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Eye Health
Computer Vision Syndrome
Anybody who spends 2 or more hours a day using a computer may
potentially suffer from Computer Vision Syndrome (CVS). The symptoms
can be quite varied but generally include some or all of the following:
Headache – due to eye-strain
Aches & Pains – especially of the shoulders and neck due
to poor posture at the computer because the wearer is sitting
at an unnatural position/angle in order to obtain good vision
Dry Eyes – due to reduced blinking
Tired Eyes –due to strain focusing on the screen
Blurred Vision – due to decreased tears and focusing difficulties
Some or all of these symptoms should send you to your eye-doctor.
He/She will likely confirm the diagnosis with or without the aid of a
specialized computer vision screening test. They will then most likely
prescribe a pair of computer glasses. In the simplest cases, these may
comprise single-vision glasses with a low “plus” power addition that
provides slight magnification, a light tint (possibly rose or gray) to
make reading more relaxing on the eyes, and a UV coat to reduce harmful
radiation from the screen. These computer glasses may alleviate many of
the above symptoms. In addition, to alleviate your symptoms you should
always follow these basic steps:
Ensure you have adequate and appropriate lighting – eyestrain occurs when the light coming from outside or inside is excessively bright. You should reduce exterior light by drawing shades/blinds – this will make the monitor easier to read. Reduce interior light where possible also.
Adjust the screen brightness & contrast on your monitor – make sure the contrast is optimized for readability of text and the brightness is adjusted for maximum comfort
Minimize glare – keep obvious light sources away from areas where reflection will be a problem. Use an anti-glare filter on the screen, or consider an anti-reflective coating on your glasses
Finally, the problem of dry scratchy eyes will often require
treatment with eye drops, supplements, or in extreme cases treatment
with punctual occlusion (a procedure in which the tear-duct drainage
points in the eye are partially blocked to allow tears to remain for
longer periods in and around the eyes).
On February 4th, 2004, a Federal Law
called the “Fairness To Contact Lens Consumers” act went into effect.
This law made it much easier for you to
enjoy the savings and convenience of ordering contact lenses on-line.
What does the law say? The law requires your eye-doctor to release your
prescription. If you had your last
eye-examination after February 4, 2004, your doctor should have handed your
prescription to you on completion of the fitting, whether you asked for it
or not.
If an online company requests confirmation of your prescription from your doctor, he/she is
legally required to confirm the prescription within 8 business hours.
If your doctor fails to respond to our
request within 8 business hours, the law allows us to assume the prescription
is valid. Your doctor may NOT require
you to sign any form of release or waiver prior to confirming your
prescription. Online companies are allowed to contact
your doctor by phone, fax or email. Online companies generally use Fax and/or Phone to request confirmation of prescriptions.
Do I need to provide you with my doctor’s phone and fax
number? No. If you provide the online company with
your doctor’s name (or the store where he works), and the city where you had
the exam, they can generally find the phone and fax number.
How long is my prescription valid for? A minimum of 1 year, and 2 years in many
states. Your doctor may place a shorter
expiration time on your prescription, but only if there are documented
medical reasons for doing so. If your
prescription has an expiration date, you may want to ask your doctor to explain
the medical reasons he/she has placed such a restriction on your prescription.
My doctor is requiring me to return for a follow-up visit
before releasing the prescription, is this legal? Yes. The doctor may want to evaluate your eyes with the trial
(fitting) lenses in place prior to releasing the prescription. He/she may also require you to pay for the
fitting in full prior to releasing the prescription
My Doctor refuses to release my prescription unless I
sign something. Is this legal? No. Your doctor may not require you to sign any form of release or waiver
prior to confirming your prescription.
Toric (Astigmatism correcting) lenses will also contain two
additional numbers:
Cyl - Cylinder
Axis
Bifocal contact lenses generally contain one additional number which is the add power. A special field will be given for this number.
Notes
A contact lens prescription is not the same as an eyeglass
prescription. In addition to the lens power, your contact lens
prescription contains several other pieces of information related to
the size of the lens.
Your prescription will also contain an expiration date. This is
typically two years from the date that the contact lenses were
fitted.
BC values range from about 8.0 to 9.5. The doctor fits the lens
with the curvature most appropriate for your eye. Most lenses come
in several different BC values. If your prescription does not
contain a BC value, this is likely because your brand of lens only
comes in one base curve.
BC values are a bit like clothes sizes - just because you are a BC
8.6 in one brand doesn't mean you will be in another.
If you are in a toric lens your prescription will contain two
additional columns entitled cylinder and axis. These numbers related
to the correction of your astigmatism.
Even the power of the lenses is generally not the same as in your
eyeglass prescription. This is because:
The contact lens sits on the surface of your eye, while your
eyeglasses sit about 12 mm in front of your eye
Regular soft contacts do not correct for your astigmatism, but
your eye doctor will typically try to partially correct for it
by changing the power of the lens.
Silicone Hydrogel lenses are the latest development in soft contact lens
materials. They are healthier than conventional soft lenses because they
allow up to 6 times more oxygen to pass through them and increased oxygen
transmission results in better overall eye health. Advantages of silicone
hydrogel lenses over conventional soft lenses include: more resistance to
protein deposits, less drying of the lenses, lower risk of eye infection,
easier handling due to increased rigidity of material, and much lower
incidence of complications with extended wear use (overnight wear).
The convenience of 30 days continuous wear (PureVision and Focus Night & Day),
as well as the lowered incidence of eye health complications are quickly making
silicone hydrogels the most popular lens of choice for both eye care
practitioners as well as patients. Most eye doctors believe that within the
next 5 years, more patients will be wearing silicone hydrogel lenses than any
other lens material.
The current brands of spherical silicone hydrogel lenses available,
in order of highest oxygen transmissibility to lowest, are:
Vistakon’s Acuvue Oasys which is approved for 2 week daily wear use or 6 night extended wear and is designed to be more wettable than the others and is therefore beneficial for people who have dry eyes
Ciba’s O2 Optix which is approved for 6 days continuous wear or 2 weeks daily wear
Bausch & Lomb’s PureVision which is approved for 30 days continuous wear
Vistakon Acuvue Advance which is a 2 week disposable lens and has not yet been approved for extended wear.
There are also currently two toric (astigmatism correcting) silicone hydrogel lenses on the market:
Bausch & Lomb PureVision Toric is a silicone hydrogel toric lens approved for 30 days extended wear use
Studies have indicated that some lens care cleaning systems are
compatible with silicone hydrogels, while others may cause adverse reactions
due to toxicity. Aquify, Optifree Express, and ClearCare multipurpose
solutions have all been FDA approved to be used with silicone hydrogels.
AOSept has proven to be an acceptable hydrogen peroxide based system to
use with these lenses. In some studies, Renu Multiplus has been shown to
cause an adverse corneal reaction when used with some silicone hydrogel
lenses (source Contact Lens Spectrum, August 2005). Additionally,
UltraCare and SoloCare are not recommended for use with
silicone hydrogel lenses.
Most people would benefit from wearing silicone hydrogel lenses as
compared to conventional soft lenses due to the health advantages, however,
these lenses are especially useful in the following types of patients:
people with high prescriptions; those whose eyes show signs that they require
more oxygen; wearers who experience end of day discomfort, dryness, or
redness with their conventional soft lenses; people who wear their lenses
for more than 12 to 14 hours a day (including overnight wear); and kids
and teenagers who tend to routinely over wear their lenses. Additionally,
since the Focus Night & Day as well as the PureVision lenses are approved
for 30 days of continuous wear, they can be considered as a useful
alternative for people contemplating refractive surgery.
Silicone hydrogels may not be the lens of choice for all patients.
These lenses are generally more expensive than non-silicone lenses so a
more price conscious consumer may not prefer this option. Also, in some
wearers, the silicone material tends to attract more lipid deposits,
which may cause blurred vision and discomfort. There are some cases
where a patient is not able to adapt well to the more rigid silicone
material, which may result in some minor defects to the corneal integrity.
These complications are rare and generally the health advantages and
increased comfort that most wearers experience far outweigh the incidences
of adverse reactions in those who do not adapt well to the material.
(c) 2006 AC Lens, Reproduction Prohibited without Express
Permission
Focus Night & Day were the subject of a three year study by Ciba Vision.
The company reported that the performance of this silicone hydrogel (SiHy)
contact lens indicated that wearers enjoyed improved corneal health and
reduced frequency and symptoms of contact lens related eye health symptoms.
In particular, the study of 317 patients showed that Focus Night & Day
wearers had less problems with red eye, reduced dryness (22%) and
neo-vascularization (the development of new blood vessels in the cornea)
was reduced by 13%. During the first 8 months of 2005, Silicone Hydrogels
represented 24% of all soft contact lens sales – more than double the figure
for the same period of 2004. Ciba lenses represented almost 50% of silicone
hydrogel sales during this time.
Bausch & Lomb (manufacturer of Purevision, Purevision Toric and
Purevision Multifocal contact lenses) reported that 40% of new
contact lens fits are now silicone hydrogel contacts. They claim that
94% of wearers of their sector leading Soflens 66 Toric contacts can be
migrated to the Purevision Toric lens without a script change.
Vistakon, manufacturer of the Ultra-Comfort series of contact lenses
which comprises the Acuvue Advance, Acuvue Advance for Astigmatism and
the Acuvue Oasys says their silicone hydrogels are all addressing the
issue of end-of-day comfort for contact lens wearers. Prescription
parameter ranges are being expanded for each of these lenses (most
recently, plus powers for Oasys were made available). Acuvue Oasys
was also recently given FDA approval for up to 7 days of continuous
wear. Vistakon claims to have the number one silicone hydrogel with
their Acuvue Advance and the number one new-wearer toric in the Advance
for Astigmatism.
We have put together a list of the most common questions received by
doctors and staff.
Can I wear soft contact lenses if I have astigmatism?
Yes, you can wear a special type of soft contact lens called a toric
lens which will correct your astigmatism. However, these lenses are
typically more expensive and there are fewer types and colors available than
there are with regular (spherical) lenses. Recently, Wesley-Jessen
introduced a 2-week disposable toric lens, the Freshlook
Toric. Several manufacturers including Ciba (Focus) and Coopervision (Preference) produce 1-3
month frequent replacement toric lenses.
Is a contact lens prescription different than a glasses prescription?
Yes. When you order contact lenses, you must have a current contact
lens prescription which specifies the power of the lenses, the size of the
lens, the type and brand of lens.
If my 2 week disposable lenses are still comfortable and in good
condition beyond 2 weeks, can I continue to wear the same pair?
In order to maintain optimal eye health and comfort, it is important
to adhere to the wearing schedule prescribed by your doctor. The main
advantage of wearing disposable lenses is that you are putting a fresh new
pair of lenses in your eyes every 2 weeks. Also, the convenient cleaning
regimen of a disposable lens is only adequate for a 2 week wearing schedule.
If I only wear my 2 week disposable contacts part time, do I still have
to replace them every 2 weeks?
No, the 2 weeks refers to the actual amount of wearing time so they
can last longer than 2 weeks if you are not wearing them full time.
What's the difference between rigid gas permeable (RGP) lenses and soft
lenses?
RGPs are smaller and made out of a harder, less pliable material than soft
lenses which makes them less comfortable initially. RGPs correct astigmatism
whereas soft spherical lenses do not.
Can I swim with my contact lenses in?
It is best if you don't because there are bacteria in the water that can
adhere to your lenses and cause infections. If you do swim in your lenses,
you should wear goggles over them and you should disinfect them immediately
afterwards.
Why is it necessary for contact lens wearers to have regular eye exams
even if their prescription hasn't changed?
Regular eye exams are important not only to check your prescription but also
to evaluate the health of your eyes. This is especially important for
contact lens wearers because the contacts could be causing damage to your
eyes without necessarily causing any obvious symptoms.
I wear contact lenses and in order for me to read, I have to wear
reading glasses over them. Are there any other alternatives whereby I don't
have to wear glasses at all?
Yes, the most common option is called monovision where one eye is
corrected for viewing distant objects and the other eye is corrected for
reading and close work. Monovision is a good solution for some people, but
not everbody can successfully adapt to the arrangement. Another alternative
is bifocal contact lenses which are available in both rigid gas permeable or
soft lens designs. However, these are typically very expensive. Recently,
however, Johnson and Johnson released the Acuvue
Bifocal which is a two-week disposable lens and is more reasonably
priced.
Do colored contact lenses work on dark eyes?
Yes, they are called opaque contacts as opposed to enhancer
tints which work only on light colored eyes. Year-long (daily wear and
extended wear) opaque contacts are available in many different colors and
shades but there is currently only one brand that offers a 2 week disposable
opaque lens. These are Freshlook Opaques by Wesley-Jessen.
Do I still need a prescription if I just want contacts to change my eye
color?
Yes, you still need to be fitted for the lenses even if you don't
need vision correction. This is because contact lenses are medical devices
and wearing them can affect the health of your eyes.
How does the Federal Law "Fairness To Contact Lens Consumers" Act affect me?
On February 4th, 2004, a Federal Law
called the “Fairness To Contact Lens Consumers” act went into effect.
This law made it much easier for you to
enjoy the savings and convenience of ordering on-line.
Dry eye is a very common disorder of the tear film that is due to a
deficiency of tear volume or excessive tear evaporation. This condition
causes damage to the surface of the eye leading to discomfort and
irritation. Dry eyes can be associated with systemic diseases, chemicals,
drugs, inflammation, allergic reactions, and contact lens wear.
The symptoms of dry eye typically include burning, stinging, redness,
foreign body sensation, excess tearing, and intermittent blurred vision.
The estimated number of people affected ranges from 10 to 14 million in
the United States.
Contact lens intolerance is often a consequence of dry eye.
Studies show that up to 50% of soft contact lens wearers complain
of dryness. A person with mild dry eye may not experience symptoms
until they attempt to wear contacts. Contacts can disrupt the delicate
balance of tear film production and can bring about dry eye symptoms.
Some dry eye patients can only wear lenses comfortably for short periods
of time and others are unable to tolerate contacts at all. Dryness is
the primary reason why people permanently discontinue contact lens wear.
Some clinical studies have indicated that preservatives used in
multipurpose solutions can contribute to discomfort and dryness in
contact lens wearers. One study specifically evaluated dry eye contact
lens wearers who compared AOSept, which has no added
preservatives, to OptiFree, Renu, Solocare, and Complete. It was
found that the majority of the subjects experienced increased comfort and
reduced symptoms of dryness with the AOSept as compared to the
multipurpose solutions.
There are ways for contact lens wearers to
combat dry eyes and feel comfortable in their lenses for
longer periods of wearing time. Possible remedies of contact lens
related dryness include:
Contact lens rewetting drops: This is usually a temporary solution but does offer some relief.
Some examples are Refresh Contacts, Clerz Plus, or Clear Eyes Contact Lens Relief. For those with sensitive eyes, it is best to use a preservative-free
drop.
Re-soak lenses during the day: People who have dryness symptoms after a few hours of wearing
time often experience much relief by removing and soaking their lenses for a few minutes. Upon reinsertion, most are able to wear their lenses comfortably
for many more hours.
Take good care of lenses: Inserting fresh new lenses as often as prescribed, as well as cleaning
lenses properly, greatly contributes to contact lens comfort. Protein deposits and other types of buildup on the lens surface contribute to increased lens
dryness. Sometimes switching to a more disposable lens or switching to a different or stronger lens cleaning system also helps.
More complete and frequent blinking: Blinking completely and often is necessary to rewet the
lenses and maintain comfort. It is often the case that when a person is concentrating, they do not blink as often as they should. This is why computer
users often complain of lens dryness. It is important to consciously be aware of blinking frequently and completely under these circumstances.
Switching to a different lens material: There are lens brands designed specifically to provide
more comfort for those who have problems with dryness. Some examples are Proclear Compatibles
and Acuvue Oasys. The newer, more oxygen permeable silicone hydrogel materials such as Focus Night & Day, Ciba O2 Optix,
and Acuvue Advance have proven to be more comfortable for patients with moderate dry eye
issues.
Prescription eye drops: Restasis is an anti-inflammatory eye drop prescribed for moderate to
severe dry eyes and has proven to be very effective in cases where inflammation is the underlying cause of the dryness symptoms. Contact lenses should be
removed before using these drops.