Alamo Optometry Blog

February 28, 2011

Contact Lenses

Filed under: Uncategorized — gkblog @ 9:20 pm

 (As appeared in Alamo Today, March 2011, pg. 21)

            My patients are always asking me about “new technology” in contact lenses and if their prescription would work for contacts.  Recent advancements in contact lens technology and manufacturing have made contact lens comfort and vision easier than ever.  Depending on your prescription, eye health, motivation, and how often you want to wear contacts, there is likely a contact lens for you.     

Daily disposable contacts are gaining popularity among patients and doctors alike.  For doctors, we like that patients are getting the healthiest option for contact lens wear   Patients enjoy the freedom of no solutions and cases, convenience, and the cost is very comparable with 1-month disposable contacts because there is no solution and cases to purchase in addition to the contact lenses.  These lenses are very thin, and therefore easy to adapt to.  From an eye health perspective, these are the best lenses for you because there is no build-up on the lenses, which can lead to decreased wearing time and possible infections.  The other advantage is you can wear these lenses as much or as little as you like.  If you want to wear them just for sports, recreation, vacation, or just going out to dinner, these lenses are the choice for you.  These lenses can be worn to correct your distance vision in addition to monovision, which allows for distance vision in one eye and near vision in the other.  However, even if you want to wear them every day, dailies are still the most convenient and healthy lenses on the market.

            The newest contact lens material to be developed recently is silicone hydrogel.  This base material is now being utilized by all of the major contact lens companies; each company has their own version which accounts for some of the differences in stiffness, oxygen flow through the lenses, and patient comfort.  Most of these lenses are now FDA approved for extended wear, the time does vary for each material.  Obviously, there are some potential health issues with the eyes that come along with sleeping in your lenses, so it is not for everybody; that can be determined at your exam and at follow-up visits.  This new material makes the lenses firmer, and allows for an average of a 4 to 6 fold increase in oxygen flow to the eye versus older lenses.  All types of lenses including multifocals and monovision are now available in this material.  Most people enjoy the freedom these lenses give you and the increased end of day comfort.  If your eye receives more oxygen, it will be less fatigued and red at the end of the day.

            Toric contact lenses are now better than ever.  If you have astigmatism, that means the front part of your eye (the cornea) is more oblong-shaped, similar to an egg.  Because the eye is not equally curved, a toric lens is needed to help you see well.  These lenses are still soft and you care for them the same as any other lens.  Toric contacts are now available in daily disposable and in the silicone hydrogel material.

            Finally, it is important to remember that contact lenses are medical devices, and can cause eye health consequences if not worn and cared for properly.  That is why annual exams are mandatory to ensure good vision and eye health.  We will patiently work with you to determine which prescription and type of lenses would be best for you.  Our goal is that your vision and comfort with your lenses is the best that it can be.

February 8, 2011

Floaters

Filed under: Uncategorized — gkblog @ 9:46 pm

(As appeared in Alamo Today, February 2011, pg. 29)

It seems as though we have had more cases of floaters in the office lately.  I am not sure if it is something in the water or just coincidence, but the number of patients complaining of flashes and floaters has increased.  This can be a potentially serious eye condition that warrants immediate attention, so I will discuss some of the causes and symptoms and what to do if you experience any of the effects.

            When patients call the office complaining of sudden onset of flashes and floaters, the most common diagnosis is a posterior vitreous detachment or PVD.  The vitreous gel, which fills the posterior 2/3 of the eye, is made of tightly-packed collagen fibers that are translucent.  Over time, the fibers that make up the gel liquefy and condense, causing it to move forward and pull away from the retina.  Since there is now an area of fibers that are situated in front of the retina, as light enters the eye it goes through this area of detachment and casts a shadow onto the retina; this is what the patient perceives as floaters.  This situation alone is completely benign and might cause slightly decreased vision but will have no long term effects on the eye.  However, as the gel pulls away from the retina there are tractional forces that develop and can pull a part of the retina away causing a retinal hole and/or detachment.   This is what needs immediate surgical intervention by a retina specialist. 

            If the retina is detached from the back of the eye, it is not receiving any oxygen and will die like any other tissue or organ in the body.  Generally speaking, the prognosis for visual recovery is related to how quickly the diagnosis and treatment is initiated and the location of the detachment.  This is why it is absolutely imperative that if you notice a sudden onset of floaters, flashes of light, decrease in vision, a veil or curtain coming over your vision, or any combination of these that you have your eyes dilated as soon as possible.  If you have any of these symptoms, we will always squeeze you in for a same day appointment.  If the diagnosis is a PVD, there is no treatment.  We will discuss some precautions and some things to watch for and do a repeat dilation in 6 weeks.  Most studies have shown that if a retinal complication is going to occur, it is going to happen within the first 6 weeks, most likely sooner.  If there is a retinal hole and/or detachment a prompt referral to a retinal specialist is ordered.  Many treatments now can be done in office without the need for hospitalization. 

            Patients will invariably ask if there is anything that can be done to remove the floaters, and unfortunately the answer is no.  The only way to clean out the floaters is to do a procedure called a vitrectomy, which involves going into the eye and removing all of the vitreous and replacing it with clear fluid.  However, the risk of retinal complications is relatively high with this procedure.  Therefore, retinal surgeons will not do surgery for a benign condition, albeit an annoying one, to risk loss of vision.  Thankfully, your brain learns to “tune out” the floaters over time so they are not as noticeable.  They never actually go away or disappear; your brain just learns to suppress them.  If you actively look for them, are out in the sun, or around a lot of light or glare it is relatively easy to find them. 

If you have had a recent episode of floaters with or without flashes of light, please have your retina evaluated as soon as possible.  I would rather you come in for an office visit and the diagnosis is floaters versus waiting for the symptoms to go away and having possible decreased vision from a retinal complication.

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