Smoking and Your Eyes

Smoking is the single largest preventable cause of eye disease.

On the third Thursday of November each year, smokers across the nation take part in the Great American Smokeout, sponsored by the American Cancer Society. This might be the ideal time for you to stop smoking and ACS has information and resources you may find helpful.

Here are some things you should know about smoking and your eyes.

Smoking at any age, even in your teens or twenties, increases your future risk for vision loss.

The more you smoke, the higher your risk for eye disease.

If you quit smoking, your risk for these eye diseases decreases considerably.

Smoking increases your risk for cardiovascular diseases that indirectly influence your eyes’ health.

Women who smoke during pregnancy increase their chance for a premature birth and a potentially blinding eye disease called retinopathy of prematurity (ROP).

A smoker is two times more likely to develop macular degeneration compared with a nonsmoker.

Smoking double your chance of forming cataracts and the risk continues to increase the more you smoke.

Smoking doubles your diabetes risk which can lead to the blinding eye disease, diabetic retinopathy.

Smokers are more than twice as likely to be affected by dry eye syndrome as a non-smoker.

Second-hand smoke also makes dry eye worse, especially for contact lens wearers and post-menopausal women.

If you smoke you can have a three-fold increase in the risk of developing AMD compared with people who have never smoked.

Smoking appears linked to the development of uveitis with smokers having more than twice the risk of non-smokers.

If you are looking to stop smoking you may also want to check out Smokefree.gov which provides free, accurate, evidence-based information and professional assistance to help support the immediate and long-term needs of people trying to quit smoking.

11/19/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

The Importance of An Eye Exam

Why You Need An Eye Exam

The end of the year is fast approaching – when was the last time you had an eye exam? Was it a comprehensive eye exam?

To keep your eyes healthy and maintain your vision, the American Optometric Association (AOA) recommends a comprehensive eye exam every two years for adults ages 18 to 60, and annual exams for people age 61 and older. However, if you have a family history of eye disease (glaucoma, macular degeneration, etc.), diabetes or high blood pressure, or have had an eye injury or surgery, you should have a comprehensive exam every year, unless otherwise indicated by your doctor.
Also, adults who wear contact lenses should have annual eye exams.

An important part of the comprehensive eye exam is the dilated eye exam to look inside your eye. Drops are placed in each eye to widen the pupil and allow more light to enter the eye. This gives your doctor a clear view of important tissues at the back of the eye, including the retina, the macula, and the optic nerve. This allows for early diagnosis of sight-threatening eye diseases like age-related macular degeneration, diabetic retinopathy, glaucoma, etc.

To better understand the importance of the dilated eye exam, here is a video from the National Eye Institute (NE) that explains what to expect.

At the end of your comprehensive eye exam your doctor should raise any concerns he has with you. But it is up to you to be prepared to react and ask questions for peace of mind and to help save your vision.

Questions To Ask After Your Eye Exam

It is always important to know if anything about your eyes have changed since your last visit. If the doctor says no, then the only thing you need to know is when they want to see you again.

If the doctor says the have been some minor changes, you need to know what questions to ask, such as:

Is my condition stable, or can I lose more sight?
What new symptoms should I watch out for?
Is there anything I can do to improve or help my vision?
When is the next time you want to see me?

If the doctor sees a marked change in your vision or give you a diagnosis of eye disease, you would want to ask:

Are there treatments for my eye disease?
When should I start treatment and how long will it last?
What are the benefits of this treatment and how successful is it?
What are the risks and possible side effects associated with this treatment?
Are there any foods, medications, or activities I should avoid while I am undergoing this treatment?
If I need to take medication, what should I do if I miss a dose or have a reaction?
Are there any other treatments available?
Will I need more tests necessary later?
How often should I schedule follow-up visits? Should I be monitored on a regular basis?
Am I still safe to drive?

Your vision is a terrible thing to lose, but with proper diet, exercise and no smoking, along with regularly scheduled eye exams, you improve your chances of maintaining your sight.

11/5/15

Susan DeRemer, CFRE

General Differences Between Polarized and Absorptive Lenses

Polarized and Absorptive Lenses

Polarized lenses can be helpful in reducing glare; in fact, they were first developed to help with glare from outdoor sports and activities. Here is a passage from All About Vision that explains the basics of polarized lenses very well.

Light reflected from surfaces such as a flat road or smooth water generally is horizontally polarized. This means that, instead of light being scattered in all directions in more usual ways, reflected light generally travels in a more horizontally oriented direction. This creates an annoying and sometimes dangerous intensity of light that we experience as glare. Polarized lenses contain a special filter that blocks this type of intense reflected light, reducing glare.

Though polarized sunglasses improve comfort and visibility, you will encounter some instances when these lenses may not be advisable. One example is downhill skiing, where you don’t want to block light reflecting off icy patches because this alerts skiers to hazards they are approaching. In addition, polarized lenses may reduce the visibility of images produced by liquid crystal displays (LCDs) or light-emitting diode displays (LEDs) found on the dashboards of some cars or in other places such as the digital screens on automatic teller machines and self-service gas pumps. With polarized lenses, you also may be unable to see your cell phone or GPS device.

Boaters and pilots also have reported similar problems when viewing LCD displays on instrument panels, which can be a crucial issue when it comes to making split-second decisions based strictly on information displayed on a panel. (Some manufacturers of these devices have changed their products to solve the problem, but many have not yet done so.) Many polarized lenses are available in combination with other features that can enhance outdoor experiences.

Absorptive Sunlenses/Sunglasses do a little more than just reduce glare.

These are special wraparound sunglasses that filter out ultraviolet (UV) and infrared (IR) light. I explained those two types of light in my post. In addition to reducing glare, they can also increase contrast, which is important for visibility.

They also come in a variety of tints: dark gray-green, medium amber, medium gray, medium plum, yellow, orange, amber, and light orange. Many of the available tints/colors also have a percentage sign. The percentage sign represents the amount/percent of visible light that is transmitted through the lens. Here are some examples:

32% medium gray
10% medium amber
2% dark gray-green
20% medium plum
65% yellow
49% orange
16% amber
52% light orange

It is the tint – in combination with the amount of light transmission of each tint – that is helpful for people with glare issues. There are a few manufacturer websites that explain the range of absorptive lenses very well.

The first is NoIR Medical Technologies (NoIR stands for “No Infra-red” light.) You’ll see that there are different colors and tints, and many of the colors also have a percentage sign. The percentage sign represents the amount/percent of visible light transmitted through the lens.

Generally, NoIR recommends the following for people with glare problems:

32% Grey
13% Dark Grey
18% Grey
40% Grey-Green
20% Plum
16% Amber
10% Amber
54% Yellow

You can see from the list that the color does not have to be extremely dark for the lenses to reduce glare and light sensitivity.

Also, Eschenback Optik provides a good overview of Solar Shields, another type of absorptive lens product.

Most styles of absorptive lenses also can be fitted over prescription lenses. The bottom line is that it’s probably necessary to visit an office that carries a supply of these lenses and determine which color, tint, and percentage of light transmission is right for your wife. It’s helpful to compare several styles to determine what tint and percentage of light transmission work best.

10/27/15

Maureen A. Duffy, CVRT, LVT
Social Media Specialist, visionaware.org
Associate Editor, Journal of Visual Impairment & Blindness
Adjunct Faculty, Salus University/College of Education and Rehabilitation

Carrots For Healthy Eyes

Lately we have heard quite a bit about carrots and the positive effects they can have on your vision, such as slowing the progression of age-related macular degeneration (AMD). This is because carrots contain pigments called carotenoids. These pigments also give vegetables their colors, in this case orange. But carrots weren’t always orange.

The beginnings of carrots can be tracked back to the dry, hot lands of Iran and Afghanistan in 3000 BC, when the root vegetables were black, white, red and purple. They were bitter and used as a healing remedy for many illnesses, as well as an aphrodisiac.

The vegetable grew in popularity because it was still edible even after months of being stored in a variety of conditions. Carrot seeds were soon picked and sold to neighboring Middle Eastern, African and Asian populations. This is when the crossbreeding started and new types of carrots were created.

Across centuries and continents, the carrot evolved, improving the composition, look, flavor and size. After years of selective breeding, in the 17th century a Dutch yellow carrot was engineered to get rid of the bitterness, increase sweetness and minimalize the wooden core. This appears to be the origin of the orange carrot we enjoy today.

Americans didn’t fully use carrots until after World War I when soldiers returning home told about French and other European cuisine which included the carrot. However, it didn’t really become popular until World War II, when England actively encouraged home growing of carrots while the US was engaged in cultivating “Victory Gardens.”

Today the carrot is found around the world in temperate regions. They have a high nutrition value, presence of ?-carotene, dietary fiber, antioxidants, minerals and ability to be prepared in a wide variety of recipes. They have become a staple in many countries.

Currently, the largest producer and exporter of carrots in the world is China. In 2010, 33.5 million tons of carrots and turnips were produced worldwide, with 15.8 million tons from China, 1.3 million tons each from the US and Russia, 1 million tons from Uzbekistan and less than a million from Poland, the United Kingdom and Ukraine.

Because of the popularity and health benefits of carrots, they are now enjoyed in a variety of ways – beyond the simple salad. Here are some recipes you might find interesting to try:

Crab Toast with Carrot and Scallion – Forget your traditional bruschetta, wow your guests with the appetizer.

Potato-Carrot Latkes with Lemon-Raisin Topping – Seems perfect with Hanukkah just around the corner.

Roasted Carrot, Squash and Sweet Potato Soup – This is a more traditional carrot recipe, it is not that hard to find a carrot soup, but this one also has squash and sweet potatoes which are also eye healthy!

Carrot Farfalle Pasta with Lemon and Herbs – Not only are carrots good for flavor, but they add a nice color to this pasta that could be the base for any number of pasta dishes.

Carrot Ginger Layer Cake with Orange Cream Cheese Frosting – Most carrot cakes have no frosting or a traditional cream cheese frosting. The idea of an orange frosting makes this cake special.

Carrot, Ginger, and Lime Juice – Refreshing and healthy.

10/22/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Tear Film Health is Essential for People with Keratoconus

People afflicted with keratoconus (KC) are often obligated to wear contact lenses in order to obtain functional vision. Unfortunately, wearing contact lenses can have detrimental effects on the ocular surface and tear film layers over the course of decades, ultimately reducing lens tolerance. Therefore, any intervention prolonging the comfortable wear time of contact lenses should be aggressively pursued. The tear film covers the surface of the eye, provides lubrication and is the primary defense against foreign bodies and infection. Without a robust and healthy tear film, safe and comfortable contact lens wear is not possible. This article will describe the structure of the tear film and review simple remedies that can keep it healthy throughout life.

Tear Film Layers

The tear film is a complex, triple layered structure comprised of mucus, water and oil. The surface of the cornea and conjunctiva contain cells specialized to secrete a sticky mucoid substance. These so called goblet cells produce the mucin layer of the tears, which creates a “Velcro” type interface and allows the overlying watery component to stick to the ocular surface without washing away.

The bulk of the tear film is comprised of the watery, or “aqueous” layer which is secreted primarily by the lacrimal gland. This specialized structure is located near the eyebrow. This gland continuously releases small amounts of watery fluid that also contains enzymes and antibodies to help fight infection and wash away contaminants.

The lipid layer is the final, outermost layer of the tears. If the tear film is the first line of defense for the ocular surface, then the lipid layer is the first line of defense for the entire tear film and the ocular surface combined. Because of that role, it is extremely important and helps stabilize the tear film by preventing evaporation. This thin, lipid based layer is released by the meibomian glands, which are modified sebaceous glands that reside in the upper and lower lids. In each lid there are 20-30 glands. These glands open up onto the lid margin and through the action of a complete blink, release the lipid secretion to ocular surface which gets spread with the upward motion of the upper eyelid.

Each one of these layers contributes to the structure of the tear film, and a problem with any one of these structures (goblet cells, lacrimal gland or meibomian glands) will negatively impact the corresponding tear layer.

Tear Film Issues

Because the tear film is so thin, each individual component is necessary to maintain the integrity of the tears as a whole. When any layer of the tear film is deficient, the tear film becomes unstable and the ocular surface becomes irritated and can progress to developing classic symptoms of dry eye. This includes burning, stinging, redness, tearing, fatigue and contact lens intolerance.

Deficiencies in the mucin layer are uncommon, and are typically the result of chemical or thermal insult, or scarring. An aqueous deficiency, primarily from a lacrimal gland related etiology, is also relatively uncommon, and can arise from autoimmune and inflammatory causes such as Sjögren’s Syndrome. The most common reason for a poor tear film is linked with excessive evaporation of our tears due to a lack of sufficient lipid secretions from non-functioning or obstructed meibomian glands. It is understood that many factors contribute to why these glands stop performing optimally.

One factor has been linked to our habitual working environments. The compressive force exerted by the muscles of our eyelids that control blinking are essential for lipid secretion. However, the use of computers or wearing contact lenses has been shown to negatively impact our blinking habits, both by reducing the number of blinks and making blinks less complete. With an incomplete blink, the upper and lower lids do not make contact. The negative consequences of this are 1) the meibomian glands do not release their lipid contents, 2) the lower part of the eye is chronically exposed to the air, increasing evaporative stress and 3) dead skin cells accumulate on the lid margin which can clog the meibomian gland openings.

When increased evaporation of the tear film occurs chronically, the integrity of the entire ocular system becomes compromised over time and problems to the health of the eye become permanent attributes. This condition is known as Meibomian Gland Dysfunction or MGD and is linked with 86% of all dry eye sufferers.

Image 2 - Histology slide of a Meibomian gland with a terminal duct blockage — Image 2 – Histology slide of a Meibomian gland with a terminal duct blockage

Contact lenses have been shown in multiple studies to have a negative impact on the integrity of the tear film. To begin with, placement of a lens onto the eye divides the tears into two sections, referred to as the “post” (behind) and “pre” (in front) lens tear films.

The characteristics of the post lens tear film can differ depending on the type of lens that is worn. For example, soft lenses and scleral lenses have very little turnover of this post-lens tear film. This can cause issues related to the build up of toxic waste and bacterial elements that ultimately aggravate the corneal surface. Conversely, rigid gas permeable lenses are designed to have substantial tear turnover behind the contact lens with every blink.

The pre-lens tear film is also greatly affected by the type of lens material, as well as the interaction between the lid and the contact lens surfaces. Eye doctors know that without a healthy tear film, chances for contact lens intolerance increases. The rate of contact lens intolerance substantially increases as patients enter their fourth decade of life, primarily because of MGD caused by years of poor blinking habits.

Tear Film Care

Fortunately, simple interventions can prevent and/or limit the severity of MGD altogether or help to manage it once it occurs. Just like brushing and flossing one’s teeth can prevent gum disease, attention to complete blinking and lid margin hygiene can improve the tear film and prevent contact lens intolerance problems.

Because partial blinking is strongly linked with developing MGD, it is vitally important that the two lids touch when blinking. It is best to practice this several times throughout the day as well as when you are reading or using the computer.

Akin to flossing the teeth, it is also important to clean the lid margins with a Q-tip soaked in saline solution or a bit of mineral oil by gently brushing the Q-tip across the lid margin 10-20 times each night. It is easiest to get the lower lid.

Finally, performing warm compresses daily can provide heat to the Meibomian glands to soften the hardened oil that can plug the meibomian gland ducts. Warm compresses need to be done continuously for at least 10 minutes with consistent heat in order to attain a temperature that is sufficient to melt the oil that clogs the glands. We recommend folding 5-6 small towels or facecloths into a rectangular shape and wrapped together into a circular bundle, similar to the appearance of a cinnamon roll. The towels should be damp and moist, placed in a microwaveable safe dish with a lid and heated for approximately 1 minute and 50 seconds. After removal, wait a minute or two and then proceed to use the outermost cloth and cover the rest. Replace the first cloth after two minutes and grab the next outer most towel from the bundle, continuing this until all towels are used. In this way, the temperature can be adequately maintained for the full 10 minutes. The high temperatures applied to the lid are transferred to the cornea and very often cause temporary deformation, a phenomenon characterized by transient visual blur immediately following compress application. Therefore, it is vitally important, especially for patients with keratoconus, that pressure never be exerted onto the globe of the eye with a compress or massage administered to the lids of closed eyes after a compress.

It is becoming apparent that MGD is developing in patients at earlier ages. Because of this, the condition has likely been present for decades by the time the patient becomes symptomatic. It may take significant time and effort to rehabilitate not only the glands themselves, but also to reduce the resulting inflammation of the ocular surface.

Meibography is the technique used to image Meibomian glands. In chronic cases of MGD, we see abnormal changes to gland structure, in the form of atrophy or loss of gland tissue and/or dilation of glands where obstructed material causes glands to become widened. In severe cases, the prognosis for recovery is guarded.

The visual clarity that contact lenses provide for patients with keratoconus is incredibly important. But the ability to comfortably wear contact lenses is reliant on our body’s ability to provide a sufficiently thick protective tear film. Taking a small amount of time daily to attend to the lipid producing Meibomian glands by proper blinking habits, exfoliation of the lid margin with a Q-tip and warm compresses will help to extend the number of hours, and ultimately the number of years, that contact lenses can be safely and comfortably worn.

10/20/15

Amy Nau, OD
Korb and Associates, Boston, MA
Contact lens fitting for keratoconus, other ocular surface disorders and dry eye

David Murakami, MPH, OD, FAAO
Tear Science, Inc.
Researcher, Dry Eye

Increased Awareness for Saving Vision

The following is a survey done by Essilor (a French company that produces ophthalmic lenses along with ophthalmic optical equipment) and a large marketing research firm in the UK, YouGov. While the focus in on people living in the UK, the results would probably be similar to the US population. Even with increased access to the Internet, many people are still not aware of the risks associated with eye disease and what they can do to help retain their vision. Increased awareness of informational resources are important for saving vision.

There are a number of websites with easy to understand information about taking care of your vision that I have listed under Resources to Help Save Vision at the bottom of this article. And while there are eye diseases that are hereditary, you can slow the onset and progression by making good lifestyle choices about smoking, diet and exercise. Your eye care specialist is also an excellent source of information about what you can to do reduce your risk of vision loss, at any age.

Increased Awareness for Saving Vision

A YouGov poll conducted with Essilor reveals that most Britons are unaware of damage to their eyes by surrounding objects, activities, and devices. This widespread lack of awareness means fewer people seeking methods of prevention and avoidance, and for those that are aware of risks, most are not informed of existing preventative measures.

The poll has shown* that many British people remain uninformed about the various ways in which eyes are damaged by common daily factors, despite evidence that eye health is affected by blue light, UV rays (reflected from common surfaces), diet, obesity, and smoking.
Of the 2,096 people polled, the percentage of respondents aware of the link between known factors affecting and eye health were:

Poor diet – 59%
Obesity – 35%
Smoking tobacco – 36%
UV light, not just direct from the sun but reflected off shiny surfaces – 54%
Blue light from low energy lightbulbs and electronic screens – 29%

More than one in ten people were completely unaware that any of these factors could affect your eyesight at all.

72% of respondents own or wear prescription glasses but only 28% knew that there were lenses available (for both prescription and non-prescription glasses) to protect against some of these factors; specifically, blue light from electronic devices and low energy light bulbs, and UV light from direct sunlight and reflective surfaces.

76% admitted they haven’t heard of E-SPF ratings – the grade given to lenses to show the level of protection they offer against UV.

Just 13% have lenses with protection from direct and reflected UV light, and only 2% have protection from blue light (from screens, devices, and low energy bulbs).

Poll results showed that younger people were most aware of the dangers of UV and blue light, yet least aware of how smoking tobacco and obesity can affect your eye health. Within economic sectors, middle to high income people are more aware of the effects of smoking & obesity on eyesight than those with low income –

39% of people with middle to high income compared to 33% of people with low income are aware of the impact of smoking tobacco.
38% of people with middle to high income compared to 31% of people with low income are aware of the impact of obesity.

Awareness of the impacts of smoking and obesity on eye health is significantly higher in Scotland (47% & 49% respectively) than anywhere else in the UK (35% & 33% in England and 40% & 38% in Wales).
Essilor’s Professional Relations Manager, Andy Hepworth, has commented: “The lack of awareness about these common risks to people’s eyes is concerning. Not only would many more glasses wearers be better protected, but also many people who do not wear glasses would likely take precautions too, if made aware of the dangers and the existence of non-prescription protective lenses.”

To see the full results of the poll, please visit the Essilor website.

For more information on the protection offered from blue light and UV through specialist lens coatings, for both prescriptions and non-prescription glasses, please see here for UV & Blue Light Protection options.

*All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2,096 adults. Fieldwork was undertaken between 21st and 24th August 2015. The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).

Resources To Help Save Vision
All About Vision
Macular Degeneration Partnership
National Eye Institute (NEI)
Prevent Blindness

10/16/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Pumpkin Season

A sure sign that fall is here is that Starbucks is offering their Pumpkin-Spiced Lattes. Since pumpkins begin to ripen in September, this makes sense. But there are so many other ways to enjoy pumpkins, which can be good for your vision.

They contain an abundance of antioxidants, vitamins, fiber and phytonutrients that are good for your skin, eyes and heart, and they may also decrease your risk of cancer.

When shopping for your pumpkin you need to look for the sugar or cheese pumpkins varieties that are good for cooking and baking, because of their dense, sweet flesh. A traditional field pumpkin that you use for decoration and carving jack-o’-lanterns has watery, stringy flesh and is not recommended for eating.

You can keep an un-cut pumpkin at room temperature for up to a month. Stored in a cool cellar or refrigerator, they can last up to three months. However, once you cut the pumpkin, pieces should be wrapped tightly and refrigerated and used within five days.

Pumpkin Season Recipes

Here are a variety of tasty recipes that will let you enjoy pumpkins beyond the traditional soup and pie (but we have included those two as well).

Breads and Muffins

pumpkin season — Pumpkin-Cranberry Muffins

Pumpkin-Cranberry Muffins from My Recipes by Heather McRae

Pumpkin Biscuits from Country Living

Pumpkin-Cranberry Breadsticks from Recipe Girl

Pumpkin and Cream Cheese Muffins from Country Living

Pastas

Chicken Bacon Pumpkin Gnoochi from Nutmeg Nanny

Ravioli with Pumpkin Alfredo Sauce from Taste and Tell

Soups

Pumpkin, Beef and Black Bean Chili from Country Living

Roasted Pumpkin Soup from Martha Stewart

Breakfast Treats

Fresh Pumpkin Pancakes from A Sweet Pea Chef

Pumpkin-Ginger Waffles from Country Living

Desserts

Pumpkin Whoopie Pies with Cream-Cheese Filling from Martha Stewart

Ginger Pumpkin Pie with Toasted Coconut from My Recipes by David Bonom

Pumpkin Chiffon Pie with Gingersnap Pecan Crust from Epicurious

Extras

Baked Pumpkin Fries from Kirbie’s Cravings

Pumpkin Salsa from Little Figgy

Pumpkin Pie Shake from My Recipes by Vivian Levine

As the days get shorter and the temperatures cool off, these recipes will hopefully get you geared up for autumn, and the holidays that are around the corner. Let us know which recipes are your favorites in the comments below.

9/29/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Cortical Visual Impairment: What Is It?

What Is It?

Cortical Visual Impairment (CVI) refers to decreased vision resulting from the visual processing parts of the brain (e.g., the posterior visual pathways and/or the occipital lobes) rather than from the eyes themselves. For example, individuals with CVI typically have normal eye exam findings. However, vision loss from CVI can range from mild to total blindness. It is also one of the more frequent causes of visual impairment in children. Regardless, children with CVI often have some level of vision that may improve over time, particularly if they receive therapy to teach them how to integrate the visual signals their brains are receiving.

CVI may be caused by a number of different conditions that damage the visual parts of the brain. Examples include stroke, decreased blood supply to the brain, decreased oxygenation in the brain, brain malformation or infection, hydrocephalus, seizure, metabolic diseases, head trauma, and other neurologic disorders. Conditions such as these make it difficult for the brain to understand and interpret what the eyes see.

In most cases, individuals with CVI do not have other neurological problems, although epilepsy and cerebral palsy are not uncommon. The presence of CVI is not an indicator of the cognitive abilities of the individual; therefore, CVI should be distinguished from vision loss secondary to global neurological damage, where other functional deficits are also present in motor, cognitive, and physical abilities.

Indicators of Cortical Vision Loss

In children, one of the most common indicators of CVI is their poor attention to visual targets, particularly to more complex targets, such as a person’s face. Other indicators are that children with CVI often prefer to look at lights for long periods of time and that when reaching for an object, they will often look away from the object before grabbing it. This is because children with CVI have difficulty integrating visual stimuli (looking at an object) with their motor ability (grabbing the object). The diagnosis of CVI is given based on the combined results of magnetic resonance imaging (also known as an MRI) and an eye evaluation by a pediatric ophthalmologist.

Treatments

If a child is suspected of having CVI, he or she should be evaluated by a pediatric ophthalmologist as part of the initial evaluation. The pediatric ophthalmologist will assess the child’s eye health as well as the need for glasses to make sure there are no additional factors that may be limiting vision.

Often, there is concern that a child with CVI has little to no vision early in life. However, vision is a learned sense, so as the child matures, he or she may have improved visual responses. As such, early intervention is important for improved visual responses over time, as well as because the treatment period for visual development is limited to the early years of life. State and local educational agencies and early intervention programs should be contacted as soon as a visual concern is noted so that an organized plan of visual stimulation activities can be developed and implemented, based on the specific needs of each child. The professionals involved in the evaluation of a child with vision loss from CVI can include teachers of students who are blind or visually impaired, physical therapists, occupational therapists, speech therapists, and certified orientation and mobility specialists. It is important to note that although the vision of an individual with CVI may improve with intervention, rarely does the vision become totally normal.

The realization and acceptance that a child is visually impaired can be a difficult adjustment for the child’s parents. Fortunately, there are many things that can enhance the functional abilities of individuals with vision loss at any age. To learn about available resources for individuals with vision loss, visit the National Eye Health Education Program low vision program page.

9/1/15

Mark Wilkinson, OD
University of Iowa Carver College of Medicine
Director, Vision Rehabilitation Service, UI Carver Family Center for Macular Degeneration
Medical Director, UI Optical
Chair of the National Eye Health Education Program Low Vision Subcommittee

Purpose of Eye Exams for Children

Many children who are 6 – 18 years old are now back in school or will be shortly. But have you given them everything they need to succeed in the school year ahead?

? New binders
? Notebook paper and dividers
? Pencil box filled with pens and pencils
? Calculators, protractors and rulers
? Backpack to carry it all

These are the tools that children and their parents focus on every year, thinking these will help their child have a fun and productive year. But the list is incomplete. For school-aged children, the AOA recommends eye exams for children every two years if no vision correction is required. Children who need eyeglasses or contact lenses should be examined annually or according to their eye doctor’s recommendations.

“But my child gets and eye screening at school every year…” While this may be true it is important to understand the difference between a screening and an eye exam.

Vision screenings are a short examination that can indicate a vision problem or a potential vision problem; however it cannot diagnose exactly what is wrong with your eyes. It can also easily miss vision issues, giving parents a false sense of security.

With an eye exam, the tests are performed by a trained professional, using specialized equipment looking for specific indicators that could affect your child’s vision. They test much more than how well your child can read letters or symbols at a distance.

Good vision is necessary for a child to succeed at school and not become frustrated or depressed. It has been estimated that as much as 80% of the learning a child does occurs through his or her eyes. Children need to read a book and see a whiteboard, write and use computers every day in the classroom and at home. When a child cannot see clearly, it becomes more difficult to learn.

It also goes beyond just seeing clearly. Your child needs their eyesight to understand and respond to what they see. This includes the ability to focus their eyes, use both eyes together, and move them effectively.

Children may not always know they have a vision problem because they think that everyone is seeing the way they do. There are some signs that may indicate a vision issue:

Repeated eye rubbing
Excessive blinking
Short attention span
Tilting the head to one side or covering one eye
Holding reading materials too close to the face
Losing their place when reading
Difficulty remembering what they just read
Trying to avoid reading or other close activities
Numerous headaches

So as you prepare your child to go back to school, give them the best advantage they can have – good vision. Make an appointment with your eye doctor today.

8/27/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

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Here are some things you should know about smoking and your eyes.

Why You Need An Eye Exam

Questions To Ask After Your Eye Exam

Polarized and Absorptive Lenses

Tear Film Layers

Tear Film Issues

Tear Film Care

Increased Awareness for Saving Vision

Pumpkin Season Recipes

What Is It?

Indicators of Cortical Vision Loss

Treatments

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