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Archive for August, 2009

A new patient came into our practice the other day upset that his former optometrist would not allow him to re-order his contact lenses. His contact lens prescription had expired and he was due for his yearly eye examination and contact lens re-evaluation. Most contact lens prescriptions are valid for one year. He wanted to know why. I thought this was a great question and it deserves an equally great answer. After I explained a few of the reasons to him, I decided to write an article about it.

Your eye doctor wants to your eyes to be healthy and stay healthy and would be happy to answer all of your questions and concerns promptly. All you have to do is ask politely (and if you do not understand an answer, it’s ok to ask them to explain things again or in more detail). There are very good reasons behind re-assessing your contact lenses yearly. Here are a few:

1. CLARITY- Your prescription may have changed and you could improve your visual clarity by ensuring that you are using the most accurate prescription powers possible. Since we use our eyes every waking hour of every day, you are really short-changing yourself by not getting your eyes checked, even a small change in prescription can eliminate blur, squinting and eye strain. You are probably spending a significant amount of money on your contact lens supply, why not get the most ‘bang for your buck’ and make sure you are seeing as clear as possible.

2. FIT-Your cornea may have changed and the contacts may not fit as well as they used to. If the cornea changes its shape, even by fractions of a millimeter in its curvature, this could affect how well the contact lens fits your eye. If it is ill-fit, the size of the contact lens must be tweaked to make sure that it does not lead to discomfort, dryness, redness and/or poor corneal health. Many environmental factors can change your cornea in subtle ways, some examples are medications you may be taking, hormonal changes and systemic diseases.

3. COMFORT- Your comfort in contacts has declined. This can happen for many different reasons but you do not have to live with an uncomfortable lens. There are things that your eye doctor can suggest to improve your comfort including trying another lens material or a different lens completely. Ideally, in a perfect world, you would only think about your contact lenses when it’s time to put them in and take them out. Give your eye doctor the chance to help you feel great again in contact lenses and to ensure your continued comfort for another year to come!

4. MODE- Each year you have a chance to talk with your eye doctor and make sure you are on the most effective replacement schedule tailored to your needs. Not everyone should be wearing two-week replacement lens. There are many different modes of replacement with daily, two-week and monthly replacement schedules being the most popular. Make certain that you are using the mode which is customized to your needs, your eye doctor will ask you the right questions to determine what mode of replacement you should be using and can also tell you the reasons behind it.

5. STAY CURRENT- The contact lens industry is ever-changing, in most cases, for the better. Sitting in the examination chair is your opportunity to reap the benefits of contact lens design improvements being made and also hear the latest updates on contact lens materials and solutions. Your eye health and continued success in contact lenses depends on this, especially if you anticipate wearing contact lenses for years to come, perhaps even your whole life through.

Bonus Reason (and really the most important reason follows):

6. HEALTH, HEALTH, HEALTH- Your contact lenses can actually cause problems with your corneal and/or conjunctival health if you have been misusing or over-wearing the lenses in some way. These problems may not even cause pain or symptoms in the beginning but can cause serious trouble in the long run. Your eye doctor will check for signs of damage to your eyes being caused by contact lens misuse and abuse and will adjust your wearing time or lens regimen accordingly. The best thing you can do is come in for your yearly eye exams on time and answer all of your doctor’s questions truthfully. Remember, they want to help.

Aside from the contact lens re-evaluation and contact lens-related health check, you should be examined yearly to check for all other eye diseases and illnesses regardless. I often tell my patients, ‘close your eyes and now imagine your life without your vision.’ That short, 2 second exercise should ‘open your eyes’ to the fact that your vision is precious. The only way to help guarantee that you will always be blessed with good vision in your everyday life is to take good care of your eyes and vision and have the eyes checked and screened for eye conditions and illnesses which can lead to damage if left untreated over the years. See your eye doctor yearly, whether you wear contacts or not, and make sure your friends and family members do the same. Protect one of your body’s most important senses, your precious gift of sight.

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When most people think of going to their eye doctor, they think about changing their glasses prescription or ordering new contacts. If you think that is all an eye exam has to offer you, think again.

The eyes are a direct extension of the brain. They are a part of your nervous system. They are also one of the only organs of the body where a doctor can get a live look at your arteries and veins without making an incision or performing an invasive procedure. They can be a reflection of your overall health and a bulletin board displaying early warning signs of systemic diseases that you may not even know you have yet.

“Abnormalities of the blood vessels in the retina can be used to predict patients’ risk for diabetes, hypertension (or high blood pressure), stroke and heart disease (source).” Wong et el studied retinal photographs for subtle changes to the structure of small blood vessels inside the eyes. These subtle changes in structure included narrowing of the blood vessels, ballooning of the blood vessel walls, as well as tiny blood clots and hemorrhages. It is well known that it is medically necessary for diabetic patients to receive yearly dilated eye exams  (and sometimes even more often than that) to closely monitor for any damage that may be occurring to the delicate blood vessels inside the eyes. But they are not the only ones that need looking after.

There are so many systemic diseases that can affect the eye, it would take a lot of time to list them all.

Here are just a few (source):

  • (we already spoke of) Diabetes, High Blood Pressure, Stroke and Heart Disease
  • AIDS
  • Graves Disease
  • Lupus
  • Atherosclerosis
  • Multiple Sclerosis
  • Rheumatoid Arthritis
  • Sickle Cell Anemia
  • Myasthenia Gravis
  • Neurofibromatosis
  • Sjogren’s Syndrome
  • Cancer
  • Antiphospholipid Antibody Syndrome
  • Tuberculosis
  • Giant Cell Arteritis
  • Sarcoidosis
  • Syphilis
Dr. Murphy

Dr. Murphy

Retinal photography is not the only way for your eye doctor to screen for signs of these diseases. A comprehensive eye exam including dilation of the pupils is essential for your doctor to get a good look at the entire inside of each eye, 360 degrees around to carefully and thoroughly check the retina, nerves and extensive networks of blood vessels.

Eye exams by no means replace a physical or visits with your general practitioner, but they say the eyes are the “windows to the soul.” Why not take that proactive, preventative approach towards your health and add it to your arsenal when trying to protect your body from the often devastating effects of undiagnosed systemic diseases. It’s not just about saving your vision, it’s about saving your life.

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