Managing Myopia Progression in Children

Managing Myopia Progression in Children

Why is it important to manage myopia progression in children?

Myopia, also known as short sightedness or near sightedness, is an increasingly common condition that affects children’s sight. There can be many causes of myopia, such as family history or genetics, spending too much time focusing on close objects as a child, not spending enough time outdoors, etc.

Myopia can progress rapidly in children if it is not managed well, and every 1 diopter increase in myopia increases risk of myopic maculopathy by 67% – there is no “safe” level of myopia. As seen in the table below, myopia increases the risks of eye diseases such as cataracts, glaucoma, retinal detachment, and myopic maculopathy.

Some other risk factors (non-exhaustive) include diabetes, high blood pressure, family history of eye disease, or taking prescription medications which may affect the eyes.

Do take comprehensive eye exams to check your child’s eyes or your and detect eye diseases such as cataracts and glaucoma. You should also maintain healthy habits such as relaxing your eyes and eating healthy to get sufficient vitamins for your eyes and body.

What are some ways to slow down myopia progression?

EyedropsEyeglassesContact Lenses
What is it and how can it manage myopia progression?Atropine eyedrops, with differing doses available depending on the child’s needsIt slows down the progression of myopia in about 50% to 60% of children for low-dose atropine 0.01%, and 20% to 30% of children may require higher dose atropine (0.125% / 1%).Bifocal lenses: top half corrects for long distance and the bottom half corrects for reading vision, research has shown that it can slow down myopia progression  Myopia control lenses of differing designs: special lenses designed to help control myopia progression more effectively than the typical bifocal and progressive designsHard contact lenses, also known as Orthokeratology or OrthoK lenses which are worn to sleep; it flattens the central area of the cornea to restore clear vision and the mid-peripheral area is steepened to control myopia progression
Soft contact lenses: multifocal lenses can help slow down myopia progression. These lenses are clinically effective for myopia progression control.
AdvantagesThese eye drops can help to complement the eyeglasses that your child uses.Eyeglasses are usually more cost-effective than contact lenses. No infection risks involved as kids are not required to touch their eyes or put lenses into their eyes.Hard contact lenses: no need to wear anything during the day to see well, parents are able to supervise closelySoft contact lenses: lowest infection risk for daily disposables, minimal lifestyle limitations such as need for sufficient sleep
LimitationsChildren on 1% atropine eye drop treatment often require photochromatic or sunglasses with UV filters, and a progressive or reading additions in their glasses. Other possible side effects are often mild and temporary e.g. glare, dry eyes, eye allergy. Eyeglasses may be inconvenient when leading an active lifestyle, or some kids may find eyeglasses uncomfortableBifocal lenses: obvious line in the middleMyopia control lenses: pricier than normal single vision or bifocal lensesHard contact lenses: need to have sufficient amount of sleep every night, need to ensure hygieneSoft contact lenses: daily disposables may cost more

References:

  1. https://www.snec.com.sg/patient-care/specialties-and-services/clinics-centres/myopia-centre/Patient-Care
  2. https://pubmed.ncbi.nlm.nih.gov/24435660/
  3. https://www.singhealth.com.sg/news/patient-care/childhood-myopia-use-of-atropine-eye-drops

Glaucoma – Causes, Signs and Symptoms

Glaucoma – Causes, Signs and Symptoms

What is glaucoma?

Glaucoma, often termed the “silent thief of sight”, is an eye disease that affects your eye’s optic nerve, usually caused by a pressure buildup in the eye due to poor drainage. Each eye has an optic nerve that relays information on things we see to our brain. Glaucoma is a serious eye disease that is often asymptomatic and should be treated as soon as possible to slow down or even halt its progression.

There are two types of glaucoma:

1. Open-angle glaucoma

This is the most common type of glaucoma that occurs when the eye is not draining as well as it should be. This type of glaucoma progresses gradually. It is painless and has no symptoms at first. However, this type of glaucoma can be detected early with regular eye exams.

2. Angle-closure glaucoma

This type of glaucoma occurs when the iris is too close to the drainage angle of the eye, so the iris ends up blocking the drainage angle. When the drainage angle is completely blocked, eye pressure rises rapidly, resulting in sudden and severe symptoms. Such cases are considered an emergency and an ophthalmologist should be consulted immediately.

Causes of glaucoma

Our eyes constantly produce fluid called aqueous humour. New aqueous should flow in while the same amount flows out to maintain normal eye pressure. However, if the drainage angle is not correct, the fluid cannot flow out and will build up in the eye. This results in eye pressure increasing, which may damage the optic nerve.

Some people are at higher risk of getting glaucoma than others. Such risk factors include:

  • Age (Risk of glaucoma increases from 50 years of age onwards)
  • Asian, Hispanic or African descent (due to genetic predisposition)
  • Existing medical conditions eg. diabetes, hypertension
  • Eye conditions eg. previous eye injury, high myopia (nearsightedness)
  • Long-term use of steroid medications

There are no specific lifestyle activities or diets that are linked to glaucoma, nor are there any definite ways to prevent glaucoma. The best thing that can be done in cases of glaucoma is early detection and treatment.

Signs and symptoms of glaucoma

The two types of glaucoma have differing signs and symptoms.

1. Open-angle glaucoma

One may not notice any vision loss until glaucoma is in its advanced stage. As the disease progresses, blind spots develop in one’s peripheral (side) vision. As this type of glaucoma tends to not show symptoms until damage is severe, it is important to go for regular eye exams, as eye exams are able to pick up on the abnormal eye pressure or any damaged optic nerve before you experience any symptoms.

2. Angle-closure glaucoma

One typically does not experience symptoms before an attack. Early symptoms of an oncoming attack include blurred vision, halos, mild headaches or eye pain.

During an attack, one may experience:

  • Severe eye pain, typically associated with headache 
  • Redness of eye
  • Blurry vision
  • Nausea and vomiting

People with such symptoms should see an ophthalmologist immediately.

How often does glaucoma lead to blindness?

Statistically, about 15% of glaucoma patients lose ability to read in one eye. However, glaucoma progresses at different rates for different individuals, the majority of glaucoma patients never reach blindness. If left untreated, glaucoma causes  one’s peripheral vision to start becoming blurry. Overtime, their central vision will be blurred as well, which leads to the person going blind.

Early detection of glaucoma is crucial in preventing any adverse consequences. With early detection, glaucoma is highly treatable. However, if glaucoma is left untreated until the optic nerve is damaged, the damage cannot be reversed, although further possible damage can still be prevented by visiting an ophthalmologist. Hence, it is important to go for regular eye exams to detect such eye diseases as early as possible, especially if you are at higher risk for them.

Treatment of glaucoma

Glaucoma is a progressive disease. While it cannot be completely cured, its progression can be slowed down or even halted through treatment.

1. Medication

Glaucoma is usually controlled with eyedrop medication. Some of these eyedrops help by reducing the amount of fluid (aqueous humour) your eye produces, while others may help fluid flow better through the drainage angle, thereby reducing your eye pressure.

As these eyedrop medicines are absorbed into the bloodstream , they may cause some side effects, such as stinging or itching sensations. Any side effects should be reported to your ophthalmologist.

2. Surgery

This option is usually undertaken if medical treatment with the eyedrops are not effective. The most common surgery is trabeculectomy, where an opening is created for the fluid in the eye to drain out. The fluid is absorbed by tissue around your eye and eye pressure is relieved.

There are other types of surgery used to treat more complicated cases of glaucoma.

3. Laser treatment

This is usually used for patients with angle-closure glaucoma. Iridotomies involve using a laser to create a tiny hole in the iris to help fluid flow to the drainage angle.

Book an eye exam to make sure your eyes are safe from the “silent thief of sight”.


Sources:

Age-related Eye Problems

Age-related Eye Problems

Not only does ageing contribute to vision problems such as presbyopia, it also increases risk for eye health problems.

What eye problems are associated with ageing?

Age increases risk for many eye diseases and conditions, including:

  • Age-related macular degeneration

Based on research by Singapore Eye Research Institute in 2009, age-related macular degeneration is one of the leading causes of blindness in people over 50 years of age.

Glaucoma is the cause of about 40% of blindness in Singapore. Based on research by Singapore Eye Research Institute in 2009, around 3% of people above 50 years old have glaucoma, while this figure is higher at 10% for those above 70 years of age.

Cataracts are the leading cause of blindness worldwide.

  • Retinal detachment

Those over the age of 40 are at higher risk of retinal detachment.

Normal, harmless floaters are often caused by age-related changes to the vitreous fluid in our eyes. Sudden onset of or increase in floaters can be indicative or retinal detachment.

As we age, our tear production decreases, resulting in dry eyes.

How to counter age-related eye problems

Comprehensive eye exams should be taken every 1-2 years for people 40-64 years old and annually for those 65 years old and above. If you have other risk factors for eye diseases, such as diabetes or family history of eye diseases, you should get a comprehensive eye exam more often.

This allows your optometrist/ophthalmologist to monitor your eye health and detect any eye diseases early. Early detection of eye diseases is important in treating the condition before it has irreversible consequences or results in blindness.

Have not had a comprehensive eye exam in the past year?


Sources:

  • https://www.singhealth.com.sg/patient-care/patient-education/age-related-macular-degeneration
  • https://www.singhealth.com.sg/patient-care/patient-education/glaucoma
  • https://www.singhealth.com.sg/patient-care/patient-education/retinal-detachment
  • https://www.aarp.org/health/conditions-treatments/info-2020/age-related-eye-issues.html
3 Benefits of Photochromic Lenses

3 Benefits of Photochromic Lenses

What are photochromic lenses and how do they work?​

Photochromic lenses also called light-adaptive lenses, or variable-tint lenses, look like regular clear lenses when indoors but automatically darken when exposed to sunlight. Ultraviolet (UV) rays from the sun affect the molecules in the photochromic lenses causing the lenses to change colour. Photochromic lenses may darken even on overcast days as UV rays still penetrate the clouds. These lenses usually would not darken inside a vehicle as the windshield glass blocks out most of the sun’s UV rays.

What are the benefits of photochromic lenses?

  1. Photochromic lenses help to reduce eye strain and decrease the risk of eye damage such as cataracts later in life by blocking up to 100% of the sun’s harmful ultraviolet light.
  2. With photochromic glasses, this reduces the hassle of needing to bring a pair of sunglasses whenever you are going out and switch between the two when travelling to different environments.
  3. Although photochromic glasses can be more expensive than ordinary prescription glasses, it may be a cost-effective option as you only have to pay for 1 pair of eyewear.

How does UV rays affect eye health?

Extended exposure to UV rays can harm your vision and increase the risk of several eye diseases in the long term. UV rays can cause the cornea (front of the eye) to become inflamed or burned. Additionally, it can also lead to skin cancer around eyelids, cataracts (clouding of the lens of the eye) and pterygium (tissue growth on the surface of the eye) which can impair vision.

One of the most popular brands of photochromic lenses are Transitions® lenses.

What are the benefits of Transitions® lenses?

  •  Automatically adapt to the perfect shade based on the changing light conditions, enabling you to see clearly with just the right amount of light
  •  Blocks 100% of UV rays and protect against harmful blue light indoors and outdoors
  •  Designed to be worn all day, everyday
  •  Anyone can wear Transitions® lenses as there are options for every lifestyle and every age, from kids to adults and elderly
  • Designed to fit virtually every frame, style, size and prescription

How long do photochromic lenses usually last?

Plastic photochromic lenses usually last about 2.5 to 3 years which is longer than the typical amount of time one changes his/her glasses due to changes in one’s prescription. In contrast, glass photochromic lenses would never lose their ability to block UV rays. In fact, its function would improve with more usage.


Sources

Essilor

http://www.x-celoptical.com/faq.php

https://www.cancer.org/cancer/cancer-causes/radiation-exposure/uv-radiation.html#:~:text=UV%20rays%2C%20either%20from%20the,can%20also%20cause%20eye%20problems.

https://www.northwoodvision.com/6-things-you-should-know-about-uv-radiation-and-your-eyes/

https://www.cancer.org/cancer/cancer-causes/radiation-exposure/uv-radiation.html#:~:text=UV%20rays%2C%20either%20from%20the,can%20also%20cause%20eye%20problems.

Comprehensive Eye Exam: Why It Is Important and What To Expect

Comprehensive Eye Exam: Why It Is Important and What To Expect

Why is it important to have a comprehensive eye exam regularly?

Keeping an eye on your vision requires different care and attention at different stages of life. Even when we are young, we should do a comprehensive eye check-up regularly as eye problems can be present at any age. 

Did you know some eye diseases such as glaucoma have no symptoms? Having a regular eye check-up gives you the best chance to diagnose any underlying eye diseases. Your eye doctor can also help to evaluate your eyes as an indicator of your general well-being.

What is the difference between a vision screening and an eye exam?

Vision screenings are basic eye tests to help recognize any issues with your vision, but it does not test for any underlying eye diseases. Usually, it checks for basic refractive errors such as myopia, astigmatism, and hyperopia.

A comprehensive eye exam performed by an optometrist or ophthalmologist involves a thorough examination of all aspects of your vision. Your eye doctor will be able to diagnose visual health issues and ocular conditions that are otherwise unable to be determined by vision screening.

What to expect from a comprehensive eye exam?

History Taking

Your eye care professional will ask for your background and health history as existing medical conditions may increase the potential risk of developing certain eye diseases.

Visual Acuity Test

This is a test to measure how well you can see in different distances by asking you whether you can see numbers and letters of varying sizes using an eye chart.

Refraction

This is a test to measure your type and degree of refractive error to determine your exact eyeglasses prescription.

Eye Pressure Test

Usually done with a tonometer, this test measures your eye pressure that checks for glaucoma: an eye condition that can cause vision loss due to built-up eye pressure damaging the eye’s optic nerve.

Check the front of your eyes: Slit Lamp Test

The front part of your eyes will be examined under high magnification to detect any abnormalities such as cataracts and macular degeneration.

Check the back of your eyes: Retinal Imaging / Fundus Examination

A high resolution, wide-angle picture of your retina will be captured to detect any abnormalities such as retinal detachment in the back part of your eyes.

A perfectly healthy retina.

Assessment and Management

After the eye exam, your eye care professional will advise you on the test results and steps needed if abnormalities are detected.

A comprehensive eye exam may involve more tests depending on your ocular conditions but these are the most common and will help cover a wide spectrum of eye diseases.

Babies (Age 6 months onwards)

Ensure that your child’s eyes are screened during regular pediatric appointments and they are free from common childhood eye conditions and diseases.

Children and Teenagers (Age 3 to 19)

Ensure that your child has a thorough eye check every 1-2 years during routine health check-ups or when getting fitted for corrective eyewear, such as for myopia.

Young Adults (Age 20 to 39)

Have a comprehensive eye examination if you have a family history of eye disease or if you are suffering from an eye injury.

Adults and Seniors (Age 40 onwards)

Eye conditions such as age-related macular degeneration are more likely to occur as we grow older. To monitor vision changes, you should get a baseline eye disease screening when you are 40 and ask the doctor to assess how often you need to return for follow-up screenings.

For Anyone with Risk Factors

If you have a risk factor for eye disease (Diabetes, high blood pressure, family history of eye disease), you should see your eye doctor annually. Ask your eye doctor for the ideal interval between check-ups.

Have not had a comprehensive eye exam in the past year?


Sources:

Cataracts – Early Signs and Symptoms

Cataracts – Early Signs and Symptoms

Have you often heard of cataract but are unsure of what exactly it is? Read on to find out more!

What is cataract?

Cataract is the most common cause of blindness in the world. In Singapore, cataract affects about 80% of people above the age of 60 and up to 95% of people above the age of 70. 

Simply put, cataract is the clouding of the lens of your eye that is normally clear. This results in impaired vision as not enough light is able to enter the eye. Having cataract would be akin to seeing the world through a frosted or fogged-up glass. Cataract affects everyday activities such as reading and driving.

Cataract often progresses slowly and may not interfere with eyesight in early stages. However, as it develops it will start to disturb your vision more and more.

Cataract Signs and Symptoms

Initially, cataract symptoms may not be that noticeable as only a small part of the eye may be affected by the cataract. However, over time, as the cataract develops the signs would become more obvious.

Extremely dense cataracts can be obvious when light is shone.

Symptoms of cataract include:

  • Cloudy, blurred or dim vision 
  • Difficulty in seeing at night that worsens over time
  • Sensitivity to light and glare
  • Needing brighter light for daily activities such as reading
  • Seeing “halos” around light sources
  • Fading or yellowing of colours
  • Double vision in one eye

A common sign of cataract would be blurred vision that cannot be corrected with the usual corrective visual aids such as glasses.

Upon noticing any change in your vision, it is important to see your eye doctor as soon as possible.

Causes of cataract

Cataract usually affects the elderly, however, it can occur in young people and even children as well. Cataract formation in the elderly is usually linked to ageing. For young people, cataract formation could be due to eye injury, other eye conditions or genetic predisposition. 

There are various risk factors that could contribute to cataract formation.

These include:

  • Age
  • Diabetes
  • Prolonged usage of corticosteroid medications
  • Excessive exposure to UV light
  • Diabetes
  • Previous eye injury or inflammation
  • Previous eye surgery
  • Smoking

Treatment of cataract

Cataracts cannot be cured with medication. Adjustments to your lifestyle can be adopted at earlier stages to help counteract the effects. Such changes include changing your spectacle lens power, using brighter lighting at home, wearing sunglasses outside during the day and avoiding night driving as far as possible.

However, when cataract starts to interfere with everyday activities, cataract surgery would be required. Cataract surgery is minimally invasive, painless and safe. During the surgery, the clouded lens is removed and replaced with a clear lens implant. After the procedure, your eye will fully heal in 1-2 months.

It is important to consult your eye doctor with regards to the progression of your cataract. If cataracts are left too long, they can become hyper-mature, making them slightly more challenging to remove in surgery, although they can still be removed safely.

Can cataract be prevented?

While there is no way to completely prevent formation of cataract, there are some things you can do to help prolong your healthy eyesight, such as:

  • Eating foods rich in antioxidants, vitamin A, C and vitamin E
  • Quitting smoking
  • Wearing sunglasses that block out UV rays and at least 75% of visible light

Book an eye exam to make sure your eyes are safe from the “silent thief of sight”.


Sources:

Caring for your eyes in COVID-19

Caring for your eyes in COVID-19

What first comes to mind when you think about your eyes in this extraordinary time of extended lockdowns and working or studying from home?

Blurred vision? Eye Fatigue? Dry eyes? Headaches? 

You may be suffering from digital eye strain, also known as computer vision syndrome.

While it is close work, rather than screen use per se that strains our eyes, Dr Maturi, the clinical spokesperson for the American Academy of Ophthalmology and a retina specialist, said that looking at bright devices can make us blink less, which leaves our eyes feeling dry. “When things are bright, we blink less. It’s behavioral. So we can train ourselves to blink more often and blink fully,” he said.

What can we do about it? Here are some tips:

1) 20-20-20 breaks: When engaging in near work activities (i.e., reading books or using digital devices), encourage regular breaks or use the 20-20-20 rule, i.e., look 20 feet (6 metres) away for 20 seconds every 20 minutes.  Remember to stretch your arms, neck and legs during this break too! 

2) Optimal reading distance: Are you too close to the screen? A recommended viewing distance for your mobile phone, laptop and desktop is 40, 50 and 70cm respectively.

For kids, the Harmon distance is recommended where they should be sitting away from their reading object between their elbow upright and 3rd knuckle (~25cm).

3) Lighting: You need to ensure the environment in which you are using the screen is brightly lit, but not so glaring (e.g. with the sun shining on you) such that you can barely see the screen.  Use warm light for less glare.

4) Appropriate eyewear: Our eyes are not made for prolonged viewing at close distance.  You can consider different types of eyewear to improve vision comfort.  For example, blue light blocking glasses can reduce glare and reflection and block out the most harmful spectrum of blue light, to about 60% in the day and 30% at night , so you can experience visual comfort from day to night.  There are also special computer glasses with a power boost at the bottom of the lenses to relax your eyes with extended digital device and near vision usage.

Get your glasses here.

5) Adequate nutrition: We are what we eat. Food that are rich in antioxidants such as lutein and zeaxanthin, or support anti-inflammation such as omega3 and essential fatty acids are critical for good eye health. Think salmon, eggs, avocado, berries and leafy greens. Supplements are available for those who would benefit from additional boost: Vitamins For Dry Eyes, Vitamins for retina


Sources:

Myopia – Risks and Management

Myopia – Risks and Management

What is myopia?

Myopia is a very common eye health condition. Often called “short-sighted,” a child with myopia can see clearly up close but has blurry vision when looking at objects in the distance—like a smartboard.

Myopia happens when the normal eye grows too long from front to back. 

Light rays have trouble reaching the right spot on the back of the eye (the retina) to achieve clear distance vision.

It’s more than just stronger, thicker glasses. Myopia in kids can get worse as they grow, increasing the risk of serious eye conditions.

What causes myopia?

  • Myopia can be inherited from one generation to the next. If mum or dad wears glasses, chances are their child will too.1
  • Lack of time spent outdoors in the sun has been linked to the development of myopia.1, 2,3
  • Spending more time reading close-up on digital devices may also contribute to a child’s myopia.2,3,4
  • And there’s the routine correction of myopia – resulting in Peripheral Hyperopia – that has also been shown to signal the eye to grow, thus causing myopia.2

What are the eye health risks?

The number of kids with myopia is growing at an alarming rate around the world.  The younger your child develops myopia, the greater the risk of serious eye conditions like retinal detachment, glaucoma, cataracts, and even blindness.5

Beyond the eye health risks, myopia can negatively impact your child’s performance in school and other activities.

There is NO SAFE level of myopia.5  Practitioners and researchers do not know which child will progress to what degree.  Each prescription (diopter) increase can have a significant impact and the impact can occur anywhere – in low to high myopia ranges.6   Earlier intervention may be ideal, but any intervention is a potential benefit.   If we can reduce the level of progression, data suggests that the impact could be significant:

  • 20% reduction in retinal detachment, cataracts, glaucoma, and overall visual impairment.6
  • 40% reduction in macular degeneration. 6

This means – ½ to nearly 1 year of visual impairment could be saved. 6

What are some evidence-based ways to slow down myopia progression?

Your eye care practitioners may be able to help slow or control your child’s myopia with specially designed glasses, eye drops, or contact lenses. All of these solutions have been shown to have various levels of effectiveness.  Talk to your eye care practitioner for more information like how each works, effectiveness rates, benefits, and limitations. 

  • Specially Designed Eyeglasses
  • Pharmaceutical Eye Drops (Atropine)
  • Specialty Contact Lenses
    • Hard contact lenses (or Orthokeratology or Ortho-K lenses) that physically re-shape the cornea at night during sleep.
    • Soft multifocal contact lenses like NaturalVue® Multifocal 1 Day Contact Lenses. 
      • NaturalVue Multifocal 1 Day soft contact lenses, by comparison, utilize patented optics to move the light rays inside the retina so that the signal for the eye to grow and elongate is reduced (addressing Peripheral Hyperopia). 16,17
      • These lenses provide excellent vision by day.18
      • These lenses are daily disposables, which means comfortable daily wear with no cleaning or maintenance.
      • Clinically effective for myopia progression control.19  
        • 98% of children showed a decrease in myopia progression19
        • 81% of children’s progression stopped completely, with some showing reversal. 19
        • 0.82D average dioptric decrease per year in children ages 6-1919*

Have not had a comprehensive eye exam in the past year?


Sources:

  1. Gifford P, & Gifford KL. (2016). The Future of Myopia Control Contact Lenses. Optometry and Vision Science. 93(4): 336-343.
  2. Enthoven CA, Tideman JWL, Polling JR, Yang-Huang J, Raat H, Klaver CCW. The impact of computer use on myopia development in childhood: The Generation R study. (2020) Mar;132:105988. doi: 10.1016/j.ypmed.2020.105988. Epub 2020 Jan 15.
  3. Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. BMC Ophthalmology (2020) Jan 14;20(1):27. doi: 10.1186/s12886-019-1220-0.
  4. Huang HM, Chang DS, Wu PC. The Association Between Near Work Activities and Myopia in Children – a Systematic Review and Meta-Analysis. PLoS ONE. 2015 Oct; 10(10): e0140419
  5. Flitcroft D. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in Retinal and Eye Research. 2012;31(6):622-660.
  6. Bullimore MA, Brennan NA. Myopia Control: Why Each Diopter Matters. Optom Vis Sci 2019 Jun.96(6):463-465
  7. Huang J, et al. (2016). Efficacy Comparison of 16 Interventions for Myopia Control in Children. Ophthalmology. 123(4): 697-708.
  8. Cooper J, Schulman E, Jamal N. (2012). Current Status on the Development and Treatment of Myopia. Optometry. 83(5):179-199.
  9. Cope j., et al. (2016). Acanthamoeba Keratitis among Rigid Gas Permeable Contact Lens Wearers in the United States, 2005 through 2011. Ophthalmology. 123(7): 1435-1441.
  10. Nichols, J. (2017). Contact Lenses 2016. Contact Lens Spectrum. 32(January 2017): 22-29.
  11. Chalmers RL, Keay L, McNally J, & Kern J. (2012). Multicenter Case-Control Study of the Role of Lens Materials and Care Products on the Development of Corneal Infiltrates. Optometry and Vision Science. 89(3): 316-325.
  12. Tan D, Tay SA, Loh, K, & Chia A. (2016). Topical Atropine in the Control of Myopia.  Asia-Pacific Journal of Ophthalmology. 5(6): 424-428.
  13. Liu Y M, & Xie P. (2016). The Safety of Orthokeratology—A Systematic Review. Eye & Contact Lens: Science & Clinical Practice. 42(1): 35-42.
  14. Gifford P, & Gifford KL. (2016). The Future of Myopia Control Contact Lenses. Optometry and Vision Science. 93(4): 336-343. 
  15. Lam CSY, Tang WC, Tse DY, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomized clinical trial. Br J Ophthalmol. 2019 May29, e pub.
  16. Dillehay S, Woods J, Situ P, Payor R, Griffin R, Tyson M, Jones L. (2014). Comparison of Three Power Levels of a Novel Soft Contact Lens Optical Design to Reduce Suspected Risk Factors for the Progression of Juvenile Onset Myopia. ARVO Poster, Poster #A00863637; Investigative Ophthalmology & Visual Science. 55(13). 3637
  17. Payor R, Woods J, Situ P, Dillehay S, Griffin R, Tyson M, & Jones L. (2014) Feasibility Testing of a Novel SCL Optical Design to Reduce Suspected Risk Factors for the Progression of JuvenileOnset Myopia. Investigative Ophthalmology & Visual Science. 55(13). 3638. Retrieved from http://iovs.arvojournals.org/article.aspx?articleid=2269075.
  18. VTI data on file. N=59. Data assessed after 1 week of wear.
  19. Cooper J, O’Connor B, Watanabe R, Fuerst R, Berger S, Eisenberg N, Dillehay SM. Case series analysis of myopic progression control with a unique extended depth of focus multifocal contact lens. Eye & Contact Lens. 2018;4(5):e16-e24.

*Both eyes combined; On an annualised basis in children 6-19. Retrospective analysis of 32 children, ages 6 to 19, across 10 different practice locations who wore the lenses for 6-25 months.

Correcting presbyopia with contact lenses

Correcting presbyopia with contact lenses

Myth: Only eyeglasses can correct Presbyopia

Fact: It is well-known that progressive spectacle lenses help you to see clearly, but did you know that presbyopes now have multifocal contact lenses that allow excellent vision at all distances? 

Contact lenses are great for those who do not like the feeling of wearing eyeglasses, do not like the look of eyeglasses, or those who lead a more active lifestyle.

The NaturalVue® Multifocal 1 Day Contact Lenses are a great option to correct Presbyopia, as these lenses offer excellent vision at all distances1 – at near (reading your phone), intermediate (computer distance), and far (trees and road signs) – without using readers. 

In a clinical study1, people with presbyopia gave higher ratings to NaturalVue Multifocal for vision in everyday situations vs. their current correction. NaturalVue® Multifocal Contact Lens wearers can perform 92% of daily activities without reading glasses, even in low light.

People prefer NaturalVue™ Multifocal 1 Day contact lenses over some options for better vision1, like reading very small print or using a cell phone:

Why NaturalVue® Multifocal?

  • See clearly like spectacles2 with little compromise
  • No need for readers – Clear vision near, far, and everywhere in between
  • Superior overall vision – 89% found better vision for everyday activities.1
  • Daily disposability for a fresh new pair every day
  • Added UV protection for your busy outdoor days**

5 pairs free trial of NaturalVue® Multifocal 1 Day Contact Lenses


Sources:

1. VTI Data on file, 2015. N=59. Data assessed after 1 week of wear. Preference based on those who expressed a preference among brands tested. p<0.05.

2. VTI Data on file, 2015. N=59. Data assessed after 1 week of wear. Of those who expressed a preference of mode of vision, 79% preferred NVMF vs. select tested brands. Attribute ratings based on subjective ratings from patients vs. select brands (100-point scale, 0=extremely poor and 100=extremely good/no problem).

**UV absorbing contact lenses aren’t substitutes for protective UV absorbing eyewear – for example, protective UV absorbing goggles or sunglasses – because they don’t completely cover the eye and surrounding area. Patients should continue to use UV absorbing eyewear as directed. Note: Long term exposure to UV radiation is a part of risk factors associated with cataracts. Exposure is according to a number of factors, for instance, environmental conditions (altitude, geography, cloud cover) and personal factors (extent and nature of outdoor activities). UV absorbing contact lenses help provide protection against harmful UV radiation. However, clinical studies have not been done to demonstrate that wearing UV absorbing contact lenses reduces the risk of developing cataracts or other eye problems.

Persistent Eye Floaters – Causes, Symptoms and Treatment

Persistent Eye Floaters – Causes, Symptoms and Treatment

What are eye floaters?

Floaters are small dark shapes that float across your vision. They can resemble dots, specks or lines.

Most people experience temporary floaters that do not require treatment as they go away on their own. However, for more severe or persistent cases, eye floaters may obstruct vision and require removal.

EYE FLOATERS: Causes, symptoms and treatment / COC

Causes of floaters

Floaters are caused by the gel-like fluid in your eye (vitreous) becoming more liquid as you age. As you age, small strands of the vitreous clump together and cast shadows on your retina, which are the tiny specks or dots that you see. As floaters are largely age-related, people 60 years old and above are more likely to experience floaters.

Most people experience floaters at one point or another, but in most cases, the floaters end up sinking and settling at the bottom of the eye, below the field of vision. Hence, the floaters are no longer noticeable.

However, some people experience more serious cases of floaters. Such cases include:

  • Eye infections
  • Eye injuries
  • Eye inflammation
  • Bleeding in the eye
  • Retinal detachment
  • Retinal tear
  • Diabetic Retinopathy

Some people are also at higher risk for floaters than others, due to:

  • Being nearsighted
  • Having diabetes
  • Having previous surgery to treat cataracts

Symptoms of floaters

Floaters look like tiny shapes such as dots, specks, rings, cobweb shapes or other irregular shapes. Floaters seem to float across your vision when your eyes are not moving, but move when your eyes move. Trying to look directly at a floater usually results in the floater moving in the opposite direction.

Floaters are likely to be more noticeable when looking at something bright like a clear blue sky or a sheet of white paper. Floaters may appear as darker or lighter than the rest of your field of vision. Other times, the area where the floaters are located may appear more blurry than the rest of the field of vision. 

When should you be concerned?

Most cases of floaters are not causes for concern as they occur naturally. However, in certain instances, an eye doctor should be consulted as soon as possible. These situations include:

  • A lot more floaters than usual
  • Sudden increase in number of floaters
  • Flashes of light in the same eye as the floaters
  • Darkness on any side of your vision in the same eye as the floaters (peripheral vision loss)
  • Persistent floaters that interfere with your vision

When consulting an eye doctor, they will perform a dilated eye exam to check for floaters and other eye problems such as retinal tears. This exam is done by administering eye drops that widen (dilate) your pupil, allowing the eye doctor to examine your eye. This exam is typically painless. You may only experience some discomfort if the doctor presses on your eyelids to check for retinal tears.

Treatment of floaters

In most cases, the best way to deal with floaters would be to ignore them. Overtime, they will either disappear to the bottom of your eye or your brain will learn to ignore them, making them no longer noticeable.

In more serious cases, where the floaters are caused by an underlying eye problem, the eye doctor will treat that eye problem.

For rare cases where the floaters require removal, the most common treatment is a vitrectomy. During the procedure, the eye doctor will surgically remove the vitreous gel that is causing the floater and replace it with a solution to maintain the shape of your eye. This procedure is usually only used for severe cases of floaters as it comes with risks.

An alternative to the surgical method would be laser vitreolysis, where lasers are aimed at the floaters to break them up or dissolve them, making them less noticeable. However, this method is not preferred as it is still experimental. Discuss the options with your eye doctor if you are experiencing severe symptoms of eye floaters.

Reducing risk of floaters

There is no guaranteed way to prevent eye floaters. However, maintaining good eye health can help reduce risks of getting floaters. One can adopt good lifestyle habits such as:

  • Maintaining a healthy diet and incorporating leafy greens, salmon and citrus fruits
  • Quitting smoking
  • Wearing protective eyewear when necessary to protect your eyes from injury
  • Wearing sunglasses when outdoors during the day
  • Taking breaks to rest your eyes

Sources:

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