This year’s Franklin Positive Ageing Expo 2014 takes place on Friday 10th October in the Pukekohe Indian Association Hall. Last year’s event was a great success and this year we will again have a stand offering information on all matters relating to eyecare. Optometrist Naomi Meltzer who runs a monthly Low Vision Clinic at our rooms will be available on the stand throughout the day. She will be able to offer advice to people who have experienced substantial losses in vision, particularly with conditions such as glaucoma, age related macular degeneration, cataract and diabetic retinopathy.
Glaucoma is an eye condition where damage to the optic nerve causes a gradual decrease in the peripheral vision. Because the fields of vision overlap, people with glaucoma often do not experience symptoms until a large amount of damage has already been done. It is estimated that 70,000 New Zealanders over 40 have glaucoma, and that half do not know they have it! To test for risk of glaucoma your optometrist will measure the pressure of your eyes, do a peripheral field test and look at your nerve to check for any changes. Treatment where needed generally involves lowering eye pressure using drops, laser treatments or surgery.
The macular is the central region of the retina, it is responsible for fine detailed vision. In age related macular degeneration this area is damaged, causing blur and distortion
It is the leading cause of blindness in older patients. A family history of the disease, smoking and UV light exposure all increase the risk of macular degeneration. Some types of this condition are treatable.
Cataracts are a very common cause of vision loss, which luckily are very easily treated. A cataract forms when the lens inside the eye becomes cloudy, preventing light from traveling into the eye properly. If you are beginning to develop cataract your vision will feel foggy, and you may develop problems with glare. Initially cataracts can also cause significant changes in prescription, causing spectacle lenses to be changed more frequently. At some point the blur from the cataract no longer can be corrected by spectacle lens changes and referral for surgery to an Ophthalmologist is required.
In people who have diabetes the small blood vessels in the retina can begin to leak, causing bleeding and swelling in the back of the eye. This condition is called diabetic retinopathy. It is especially important that people with diabetes have regular eye examinations, as the damage which is occurring to the eye blood vessels indicate what is happening the rest of the body and how well the diabetes is controlled.
We recommend you have an eye examination every two years to check the health of your eyes.
We all know how uncomfortable it is getting something in your eye and the relief when it is removed. But what if the thing in your eye is part of your eye.
Trichiasis is the term for misdirected eyelashes which contact the front of the eye. This can be caused by chronic lid infections causing lid margin scarring, trauma, surgery or just the lashes growing the wrong way. Although difficult to do safely yourself, careful removal of the offending lashes will result in temporary relief, until the lashes grow back. If untreated the lashes may cause abrasion to the cornea which may result in infection or scarring. Permanent treatment is possible from an ophthalmologist, who will use radiowave ablation via a small probe inserted in the hair follicle.
There may be other causes of your eye irritation, so to be certain of getting the correct treatment, see your local Optometrist.
Having red irritated eyelids is a reasonably common complaint with many patients. Often the cause of this is blepharitis. There are two types of blepharitis – anterior blepharitis affecting the eye lashes and the skin around them, and posterior blepharitis affecting the oil producing glands in the eye lids.
Anterior blepharitis is a mild infection of the eyelashes, caused by an accumulation of oil, dead skin cells and Staphlococcus Aureus. Staphlococcus Aureus is a bacteria which is always present on the surface of your skin, in small numbers it causes no problems, but in higher concentrations the toxins released by the bacteria cause irritiation and redness.
Anterior blephritis is very easy to treat, either by using premade treatments like “lid care” or rubbing a small amount of diluted Baby Shampoo onto the eyelashes (with your eyes closed) for about 15 to 20 seconds for each eye, twice a day, and then rinsing.
Stopping this treatment often result in a return of the condition, since the bacteria that cause the condition are very common on the skin and eyelids and will return.
Posterior blepharitis is also known as Meibomian gland dysfunction. The meibomian glands are the oil-producing glands located in the upper and lower eyelids. There are 25-30 of these glands which slowly release oil into the tear film.
This oil stops the water in the tears from evaporating, thus helping to prevent dry eyes. Sometimes the oil becomes slightly thicker than normal, which can lead to blockage of the narrow ducts which take the oil from the gland to the tear film.
The oil continues to be produced leading to filling and swelling of the glands.
This blockage can cause dry eyes, cyst formation or even infections.
It is therefore important to unclog the glands and prevent them from blocking up again as much as possible.
Posterior blepharitis is treated by using a warm compress to liquefy the thickened oil in the glands, and gentle massage to help express the old oil.
Usually treatment for blepharitis needs to be ongoing, or the discomfort and redness will return.
If you have previously worn contact lenses without success or if you haven’t tried contact lenses before, now is a good time. With the latest technology it means that there’s a contact lens suitable for almost every person requiring a correction.
In the past with conventional lenses that were replaced very infrequently, there were many problems with irritation, redness and discomfort.
The types and quality of contact lenses have improved over the years. The conventional lenses of yesterday have been replaced by monthly disposable, 2 week disposable and daily disposable lenses which reduce the problems that older style lenses caused.
End of day dryness, lens depositing and discomfort are the most common reasons for contact lens failure. Particularly for people who previously have worn permanent soft contact lenses.
Modern contact lenses materials, including silicone hydrogel lenses, have improved moisture, oxygen permeability, and surface integrity. In fact, silicone hydrogel lenses enable up to five times more oxygen to reach the cornea compared to other lenses, which results in better eye health.
There are also many new advanced contact lens cleaning solutions available, which provide much more thorough cleaning of the lenses for better vision and less irritation and infections.
Another common complaint from contact lens wearers is reduced vision and glare in low lighting conditions. There is now a lens out on the market especially designed to reduce halos and glare and to enhance clarity of vision especially in low illumination.
In the past it has been very difficult to fit people who had astigmatism or the need for reading glasses with contact lenses, but with modern developments in progressive contact lenses and custom made soft contact lenses in new materials, even more people can experience the convenience of vision without glasses.
For those who only wear their contact lenses infrequently but still want all the benefits of improved vision and comfort there are a number of new daily contact lenses on the market. These include daily disposable progressive and astigmatism correcting contact lenses. This means that you don’t have to bother with the inconvenience of cleaning the lenses, and a new fresh pair of contacts every time you wear them means your eyes are a lot healthier too!
Our experienced optometrists can assess your eyes to find the best contact lens to suit your lifestyle requirements, so feel free to contact us on (09) 2383796 or (09) 5201000 for an appointment.
There are many myths about our eyes, that often leads people particularly in older age to reduce the amount of reading and close hobbies they do. The most common examples of this are using “my eyes too much will make my vision worse” and “wearing glasses will make my vision deteriorate more quickly”.
In the normal eye, clear vision is set for distance viewing. When focusing on near objects the lens inside the eye accommodates (changes its focus) to help us see clearly at a closer distance. The amount of accommodation decreases with age and this is a normal occurrence. From around age 45 it becomes noticeable that near objects are becoming harder to focus on. By the time most people reach age 55 our ability to focus is close the zero and we require glasses or contact lenses to see any details up close.
When people first start to wear glasses for reading they often feel that this first correction caused the subsequent deterioration in uncorrected near vision. As long as the glasses were correctly prescribed then this as not the case, as the persons near vision would have decreased even if they had not got the initial correction. They just would have struggled to read for a longer period.
In the case of ready readers which are not made to take into account the difference in focusing between the two eyes, astigmatism and eye separation these can cause fatigue when reading but will general not cause the persons eyes to get worse. Choosing powers that are too strong can cause the person’s ability to focus at near to deteriorate more quickly. Thus it is best when doing concentrated visual tasks to wear glasses that are based on an examination from an optometrist. Ready readers are more useful for intermittent use in situations where they are likely to be lost or damaged.
Generally using our eyes for extended near tasks will not make our eyes get worse, but can cause increased fatigue and intermittent blur. This is particularly the case where an incorrect prescription is used or where people try to maintain near focus for long periods without a break.
A thorough eye examination is the best way to make sure that visual clarity and comfort is maximised and any eye health issue is picked up and treated as early as possible. Feel free to make an appointment to address any concerns you have with your vision.
Diet plays a role in the health of your eyes, in allowing your body to make good quality tears, and protecting your eyes from damage that leads to conditions like macular degeneration.
The oil glands in your eyelids play a critical role in forming the tear film which keeps your eyes comfortable and allows you to see well. If your body does not get enough Omega-3, then it cannot make good quality tears and your clarity of vision and the comfort of your eyes suffers. Omega-3 can be found in high quantities in oily fish like salmon and tuna.
When your body turns food into energy it produces free radicals which are thought to be a contributing factor in the development of macular degeneration, cataracts and other diseases. Antioxidants neutralize the free radicals and help protect your body from damage.
The antioxidants that are particularly helpful in protecting eye are lutein and zeaxanthin. These can be found in green leafy vegetable such as spinach and silverbeet, and also in yellow fruits and veges.
Vitamin E and selenium also protect against free radicals. They can be found in nuts, whole grains, mushrooms and oats.
Zinc helps with your body to heal wounds and allows your cells to function properly. Zinc is present in meat, yoghurt and seafood, especially oysters.
Vitamin C is also important for the general health of the eyes and this can be found in citrus, tomatoes and capsicum.
For great eye health it is important to have a well balanced diet, with fish a couple of times a week, green leafy vegetables and fresh fruit daily, low GI carbohydrates and a handful of nuts occasionally.
However there are products available to supplement your diet if necessary.
TheraTears Nutrition supplements is specially developed with flaxseed oil, fish oil and vitamin E to enable your body to produce the best quality tears. Also available are lutein supplements and combination supplements to help reduce the progression of certain types of macular degeneration.
It is important to discuss with your health care professional before you take any new supplements, as they may have an adverse impact on other health conditions and medications.
If you would like to find out more about how the right nutrition can affect your eyes please contact Optik Eyecare on 09 2383796, and we can post you out a free information brochure.
Since 1999 the maximum term a licence can be issued for is 10 years. Up until the age of 75 vision is screened at the driver licensing agent when applying for renewal. If the applicant fails the screening they are required to have a further vision assessment at their optometrist. Vision screening machines are designed to detect as many drivers with insufficient vision as possible, in doing so some drivers fail the screening test but will latter pass at the optometrist or GP’s.
Drivers 75 or older can only renew licences for between 2 and 5 years and also require a medical certificate from their GP.
The standard of vision required to drive is complex and varies with the type of vehicle being driven, with higher standards required for trucks, buses and dangerous goods vehicles. Vision standards include minimum requirements for single vision, monocular and binocular acuity, fields of vision and night vision. All drivers require a minimum horizontal binocular field of vision of 140 degrees and no significant pathological field defect within 20 degrees of straight ahead.
For car and motorbike licence classes 1 and 6 (includes endorsements D, F, R, T or W) a minimum binocular acuity of 6/12 is required. For truck classes 2,3,4 and 5 (includes endorsements P, V,I or O)the requirement is 6/9. If this standard is only reached with the use of correcting lenses, then this condition will be recorded on the licence.
If acuity in the worse eye is between 6/18 and 6/60, correcting lenses should be used if a substantial improvement in acuity can be achieved. For these drivers applying for class 1 or 6 no general restrictions apply. For classes 2,3,4 and 5 the applicant would not meet the required standard and would need to apply to the NZ Transport Agency for exemption.
Drivers are regarded as monocular when they have only one eye or acuity in the worse eye is less than 6/60. As long as acuity reaches 6/12 in the best eye the driver passes classes 1 and 6 standards. Class 2, 3, 4 and 5 drivers will again fail to meet the standard or will need to apply for exemption.
The condition of “external mirrors fitted on both sides” is generally applied to licences where corrected acuity in the worst eye is less than 6/18. For these drivers a thorough eye examination is generally recommended.
This is a simplified outline of visual requirements for driving and more details are available by calling us or at www.nzta.govt.nz
We use our eyes on a daily basis without realising it, so whats actually happening inside our eyes that enable us to see?
Let’s follow the path of light as it moves through the eye. Firstly light enters our eyes through the cornea. The cornea is a clear and spherical structure that sits in front of the iris, the coloured part of your eye, and is the major focusing structure of the eye. Vitally important to the cornea is the tear film which protects, nourishes and provides an optically smooth surface for the cornea to function properly. Without a functioning tear film, the cornea becomes compromised.
Light then passes through a hole in the middle of the iris which we call the pupil. In everyday situations the amount of light varies significantly between places and time of day. The iris changes the size of the pupil (e.g. larger at night) to control the amount of light entering your eye, therefore the role of the iris is crucial in helping us see in all conditions.
The lens is the next structure light passes through on its way to the retina. The lens provides the eye’s adjustable focusing power enabling us to see at different distances. The brain sends signals to the lens in response to a blurry image on the retina within milliseconds, to make the lens change focus and clarify the image!
The retina contains over 150 million cells that send information to your brain. It is a complex light sensitive layer responsible for processing light into a message that the brain can interpret. The macula is the area on the retina responsible for detailed central vision.
All these structures work together to produce a final signal that is sent to the brain to help you perceive the world around you. These structures are very delicate! Even though a majority of people may not have any problems with their eyes, it is vital to be aware of and care for your eyes appropriately, especially when something does go wrong. You only have two eyes, and there have been no successful eye transplants as of today.
If you feel something is wrong with your vision, do not hesitate to see an optometrist. At Optik Eyecare we pride ourselves in clinical excellence. We are here to provide you with the highest quality eye care service available.
A 50 year old with normal vision is said to require about twice as much light as a child for comfortable reading, rising to about ten times more light for someone in their 80s or older.
Conditions that affect the retina at the back of the eye such as Macular Degeneration, the optic nerve such as Glaucoma or Parkinson’s disease, or clouding of the lens in the eye (cataract) will create changes in the amount of light required for efficient and comfortable vision and the amount of glare produced.
“As we move into the winter months, the days are not only shorter but the light is duller. Older people often struggle to see clearly particularly when trying to read poor quality print such as newsprint. Most people assume that daylight is sufficient, but it really isn’t and we have no ability to control the intensity or direction of daylight.” says Optometrist Naomi Meltzer. “People tend to think it is the size of the print which makes reading difficult, but often it is the lack of light and the poor contrast of the greyish print which does not stand out against the off-white or coloured background, which actually makes it difficult to read. This is particularly a problem to people who have some loss of vision due to Macular Degeneration or other age-related problems.”
Naomi Meltzer specialises in helping people with low vision, when changing their spectacle prescription no longer helps sufficiently. “So much of my work is teaching people to use a reading lamp correctly placed directly onto their reading or work bench to get better light onto the task to help them to see better. Lights in the ceiling, regardless of the type or wattage of the bulb, are not sufficient to help with reading either, because the light is so far away that by the time it falls on the book it is somewhat diluted and too weak for reading.”
She advises placing a light close to the task which then throws a strong light onto the task and makes it much easier to see. The light needs to be placed so that it does not reflect back into the eyes causing hot, dry tired eyes from glare, or cast shadows over the page. There are many magnifiers available which have the light built in as well as electronic magnifying aids which also convert grey print to bold black print to help people with low vision.
Naomi Meltzer is a low vision consultant. Her practice Magnifiers + More is located in Remuera. She is also available for low vision consultations once a month at Optik Eyecare, 20 Hall Street, Pukekohe. Independent optometrist John Kelsey is pleased to offer this service in the range of specialist optometric services provided by Optik Eyecare.
Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method ophthalmologists and optometrists use to determine the IOP and this is usually recorded in millimeters of mercury (mm Hg). It is normally measured as part of a comprehensive examination for all adults.
IOP is an important component in the evaluation of patients at risk from glaucoma and in determining the effect of treatments used in patients with glaucoma. Increased IOP above a normal range increases the risk of glaucoma but some patients can have high IOP levels without having damage to their optic nerves and fields of vision. These patients are called ocular hypertensive. Equally some patients can be diagnosed with glaucoma even with IOP in normal ranges, these patients have what is called low tension glaucoma.
The IOP is created from the balance between the rate of fluid production inside the eye and the rate at which this fluid drains from the eye. This balance can be affected by many factors including medications particularly steroids, genetic factors and by trauma to the eye. IOP varies throughout the day and night but is most commonly in the range of 10 and 20 mm Hg. IOP can also vary between a persons two eyes.
There are a number of different types of tonometers used to measure IOP. The reliability of all measures can be influenced by many factors including poor tear film quality, corneal thickness and scarring and previous laser refractive surgery. The most commonly used types are-
-applanation tonometry measures the force required to flatten a fixed area of the cornea. The higher the IOP the greater the force required. As the probe touches the eye anesthetic drops are required.
-air puff tonometry involves measuring the force required to flatten a certain area of the central cornea using a rapid pulse of air. This does not require any anesthetic drops but many patients find the puff of air disconcerting
-rebound tonometry involves a small light weight probe that makes momentary contact with the cornea. Soft wear within the instrument measures how the motion of the probe is altered by the cornea. As the touch of the probe is very gentle no anaesthesia is required and patients find this new instrument much preferable to the air puff tonometer. Due to these factors we now use this method as our first choice for routine IOP screening.