Ross' Blog

School Vision Screenings

School vision screenings are a critical component of our health care system and help to detect gross visual problems in children that may otherwise go undetected. School vision screenings however are not a substitute for a comprehensive eye examination by an optometrist. All children, 3 years of age or older, should receive a complete eye examination at least once a year.

An optometrist can examine your child to ensure that they have the adequate visual skills needed to succeed at school. With almost 80% of all learning being visual, it is critical that your child’s visual system be operating perfectly.

An eye examination by an optometrist is more then about 20/20 vision, it’s also about having proper visual skills. Some of these skills include colour vision, depth perception, focusing, eye teaming, and eye tracking.

Did you know?

  • Children are covered under Alberta Health Care for a comprehensive eye examination once a year. There is no cost to you as a parent to have your child’s eyes examined by an optometrist.
  • Children are also covered under Alberta Health Care for emergency eye exam appointments for things such as: pink eye, eye infections, allergies, injuries, etc. 

Dr. Ross McKenzie is a member of the Alberta Association of Optometrists and is proud to participate in the Eye See…Eye Learn program. A partnership between optometrists, private business and the Alberta Government with a focus on ensuring that every child receives an eye exam before starting kindergarten. To learn more about the Eye See…Eye Learn program please refer to the Alberta Association of Optometrists website.

Best Eyeglass Upgrade

Anti-reflective or non-glare coatings are by far the single best eyeglass upgrade a person can purchase. Eyeglass lenses that do not have an anti-reflective or non-glare coating can actually reduce your overall visual acuity and can lead to eyestrain and visual fatigue.

Basic non-coated eyeglass lenses can reflect up to 10% of the light, making objects appear dimmer and less vibrant. Thin high index eyeglass lenses can further increase this because of internal reflections, making anti-reflective or non-glare applications absolutely crucial for optimal vision in these thinner lighter lenses.

Anti-reflective eyeglass lenses allow up to 99% of light to pass directly through the lens. This produces a brighter, sharper more natural image to the wearer. Reduced internal and surface reflections also helps with improved cosmetic appeal during both work and social situations. Anti-reflective or non-glare coatings allow for better eye-to-eye contact and are a must have for anyone who works with the public. 

Night driving can also be dramatically improved by using anti-reflective or non-glare lenses. These eyeglass lenses help to reduce distracting glare from on coming headlights as well as from auxiliary sources within the vehicle such as the instrument panel or navigation systems. These same principles also apply to working on the computer or playing video games. By reducing unwanted glare from computer monitors and overhead lights, anti-reflective lenses can actually help to reduce end of day visual fatigue.

Anti-reflective lenses have evolved immensely over the past few decades since they were first introduced. Today, high quality anti-reflective lenses offer the best resistance against scratching, as they must be applied over an ultra-tough base coat. Some anti-reflective coatings also help to repel dust and oil from the lens surface and make cleaning your eyeglasses faster and easier.

5 Reasons to purchase anti-reflective eyeglass lenses:

  1. Improved light transmission    
  2. Improved cosmetic appeal   
  3. Improved night time vision  
  4. Improved computer vision  
  5. Improved scratch resistance   

5 Common Questions Answered

1.    Does sitting to close to the TV hurt your eyes?

No. There is no research that shows that sitting to close to the TV will hurt your eyes. Sitting to close to the TV can lead to excessive eye strain, increased fatigue and headaches as your eye muscles must work harder to focus. Like all activities, watching TV should be in moderation.

2.    Will reading in the dark make me go blind?

No. This is a very old myth that dates back to the famous music composer Johann Sebastion Bach who progressive went blind from an eye disease. It was originally believed that he lost his vision because he was always working with dim candlelight.

3.    Are 3D movies or video games hard on your eyes?

Yes and No. Watching 3D movies or playing 3D video games will not hurt or damage your eyes. Infact, it may be a useful diagnostic tool for finding young children who may have vision problems. 3D movies and video games do however increase strain on your eyes, so over time they can lead to increased fatigue and headaches. Once again, something that should be done in moderation.

4.    Will I need reading glasses in the future?

Yes. The only people who don’t require reading glasses are those who are just slightly nearsighted and can remove their eyeglasses to read and those who are in denial and spend their whole life increasing the font size on their computers. Presbyopia (or the loss of your near vision) is a normal course of life. The majority of us will start noticing problems focusing up close some time between the ages of 40-45.

5.    Am I legally blind?

The definition of legal blindness is as follows: 20/200 or less in the better eye wearing the best correction possible or a visual field (peripheral vision) of less then 20 degrees.

So the bottom line is that it doesn’t matter if your eyeglass prescription is +20 or -20, as long as you can see better then 20/200 with your eyeglasses or contact lenses on, then you’re not considered legally blind.

Change or Enhance your Eye Color

If you are looking to change your eye colour or enhance your eye colour then coloured contact lenses may be a great option for you. Coloured contact lenses are designed to bring added attention to your eyes. They can make blue eyes bluer, green eyes greener and brown eyes, well, not brown.

Enhancer coloured contact lenses such as the Acuvue 2 Enhancers help to bring a little extra pop to your own natural eye colour. They are designed for people with light coloured eyes such as blue and green and will not work for people with darker eyes. A light tint is added throughout the entire lens and enhancer contact lenses tend to provide the most natural appearance. The downside to enhancer contact lenses is that they can change your colour vision and you may not be able to accurately judge subtle colour variations or you may fail a colour vision test when you wear them. 

Opaque coloured contact lenses such as Freshlook Colorblends are used when people want to change their own eye colour. They are best designed for people with darker coloured eyes but can still be used in people with lighter eyes. A paint like finish is applied to the outer edge of the lens that closely resembles the natural human iris, but the centre of the lens in front of the pupil is left clear. Unlike enhancer lenses, opaque coloured contact lenses will not impair your colour vision. However, due to the peripheral colour they can impair a person’s peripheral vision and should never be worn for sports.

Circle lenses from companies such as Geo Medical Ltd. are the newest craze in contact lens wear and have started to pop up in many of the Asian countries. Circle lenses are used to produce the illusion that a person’s eye is larger then it really is. This is achieved by making the contact lens slightly larger in overall diameter. The challenge with these contact lenses arises in the fact that they are made with older conventional style contact lenses materials, which do not allow the same amount of oxygen to the cornea. In fact, most of these contact lens materials have not been used in our optometry clinics in over 10 years. So as an eye doctor I cannot endorse my patients wearing these contact lenses as they may compromise the overall health of your eyes.

So if you would like to try enhancer or opaque coloured contact lenses then book an appointment with Dr. Ross McKenzie for a professional contact lens fitting.

Help for Dry Eye Syndrome

Dry eye syndrome or simply dry eye is the #1 problem eye doctors face in Edmonton and the most common health condition encountered in the eye care profession.  Patients suffering from dry eyes need to be taken and treated seriously as it can have profound affects on their daily lives. Dry eye syndrome may simply be a mild irritation, or it can have serious visual consequences that require the aid of an eye care practitioner. Dry eye syndrome can both be acute or chronic in nature based on the underlying cause.

Dry eye syndrome is either a deficiency in the quantity or quality of a persons tear film layer. Medically the diagnosis goes under 2 names, either keratoconjunctivitis sicca or keratitis sicca, 2 big words that simply mean dry irritated eyes. Your tears are a combination of water for moisture, oils for lubrication and mucous to help spread and adhere the tear film to the outer layer of the eye (the cornea). Tears are produced by glands in your eyelids, which are different from the tears we shed when we cry or when our eyes water, which comes from the lacrimal glands located under the eyebrow area.

Dry Eye Syndrome will often illicit feelings of sharp needle like pain, burning, light sensitivity, gritty sensation, itchy, redness, blurred vision, and watery eyes. Chronic or acute dryness symptoms may also lead to a patients inability to wear contact lenses or undergo refractive laser eye surgery.

A number of eye tests can be performed by your optometrist to confirm your diagnosis of dry eye syndrome. Specific tests include the Shirmer test, and the tear break up test (TBUT). A new computerized test developed by the people at TearLab is now available, which measures the osmolarity of the tear film. The best testing however still involves a detailed examination of the ocular surface, the eyelid area and the tear film layer. An accurate case history can also shed light as to the diagnosis and potentially the underlying cause of your dry eyes.

Dry eye syndrome is caused by a number of factors and includes: medications (anti-histamines, birth control, anti-depressants, hypertensive meds, etc.), environmental factors (computer work, reading, dry office, dry home, etc.), lifestyle (sports, sunlight or wind exposure), contact lens wear (over wear, extended wear, dirty lenses, poor lens fit, or chemical toxicity secondary to contact lens solutions, etc), age, menopause, and smoking. Dry eye syndrome may also be the result of underlying medical problems such as Sjogren’s syndrome or ocular rosacea. 

Dry eye syndrome is usually seen as a chronic eye condition by most eye care professionals. With appropriate care and treatment however, it is possible to reduce or completely eliminate a patients symptoms. Always discuss your unique circumstances with your optometrist to determine the best treatment option that fits both your lifestyle, comfort level and budget.

Treatment Options for Dry Eye Syndrome

☐ Warm Compresses – Take a washcloth and wet it with warm water. Close your eyes and gently hold the warm washcloth over your eyes until it cools off. Repeat this cycle 4 times or for approximately 1-2 minutes.  Warm compresses should be performed every morning and every evening before bed. Performing warm compresses more regularly has no adverse side effects. Warm compresses help to open up your oil glands and tear glands. Showering or bathing alone will not do this.

☐ Lid Scrubs – Lid scrubs are performed to remove any oil buildup from the eyelid area. Lid scrubs are always performed after warm compresses, as the warm compresses help to soften the oil. Lid scrubs are best performed in the shower, by placing a small amount or baby shampoo on a washcloth or using a commercially available product like Lid Care Towelettes. Gently wash around the lid area, taking special attention around the oil gland area located right along the lid line by your eyelashes. Thoroughly rinse any soap residue away. Lid scrubs should always be performed prior to using any medicated ointments or creams around the eyelid area.

☐ Environment / Personal Factors – If your dry eye symptoms is being caused by any environmental or personal factors that you can control, try to reduce or limit your exposure. This may mean reducing how long you wear your contact lenses for in the day. Looking up and away from your computer screen at work, or the newspaper at home every 15 to 20 minutes. It may also mean discussing alternative medical therapies with your family physician if your dry eye is the result of a new or existing medication.

☐ Water & Air Humidifiers – Drinking water and limiting your intact of dehydrating beverages that include caffeine and alcohol, is a simply way to keep your whole body feeling better. Humidifiers are also a great way to help decrease tear evaporation. Edmonton is a dry city that only gets dryer in the winter. Adding a humidifier to your home furnace and air conditioner can greatly improve your home environment. Using a standalone warm air humidifier in the bedroom can also dramatically reduce dryness in the morning.

☐ Fatty Acid Supplements – Oral polyunsaturated fatty acid supplements are the newest trend in dry eye treatments. A large study out of the University of Waterloo, found that adding fatty acid supplement to ones diet, either through supplementation or better dietary choices can help to reduce ocular inflammation, improve oil secretion and improves dry eye symptoms overall. Supplement options include: Flaxseed Oil, Omega 3 and Fish Oil.

☐ Lubricating Eye Drops – Lubricating eye drops such as Systane Ultra, Blink tears, or Refresh tears are a great way to add additional lubrication to your eyes and provide comfort and relief. Please don’t get trapped into the mind set that all lubricating eye drops are the same, as they are most certainly not. Each brand of eye drops on the market targets a specific area of the tear film. Some lubricating eye drops may be better suited than others, depending upon your unique situation. In order to gain any positive affects from lubricating drops, they must be used regularly.  I also highly discourage my patients from using any 'red eye' lubricating eye drops, as they can often worsen dry eye symptoms, and increase healing times. Be certain to discuss any chemical or preservative allergies that you may have with your doctor, as there are now numerous 'preservative free' formulations available on the market. (Image via Alcon Canada website)

☐ Lubricating Eye Ointments – If additional lubrication is required for longer periods of time, than lubricating ointments such as Refresh PM are a great alternative. Ointments however, do produce more matting or buildup around the eyelids and can greatly blur ones vision. So typically they are used only before bed or prior to having a nap. However in some severe cases of dry eye syndrome they may be our go to product. Most lubricating ointments are also 'preservative free' which allows them to be used more frequently and in greater amounts.

☐ Medications - In some dry eye syndrome cases, medications may be used to help treat either the underlying cause of your dry eye, or the symptoms. Occasionally using antibiotics or anti-inflammatory medications can help bring your dry eye under control, and make it easier to manage with over the counter medications or homeopathic treatments. You may also see advertising for a product called 'Restasis', which is a prescription medication used to treat inflammatory dry eye. Watch their commercial.

☐ Temporary Punctal Plugs –These are small collagen plugs that are placed in the lower and potentially upper punctual canals in your eyelids. They are invisible to the naked eye, but prevent tears from draining out of your eyes, thus maximizing the contact time with your eyes and reducing your dry eye symptoms. Depending on the style of plug used, temporary punctual plugs can last for 3 days up to 3 months prior to dissolving away.

☐ Permanent Punctal Plugs – These are similar to temporary punctual plugs, but are usually made out of silicon. They are designed to last longer, and are used if temporary plugs are found to be successful in treating your dry eye syndrome.

Always discuss both the risk and benefits with your optometrist, prior to starting any medical treatment.

To learn whether or not you suffer from dry eye syndrome, and what treatment options might best suit your unique personal situation please schedule an appointment for a routine eye health exam.

Bausch and Lomb Advisory Board Meeting

I had the pleasure of being invited to attend a Bausch and Lomb drug advisory board meeting in Calgary this week. We reviewed antibiotic medications, anti-inflammatory medications and dry eye syndrome treatment protocols. We also spent the afternoon talking about all the new vitamins and nutraceutical products on the market and their involvement in ocular health and their specific benefits towards age related macular degeneration.

The one thing that emerged from the meeting was the confusion surrounding the vitamin or nutraceutical industry and the information or miss information that is available to the public.

Stay tuned for a number of future articles that will touch on many of these topics over the next few weeks.

Meibomianitis

Meibomianitis is an inflammatory condition involving the eyelid margins. I would venture to say that meibomianitis is one of the top 10 most common eye care conditions that I encounter within the clinic. Meibomianitis is often the underlying root cause to numerous other eye conditions, but is often neglected in the treatment process. Meibomianitis is caused when the oil glands located along the eyelid margin become inflamed or infected.  Left untreated meibomianitis can cause hordeolums (stye), madarosis (loss of eyelashes), blepharitis, burning eyes, contact lens irritation and dry eye syndrome.

Treatment for meibomianitis consists of warm compresses to melt and soften the oil in the glands, lid scrubs to remove the old oil and gentle eyelid massage to express out the old oil. Lid Scrubs are best performed in the shower with a 1 part baby shampoo to 3 parts water mixture or with commercially made products like Lid Care Towelettes as you can ensure that you thoroughly rinse any soap residue away. Occassionally for more severe cases, a short course of oral antibiotic medications such as Doxycycline are used. Prescription eye drops are usually ineffective in treating meibomianitis, but lubricating eye drops like Systane Ultra may provide some temporary relief from dry eye symptoms. Occasionally anti-inflammatory eye drops or antibiotic eye dorps are used to help initially get the inflammatory condition under control. In more chronic cases oral antibiotics may also be given.

If you suspect that you suffer from meibomianitis, please book an eye exam with your eye doctor.

My eyelashes are falling out. Help!

Have you been noticing a thinning appearance to your eyelashes or eyebrow area over the past few months? If so, you may be suffering from an eye condition known as madarosis.

One of the most common causes of madarosis is inflammation around the eyelid margins. Inflammation constricts the normal blood flow to the follicle or root of the eyelash, causing it to weaken and fall out. Inflammations may be secondary to normal bacterial infections such as blepharitis or more rare things like parasites and mites. Allergic reactions secondary to seasonal allergies or to cosmetic products can also cause eyelashes to fall out. Makeup use is often one of main causes behind madarosis as some waterproof mascaras or eyeliners can require a lot of scrubbing in order to remove them. This can loosen eyelashes and cause them to fall out.

Trauma to your eyelash or eyebrow area is another primary culprit. Trauma can be secondary to an injury, or can be self-induced by waxing or plucking. Eyelash or eyebrow hairs may not grow back or they may not grow back in the right direction. Trichotillomania is a psychological impulse disorder were by patients pull out scalp, body, eyelash and eyebrow hairs. This condition may require behavioral therapy versus medical therapy. Madarosis can also be induced from some cancer treatments, as these treatments target fast growing cells like hair follicles.

Madarosis can on occasion be secondary to more severe medical or ocular conditions such as benign or malignant tumors, endocrine disorders, or autoimmune conditions such as discoid lupus erythematosus. In some causes patients who have alopecia areata already may develop madarosis over time.

The initial treatment for madarosis is of course trying to determine the underlying cause of the condition and then treating that. If an underlying cause is not easily determined, then there are a few things patients can do. The first thing is to realize that it can take up to 2 months for eyelashes to regenerate, so you will not notice a difference overnight. Patients should also consider taking a close up photograph of their eyelids, so that they can monitor the progress and quantify the loss or gain of hair follicles.

I always suggest that patients stop wearing any makeup, mascara, eyeliners or fake eyelashes for about 2 months. The goal of this is to remove any chemicals that may be irritating the eyelid. I also suggest that contact lens wearers either consider wearing eyeglasses for this time or at the very least switch to a non-preservative contact lens solution such as ClearCare.  Patients should also perform warm compresses over their closed eyes every morning and every night for about 2-3 minutes, which helps to improve blood flow to the eyelashes. Gentle cleaning of the eyelash and eyebrow area can also be done every morning in the shower with a diluted baby shampoo mixer (1 part baby shampoo, 3 parts water) to remove any bacteria buildup that may be present at the base of the eyelash.

If you still are not noticing any improvement in the appearance of your eyelashes, then you should book an eye exam with your optometrist. In some cases, your eye doctor may need to refer you to an oculoplastic specialist or family doctor for further testing.

Blepharitis

Blepharitis is an extremely common and potentially chronic eye care problem encountered by eye doctors. Blepharitis is defined as an inflammation of the eyelash follicles caused because of an overgrowth of normal skin based bacteria. This can be the result of excessive oil production around the eyelids, which provides the perfect home for bacteria to flourish.

Symptoms of blepharitis included crusty eyelids, itchy burning eyes and red swollen look eyelid margins. Left untreated, blepharitis can cause hordeolums (styes), eye irritation, eye infections and madarosis (loss of eyelashes). Blepharitis can be diagnosed during a routine eye exam with your eye doctor after a detailed examination of your eyelids and eyelashes.

Treatment for blepharitis involves daily cleaning of your eyelid area to remove any build up of oil or overgrowth of bacteria. Patients are directed to perform warm compresses over their closed eyes to loosen the bacteria and melt the oil. Lid scrubs are then performed in the shower with diluted baby shampoo or commercial made products such as Lid Care Solution or Lid Care Towelettes. In more severe cases, topical antibiotic ointments such as Besivance, Erythromycin or Bacitracin (not available in Canada but commonly used in the United States) may be required. Topical antibiotics are often used on patients prior to eye surgery to minimize the risk of a post-operative eye infection. 

Unfortunately, blepharitis can be a chronic eye condition, but with continual treatment the long-term prognosis is excellent. If you suspect that you suffer from blepharitis then book an eye examination with Dr. Ross McKenzie.

Viral Conjunctivitis - Pink Eye

Viral conjunctivitis better known as ‘Pink Eye’ is a common and highly contagious eye condition. Typically pink eye is spread in environments where people have close contact with one another like schools, offices, buses, airplanes and daycares. Infections develop through direct contact with a person who is already infected with the virus. There is some belief that pink eye can also be transmitted through swimming pools. Due to the high contagiousness of the condition whole families can develop pink eye if one member of the household becomes infected.

How do I know if I have a viral conjunctivitis or pink eye? Symptoms for pink eye are typically very classic in presentation. Patients usually report a sudden onset of eye irritation, red eyes, light sensitivity and excessive tearing. Eyes do not look blood shot, but have a general pink hue to them that covers the entire white of the eye. Typically pink eye begins in only one eye, but quickly spreads to the other eye because of people rubbing their eyes.

What can be done for pink eye? Because pink eye is a viral infection, antibiotics are not effective at treating the problem. For mild pink eye infections, cold compresses and bland lubricating eye drops such as Systane Ultra are the primary treatment, along with good personal hygiene. Vasoconstrictor eye drops such as Visine used to whiten eyes often have minimal benefit in these cases and should be avoided in general. If you have a more severe form of pink eye, occasionally your optometrist will prescribe topical anti-inflammatory medications such as steroids.

Although most viral conjunctivitis eye infections do not require a trip to your eye doctor, you should seek the assistance of your optometrist if you ever experience pain or blurred vision or if your condition seems to be worsening. A trip to your optometrists office for viral conjunctivitis is usually covered under Alberta Health Care.

All New PureVision 2 HD Technology by Bausch & Lomb

purevision_2.jpg

PureVision2 HD Contact Lens Benefits

Reduced edge thickness

  • Reduces lid awareness and improves comfort
  • Easy to handle lens design

High Definition Optics

  • Improved night vision, reduced glare and halos

Monthly Disposable

  • Easy to remember when they require replacement

Highly Breathable

  • Promotes bright, white, healthy eyes

Comfort Moist Technology tm.

  • Moisture rich packaging solution
  • Supports wearing comfort upon insertion

Ask how you can experience the benefits of the new PureVision 2 HD technology at your next eye exam with Dr. Ross McKenzie and book a contact lens fitting. 

Safety Eyewear

Protective safety eyewear can be as simple and inexpensive as a pair of goggles or shields that fit over your own glasses. These can be purchased at your local hardware or home improvement store. However, if you work with power tools a lot, you may wish to invest in a pair of specially fitted safety eyewear made with polycarbonate or trivex lenses. These safety eyeglasses can be made by your optometrist and can incorporate your own eyeglass prescription to give you clearer, more comfortable vision. 

To qualify as true safety glasses, the frame and lenses must pass a strict set of criteria set forth by the Occupational Safety and Health Administration (OSHA) known as ANSI standards or the Canadian CSA Z94.3 safety standard. The frames must be sturdier than standard “dress” eyeglass frames and the lenses must pass a “drop ball” test. In this test, a small metal ball is dropped onto the lens from a specified height. The lens must survive impact without any chipping or cracking.

If your work requires using power tools or machinery, or if you work in an area with any kind airborne particles or noxious chemicals, your employer needs to provide safety eyewear for you. They may even provide prescription safety glasses for you, so be sure to check with your employer. But no matter what type of protective eyewear you choose, the most important thing is that you wear it!

 

What Diseases Can Be Detected During An Eye Exam?

Shakespeare once wrote that, “The eyes are the window to the soul.” It is also true that the eyes can be considered a window to the internal workings of your body. Nowhere else on the body are we able to view actual blood vessels in action like we can when we look at the retina. As such, we can often detect general physical diseases by looking at the eyes.

Check out the following list of eye diseases, followed by a list of systemic diseases, that all can be found during a routine eye exam:

Common Eye Diseases That Can Be Detected During An Eye Exam:
•    Cataracts
•    Glaucoma
•    Macular Degeneration
•    Retinal Detachment
•    Dry Eye
•    Corneal Degeneration

Systemic Diseases That Can Be Detected During An Eye Exam:
•    Diabetes
•    Hypertension – High Blood Pressure
•    Hypercholesterolemia – High Cholesterol
•    HIV/AIDS
•    Multiple Sclerosis
•    Graves Disease
•    Herpes Simplex/Herpes Zoster infections
•    Carotid Stenosis – a narrowing of the carotid artery and a risk factor for strokes