Archive for the ‘General Topics’ Category

What to do when your eye doctor asks more than just "which is better, 1 or 2?"

If your optometrist asks you if you have recently had your cholesterol and lipid levels checked, they may not be just making conversation. Did you know that during an eye exam the eye doctor is looking for cholesterol?

(They might even be able to spot it in the waiting room. Yellowish, fatty deposits of cholesterol can appear on the skin of and around the eyelids. These deposits are called Xanthelasma and can be seen with the naked eye. If your eye doctor spots and identifies these plaques on the skin as Xanthelasma, it will be necessary to get your cholesterol checked. Now, let’s go into the exam room…)

With the biomicroscope, your doctor searches for cholesterol in your eyes in two more places, one of which is the cornea where cholesterol can deposit in an arc-like formation, circling the outer cornea resembling a white, gray or yellowish ring around the normally clear corneal tissue.  This ring is called Arcus Senilis in those over 60 years of age and is often considered a normal finding as the cornea is one of the places in the body where cholesterol can naturally accumulate over the course of one’s lifetime. Have you ever seen this in your grandparents’ eyes? It almost looks like a halo in front of their iris and I have had some patients with it tell me that their eye color ‘has gotten lighter’ which of course isn’t the case, it just may appear that way through the white veil of cholesterol.

If you are under 60 or even more strikingly under 40, and corneal arcus is noted by your doctor then they may ask about your lipid levels, the last time you had blood work done and also may note any family history of high cholesterol or other cardiovascular conditions.

Cholesterol is an essential component in cell structures and as you have probably heard sometimes cholesterol isn’t such a bad guy. If your optometrist sees cholesterol deposited on your cornea, further testing is needed to determine whether or not the cholesterol there is a sign of something you should be worried about. To learn more about lighter side of cholesterol and why we absolutely need it in our lives (and our cells), check out this awesomely cute article by Jeanne Garbarino and video by Perrin Ireland!

The second place cholesterol can show up is inside the eye in the arteries of the retina. A piece of cholesterol may even be seen stuck in one of the retinal arteries usually at a bifurcation or branching point of an artery. When this happens that once free-floating piece of cholesterol now momentarily lodged  in the retinal artery is referred to as a hollenhorst plaque. If your eye doctor sees this, they will quickly refer you to your general physician for additional evaluation and testing to determine from where this embolus originated. In other words, if there are small plaques of cholesterol lodged in small arteries of the body there may be larger plaques in larger arteries of the body. These larger plaques put you at risk for heart attacks and strokes. Since the presence of hollenhorst plaques is a sign of severe atherosclerosis,  if cholesterol is seen in the retinal arteries inside the eye, your doctor will take it very seriously. And so should you.

The eyes can tell you a lot about your health so the next time your eye doctor asks you about your medical history or your family medical history, be honest, be open and tell them all about it. It may turn into one of the most important conversations of your life, one that can save it.

Keep the Conversation with your Eye Doctor going. There is a reason why they are asking each question.

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"Wish you Were Here!" Oh, wait, you can be!


Just dropping you a virtual postcard to let you know my whereabouts and why I have not posted on here in a while! If you aren’t following me yet on Facebook and Twitter please do! It makes it super easy for us to stay in touch and I always link to all of my articles on there.

Lately I have felt like a bit of a vagabond! A world (wide web) traveler! I have had the honor of contributing to the guest blog at Scientific American and also Scientopia. It has been quite a thrill for me! I have actually been over at Scientopia all last week and will be there this week too so feel free to head over there and check me out and some of the other great science blogs on there too! I have another Scientific American guest blog post also in the works so look for me there and be sure to check out their incredible network of bloggers on everything from Anthropology to Cocktail Party Physics, they are really an awesome group of people and you will learn a ton, keeping up with the latest and greatest news in the science realm along the way!

Keep in touch and feel free to contact me with topic requests!

Cheryl G. Murphy, O.D.

PS- Here are the links to my previous three posts at Scientific American!

Lost in the Details or just paying attention? 

Pssst!! Gossip and the Link to your Vision. 

Will Carrots help you see better, No. But Chocolate Might. 

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Sports Vision entails more than just 'clear vision.'

“You miss 100% of the shots you never take.” Sure, but you also miss 100% of the shots you don’t see.

I don’t think anyone would question the importance of comfortable, clear vision while playing sports. And we have all heard having proper hand-eye coordination is important too but Sports Vision is much more than that. Visual awareness, visual experience and good binocularity are key cornerstones needed when trying to achieve your peak performance level. You could spend hours at the gym training, building body muscle and working on your swing but if you possess poor visual sensory skills then you are at a tremendous disadvantage. So, whether you are an athlete or if you just play sports for fun on the weekends, there are steps you can take to ensure your vision is up to par and will help, not hurt, your game.

Steps to maximizing your vision and game play:

  • Use vision correction: See perfect 20/20 near and far, with both eyes and with each eye individually (if one eye is not seeing as clear as the other eye your 3D vision or depth perception might suffer). Correct for any refractive error you might have through the use of prescription eyeglasses, rec specs, contacts, or LASIK. Your eye doctor will help you to determine which mode of vision correction will best match your needs and environment. Have your optometrist also test your binocularity, eye teaming, focusing and aiming skills and follow any recommendations they might give. Sometimes further testing may be required to ensure your visual system is working as efficiently and effortlessly as it should be. If there is a problem found with your binocularity, your doctor may suggest vision therapy as a treatment.
  • Guard your eyes: Use impact-resistant eye protection. There are around 40,000 sports related eye injuries each year in the US, 90% of which are considered preventable. “Basketball and baseball cause the most eye injuries, followed by water sports and racquet sports.” (source 1Prevent sports-related injuries to the eyes, particularly in high-risk sports, by wearing the right eye protection. Sports goggles such as Rec-Specs, when made with polycarbonate lenses (the most shatter-resistant lens material available), are among the most popular modes of protection.
  • Sports Vision Therapy: Seek a sports vision therapist evaluation or sensory testing. Areas tested will be skills such as eye tracking, visual concentration, eye-hand-body concentration and control, visual memory, visual reaction time, peripheral vision, depth perception, dynamic visual acuity and visualization. The American Optometric Association provides a simple and easy explanation for each of this areas here. Optometrists specializing in sports vision can make a customized treatment plan for you to help you excel in the visual and sensory areas you test weak in. There are also coaches who have used principles of sensory testing to host their own programs and clinics like Chris McKnight’s baseball vision program and Nike’s SPARQ program (Speed, Power, Agility, Reaction, Quickness).
  • Minimize Glare: Fighting the effects of glare is a hot topic lately in outdoor sports, even the NY Times recently reported on how baseball players with lighter eyes have a heightened sensitivity to glare.
  • Protect eyes from UV: If you play outdoors, protect your eyes from the sun’s harmful UVA/UVB rays  with the proper, high quality sunglasses recommended by your eye doctor, ‘wraparound’ frames are a popular choice since they block light coming in not only from the front but from the sides as well. Some contact lenses even come with UV protection built right in. Damage to the eyes from UV light exposure over time has been known to accelerate the development of cataracts and macular degeneration.
  • Protect eyes from eye diseases: Checking the health of your eyes is crucial. Close your eyes for a moment, would you be able to play your favorite sport without your vision? Do not let preventable eye diseases rob you of your sight, take a proactive approach in keeping your eyes healthy by having them checked by an eye doctor once a year.

All of these tips are important but Sports Vision Therapy and sensory training can take your game to the next level. Chris McKnight, associate scout for the Philadelphia Phillies and creator of the baseball vision program shares with us one of his sensory exercises used to help sharpen players’ visual sensory skills.

Super Vision Ring

“The Super vision ring is a training tool that is a circular plastic tube with 4 colored wiffle balls. Two partners face each other, one holds the Vision Ring while the partner ready to receive stands about 7 feet away. The partner holding the Vision ring will show the receiver one colored ball (out of four) and tell him/her the color (this provides audio and visual stimulation). As the partner holding the ring prepares to toss the ring, the receiver will begin to focus on the movement and the release point of the ring. The ring should make three rotations in the air, while the receiver tracks the color of the ball the tosser called out. We want the receiver to try to catch the ball, with the specific color that the tosser called out, and with their two hands out in front of the body. As the ball approaches, the receiver is using our EBH method- (otherwise know Eye Brain Hand)- as the Eye sends a signal to the brain, the Brain then sends a signal to the hands and the Hands perform the function, in this case catching the ball. 
This drill is used for speed of recognition, tracking, depth perception and eye hand coordination.”
-Chris McKnight
As you can see, if we take the seemingly simple action of catching a fly ball and break it down into steps, there are many mechanisms of that action that the eyes, brain and body have to perform and coordinate. For instance:
  • Visual Acuity: locate what player has the ball and see it clearly
  • Visual Concentration: concentrate on the ball and block out visual distractions (the crowd in the stadium for example)
  • Visual Reaction Time: read the player’s body language to know when he will hit the ball with the bat (the trigger to a cascade of events leading up to your visual reaction time)
  • Eye Tracking: follow the ball with your eyes as it flies through the sky
  • Depth Perception: use your 3D vision to see it getting closer to you
  • Dynamic Visual Acuity: focus it clear the entire time as it moves
  • Visual Memory: running up and navigating your way through the field to the ball to catch it
  • Peripheral Vision: making sure you will not collide with your teammates
  • Visualization: imagining yourself, in your mind’s eye, catching the ball
  • Eye-Hand-Body coordination (and end stage of visual reaction time): catching the ball
It would be impossible to remember or consciously perform each of these steps individually every time we catch a fly ball, so we can train our brain to remember this pathway for us. By exercising each of these sensory skills individually, we can optimize their wiring in the brain and then put it all together to enhance our performance when playing without even thinking about it.

If you have ever played golf, you have already probably practiced this method of breaking down an action into individual steps and then trying to perfect those steps when you work on your golf swing. In order to have a great swing at the ball, you must have “proper alignment, ball position, feet and hand position, posture, balance and more.” (source 2)

If you haven’t thought about other sports in that way, maybe now is the time. By enhancing each visual sensory step, your athletic performance as a whole can soar to new heights that you may have not even thought possible in the past. Seeing your eye doctor is the first step. Now let’s play ball!

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Correcting for an astigmatism puts it all in fine focus!

Most people understand that nearsightedness means things near to you are clear, things far away from you are  blurry. And on the flip side, farsightedness means that things far away from you are clear while things closest to you are blurry. Got that? If not, let’s simplify it.

Nearsight= near objects clearest, far away ones are blurry

Farsight= far away objects clearest, near objects blurry

Now if I really want to confuse you, I’ll talk about Presbyopia which is what happens to all of us around age 40. That is when our eyes lose their ability to “auto-focus” things near to us to make them clear. You see, there is a crystalline lens behind your iris that changes its shape to autofocus things for near or far, much like the autofocus lens of a camera. As we get older, the lens can’t as easily change its shape anymore and things up close start to feel fuzzy, we can’t get them into focus (like the newspaper, small print on a pill bottle, a menu in a dimly lit restaurant.) It is then that we require a reading prescription to be able to get those objects close to us clear once again.

Presbyopia= the need for a reading prescription after age 40 due to the crystalline lens inside the eye losing its ability to autofocus.

Sometimes people who are nearsighted don’t feel the burden of presbyopia so much at first because they see ‘near objects clearest’ naturally. All they have to do is take off their glasses or peek beneath the frame and the natural focal point of their eyes happens to be at the perfect distance for reading. They can see clear and read very comfortably like this for long periods of time without glasses. It’s ok to use your natural nearsight to read, it won’t harm your eyes, but it may become cumbersome to put the glasses on and off all day long and there may come a point where doing this just doesn’t work for you as well as it did in the beginning. But maybe we can get into that in another article.

What I really wanted to talk to you about today is astigmatisms. An astigmatism has to do with the curvature of the front of the eye, the cornea. If the cornea is not shaped like a perfect sphere, if it is, let’s say, a little more pointed than it is round like the tip of a football, then your view through that imperfectly shaped cornea is distorted and vision will be blurry at ALL distances, (near, far, intermediate and everything in between). The cornea is a clear tissue, you can think of it as the ‘windshield of the eye.’ Notice how your windshield has a certain even curve to it? Now imagine the windshield was distorted, maybe even coming to a point in the middle, it would distort your view through it and everything you saw through it would appear a bit warped and a little blurry. That is what an astigmatism is!

Having an astigmatism is sort of like having a warped windshield, your view through it is distorted at all distances.

Astigmatism= blur at all distances due to imperfectly shaped cornea

You can have an astigmatism by itself in your prescription or it can be accompanied by nearsight or farsight and/or presbyopia. Your eye doctor can tell you precisely which type/types of these ‘refractive errors’ you have during your eye exam. Some people don’t have any refractive error, their eyes see perfect 20/20 vision naturally, we call them ’emmetropes.’

Emmetrope= no refractive error (no astigmatism, nearsight, farsight present), no glasses needed

But back to astigmatisms and our example of the car windshield. This type of visual distortion causes blur. We correct for this distortion or blur in your new glasses and that requires us putting a corrective lens in your glasses that counterbalances the distortion caused by your own cornea. This can sometimes take some getting used to because essentially what the new glasses are doing is taking the picture of the world that you usually see and stretching it in a different way. Glasses that correct for an astigmatism can sometimes feel a little strange when you first try them on, the floor may look curved, the walls may look bowed, you may feel like you are walking around in a fish bowl for the first few days until your eyes and your brain get used to the new way the world is being stretched. Most people adapt to most changes in astigmatism in their glasses within about a week and then they benefit from the extra clarity without experiencing that funny feeling anymore.

It is also possible to correct for an astigmatism with contact lenses, these special contact lenses are often referred to as toric contact lenses. They are a little more complicated to fit than regular spherical contact lenses (the kind that correct for nearsight or farsight) because they have to be lined up at a precise angle and maintain that precise alignment even when you blink or move your eyes a lot in order for you to see clear at all times. It’s common for them to move a little, or come out of a focus maybe a couple of times throughout the day but the majority of the time we want the lenses stable with no rotation and that will ensure the best clarity.

So, see? There is no stigma involved with having an astigmatism (sorry, I had to). Many people have an astigmatism, it is very common for the front of the eye not to be shaped like a mathematically perfect circle. See your eye doctor for an eye exam and get an up-to-date prescription. If you are prescribed glasses that correct for an astigmatism or if you have a change in your astigmatism prescription, the new glasses may take a little getting used to but once you do, you just might be amazed to see what you have been missing!

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It's all Thanks to YOU!

It happened! I have hit 10,000 views on my eye blog! I feel like setting off fireworks! I feel like celebrating! I also feel like thanking all of those you have read it, inspired me, helped me with ideas, editing, pictures, encouraged me and referred others here! I will continue to write, and am as always, accepting ideas and suggestions from friends of the eye blog and readers. I don’t know where this journey of science writing will take me but just knowing that I have helped people get some information and answers that they couldn’t find elsewhere gives me the excitement to keep going and keep writing. It is something I love to do! Thank you so very much!


Cheryl G. Murphy, OD

Go ahead, LIKE me on Facebook so you’ll hear about new blog posts first or have a little birdie tell you when my newest articles are posted on Twitter.

Great quote: "A journey of a thousand miles begins with a single step."

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A memo from the desk of Cheryl G. Murphy, O.D.

Something came to my attention the other day and what better way to talk about it than here on my blog. I use this blog as a sounding board for patient education and proper patient care.

As a patient, you should know, it is okay to ask your doctor questions. Here are a couple of tips on how to do so:

It helps to keep these questions, clear and concise. Do your research beforehand and write down a short list of things you’d like to know. Your doctor should be able to take the time to answer them for you if you keep things straight-forward and short. If they appear busy or if there are twenty other patients waiting to see them after you and they can not take the extra time to address your concerns right then and there, then ask if there would be a better way or time to do so. Some doctors may make phone calls at the end of the day or when things are a bit less hectic to make sure their patients’ questions are answered. They may even be willing to contact you via professional email if this is a method of communication that you are both comfortable using.

Perhaps they would like to schedule another office visit with you to discuss things further, gather more information, and do more testing if needed. It is important to realize that an extra office visit may incur more fees that go beyond your initial visit so find this out ahead of time and be aware that your insurance company or you may be billed for a second visit.

Gather resources from your doctor. Your doctor may know of very good resources where you can get the information you need online, over the phone or through the mail. There are many organizations and foundations that provide educational material about different conditions, illnesses and diseases. You could use these well-trusted resources recommended to you by your doctor as a way to build a better understanding of the topic that concerns you.

Also, remember that not one doctor on the planet knows every answer to every question, it is impossible. Accept that sometimes there may not be such a clear-cut answer to your inquiry, sometimes more scientific research has to be done on a subject to find out the ‘whats’ and ‘whys.’ There is a lot about medicine and health science that we have yet to discover. The answer to certain questions may not exist yet but your doctor will give you the best explanation they can of what we know now and will keep you up to date of all of the latest discoveries and developments. You can help to ensure you have the latest information and treatment options by adhering to the recommended return schedule for examinations set for you by your doctor.

Nowadays it is getting more common for doctors to have, not only a website but also professional accounts under various social media outlets such as Twitter, Facebook and Foursquare through which they can relay the latest health news and information to a broad range of their patients. Just look at how Twitter helped doctors SAVE THE LIVES of their patients after the earthquake in Japan! 

Remember, most doctors enjoy helping patients and gain satisfaction in knowing that their needs and concerns are met. You should never feel like you can not ask your doctor a question.

Lastly, if your doctor blatantly refuses to answer any questions from you or refer you to well-trusted sources where you could get the answers you need, then the only question you should really be asking is: Am I with the right Doctor?

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Find it a little harder for you to drive at night? It may be time for an eye exam.

CLEAR AND WELL-FUNCTIONING VISION- Improve your everyday life by ensuring that you are seeing 20/20. Good clarity and visual function can enhance your work/school performance and increase your safety as you navigate around your world. Not to mention allowing you to enjoy your environment without strain or squinting! If you paid $10 for the movie ticket, shouldn’t you be able to see it without squinting? Wouldn’t you like to be able to use the computer without that headache at the end of the day? Wouldn’t it be nice to see every leaf on every tree? Read the fine print on a medication bottle? Feel confident driving at night? Know why it’s hard for you to play those 3D video games or see the hidden picture in those magic eye posters? Your eye doctor can help with many of these issues to enhance your everyday life and make it less visually stressful!


EYE HEALTH and OVERALL HEALTH- Do you have allergies? Systemic allergy medications not relieving your itchy, watery red eyes? Do your eyes feel dry? Are you constantly using eye drops to re-wet them? Do your contact lenses bother you every single day? Tell your eye doctor, we will evaluate your eyes and can prescribe ways to help you get relief!

Also, did you know that many eye diseases are symptomless and since they do not cause you any pain you may not even realize they are there until they start to affect your vision? Your eye doctor checks for early signs of these conditions and can help initiate treatment and closely monitor you to make sure these eye conditions do not rob you of your precious sight!

Early warning signs of systemic conditions that can affect your overall health such as diabetes, uncontrolled high blood pressure, and high cholesterol, just to name a few, are searched for during your eye exam as well. Eye exams do not replace a regular physical and check up with your general physician but during your exam, your eye doctor may pick up on signs of these conditions that you otherwise may not have even known you had or that you thought were being managed properly. So getting an eye exam is a benefit to your eye health and can also be a great benefit to your general health!


Function and Fashion, new glasses can show you are well put-together!

AN UPDATED LOOK. A LOOK OF CONFIDENCE- You wouldn’t go to a job interview with a wrinkled suit, so why go with outdated eyeglasses? Get an accurate prescription and the latest style to boost your confidence and show others you are well put-together. Glasses may be something you will use everyday, it is a good idea to invest in a nice high quality pair that you will enjoy using and be proud to wear! Just like a good watch, it is an accessory you (and others) will be seeing a lot of, make it reflection of your own personal style. It is also a good idea to get a high quality pair of prescription sunglasses (again, for function-protecting your eye health from the damaging UVA/UVB light rays from the sun, and for fashion).

The time to look and feel your best is now! Call for an appointment for an eye exam today!

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