I see great, why should I have an eye exam?

Even if you have perfect vision, most organizations, like the American Optometric Association feel that an adult should have an eye exam at least every 3 years.  Once you reach your 40’s exams are recommended a minimum of every two years.  Those 50 years of age or older should have an eye exam annually, as should people who wear corrective lenses and/or have a family history of eye disease.  Diabetics must have an exam with dilated pupils and special photographs annually (see below for more on diabetes and the eye).

The reason that even those of us with perfect vision should still have periodic eye exams is that many eye diseases have no symptoms early in their course.

Glaucoma, for example, is often called the “sneak thief of sight” because millions are suffering from this condition with no symptoms.  It is not until one has lost 80% or more of their vision that symptoms develop.  Unfortunately, any vision you have lost cannot be recovered.  That makes early diagnosis essential in the treatment of this disease.

Other conditions like Macular Degeneration (AMD) can sometimes be prevented or at least delayed. Often the precursor to this condition can be seen 20 years before AMD begins to affect vision.  With appropriate nutritional therapy, research shows that we can reduce the likelihood of a person developing AMD by up to 30% or more.

I have diabetes, what should I do to protect my eyes?

Diabetes is the number one cause of vision loss in Americans under age 65, and number 2 across all ages groups.  While most people think of diabetes as a blood sugar disease, in the eye we are concerned about changes to blood vessels that can result in hemorrhaging (bleeding) inside the eye.  This results in damage to the retina (which can be thought of as similar to the film in a camera).  This damage can result in permanently blurred vision or even total blindness if left untreated.  Early diagnosis and treatment can help preserve good vision for life.  Annual eye exams with special photographs of the retina are imperative in preserving sight for people with diabetes.

I’m in my 40’s why can’t I see up close anymore?

We all lose the ability to focus up close.  This process begins in our twenties, and typically becomes a noticeable problem in our early to mid 40’s.  This loss of focusing, called presbyopia, diminishes our ability to see clearly up close through our distance prescription. Presbyopia is a natural process, it is also a progressive process, so we tend to have greater and greater difficulty with near tasks as we move through our 40’s and into our early 50’s.  By our early to mid-50’s, the progression stops, but we never regain our ability to focus up close.

This often means a transition to bifocal glasses (often called progressive lenses) or necessitates the need for reading glasses over our contact lenses.  The good news is that with the new digitally surfaced, HD style progressive lenses, it is easier than ever to make a successful transition to multifocal glasses.  At Spectrum Eyecare, we are even having good success with people who were previously unable to use this type of eyeglasses lens.

I wear contacts and replace them online, why should I bother with an annual exam?

Contact lenses (CL) are a prescription device that when cared for appropriately are very safe.

However, as we age our eyes change, often requiring a change in the type of contact lens worn, solutions used or the replacement schedule of the lenses.  That is why all contact lens prescriptions have an expiration date.  Since CL use increases the risk of dry eye, abnormal blood vessel growth and serious eye infections it is critical to have regular, annual checks of your eyes and contacts.  This is true regardless of your age.  However, our eyes become less resilient as we age requiring even greater care in monitoring the health of our eyes as we age.

At many leading practices, including Spectrum Eyecare, it is understood that you can get your contacts from many sources, so CL’s are priced very competitively with mail order and big box retailers.  The important thing is to have an annual exam and to replace your contacts as advised by your eye doctor.

Is it safe to sleep in my contacts?

Sleeping in contact lenses is the single greatest cause of complications among those who wear lenses.  Even in the safest materials, contact lens over-wear causes at least a tenfold increase in eye infection and other dangerous complications.  Teaching and reinforcing the dangers of contact lens over-wear is one of Dr. Henahan’s top priorities.

What type of contact lens is best for me?

For most, soft disposable lenses represent the best balance of comfort, easy care, clear vision and safety.  For some people, disposable lenses are not an option due to the nature of their prescription, but other lens options do exist which allow us to fit almost any child in contacts. Advances in bifocal contact lens technology have been slow, so most people struggle to succeed with this type of lens, despite what the TV commercials want you to believe.

What about LASIK?

LASIK eye surgery is an excellent option for many people with glasses or contacts who wish to eliminate their dependence on glasses or contacts.  However, one must be at least 18 years of age to undergo LASIK.  Furthermore, it is important that the prescription is not changing.

It is also important to understand that LASIK does nothing to prevent the loss of focusing capability that afflicts those of us in our 40’s.

NEXT MONTH:  Eye FAQ’s for Seniors

Dr. John Henahan is a fellowship trained 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 www.speceye.com.

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At what age should my child have their first eye exam?

Most organizations, like the American Optometric Association feel that a child should have a first exam before age 1.  The problem with this is that finding an eye doctor who has the special equipment and training to evaluate infants is difficult.  In our area, the waiting time for an appointment with a pediatric ophthalmologist is more than six weeks.

If you (or your pediatrician) suspect any vision problems, have a family history of congenital vision problems, then it is advisable to have an infant eye exam with a pediatric specialist.

For most other children, a first eye exam around age 5 is ideal.  The child is old enough to allow for a very thorough eye exam that with great accuracy can determine if glasses are needed.  If no problems are found, repeat exams are recommended approximately every three years.

What is lazy eye?

Amblyopia, also known as lazy eye, affects just two to three percent of the population. But, if left uncorrected, this vision problem can have a very big impact. Central vision fails to develop properly, usually in one eye, which is called amblyopic.  Untreated amblyopia may lead to functional blindness in the affected eye. Although the amblyopic eye has the capability to see, the brain “turns off” this eye because vision is very blurred, and the brain elects to see only with the stronger eye.  Proper intervention, which may include glasses and eye exercises (vision therapy), can drastically improve vision in the affected eye of these children, especially if diagnosed before age 6.

Why does my child struggle in school?

There are many reasons for poor school performance.  Developmental and learning disabilities, AD/HD, Asperger’s and autism are just a few possible causes.  Even if your child is diagnosed with one of these conditions, an eye exam to rule out vision problems is essential.  Remember, approximately 80% of what a child learns comes through their visual system.  A complete eye exam with dilated pupils is a key way to determine if your child’s visual system is doing it’s part.

My child is complaining of difficulty seeing the board in school, what does that mean?

Myopia (nearsightedness) is a vision problem that manifests as difficulty seeing far away.  This condition can come on at any age, but most commonly arises in late elementary school or early middle school.  Correction of myopia is straightforward with glasses or contact lenses.

At what age can my child wear contact lenses?

Depending upon your child’s prescription and level of maturity, a good rule of thumb is around age eleven.  Dr. Henahan has fit younger children in contact lenses, but it is important for parents to carefully monitor the younger child’s actions to insure safe practices with respect to contact lens care.

Advances in contact lens care and materials have made them dramatically safer than five or ten years ago if the child cares for their contacts properly.

Can my child sleep in their contacts?

Sleeping in contact lenses is the single greatest cause of complications among those who wear lenses.  Even in the safest materials, contact lens over wear causes at least a tenfold increase in eye infection and other dangerous complications.  Teaching and reinforcing the dangers of contact lens overwear is one of Dr. Henahan’s top priorities.

How important is it to replace my child’s contact lenses on schedule?

Apart from sleeping in lenses, failure to replace contacts on schedule is the second biggest cause of complications that arise from the use of contact lenses.  Contact lenses should be replaced as directed by your eye doctor, or monthly at a minimum (this does not apply to patients wearing rigid or hard contact lenses).

Additionally, your child should get a new case with their contact lenses with each new bottle of solution.  Additionally, replacing the solution that your contacts soak in should be done daily.  The contact lens solution is not effective in cleaning or disinfecting a contact lens after the first night.  Each morning when the contact lenses are put on, the case should have the solution rinsed out of it and allowed to air dry (with the top off) during the day. Fresh solution should be used when taking the lenses out in the evening.

What type of contact lens is best for my child?

For most children, soft disposable lenses represent the best balance of comfort, easy care, clear vision and safety.  For some children, disposable lenses are not an option due to the nature of their prescription, but other lens options do exist which allow us to fit almost any child in contacts.

What about LASIK?

LASIK eye surgery is an excellent option for many people with glasses or contacts who wish to eliminate their dependence on glasses or contacts.  However, one must be at least 18 years of age to undergo LASIK.  Furthermore, it is important that the prescription is not changing.  Typically, most children continue to see prescription changes until they are in their early to mid 20’s.  Dr. Henahan advises against LASIK until your child’s prescription has been stable for two years.

Dr. John Henahan is a fellowship trained 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 request an appointment here.