I should see an eye doctor for that? - Grandma had glaucoma

 

"...THEIR HEALTH HISTORY COULD BE YOUR HEALTH FUTURE."

There is a lot of confusion about what optometrists really do. We are so stereotypically associated with asking people "Which is better, 1 or 2?" and correcting vision problems that people are sometimes surprised to hear that we do a lot more! To help with the confusion I decided to start this blog series "I should see an eye doctor for that?". Some might surprise you, some might not. In today's blog we're going to talk about your why if grandma had eye problems, like glaucoma, you need to have regular eye exams.

Alright, we don't really mean JUST if grandma had eye problems. Grandma shouldn't take all the blame. If someone in your family has an eye disease it's important for you to know what it is and who has it! Why should it matter to you, a healthy person with perfect vision, that someone in your family has an eye disease? Unsurprisingly since you share at least some of their genes their health history could be your health future. 

It's all in your genes.

Many eye diseases are genetic which means that if someone in your family had them, you could too. Much like if someone in your family has diabetes, high blood pressure or heart disease you're at a higher risk of developing those same problems if someone in your family has glaucoma, macular degeneration or a host of other diseases you too are at a higher risk.

 

"80% OF EYE DISEASE HAS NO SYMPTOMS IN ITS EARLY STAGES"

A couple important points. When I say someone in your family I mean 'blood relatives'. For example if your step mother has glaucoma or your sister-in-law has macular degeneration you don't share their risk because you don't share their genes. It's also important to point out that an increased risk does not mean certainty. Simply because your mother has diabetes or glaucoma does not mean you are doomed to have the same problems but it does mean you need to be careful and get your health, including your eye health, checked regularly.

So what has a genetic link? Almost everything unfortunately. The big three eye diseases, glaucoma, macular degeneration and cataract all have a genetic component. Diseases like diabetes, high blood pressure, high cholesterol, stroke to name a few all directly impact the eye as well and often signs of those diseases will show up in the eye before they show up anywhere else!

This is one of the main reasons (though not the only one) why I recommend yearly eye exams. 80% of eye disease has no symptoms in its early stages and the only way to detect the problem and prevent it from getting worse is to have an eye doctor check the health of your eyes. Even if your vision is perfect there may be something going on that hasn't made itself obvious just yet.

As always, if you have any questions about this or anything else feel free to contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

So if I come in for an eye exam, what are you going to do to me?

If you’ve been reading my blog you know there are a lot of reasons to come in for an eye exam even if you feel that your vision is perfect and that you don’t need glasses. You already understand that there’s the health and muscle function side of an eye exam that is just as important as how well you see. For many people who have never had an eye exam though they wonder what is involved. Anything new can be uncomfortable and if you feel like everything is fine people hesitate to come in. So let’s go over what an eye exam is all about.

When you first come for a visit we’re going to have you fill in a nice form with a lot of your personal medical information. We need this to rule in  or out certain eye problems and to know a bit more about your health. All of this information is kept strictly private and cannot be released to anyone or any group without your consent (this is true of ALL medical and personal information we obtain).

Once you’re all checked in there are some preliminary tests done by our optician. At Eye Spy Optometry we first get an estimate of how well your eyes are focusing using a machine called an auto-refractor. These results are what I use as a starting point to narrow down an exact prescription. Next, we take pictures of the back of your eye as well as scans of both your optic nerves and your maculae. The optic nerve is what sends the information back to your brain and is affected in many disorders including glaucoma. The macula is the part of your eye used for fine central detail. There are many things that could go wrong here too but one of the most common is macular degeneration. These scans give us the ability to detect changes that may be related to an eye condition much earlier than just looking inside of the eye.

Next you get to see me. I’ll review your medication and health information with you and then we jump right in. I check to see how you’re seeing with glasses if you have them, without if you don’t. I also check to see how well the eyes are working together and check pupils for signs of any neurological concerns. What comes next is the stereotypical part of the exam. I put a machine called a phoropter in front of your face and show you a variety of lenses, asking you which makes the image at the end of the room better. This is the part of the exam that causes people the most stress. Don’t worry though! My job is to help you through it and make sure we don’t come out with the wrong prescription. You can’t fail the test, I promise, because it isn’t a pass/fail sort of test! I will also have a look at the health of your eyes, inside and out, and finally I’ll check the pressure in your eyes, but not with that puff of air test!

This is a traditional phoropter (used in the 'Which is better, one or two?' test). At Eye Spy Optometry we have a more modern, digital phoropter.

This is a traditional phoropter (used in the 'Which is better, one or two?' test). At Eye Spy Optometry we have a more modern, digital phoropter.

The final step to your eye exam is to review everything. I’ll show you the photos and scans and explain what they mean, discuss any health concerns and review your prescription, if there is one. I’ll make any recommendations about how to help keep your eyes healthy or improve your vision that make sense based off of your results. Most importantly though, I’ll answer your questions. I do my very best to make sure everything we review together is clear but sometimes jargon slips in. Always feel comfortable asking questions and I’ll do my best to make sure it all makes sense.

If you do happen to need glasses there is ONE more thing that happens. You get to pick out frames! That’s the fun part of the exam. There are so many different colours, shapes and styles to pick from and wide range of prices to suit every budget that finding something that works for you is fun and stress free.

So book an appointment today! You know you should get everything checked out even if your vision is great. Now that you know what we do when you come to see us there’s no excuse not to give us a call at (403) 474-6744 or book online here.

As always, any questions feel free to contact us on Twitter, Facebook, Google + or via our website.

Macular Degeneration: A tale of two types (Dry ARMD)

In my last blog about ARMD (age related macular degeneration) I went over the bare basics of what macular degeneration is.  There’s a lot more to macular degeneration than what I discussed and many people are confused about what exactly is going on. In this blog I want to go over one form of macular degeneration: dry macular degeneration.

Dry ARMD is the most common form. It makes up about 90% of all  ARMD. The good news though is that it only accounts for about 10% of serious vision loss.  That’s not to say that people with dry ARMD don’t suffer a loss of central vision and have trouble seeing, it just means that they are still able to function reasonably well. But what IS dry ARMD. What does it mean? For that we have to dive into a little bit of anatomy and physiology (I promise it's not too hard).

You might remember from science class that our retina has a bunch of different layers. The important ones for ARMD are the photoreceptors (better known as the rods and cones) that detect light and the retinal pigmented epithelial layer that keeps food and oxygen going where it should (these layers were not named to be short… that’s why we call that one the RPE). So what goes wrong in someone with ARMD? It all starts with little yellow flecks called drusen.

The yellow flecks in the middle are drusen. You don't want these.

Drusen are thought to be clumps of waste product from the cells of the retina that haven’t been cleared out by your blood vessels. Some more recent research suggests they come from ongoing inflammation. Regardless of where they come from they mean trouble. Drusen on their own do not mean that someone has ARMD. In fact the great majority of people with drusen don’t have ARMD at all! Drusen are a huge risk factor for developing the disease though and shouldn’t be ignored.

Like many things in the eye the exact way that drusen cause damage to the RPE isn’t fully understood but the most commonly accepted reason is that drusen decrease the amount of food and oxygen that can get to the RPE. Unsurprisingly this isn’t good for the RPE and it dies. Since the RPE’s job is to feed the photoreceptors in the eye when the RPE goes the photoreceptors in the same area die off too. This degeneration of the RPE and photoreceptors is what we call dry macular degeneration or if you want to be really fancy and impress your friends the official term for this is geographic atrophy.

In some cases though, these drusen do not lead to degeneration of the RPE and photoreceptors. In some cases they cause wet macular degeneration. We'll learn more about wet ARMD in another blog.

If you want to read more feel free to check out the following links or as always you can contact us on Twitter, Facebook, Google +, via our website or phone us at (403) 474-6744.

CNIB - ARMD

Doctors of Optometry Canada - ARMD

AMD.org - Dry ARMD

Mayo Clinic - Dry ARMD

UV and you: Why sunscreen isn’t all you need to protect yourself from the sun

Everyone knows how important it is to wear sunscreen, especially if you’re going to be spending the day outside. Sunscreen has become a part of many of our daily routines and is in most skin creams. Enjoying our short summers here in Calgary usually means spending as much time as possible outside while the weather is nice and we all know we need to wear sunscreen when we’re outside all day. Protecting your eyes from the sun though is just as important.

In my last blog I talked about cataracts and how UV light increases your risk of getting cataracts sooner. Several blogs ago I talked about macular degeneration and how one of the main preventable risk factors in the disease is exposure to UV light! If you’ve been reading my blogs you already know how important protecting your eyes from the sun is. UV light also increases your risk of certain eye and eyelid cancers as well as wrinkles, lumpy fleshy elevations on the white of your eye called pingueculae or even fleshy growths over the clear part of your eye called pterygia!

So I’ve convinced you how important sun protection is (I hope!) and you get it now. Even though sun protection is really important did you know that almost one third of people don’t wear sunglasses at all? When we talk about kids that number increases to almost 50%! While it is definitely important for people of all ages to wear sun protection it is extra important for kids. A combination of very large pupils, a more transparent lens inside of their eye that allows far more UV to penetrate inside and spending more time outside than most adults leads to 80% of lifetime UV exposure to the eye to happen before the age of 18!

UV light is sneaky and may be getting to your skin and your eyes in situations you might not expect such as underwater, on cloudy days or getting a double dose from light reflected off of snow or water!

All sunglasses are the same though, right? Wrong. Not all sunglasses block all UV light rays. All sunglasses sold in Canada have some degree of UV protection but not all block 99% of UVB rays which is what is recommended to best protect your eyes! If you have sunglasses and want to know how much UV they block feel free to bring them in to our office and we can measure how much UV is blocked at no cost to you.

So you’re saying to yourself alright, I get it, I need to wear good sunglasses: I have more news. Sunglasses are often not enough. Even nice big sunglasses still let some light in around the edges and especially some of the extremely cool aviator frames are flat (they don't 'wrap' around your face) and don’t offer much protection from the side. You have some options to help protect yourself further. A good hat with a wide brim helps prevent as much sunlight from getting around your sunglasses. Another option though is to wear contacts!

I know you’re wondering how on Earth contact lenses could help. It’s a fair question since most do not. All contact lenses offered by Acuvue though have some degree of UV protection. They have many that will block over 99% of UVB!  This is a great option for protecting your eyes from the sun and at Eye Spy Optometry we carry a wide variety of Acuvue products.

So which is best? Sunglasses? A hat? UV blocking contact lenses? The answer is all of them together. All these options will work together to give you comprehensive UV protection for your eyes. It’s important to remember as well that UV exposure doesn’t decrease  very much on cloudy days, under water, in the winter or at dawn or dusk. If you think you only need sun protection from 10:00am-4:00pm on sunny days in the summer you’re going to still get a heavy dose of UV the rest of the time! Think about all those times on the ski hill when you’ve ended up with a burn on the few exposed areas of skin you had.

Remember to protect your eyes, protect your skin and protect your health with as many UV blocking options as you can find. Your body will thank you for it!

If you have more questions about this or anything else always feel free to contact us on Twitter, Facebook, Google + or via our website. For more information feel free to follow the links below:

The Vision Care Institute

Doctors of Optometry Canada - Risks Associated with Sun Exposure

Doctors of Optometry Canada - Children and Risks Associated with Sun Exposure

Macular Degeneration: an introduction

Age Related Macular Degeneration (ARMD) is the most common cause of blindness in Canada, affecting more than one million Canadians. That is more people than breast cancer, prostate cancer, Alzheimer’s and Parkinson’s combined! As you may have guessed from the name, it primarily affects people over the age of 50. In its earliest stages ARMD has no symptoms and can only be detected during a regular eye examination. In the later stages of ARMD, central vision is distorted or completely lost, leaving a central blindspot.

This is what things can look like in advanced ARMD.

So what if you’re under 50? What then? Doesn’t that mean that you have nothing to worry about? Well, sort of. ARMD doesn’t typically strike people when they’re young in the same way that skin cancer doesn’t typically affect younger people. That means that someone who is 30 is almost definitely not going to show any signs of ARMD. However, just like you can wear sunscreen to decrease your risk of skin cancer there are things that you can do to decrease your risk of getting ARMD. And just like sun protection, the younger you protect your eyes, the lower your risk.

Alright, so maybe now I’ve convinced you that prevention and detection are important. What can you do? Lifestyle plays a huge role in ARMD. People who smoke have a greatly increased risk of developing ARMD. Poor eating habits and a lack of cardiovascular activity also increase your risk. Exposure to UV light is also harmful and increases your risk. There also factors that you cannot change such as age, gender, family history and ethnicity that increase your risk. As you age your risk increases, women are more commonly affected than men, people with lighter coloured eyes or skin colours have a greater risk and if someone in your family has ARMD you have a higher risk (good ol’ genetics). All that said, if you wear sunglasses, avoid smoking or second hand smoke and live a healthy lifestyle you can greatly decrease your risk of developing ARMD. A healthy diet is often a challenge even for the most health conscious of people and there are specific eye vitamins on the market both for people with risk factors for ARMD and for people who currently have ARMD. Speak with your optometrist about which of those vitamins is right for you.

Since there are no symptoms even if you’re doing everything right it’s very important to see your optometrist regularly. Even though ARMD cannot be cured, early intervention and detection can help slow down how rapidly the disease progresses and keep your vision from worsening. Technology such as an OCT scan, which is offered at our clinic, can help to detect ARMD at its earliest stages.If you have any questions feel free to call or email us. You can also reach us on Twitter, Facebook, Google + or via our website. For more information feel free to explore these other sites.

CNIB - Macular Degeneration

Doctors of Optometry Canada - Macular Degeneration