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What To Expect On Your Next Visit To Your Eye Care Practitioner During COVID-19 Pandemic

Taking care of your health is critical and you may have concerns related to eye health as a result of the COVID-19 pandemic. The offices of Ophthalmologists and Optometrists are resuming the delivery of comprehensive eye and vision care and implementing new protocols to provide care in a safe and healthy environment.

While changes vary from state-to-state as well as individual practice locations, patients should expect that their eye doctors, like all medical professionals, are adhering to federal, state and local health directives regarding infection prevention measures and implementing appropriate safety procedures to reduce the risk of COVID-19 transmission within the office. These not only include strict protocols for cleaning and sterilization, but measures to effectively manage patient flow and encourage physical distancing. Patients should expect screenings for symptoms of COVID-19 and taking patients’ temperature upon their arrival at the facility, limiting the number of guests allowed in waiting rooms and requiring everyone to wear a facemask and/or gloves before entering the office.

Prior to the appointment, you should be asked a series of questions such as whether you have been diagnosed with COVID-19, whether you have been exposed to anyone who has an active COVID infection, and whether you have any of the typical symptoms of a COVID-19 infection including fever, cough, shortness of breath, or some impairment of your sense of taste or smell. You may also be asked about recent travel history. If there is a concern that you may have COVID-19 infection, then the appointment may be rescheduled to a later date.

Once you get to the office, you will be interviewed again to see if you have any symptoms suggestive of COVID-19 infection. You may be asked to have your temperature taken with a non-contact thermometer and to wash your hands or scrub your hands with hand sanitizer before entering the office. You may be asked not to bring any family members or assistants with you.

Every patient (and anyone accompanying the patient) is required to wear a mask, and the mask must be worn properly, covering both the nose and mouth. The mask must be worn through the entire visit, and conversations with the doctor or staff will be limited. The tests that are used to monitor glaucoma may be performed with modified protocols to minimize the time you spend at the office.

How to Prepare for Your Eye Doctor Visit

Don’t go if you’re feeling sick. If you wake up with a cough or a sore throat, it’s probably best to reschedule your appointment and call your primary physician. Your routine eye exam can wait. Don’t be surprised if someone takes your temperature upon arrival to ensure safety for everyone.

Fill out forms in advance. If possible, fill out your intake forms online before your appointment. This will limit your face-to-face contact and your overall time within the office. Any additional information that’s requested by your doctor can also be done over the phone.

Follow social distancing guidelines. There may be new procedures in place to help with social distancing, from markers on the ground indicating where to stand, to a limited number of people allowed in certain areas. Depending upon the office location, you may need to call from your car to check in. Every office is different, so be sure to check with your doctor’s office about their requirements.

Go alone to your appointment. Most offices are only allowing the patient to enter the office, with the exception of those who require a caregiver or a guardian to attend the appointment with them. This limits the amount of people going in and out of the office, and helps maintain a more sterile, clean environment.

Wear a mask to your appointment. Depending on your state, a mask may either be mandated or highly recommended when you are in public places. The Centers for Disease Control and Prevention highly advises people to wear a mask covering their nose and their mouth in order to help stop the spread of COVID-19.

As your eye care doctors begin reopening and operations proceed under a “new normal,” your ophthalmologist and/or optometrist are working to ensure the continued safe delivery of essential eye care during the COVID-19 pandemic.

To know exactly what to expect during your appointment, call your doctor’s office to find out how to best prepare for your visit.

June is Cataract Awareness Month

June is Cataract Awareness Month. This is a time to raise cataract awareness and help to educate people about one of the leading causes of treatable vision loss in the United States. There are 24 million Americans over the age of 40 who are affected by cataracts, so it seems fitting that an entire month should be dedicated to cataract education and awareness.

A cataract is a clouding of the eye’s lens, which blocks or changes the passage of light into the eye. The lens of the eye is located behind the pupil and the colored iris, and is normally transparent. Vision may become blurry or dim because the cataract stops light from properly passing through to the retina. Generally, a cataract does not cause pain, redness or tearing, but does cause increasing difficulty in seeing clearly.

Here is an overview of Cataracts:

View Video

Cataract symptoms:

Cloudy
Night vision
Glare
Halo
New glasses
Yellow tint
Double vision

Some Risk factors for cataracts include:

Older age
Intense heat or long-term exposure to UV rays from the sun
Certain diseases, such as diabetes
Inflammation in the eye
Hereditary influences
Long-term steroid use
Eye injuries
Eye diseases
Smoking

Cataracts can be easily diagnosed and visiting your eye doctor regularly is important in helping protect your eyes from further damage. An annual eye exam is recommended for everyone over the age of 60, and bi-annual exams for adults between 41-60 years to check for developing eye or vision problems.

There are a few treatment options, below is one of the newest options:
View Video

There is no proven way to prevent age-related cataracts. However, choosing a healthy lifestyle can slow the progression of cataracts. Some ways to delay the progression of cataracts include avoiding smoking, reducing exposure to UV rays, eating healthy foods, and wearing proper eye protection to avoid eye injury.

For more information and where you can find support for Cataracts click here .

Coronavirus and Your Eyes: What you should know

Coronavirus (COVID-19) can cause mild to severe respiratory illness. Symptoms such as fever, cough, shortness of breath and pink eye can show up 2 to 14 days after a person is exposed. People with severe infections can develop pneumonia and even die from complications of the illness.

To cut your personal risk of contracting the COVID-19, avoid touching your eyes, nose, mouth and face with unwashed hands. It is the mucous membranes (membranes that line various cavities in the body) that are most susceptible to transmission of the virus.

To avoid infecting others with the coronavirus, the Centers for Disease Control and Prevention (CDC) has recommended the use of face masks to be worn when out in public. Face masks can reduce the spread of coronavirus by people who are infected but have no symptoms of the virus (asymptomatic). Face masks, however, do not protect your eyes from infection.

Here are a few tips on how to protect yourself and others:

1. Practice safe hygiene and social distancing — The Centers for Disease Control and Prevention (CDC) offer these general guidelines to slow the spread of disease:

Wash your hands often with soap and hot water for at least 20 seconds. (Singing Happy Birthday twice is about 20 seconds)
You should especially wash your hands before eating, after using the restroom, sneezing, coughing or blowing your nose.
If you can’t get to a sink, use a hand sanitizer that has at least 60% alcohol.
Avoid touching your face — particularly your eyes, nose, and mouth.
If you cough or sneeze, cover your face with your elbow or a tissue. If you use a tissue, throw it away promptly. Then go wash your hands.
Avoid close contact with sick people. If you think someone has a respiratory infection, it’s safest to stay 6 feet away.
Stay home when you are sick.
Regularly disinfect commonly touched surfaces and items in your house, such as doorknobs, refrigerator door handles and counter tops.

2. Coronavirus may cause pink eye, so avoid touching eye discharge — Someone may have pink eye but it doesn’t mean that person is infected with coronavirus. But a recent study suggests that up to one third of people hospitalized with coronavirus experience eye problems, such as viral pink eye or conjunctivitis. It’s important to know that the virus can spread by touching fluid from an infected person’s eyes, or from objects that carry the fluid.

3. Avoid rubbing your eyes — We all tend to do it and natural habits can be hard to break but doing so will lower your risk of infection. Use a tissue instead of your fingers when you feel the urge to rub your eye or even to adjust your glasses. Dry eyes can lead to more rubbing, so consider adding moisturizing drops to your eye routine. If you must touch your eyes for any reason wash your hands first with soap and water for at least 20 seconds. Then wash them again afterwards.

4. If you wear contact lenses, consider switching to glasses for a while — There’s no evidence that wearing contact lenses increases your risk of coronavirus infection although contact lens wearers touch their eyes more than the average person. Substituting glasses for contacts can decrease irritation and will lower the chances of you touching your eye. If you choose to continue wearing contact lenses, follow these hygiene tips.

5. Make sure you are well supplied on eye medicine prescriptions if you can — During this pandemic experts have advised patients to stock up on critical medications, enough to get by if you are quarantined or if supplies become limited. If your insurance allows you to get more than 1 month of essential eye medicine, such as glaucoma drops, you should do so. Some insurers will approve a 3-month supply of medication in times of natural disaster. Ask your pharmacist or ophthalmologist for help if you have trouble getting approval from your insurance company. Don’t wait until the last minute to contact your pharmacy, request a refill as soon as you’re due.

IF YOU’RE NOT FEELING WELL – Call your family doctor. If you suspect you may have pink eye (conjunctivitis), call an eye doctor near you. It is suggested that patients not go directly to medical or eye care facilities without a prior phone call to help to decrease the possible spread of the virus. A phone call allows the health facility to prepare for your visit and diagnose and treat you in a proper manner.
You may feel nervous about going to the doctor’s office during this pandemic. But treatment for eye emergencies should not be delayed. Ophthalmologists, like all medical professionals, follow strict hygiene and disinfection guidelines.

Ophthalmologists are available to treat urgent eye issues, deliver eye injections and provide critical care. Call your ophthalmologist or other medical doctor as soon as possible in the following situations:

You have macular degeneration or diabetic retinopathy and get regular eye injections.
You notice changes in your vision (like blurry, wavy or blank spots in your field of vision).
You experience an eye injury, even if it seems minor.
You suddenly lose some vision.
You have eye pain, headache, red eye, nausea and vomiting.

Protect yourself and the eye care team by following these precautions:

Wear a mask to a medical appointment. The mask should cover your nose and mouth.
If you have a cough or a fever, or have been in close contact with someone who has these symptoms, you must call your doctor’s office ahead of time and let them know. After you speak with the health care profession, it may be decided that your visit is not an emergency, and you can be treated at home. If you arrive sick at the doctor’s office, you should wear a protective covering or mask, and they may want you to wait in a special room away from other patients.
If you need to cough or sneeze during your exam, move back from the microscope. Bury your face in the crook of your arm or cover your face with a tissue. Wash your hands with soap and water right away.

For more Coronavirus information visit: www.cdc.gov/coronavirus

For more information about the Discovery Eye Foundations new research for Coronavirus vaccine visit: www.discoveryeye.org/covid-19-emergency-research/

Your EYES will be thankful for Thanksgiving Dinner!

Thanksgiving is almost here; a meal that nourishes the family bonds and traditions. It’s the one time of the year where you can guarantee your eyes will be bigger than your stomach. This meal also has another added bonus — almost every item on the Thanksgiving table is healthy for your eyesight!

Here are several of the most popular Thanksgiving dishes and their corresponding benefits to your eye health:

Turkey –

No Thanksgiving is complete without a turkey, roasted golden brown and stuffed with fresh vegetables and herbs. Turkey is loaded with zinc and B-vitamin niacin, which helps prevent the formation of cataracts. Cataracts are the leading cause of vision loss in the United States, so gobble up! You are “preventing” cataracts with every bite.

Spinach, Green Bean Casserole, Asparagus and Brussel Sprouts –

These foods and other leafy greens are loaded with lutein and zeaxanthin, two nutrients that protect the retina, which may also help reduce the risk of cataracts and macular degeneration. Healthy Green Bean Casserole Recipe

Sweet Potatoes –

Sweet potatoes are full of Beta-carotene, which is a carotenoid and antioxidant that promotes night vision and overall good eyesight. Sweet potatoes are also loaded with vitamins C and E. Diets that are rich in these vitamins can help prevent or delay the development of cataracts and macular degeneration. Mashed Sweet Potatoes Recipe

Cranberry Sauce –

Cranberries contain bioflavonoids, a large class of antioxidants. Bioflavonoids are found in the pulp, skin and rinds of foods that contain vitamin C. Both flavonoids and vitamin C help protect the eyes from free radical damage caused by pollution and the body’s normal metabolic processes.

Pumpkin Pie –

Pumpkin is one of the best sources of vitamin A, so pumpkin pie is an eye-healthy dessert. In fact, one cup of cooked, mashed pumpkin contains more than 200 percent of the recommended daily intake of Vitamin A. Vitamin A provides nourishment and protection to the eye’s lens, cornea and macula (part of the retina), so it improves night vision.

A diet that’s full of the right nutrients is a great start to keeping your eyes healthy, but don’t forget that regular eye exams are equally important! We hope you enjoy a happy and delicious Thanksgiving with family and friends.

*For more eye healthy recipes click here EYE COOK

September is Healthy Aging Month

Healthy Aging Month is an annual health observance designed to focus national attention on the positive aspects of growing older. Aging is a process that brings many changes. Vision loss and blindness, however, do not have to be one of them. There are several simple steps you can take to help keep your eyes healthy for the rest of your life.

Eye diseases often have no early symptoms, but can be detected during a comprehensive dilated eye exam. A comprehensive dilated eye exam is different from the basic eye exam or screening you have for glasses or contacts. By dilating the pupils and examining the back of the eyes, your eye care professional can detect eye diseases in their early stages, before vision loss occurs. By performing a comprehensive eye exam, your eye care professional can check for early signs of –

Here are some other tips to help maintain healthy vision and body now and as you age:

Eat a healthy, balanced diet. Loading up on fruits and vegetables can help keep your eyes healthy and disease free.

Maintain a healthy weight. Being overweight increases your risk for heart disease and diabetes. Complications from diabetes, such as diabetic retinopathy or glaucoma, can eventually lead to vision loss.

Don’t smoke. Smoking increases your risk for age-related macular degeneration, cataract, and other systemic diseases, including cancer. Wear protective eyewear when outdoors. Protecting your eyes from the sun’s ultraviolet rays when you are outdoors is important for your eye health. Choose sunglasses that block 99 to 100 percent of both UV-A and UV-B radiation.

Even if you are not experiencing vision problems, visiting an eye care professional regularly for a comprehensive dilated eye exam is the most important thing you can do to reduce your risk of vision loss as you age.

Download “Everyone’s vision can change with age”
A handout with explanation on how vision can change with age.

June is Cataract Awareness Month

I remember my father experiencing the removal of cataracts in the early 60’s, and being told by his Ophthalmologist that the recovery time would be weeks rather than days and a positive outcome was not guaranteed. The truth is that surgery of any kind carries with it a certain amount of risk. But now the removal of cataracts has become routine for thousands thanks to amazing technology and gifted eye surgeons. To the doctor, the surgery might be considered routine. But to the patient, when vision is at risk their concerns and real fears are not in any way routine.

A year ago at 96 years young, my friend and actress Betty White was worried about her vision. She told me that she was having a great deal of difficulty reading scripts and that her eyes would tire with the strain of trying to see the pages. Her ophthalmologist determined that the removal of cataracts was necessary and the surgery on the first eye was scheduled for the next Tuesday. “Is it safe? she asked me.” I assured my friend that the removal of cataracts was not something to be afraid of. “It’s routine” I told her. “Please don’t be frightened.” Betty’s surgery was completely successful. In fact, she tells me she can read everything including the smallest print on any label.

At the Discovery Eye Foundation (DEF), we are committed to supporting research that we believe will make the treatment of many forms of vision loss far more predictable and successful. Whether it’s through the breakthroughs in surgery or the development of new drugs or the advancement in genetics or the use of stem-cells the major forms of vision loss are being greatly affected through the power of your contributions and the commitment of the gifted researchers DEF supports.

Please know that the dollars you contribute to DEF will go directly into the hands of the researchers where they can do the most good.

All of us at the Discovery Eye Foundation thank you for your support and look forward to a time when most forms of blindness will no longer limit vision.

Tom Sullivan
DEF’s Ambassador of Vision
sullivanvision.com

Your Vision is Your Wealth

We see more than 24 million images in our average life span. The huge task in a human body is seeing, which requires half of one’s brain to function. Our eye lenses are equal to 576 megapixels Camera lens.

One man out of every twelve men is color blind and the chances of losing eye function increase with age. In the UK 74% of people correct their eyesight by Laser Surgery, Wearing Contact lens and glasses to have a better view. Our eyes take only 48 hrs to repair from a corneal scratch. In order to avoid these problems, restrict the continuous usage of contact lens less than 19 hours in a day.

For a better understanding, read this infographic from Paul Gill Optician.

Source and Author:
Amy Lynn
Paul Gill Optician

Cataract Surgery and Keratoconus

1/8/15

The eye works like a camera, specifically a digital camera. There is the front lens of the camera (cornea), the aperture (iris), the film (retina), and a cable to take the image to the brain (optic nerve). This “camera” also has an additional lens – the natural crystalline lens, which lies behind iris. This natural lens is flexible when we are young, allowing us to focus at distance then instantaneously up close. Around age 40-45, this natural lens starts to stiffen, necessitating the need for reading glasses for most people. This stiffening is the beginning of the aging process that eventually leads to formation of a cataract. We refer to the lens as a cataract when it becomes sufficiently cloudy to affect ones quality of vision. In general, cataract surgery is one of the safest and most successful of all surgeries performed. The basics of cataract surgery in eyes with keratoconus is very similar to non-keratoconic eyes.

Keratoconus (KC) affects this “camera” by causing the front lens (cornea) to bulge. This causes the optics to be distorted. In many cases, this can be corrected for with hard contact lenses (CL) or spectacles; in other cases a corneal transplant may be necessary. When it comes time for cataract surgery in the setting of KC, there are several factors that need to be considered.

Corneal Stability
The first thing to be considered is the stability of your cornea. In general, KC progresses more in your late teens to early twenties, and then stabilizes with age. A very exciting treatment for KC is collagen crosslinking. This treatment is meant to stiffen the cornea to prevent instability that is inherent to KC. This treatment promises to stop the progression of KC at a young age. Fortunately, with age, the cornea naturally crosslinks and stiffens, therefore when it comes time for cataract surgery, there is little chance of the progression of KC. Your doctor needs to choose the appropriate intraocular lens (IOL) to refocus your eye after surgery. Two of the most important factors in IOL selection are the length of your eye and the shape of your cornea. Long term CL wear can mold your cornea. It is important to assure that you stay out of your CLs long enough for your cornea to reach its natural shape. Depending on how long you have worn your CLs, it may take several months for the cornea to stabilize. This time can be challenging as your vision will be suboptimal (because you can’t wear CLs), and will be changing (as your cornea reaches its natural shape). When your cornea does stabilize, it is important to determine whether the topography (shape) is regular or irregular. This “regularity” is also known as astigmatism. If the astigmatism is regular, light is focused as a line – generally, this distortion can be fixed with glasses. However, if the astigmatism is irregular, light cannot be focused with glasses, and hard CLs are needed to provide optimal focusing. If you have had a corneal transplant, I generally recommend all your sutures to be removed to allow your new cornea to reach its natural shape.

IOL Selection
The second thing to be considered is the type of IOL. IOLs allow your doctor to refocus the optics of your eye after surgery. In many cases, the correct choice of IOL may decrease your dependence on glasses or CLs. There are several factors that are important when considering the correct IOL for a keratoconic patient. The amount and regularity of your astigmatism plays a very significant role in IOL selection. In general, there are four types of IOLs available in the US – monofocal, toric, pseudo-accomodating, and multifocal. In general I do not recommend multifocal IOLs in patients with KC. These IOLs allow for spectacle independence by spitting the light energy for distance and near, however, with an aberrated cornea (which is what happens in KC), these IOLs do not fare well. If there is a low amount of regular astigmatism or irregular astigmatism, your best bet is a monofocal IOL. This is the “standard” IOL that is covered by your health insurance. If you have higher amounts of astigmatism that your doctor determines is mostly regular, you may benefit from a toric (astigmatism-correcting) IOL. These IOLs can significant improve your uncorrected vision and really decrease your dependence on glasses. It is important to realize that monofocal and toric IOLs only correct vision at one distance. With a monofocal IOL you still can wear a CL to fine-tune your vision, however, with a toric IOL, in general you will need glasses for any residual error. There is a pseudo-accomodating toric IOL available, and this may be a good option if you are trying to decrease your dependence on glasses and correct some of your astigmatism. These IOLs are relatively new to the US market.

If You Had A Corneal Transplant
In the setting of a corneal transplant many of the same factors need to be considered – stability of the graft, choice of IOL, etc. In addition, the health of the graft has to be judged. Prior to cataract surgery in my patients with corneal transplants, I make sure to remove all of their sutures and give the cornea time to stabilize (just as if they were a CTL wearer). If you are a CL wearer, the same rule of being out of the TL until the topography is stable applies. The health of a transplant needs to be established prior to undergoing cataract surgery. The cornea has five main layers to it – the back layer (inside) is called the endothelium. This layer is responsible for “pumping” fluid out of the cornea, allowing it to stay clear. In all eyes there is a loss of endothelium cells with cataract surgery. I generally perform a “specular microscopy,” which allows me to visualize and quantify the corneal endothelium prior to surgery. This allows me to risk stratify you before your surgery. It is important to realize that corneal transplants have a lifespan and may have to be repeated in the future.

Keep in mind, there is some uncertainty in biometry (the process of selecting an IOL) in all eyes – this error can be higher in keratoconic eyes. This highlights why assuring stability is important. Equally important is picking the correct IOL for your situation. Also, keep in mind that I have discussed generalities in this article. Your individual case could be different. This is a conversation best left between you and your surgeon. In general, cataract surgery and keratoconus or a corneal transplant can be a very safe and effective way in restoring vision.

Sumit (Sam) Garg, MD
Interim Chair of Clinical Ophthalmology and Medical Director
Gavin Herbert Eye Institute at the University of California, Irvine

What You Need to Know About Cataracts

6/5/14

Do you feel like your vision is getting worse? Do you feel like colors are not as vibrant as they used to be? Are you having more trouble with glare? If you have any of these symptoms, you may be experiencing the effects of cataracts.

Cataracts are a normal aging process of the crystalline lens in the eye. Well you may ask — what is the crystalline lens? It is easiest to think of the eye as a camera. The eye has a lens (actually two) – the cornea (the front window of the eye) and the crystalline lens (inside the eye). It also has an aperture (the colored iris), and film (the retina). All these structures work together to focus light and allow us to see – just like a camera. When we are young (less than 40), the crystalline lens is flexible. This is why we are able to see distance and then near without the need for reading glasses. The crystalline lens is able to change its shape depending on where one is looking.

Figure 1 – Slit-lamp photo of a visually significant cataract.

As we age, the crystalline lens becomes less flexible, thereby causing one’s near vision to be more blurry. This necessitates the need for reading glasses. As the crystalline lens become less flexible with age, the lens also starts to become more yellow and can also become cloudy. When the yellowing and/or clouding become visually significant, we refer to this as a cataract (figure 1).

Are cataracts dangerous? The simple answer is no. In the vast majority of cases, a cataract can be monitored until it becomes visually significant (drop in vision, glare, decreased contrast, vision related difficulties with day to day activities, etc). However, there are a few instances in which cataract removal is a medical necessity. Routine examinations by your eyecare provider can help you determine if you are at risk for these less common instances.

Figure 2 – Intraoperative photo during cataract surgery (prior to cataract removal).

What can I expect during cataract surgery? Do you have to replace the crystalline lens with anything? Cataract surgery involves removing the clouded crystalline lens (figure 2) and replacing it with an artificial lens known as an intraocular lens (IOL) (figure 3). Surgery generally takes 10-15 minutes under a mild sedative, and you don’t have to stop any of your current medications. Anesthesia is achieved with drops and you will only feel mild pressure during the surgery. IOLs come in different styles – Standard IOLs grossly correct your vision and you can fine tune your vision (distance and near) with glasses post-operatively;

Figure 3 – Intraoperative photo during cataract surgery (after implantation of an IOL).

Toric (astigmatism correcting) IOLs allow for increased spectacle independence, but glasses will still be needed for distance or near; Accommodating IOLs “flex” within the eye to decrease your dependence on distance and near glasses; Multifocal IOLs allow spectacle independence for distance and near. I always counsel patients that there is no perfect IOL and you have to determine which IOL is best for your particular situation. Your doctor can help you decide which IOL is best for you. Generally, cataract surgery is extremely safe. Your doctor will discuss particular risks specific to your eye.

How do I know if cataract surgery is right for me? The best way to know if you have a cataract and if it time to consider surgery is to consult with your local ophthalmologist. If you have experienced a recent drop in vision, that is not correctable with glasses, cataract surgery may be able to restore your vision!

Sumit “Sam“ Garg, MD
Medical Director
Vice Chair of Clinical Ophthalmology
Assistant Professor of Ophthalmology
Gavin Herbert Eye Institute – UC, Irvine

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