from the lid margin while styes will often occur along the lash line. These conditions can warrant medical intervention, especially if they become recurrent or if they are especially painful, do not resolve, or become actively inflamed and tender to the touch. People with oily skin types can be at a higher risk for stye/chalazion development. 

Styes are often the result of a bacterial infection. In appearance styes resemble small pimples and can be red and inflamed. Washing the lids and ensuring that makeup is properly cared for are two ways in which you can avoid putting yourself at undue risk for styes. Styes will usually self-resolve, but can last for a week or longer if left untreated. Treatments include topical ointments which your doctor would prescribe.Chalazia (the plural of chalazion) can occur much like styes; while styes appear similar to pimples, chalazia often look and feel like firm lumps under the lid. They can be tender to the touch or can be painless. A chalazion can resolve on its own but may need intervention from an eye care professional in the form of warm compress use, topical drops, topical ointment, surgical drainage, and/or surgical excision and biopsy.

You can reduce your risk for styes and chalazia by using warm compresses as often as you can (this is especially beneficial for patients with meibomianitis and/or oily skin), removing and storing contact lenses according to your eye professional’s recommendations, washing your hands prior to touching your eye area and/or applying makeup, avoiding makeup use while a stye or chalazion is active, and avoiding eye rubbing altogether. Above all, do NOT attempt to pop any bump which appears on or around the ocular area; this can worsen styes and chalazia by causing them to spread and affect a broader area of your eyelids.


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Makeup Health

April 3, 2013

Makeup can certainly accentuate your beautiful eyes! With proper, hygienic use, makeup for your eyes can be a safe addition to your daily regimen. Unfortunately, many makeup users do not take the safest approach to makeup use and can end up with mild to severe complications, including corneal scratches, infections, and even blindness. This week, we’re offering some helpful tips to aide you in avoiding ocular complications when using makeup.

Tips For Makeup Use

Make sure to replace eye makeup often.Never share your eye makeup!Do not apply makeup while driving or moving; use your best judgment when applying makeup to avoid potential vision-threatening injuries.Skip makeup use when you have an actively infected or irritated eye and throw away any makeup used around the time your eye first became infected/irritated. This can reduce reinfection and/or the spread of infection from one eye to the other.Wash your hands prior to doing anything around your eyes, including drop instillation and makeup application.Be sure to thorougly clean off makeup prior to going to sleep to avoid causing irritation. If you use a makeup remover, do your best to avoid getting it in your eye.Avoid store samples as there is less assurance that it is sterile.Remember that eye makeup can contribute to the following conditions: infections (some potentially blinding), pink eye, watery eyes, dry eye, trauma, chronic inflammation, and styes.

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Focus on Optical

March 27, 2013

Opticians are specialists in all aspects of glasses, including current fashion trends; it is okay to ask them questions or have them help you select the best kind of eyewear suitable for you. They are here to assist you in selecting and enjoying your eyewear choices. Feel free to come in during any of our office hours to visit the optical department and ask them any questions you may have regarding glasses or contacts. We asked one of our specialized opticians, Tim, the following questions:

What do you take into consideration when helping someone select glasses?

Tim:  The fit, style and prescription. We will talk to the patient to find out what they are looking for or what they like.

What are your recommendations when someone wants to wear contacts for the first time?

Tim:  We would recommend starting with Daily Disposables (if applicable).

What is the best and proper way to clean my glasses? What about my contact lenses?

Tim:  To clean glasses, use our spray cleaner and a soft cloth (NO paper products!). And for contacts, use an all in one solution to clean contacts every day!

What is the difference between all of the lens types? What about frame materials?

Tim:  Basic is CR 39 Plastic, Better is Polycarbonate (thin, durable, UV & scratch resistant), Best is 1.67 High Index (thinner than the Polycarbonate plus all the other benefits), Premium is 1.74 High Index. The Crizal anti-reflective coating can go on any lens. All of these are available in Single vision, Bi-focals and Tri-focals, and numerous styles of progressive lenses.

What are some of the brands/labels you offer at Legaretta Eye Center?

Tim: Dolce & Gabbana, Prada Linea Rossa, Coach, Michael Kors, Silhoette, Ray Ban, Oakley, Axel, BCBG, Line Art, OGI, Maui Jim


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Headaches

March 20, 2013

Headaches can certainly interrupt the flow of your day! Though some are idiopathic in origin (meaning, we don’t really know what causes them), many can be caused by outside factors, including eye strain. There are many common eye problems which can bring on headaches, including astigmatism, hyperopia or presbyopia, and glaucoma. For this reason, recurrent, especially painful, and/or vision-impairing headaches should be diagnosed as early as possible. For example, a condition called acute angle closure glaucoma can cause severe eye pain/headaches in addition to vision loss. If this is not treated in an expedited timeframe, vision loss can be permanent and irreparable.

Ocular strain can be the cause of headaches; subconsciously, we focus harder when trying to compensate for uncorrected vision. This is one of the reasons why having an up-to-date glasses or contact lens prescription can be essential for eye comfort. Further, the extent to which we use computers, smart phones, and tablets can increase our eye strain; as we discussed in our blog post on dry eye, computers can be detrimental to tear film as we tend to blink less when performing staring activities.

Headache symptoms can present (in relation to the eye) as: tearing, ocular redness, ptosis (eyelid drooping), pupil size changes, blurred vision, and pain or discomfort in and/or around the eye(s). Any presentation of a headache can be cause for some concern; when they become recurrent, it is usually best to follow with your primary doctor, your eye care doctor, and/or a neurologist as headaches can denote severe problems which can require medical attention.


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Vitamin Therapy

March 13, 2013

As with the rest of the blog entries, this entry is not intended to replace a doctor’s medical advice, nor should it supersede your current health regimen. Please consult your medical care provider PRIOR to beginning any medical regimen, even vitamin therapy, as some vitamins can counteract certain medications and even put your health at risk.

Having a broad range of food groups from which you obtain your daily caloric count is essential to overall health. Ensuring that you include leafy greens, naturally-vitamin enriched fruits and vegetables, and limiting your intake of fats and simple carbohydrates can do quite a bit to increase your overall health. However, even diets rich in the essential nutrients for your best health can benefit from the addition of vitamin therapy. Certain vitamins can even aide in ocular health! Always make sure that you purchase vitamins from a reputable company; while certain products may be absorbed by the body more easily than others, purchasing higher quality vitamins can even be safer than inexpensive, foreign-market derived vitamins.

Dietary Choices and Ocular Health

There is a veritable smorgasbord of foods that are wonderful for eye health. Focusing on the main vitamins that promote ocular health is a great way to start any dietary change as the foods that aide in eye health aide in overall health as well.

Types of Vitamins Which Can Aide in Ocular Health:

A. Fish Oil/Flaxseed Oil/Omega-3s; these vitamins are a full-body enhancer, meaning, they can aide in the overall health of the body, from hair growth to ocular lubrication, to protection against cancers and Alzheimer’s disease. One tip for fish oil supplements: freezing the tablets can reduce their “repeat” effect (burping/fishy taste), which can often be a deterrent for patients who have had issues in the past. The addition of fish or flaxseed oils should be monitored by your primary care physician. There are natural sources for Omega-3s as well, including seafood, walnuts, flaxseed, fresh basil, and Chinese broccoli. 

B. Antioxidants and Vitamins C and E; while there are many delicious natural sources of antioxidants and Vitamins C and E (including blueberries, sweet red peppers, strawberries, citrus fruits, and broccoli), many patients may prefer to add a vitamin supplement in addition to their dietary regimen.

Because Vitamin C is water-soluble (meaning, excess amounts are excreted in urine), taking above the recommended daily allowance is generally considered to be safe. In addition to providing a reduced risk for coronary heart disease, it is believed that 500mg of Vitamin C daily can reduce the risk of early cataract development. Smoking, while detrimental to general health, can decrease the effectiveness of Vitamin C, and should be considered when taking therapeutic treatments.

C. Lutein & Zeaxanthin.These important nutrients are found in leafy green vegetables and eggs. They can reduce risks for AMD and cataracts. High intakes of Lutein, Zeaxanthin, and Vitamin E can decrease cataract development by neutralizing free radicals.

D. Zinc.An essential trace mineral, zinc aides in transferring Vitamin A from the liver to the retina to produce melanin, which provides pigmentary protection to the eyes. Zinc deficiency can lead to poor night vision, cataracts, and infection susceptibility. Patients who are at risk for AMD may benefit from increased zinc intake. This can be done via supplementation or by adhering to a diet rich in wheat germ, eggs, seafood, mixed nuts, black-eyed peas, tofu, and baked beans.


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Hypertension

March 6, 2013

Hypertension, or High Blood Pressure, can and does affect ocular health in many patients by causing a disorder known as Hypertensive Retinopathy. Hypertensive Retinopathy can damage the retina, the back layer of the eye where visual imaging occurs, which can severely deplete visual capabilities. Further, Hypertensive Retinopathy can signal to your ocular specialist that your blood pressure is not under control and you may be at a greater risk for severe systemic damages, including blindness, stroke, and even death. 

Unfortunately, Hypertensive Retinopathy is much like glaucoma, in that it can often be a “silent” until the disease has progressed to late or severe state. Symptoms can include: loss of vision (sometimes sudden), visual changes, double vision, blurred or dim vision, and headaches. If you experience any of these symptoms, especially if they occur suddenly, immediacy of treatment is one of the most important factors in potentially saving some of your vision. 

Depending on the severity of retinopathy, your eye care professional may wish to monitor your status or send you to a retinal specialist for further evaluation, which may include more extensive testing to determine blood vessel flow. Hypertensive retinopathy is graded on a scale of 1 to 4, 1 being minimal to no damage and 4 being severe damage, possibly including optic nerve or macular swelling and severe decreases to vision.

Treating your hypertension, whether with medications, diet, exercise, or a combination of the above, is the best method to ensure that hypertensive retinopathy is not an issue affecting your ocular health. Following with eye care professionals and your primary medical doctor may provide a significant boon to your overall health.


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Safety Glasses and Workplace Eye Wellness Month

February 27, 2013

Workplace safety is often discussed in certain industries more than others. Wearing safety glasses when performing certain activities wherein dirt, chemicals, dust, or metal may enter the eye is integral to a safe approach to ocular health at work. Your workplace may even cover a pair of safety glasses in your prescription, if they are required for your occupation (don’t forget that proper ocular safety is important even off the job! Wearing safety glasses while performing activities which could risk ocular health at home is always the safest option).

It should be surprising, and even concerning, that the American Academy of Ophthalmology estimates that only 35% of people polled always wear protective eye wear. Although OSHA (the Occupational Safety and Health Administration) estimates that 90% of workplace injuries could have been avoided with proper safety glasses, many workers fail to use proper protection, or avoid them altogether. Although it can be a hassle to wear safety glasses, the slight annoyance is far less of a price to pay than the price one risks paying when avoiding proper eye safety material use. The risks of permanent, irreparable ocular damage are certainly much higher in severity when one avoids wearing recommended safety equipment.

Ocular eye injuries can result in temporary or permanent visual or ocular damages in addition to requiring possible numerous doctor visits, causing discomfort, and lost wages due to an inability to work during healing, if the injury is severe enough to warrant time off from work.

Picking the proper lens material for your workplace needs can be a daunting task. While glass lenses are resistant to scratches and protect against chemical exposure, they lack resistance to injuries from impact (and can, in fact, worsen injuries). Polycarbonate lenses are lighter than glass and are more likely to withstand impact. We have many options for safety glasses in our optical department and our optical staff is available to assist you in choosing the proper safety eye wear for your needs.


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Macular Degeneration

February 20, 2013

Age-Related Macular Degeneration, or AMD, is a disorder which can negatively affect your vision. People who smoke, the aged, people with a family history of AMD, females, people who are obese, patients with hypertension or cardiovascular disease, and those whose diets are low in ruffage vegetables and high in fatty foods are at a higher risk for AMD development. Although these patients may have a higher propensity for development of AMD, it can and does occur in patients with few or none of the above risk factors. Macular degeneration affects the area of the eye which controls central vision. While glaucoma, which we discussed in January, affects the peripheral vision and may go unnoticed for extensive periods of time, macular losses can be much more easily subjectively noticed as central vision can be reduced, blurred, or completely lost.

There are two primary types of age-related macular degeneration: dry and wet. While the dry form is the most common type, it can progress into the more severe wet form. Loss of vision is a risk in both types; however, it occurs at a more expedited rate with wet macular degeneration.

Check out the videos below for a more comprehensive discussion of macular degeneration!

Dry Macular Degeneration

Wet Macular Degeneration

Healthcare professionals suggest that preventative dietary choices can reduce the development of AMD and may decrease its progression in already affected patients. Vitamin therapies and the addition of certain food groups can be beneficial in reducing macular degeneration risks, severity, and progression rates.

Diets rich in certain foods can aide in macular and overall health. Suggested ruffage to include in your everyday diet:

KaleSpinachCollard greensBroccoliCabbageEndiveTurnip greensSwiss chardMustard greensRomaine lettucesWatercressRadicchio

Below is a macula-healthy shake recipe! Enjoy!


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Loving Your Eyes

February 13, 2013

We often take for granted our vision. Seeing isn’t a voluntary action; we see without thinking of the process of vision or the opportunities that visual capabilities give us. Keeping our vision and eyes healthy are excellent ways to celebrate this gift; routine eye examinations are an important facet of loving your eyes. Your eye care professional can monitor your vision and eye health and can best recommend appropriate treatments, glasses, and lifestyle choices.

Ways to Love Your Eyes:

Wearing UV protection in direct sunlight; this helps to limit the negative impact of UV light on ocular health. UV protection helps to guard against complications to vision and eye health such as: pinguecula, pterygium, and retinal damage.Good hygiene; a boon to overall health, hygienic approaches to daily activities can decrease the risks of ocular complications (including bacterial and chemical infections).Dilated exams, frequency based on eye care professional’s recommendation. Dilation, while sometimes irritating to your comfort on sunny days, is a vital part of routine eye exams and/or medical examinations of the eyes. Dilation opens the pupil (the black part of the eye) and allows your doctor to have a less restricted view of the retina, macula, optic disc, and optic nerve.Wearing safety glasses when appropriate. If there is a risk for exposure to a foreign material (metal, glass, dust, paint, wood, etc), wearing safety materials can reduce your risk of ocular complications.Diet and exercise. Healthy living means healthy eyes! While diet and nutrition are integral parts of any lifestyle, always ensure that you check with your primary medical doctor prior to beginning any new regimen.Diets rich in leafy green vegetables and Omega-3s; leafy greens aide in macular health, while Omega-3s (fish oils, flaxseed oils, eggs, and walnuts).Diabetic patients adhering to their doctor’s advice on blood sugar control, medication, and advised routine examinations, which will often include dilation.Avoiding smoking.Examinations in childhood to follow and treat common childhood disorders.

“I think the eyes flirt most. There are so many ways to use them.”-Anna Held


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Heart Disease

February 6, 2013

February is American Heart month. Healthy eating, exercise, stress reduction, avoiding smoking, and routine exams with your primary care physician can be integral to your continued overall and heart health. What you may not know is that your retinal health can reflect the health of your heart as well. It is even possible that your eye doctor could be the first professional to notice and diagnose systemic diseases during a dilated examination. This is able to occur in ophthalmology because the eye is the only organ in which doctors can view blood vessels unobstructed. Dilated examinations are vital for continued eye health, and may even result in a systemic diagnosis which could save your life!

Strokes are both a heart and an eye concern. While you may be familiar with the damages associated with a stroke, including decreased mobility, speech changes, and death, you may not be aware of the damages caused by an occlusive, or stroke, event in the eye. There are multiple types of occlusive attacks, but they all generally share a common element: they can be severely detrimental to vision and can indicate a need for cardiovascular evaluation.

Two Types of Occlusive Eye Attacks

BRVO: Branch Retinal Vein Occlusion

Often characterized by a sudden onset of central vision defect or blurry vision.Vision loss is usually unilateral, but can be bilateralTreatment options can range from increased aspirin regimen to laser treatment to intraocular injections; these treatments are usually to reduce, prevent, or eliminate further complications from BRVO.

CRVO: Central Retinal Vein Occlusion

Often characterized by a sudden or gradual loss of vision, ranging from mild to severe; onset may be instantaneous but may take as long as a few weeks to present. This can progress to constant vision loss, a blind, painful eye or eyes, light sensitivity, and ocular redness.Vision loss is usually unilateral, but can be bilateral.Although there are treatment options available for CRVO, there is limited possibility for full recovery in an eye after this type of occlusive attack. Good visual recovery occurs in 10% or less than 10% of patients who suffer CRVO. Further, 10% of patients who suffer a CRVO in one eye will develop a CRVO in the other eye. Although there is no definitive prevention for CRVO, it is advised that good intraocular pressure control in patients with glaucoma and control of general systemic diseases may reduce risk.

Why Immediate Evaluation is Important if Vision is Lost

Vision may be saved, even partiallyOcclusive attacks may suggest a need to evaluate medicationsOcclusive attacks could indicate a need to have a cardiovascular evaluationThough occlusive attacks are possible, vision may be lost to other reasons, some of which are easily treatable, provided immediate intervention occurs.

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Winter Eye Conditions: Dry Eye

January 30, 2013

As we discussed last week, Pink Eye can be more frequent in the winter months. The same holds true for many cases of dry eye. One common misconception about ocular dryness involves the presence of tearing; often, patients will notice that their eyes tear very frequently and are surprised when told their eyes are actually dry. Their eyes are “wet,” so how can they be dry? It can be easier to understand with an example: your eye will tear reflexively if an eyelash or other foreign body falls into it. The same holds true for dryness; just like an eyelash in the eye, dryness makes the surface of the eye irritated, and it will tear in an attempt to flush out the irritant. While beneficial when there is an actual foreign material in the eye, these flushing tears are often of a low viscosity, meaning that they are thin and do little to provide adequate lubrication for the surface. If you are noticing frequent tearing and/or eyes that are sore, difficult to keep open, or have a feeling of a foreign body in the eye, an evaluation with any of our eye care professionals can help to reduce, or even eliminate, your ocular discomfort.

Dry Eye Symptoms Can Include:

IrritationA feeling of drynessTearingPainDiscomfortRednessDifficulty opening eyes and/or eyes “crusted” shut in the morningsBlurred, fluctuating vision

 

Why this can be more prevalent in the winter:Heaters and low humidity areas are prevalent in Buffalo’s cold winter months. Heaters can dry out our eyes, leading to ocular discomfort and irritation; when dry eye is severe enough, it can even increase the risk of ocular infection.

Colder months can also mean an increase in indoor activities; prolonged staring activities alone can increase dry eye; when coupled with exposure to low humidity and artificial heating systems, it is no wonder that many patients will notice an increase in dryness. It is suggested that, when performing staring activities (reading, television watching, or working on a computer) for a prolonged period of time, patients remember to take frequent breaks and attempt to be aware of their blinking habits. Computer use has been shown to decrease blink rate significantly; in our digital world, it is important to not only be aware of this, but to be proactive in your own ocular health. Lubricating drops, or, artificial tears, are an excellent over-the-counter method of decreasing dryness. One caveat, always buy “name brand” eye drops and avoid drops whose primary focus is decreasing redness (eg. Clear Eyes) as they can cause rebound inflammation with overuse. Quality brands suggested are: Systane, Optive, and Theratears. If you wear contact lenses, it is recommended that preservative-free lubricant drops are used.

 Other factors which can impact dryness:

thyroid disordersmedicationssleep apneasystemic dryness

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Winter Eye Conditions: Pink Eye

January 23, 2013

While pink eye can and does happen during any time of the year, it can be more frequent for some patients during the winter months. Pink eye (or, conjunctivitis) can occur in any patient, regardless of age or health. If there is any concern for this condition, an evaluation by a medical professional is encouraged. While this list of symptoms can be beneficial, it is no substitute for medical care, and should not be taken as diagnostic advice. 

Pink Eye Symptoms Can Include:

CrustinessDischarge; depending on type of conjunctivitis, this can range in color from pale to yellow to green.RednessPainIrritationSwellingDecreased visionPossibly lymph node swelling, especially if combined with systemic sickness.

Why this can often be more frequent in the winter months:

Cold and flu season can increase frequency of pink eye, either by contamination from an infected person, or the virus/bacteria itself including the ocular area. A good rule of thumb for winter months is to wash your hands and avoid touching or rubbing the eyes; in addition to reducing exposure to pink eye, this can decrease rate of contraction of other communicable diseases.

Though the term “pink eye” often carries the connotation of a bacterial or viral infection, there is always the possibility of different factors causing conjunctival irritation. Allergic conjunctivitis can affect the eye as well, even in seasons not typically associated with systemic allergies; chemical conjunctivitis can occur when the eye is exposed to chemical irritants.

 Treatment for pink eye can include:

Eye dropsMonitoringAllowing the virus to take its courseRemaining home from work/school until resolution of symptoms to avoid spread of virus/bacteria

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Glaucoma

January 16, 2013

January is glaucoma awareness month. Raising awareness of what glaucoma is, what it does, and how it is treated is especially important this month. While there isn’t one single “type” of glaucoma, the disease, in its varied forms, often has the same symptoms and results on ocular health and vision. The most common form of glaucoma is open-angle glaucoma, which accounts for approximately 90% of all cases.

What is glaucoma and how is it treated?

Glaucoma is an eye disease in which eye pressure can rise, the optic disc can develop a “cupped” appearance, and the affected eye(s) may lose peripheral vision. Peripheral losses may vary from minimal, which may not impact daily life and may not even be noted from a subjective standpoint, to severe, which can limit visual capabilities and can decrease quality of life. Depending on the severity and type of glaucoma, your eye doctor may suggest a number of treatments ranging from close monitoring to eye drops to surgical intervention. For a more in-depth look at glaucoma, visit this link: http://www.legarretaeyecenter.com/glaucoma-surgery.php#mn-main 

Who is at risk?

Glaucoma can be a congenital disorder, meaning, patients can be born with glaucoma; glaucoma can also be developed later in life, even as a result of an injury to the eye. While anyone can have or develop glaucoma, patients with a family history of the disease are at a higher risk for developing glaucoma; patients with a first-generation relative (parent, sibling, child) with glaucoma should be aware of their increased risk and should follow accordingly with their eye care provider. In our office, patients over the age of 18, regardless of possible genetic disposition, are tested during their routine exams for visual field losses; it is important that testing is done as glaucoma treatment is best begun within the earliest stages of the disorder.

How is glaucoma monitored?

While there are many methods for monitoring glaucoma, recurrent testing for progression can reduce significance of losses, if treatment suggested is followed. In our office, testing for a patient with glaucoma can consist of mappings of the optic disc, photographic tracking, and field of vision testing.

Glaucoma is considered a “silent” disorder; although it can affect comfort, clarity, and quality of vision, it is most often associated with loss of peripheral, or side, vision. Because losses can go unnoticed from a subjective standpoint, close monitoring from a qualified eye care professional is warranted, especially if there is a concern for development or progression of the disorder. Unfortunately, at this time, there is no cure for glaucoma and fields of vision lost to the disease’s effects are permanently lost. Patients who have glauoma or are suspected to have it are urge to take this concern seriously and follow closely with their eye doctor.


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New Year, New You!

January 9, 2013

We’re into the swing of 2013 now; when keeping your New Year’s Resolution of healthy life approaches, don’t forget to care for your vision!

Health ExamsAnnual eye exams are always a good idea, even in an otherwise healthy patient. Certain eye disorders are best treated when caught in early stages. Patients with certain already diagnosed conditions, such as diabetes and hypertension, may be better suited to more frequent eye exams. Adults should follow with a medical eye professional for many reasons, including: diabetes, hypertension, glaucoma, macular degeneration, and cataracts. Children, too, may need the benefits which eye care professionals can offer; children’s eye disorders may go untreated if a professional is not involved in their healthcare, as children often do not complain of their symptoms or know how to best describe them. Symptoms which would indicate a need for more immediate care for children include, but are not limited to: complaining about poor vision, squinting, sitting closer to the television, sudden or progressive drop in scholastic achievements, poor hand-eye coordination, and an eye (one or both) which is misaligned (“turns” in, out, up, or down) either constantly or in a fluctuating, sometimes erratic manner.

Our optical departments in each of our three offices have a wide array of options for every budget, style, and need, from safety glasses to high end sunglasses.

New Look: Contact LensesContact lenses are a great addition to your ocular wear, provided they can medically be approved and the wearer is able to understand and comply with the proper care of their contacts. Contacts need to be cleaned, stored properly, and instilled with clean hands. Good hygiene and hand washing prior to handling contact lenses, whether inserting or removing lenses, are integral steps to successful contact use. There are steps one must take prior to being able to procure contact lenses, this entails an initial exam, fitting, trial lenses, and ordering lenses. If contacts are purchased from a reputable site, these steps (or ensuring these steps were followed by validating prior professionals) should be followed. It is important to obtain your contacts from a reputable source; contacts can be purchased from non-ophthalmic sources; these lenses can carry higher risks and can compound ocular problems, even leading to infection and blindness. While there are risks to contact wear, proper use can provide aesthetic improvements and more freedom from glasses.

New Look: GlassesThere are numerous options for glasses, many of which may be covered by your insurance.

A simple update to your glasses frames, even if your prescription hasn’t changed, can make a vast difference in your appearance and your confidence; a fresh look can give you a fresh appearance with which to meet the world.Transition lenses provide more freedom and can increase clarity of vision in situations where your vision is impacted by bright light. Transition lenses change from plain lenses to tinted lenses when exposed to higher lighting conditions; this allows a reduction of discomfort and can provide better vision.Bifocals and progressive lenses can reduce the need for multiple pairs of glasses once presbyopia (reduced near vision clarity, usually after age 40). Our optical professionals can suggest the best fit for your lifestyle and vision.Sunglasses, both prescription and nonprescription, provide both style and UV protection.Optional glare coating can aide in the reduction of halos and nighttime and/or daytime glare.Safety glasses, often covered by your employer, are vital to ocular health if you work in situations where foreign bodies, dust, particles, or other materials may enter into the eyes. It is important to protect your eyes, especially when there is a possibility of injury.

For more information on our selection of optical wear, visit our optical departments at any of our three offices, and visit our optical website at: http://www.legarretaeyecenter.com/optical-shop/

“For my part, I know nothing with any certainty, but the sight of the stars makes me dream.” (Vincent Van Gogh)


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FSA Investment Planning

January 2, 2013

What is an FSA?

Depending on your employer, you may be offered the option to contribute to a FSA, or, Flexible Spending Account. Money is taken out of your paycheck, pretaxed. This money can be used for qualified medical purchases, even some over-the-counter products, provided certain guidelines are adhered to.

How to contribute to your FSA:

This is done via your employer, in most cases, money will come out of your paycheck in small increments, based on how much money you elected to contribute.Example: Rachel elected to contribute $1000 for the 2013 FSA her employer offered; she is paid bimonthly and approximately $39 will come out every pay period.

Budgeting and Planning For Medical Expenses:

Healthcare costs continue to rise and many people find their expenses are difficult to afford. With your FSA, the money you would already pay out for many products and services is available in pretaxed dollars. FSA money can also reduce your income taxes! One caveat with FSA contributions: any money put aside must be used in the calendar year in which it was deposited. If the money contributed isn’t used by the end of the contributing year, it is lost.

How to Use Your FSA at Our Office

Your FSA can be used for our products and service in office including, but not limited to:

Prescription glasses and prescription sunglassesContact lensesCopaymentsExam feesPrescription medicationsCertain over-the-counter medications (artificial tears, contact solution, eye patches, lid scrubs, vitamins), provided a prescription from a doctor can be given for them

What your FSA CAN’T be used for:

Nonprescription sunglassesCosmetic treatments and medicationsMultiple vitaminsLotions and skin moisturizers

Depending on your employer, you still may be able to participate in this program!

“The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” (Marcel Proust)


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