A common theme relates to complaints of poor night vision (even with glasses on).  Other patients report that they have been told that they do not need glasses, but they feel they have poor vision at night and/or when it is raining.  While there can be a number of causes of this feeling, there are typically 5 causes of this complaint.

1) Cataract formation

Cataracts are a normal part of the aging process that result in a gradual clouding of one of the lenses in the eye.  This clouding reduces the amount of light that can enter the eye.  The clouding also dramatically increases glare. This is especially problematic when driving at night or in rainy conditions. When the cataract is starting to impact quality of life, then cataract surgery is indicated.  In most cases, this is a 15 minute out-patient surgery with no stitches.

2) Dry Eyes

Most people mistakenly believe that the main focusing lens of the eye is the cornea, but that is not the case.  The cornea exists to create a lens made out of your tear film.  If you have dry eye, then you will have a poor quality tear film.  That will cause reduced quality of vision, especially at night. There are many treatments for dry eye. See our dry eye page for more information

3) Scratched or pitted eyeglass lenses

As your glasses age, they begin to develop fine scratches and pits in the lenses that will effect the optical quality of the lens.  This, in turn, will blur the vision, and cause glare issues, especially from oncoming headlights.  Replacing the lenses can solve this problem, especially if the new lenses incorporate an anti-reflective coating.

4) Retinitis Pigmentosa (RP)

This relatively rare disease destroys the part of the eye that senses vision at night, resulting in serious night blindness. Unfortunately there is no treatment other than low vision aids for patients with RP.

5) Higher order aberrations (HOA)

This final category is one that most people have not heard of.  Generally speaking, the typical components of a prescription, such as nearsightedness and astigmatism only account for about 90% of your total correction. The other factors, such as chromatic and spherical aberration (among others) primarily effect the vision at night.  Eye doctors lump together all those other components in a category that we call “Higher order aberration” or “HOA’s.

In some patients, HOA represent their only vision problem.  These patients often complain about blurred vision, only to be told by their eye doctor that they do not need glasses.

New technology from the German optics company Zeiss has allowed us at Spectrum Eyecare to measure these HOA’s.  Moreover, they have new lenses that allow for incorporation of HOA’s to allow for the best possible night vision.  At Spectrum Eyecare, we are one of only three practices in Georgia that have implanted this technology in our practice.  We measure each patient to see if they need this special lens technology incorporated into their prescription.

Whatever the cause of your night vision problem, at Spectrum Eyecare, Dr. Henahan will take the time to fully evaluate your eyes to discover what is causing your difficulty.  He will also take the time fully explain the issue and your options for solving the problem.

Dr. John Henahan is a Peachtree City resident and founder of Spectrum Eyecare.

Winter is the season for celebration.  The joy of Christmas trees, stockings and fires crackling in the hearth make the season bright.  Unfortunately for many people, the colder weather and drier air also leads to a flare up in their dry eye symptoms, according to Dr. John L Henahan at Spectrum Eyecare in Peachtree City.

The good news is that the treatment options for dry eye continue to evolve.  “We use a staged approach to treating dry eye to find maximum relief of dry eye without over treating”, continues Dr. Henahan.   “We also firmly believe in using natural therapy whenever possible, and we resort to prescription medications only when necessary.”

Advances in Treatment

Of the big advances in 2010 in treating dry eye, perhaps none is more exciting than a new contact lens that secretes a moisturizing compound as it is worn.  This breakthrough product uses the most effective moisturizing compound used in eye drops for treating dry eye.  Since contact lens wearers are among those who most commonly suffer from dryness problems, this exciting lens can represent a real breakthrough.  Imagine a contact lens that corrects your vision AND secretes artificial tears all day!

Another exciting development is in the arena of topical foams that reduce dry eye caused by blepharitis, which creates symptoms due to inflammation in the eyelid.  This hygiene regimen is especially powerful when combined with nutritional intervention such as vitamins and fish oil capsules.

A simple in office procedure, called punctal plugs can provide almost immediate relief for a majority of patients with chronic dry eye.  It is often a first line treatment due to it’s ease, the fact that it is covered by most insurance companies, and it’s simple “set it and forget it” nature.

Smart Strategies for Treating Dry Eye

Before undergoing treatment for dry eye, patients should ask themselves some simple questions, reports Dr. Henahan.  “Do you drink adequate amounts of water every day?  Do you eat a healthy diet or is your diet overloaded with fried foods and products loaded with High Fructose Corn Syrup?  Are you having other symptoms, that might be associated with thyroid problems?  Finally, if you are on any number of different medications including anti-histamines, birth control or hormone replacement therapy they could be playing a role in your symptoms.

In most cases, if you can make changes in these areas, your symptoms may be reduced.  For many, these changes are not practical, in which case evaluation and treatment by your eye doctor is warranted.

Dr. John Henahan is a fellowship trained doctor of optometry practicing and living in Peachtree City, GA with his wife and two sons.  You may call his office at 770 487-0667 or visit him on the web at www.speceye.com.

According to a recent post by Andrew Weil, MD multiple studies have again reiterated the importance of a nutrition and healthy diet in reducing the risk of Macular Degeneration, the leading cause of vision loss in older Americans.  ”Dr. Weil has been a real pioneer in integrative medicine”, according to Dr. John Henahan at Spectrum Eyecare in Peachtree City. “I have long worked to integrate nutrition counseling and judicious use of supplements to reduce the risk of eye disease and improve symptoms of various eye conditions”, continues Dr. Henahan.

“Researchers at the Agricultural Research Service (ARS)-funded Laboratory for Nutrition and Vision Research have found that the combination of a low-glycemic diet combined with vitamins C and E, zinc, lutein, zeaxanthin, and omega-3 fatty acids can help maintain quality of life and reduce health care costs due to sight-robbing eye diseases.”, reports Dr. Weil in his recent post.  A low glycemic diet has many other health benefits (Learn more). Omega-3 fatty acids, especially those found in fish oil have recently been reported to reduce the risk of macular degeneration markedly.  They also reduce dry eye symptoms in about 70% of patients.

Dr. Weil favors additional lifestyle and dietary changes to help reduce the risk of macular degeneration.  These include smoking cessation, sunglasses, and a diet rich in Vitamins, C, E as well as lutein and zinc.  According to Dr. Weil’s website, “Vitamin C-rich foods include citrus fruits, melons, tomatoes, potatoes and broccoli. You can get vitamin E from soybeans, greens, fish, wheat germ, nuts and seeds.Dietary sources of zinc are legumes (peas, dried beans, garbanzos/chickpeas, black-eyed peas, lentils and soy products) and whole grains. The carotenoid pigment lutein is found naturally in spinach, kale, collard greens, romaine lettuce and peas. Other protective compounds are the red and purple pigments found in berries and other fruit. Eat berries, especially blueberries, often. You can also get these pigments into your diet with supplements of bilberry, grape seed extract or pine bark extract. My recommendations for daily vitamin E are to take 400-800 IU of natural mixed tocopherols, or at least 80 mg of natural mixed tocopherols and tocotrienols. People under 40 should take 400 IUs a day; people over 40, 800 IUs.”

At Spectrum Eyecare, Dr. Henahan favors a preventive approach to macular degeneration.  ”You must act as soon as the earliest signs of macular pigment loss are apparent, which often occurs in the forties and fifties.  If you wait until macular degeneration is apparent, then it is too late to prevent it.  If your doctor is not looking carefully for signs of early macular pigment loss, called drusen, then you may be missing an opportunity to prevent this devestating condition.”, reports Dr. Henahan.  ”Look for health care professionals that want to partner with you to help you stay well, not wait until your eye is sick.”

With millions of lives in their hands, airline pilots have a lot to worry about.  Vision plays a large role in ensuring that they safely deliver their passengers to their destination, according to Dr. John Henahan, optometrist at Spectrum Eyecare in Peachtree City.

No other profession requires crystal clear vision in such a huge array of lighting conditions.  From near zero visibility to suddenly blinding sunlight as the aircraft climbs above the clouds; the eyes of airline pilots are required to perform at a much higher level than most professionals.  On top of that, pilots typically do not wear polarized sunglasses when flying because the polarization causes difficulty seeing through the cockpit glass and may make it more difficult to see some instruments.

Night flying and runway approaches challenge the pilot as well.  Since maximal night vision is critical when on approach, care must be taken to allow time for full dark adaptation prior to approach.  Moreover, eyeglasses lenses that do not take advantage of the latest in HD lens technology as well as anti-glare coatings can interfere with this critical ability to see at night.

The extremely dry environment in the cockpit can cause dry eye related visual disturbances even in those who normally do not suffer from dry eye, especially for contact lens wearers.  “It can be quite a challenge to ensure the top performance from their eyes that pilots demand.”, according to Dr. Henahan.  With more than ten years practicing in Peachtree City, home to a large population of airline pilots, he has seen many concerns that are commonly expressed by these professionals.

Concerns about clearly viewing instrument clusters, approach plates and flight operations manuals are common, especially in those who are starting to struggle with their close vision.  This loss of clarity, known as presbyopia, occurs when one is in their early to mid- forties.  While presbyopia is a nearly universal experience, it can be particularly troubling to pilots, since they require clarity at close range both above and below their line of sight.  This is in stark contrast to most of us, who only need to see clearly at close range below eye level (think papers on your desk versus instruments both below eye level and overhead in the cockpit). Since most bifocals and progressive lenses are designed to only help with close focus below eye level, special designs are sometimes used for pilots that can help with instruments above and below the line of sight.

While the cockpit glass provides reasonable protection from the sun’s harmful UV rays, radiation levels from the large number of instruments in the cockpit warrant strong protection from UV, even in clear eyeglasses and contact lenses.

Another challenge pertains to the poor comfort with eyeglasses that are not fit with the pilot’s headset in mind.  The ensuing hotspots can be very distracting. Both Telex and Dave Clark headsets can cause problems if eyeglasses are not properly fit with the headset in mind.

New advances as well as time-honored strategies can help the pilot maintain excellent vision throughout his or her flying career, allowing the pilot to protect passengers and help to ensure good vision even well into retirement.

Dr. John Henahan is an AOA certified Aviation Vision doctor of optometry practicing and living right here in Peachtree City with his wife and two sons.  You may call his office at 770 487-0667 or visit him on the web at Spectrum Eyecare’s website.

Large-scale study shows omega-3 fatty acids may lessen AMD severity

At Spectrum Eyecare in Peachtree City, Dr. John Henahan has long been an advocate for use of high quality fish oil in treating dry eye.  Now a new study from National Institutes of Health researchers found that those reporting the highest intake of omega-3 fatty acids (from fish oil) had the lowest reported rating of Age related Macular Degeneration (AMD) severity.

J.R. Chang, MD, and colleagues reported that “dietary DHA/EPA (the key components of fish oil) was inversely related to AMD score in energy-adjusted comparisons of participants reporting highest vs. lowest quintile intake.”  In other words, those with the highest level of fish oil intake had the lowest risk of AMD.

There were 4,203 patients in the study; they had a baseline mean age of 73 years; and 57% of the patients were women. All patients had good visual function at baseline, but the majority had risk factors for progression to advanced AMD, according to the poster.

“This is the strongest evidence yet that we can help reduce the severity or possibly even prevent macular degeneration in at risk patients with a strong nutritional program that includes fish oil, lutein and other vitamins”, according to Dr. Henahan.

“Historically, I have been recommending smoking cessation, polarized sunglasses, a multi-vitamin and 20mg of natural lutein per day.  But now I will be adding fish oil to my recommendations.  The great thing about fish oil is that it appears to have so many collateral benefits, such as reducing symptoms of dry eye, improving cholesterol levels and reducing the risk of cardiovascular events. However, those taking blood thinners (such as coumadin) should consult their physician before beginning fish oil”, continued Dr. Henahan.

When looking at fish oil supplements, it is important to shop very, very carefully.  Lower quality fish oils have increased contaminants such as lead or mercury and lower levels of the key omega-3′s called EPA and DHA.  Look for at least 40% of these components in each capsule.

At Spectrum Eyecare, Dr. Henahan takes the time to truly understand how he can work with patients to prevent the most serious eye diseases, especially through the use of nutritional supplements and other non-drug interventions.  Of course, he uses prescription medications when indicated, so you can be sure that you will get the best of both traditional and natural medicine to provide a lifetime of great vision.  If you would like to have Dr. Henahan evaluate you, please contact us by clicking here or calling 770-487-0667. Dr. Henahan is in the Peachtree City office every Monday, Wednesday and Friday as well as two Saturday’s per month.

Every year, more women than men are diagnosed with eye diseases such as dry eye, glaucoma, cataracts, macular degeneration and diabetic retinopathy, according to Dr. John L Henahan, of Spectrum Eyecare in Peachtree City, GA.

Of the many health differences between men and women, many may not be aware of the fact that women are more affected by eye disease and other eye conditions than men.

The 2008 “Vision Problems in the U.S.” study from Prevent Blindness America and the National Eye Institute consistently shows that more females are diagnosed with major eye diseases. Of the more than 3.6 million Americans age 40 and older suffering from visual impairment, including blindness, 2.3 million are women.

Women are also more susceptible to dry eye syndrome, a condition where not enough natural tears are produced.

Approximately 6 million women and 3 million men have moderate to severe symptoms of dry eye syndrome, according to the National Women’s Health Resource Center. It is more frequent in post-menopausal and pregnant women, due to hormonal fluctuations.

Women who are pregnant or receiving fertility treatments may experience changes in their vision. Because of an increase in hormones, some may notice refractive changes, dry eyes, puffy eyelids that obscure side vision and sensitivity to light due to migraine headaches.

Some vision changes in pregnant women, such as blurred vision and seeing spots, may be signs of a more serious problem and should be discussed with a doctor immediately as this may be a sign of pregnancy related diabetes or high blood pressure.

If you or someone you love  is diabetic and pregnant or  planning to become pregnant should get a full eye exam.

For older women, a recent study published in the March 2010 issue of Ophthalmology showed that women who are post menopausal and receiving Hormone Replacement Therapy (HRT) treatments may be at an increased risk for cataracts.  The study by Birgitta E. Lindblad, M.D., Sundsvall Hospital, Sweden, as part of the Swedish Mammography Cohort (SMC), states that of the more than 30,000 post- menopausal Swedish women studied who were using or had used HRT had significantly higher rates of cataract removal compared with women who had never used HRT. The “Hormone Replacement Therapy in Relation to Risk of Cataract Extraction: A Prospective Study of Women” data showed the risk for cataract removal was increased by 14 percent in women who had never used HRT and by 18 percent in current HRT users. And, longer duration of HRT use correlated with increased risk.

“Although more research needs to be completed regarding linking cataract increases with HRT, the message is clear that all women need to take the time to take care of their eyes today in order to maintain healthy vision in the future,” said Hugh R. Parry, president and CEO of Prevent Blindness America. “No matter what age you are, it’s never too early to start visiting your eye doctor and scheduling regular dilated eye exams.”

For more information, visit speceye.com or call 770-487-0667.