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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).

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Contact Lens Prescriptions And The Law

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.



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  How to Read Your Contact Lens Prescription

Here is a typical contact lens prescription:

Eye Power
(sphere)
BC Dia Brand
OD (Right) -2.25 8.8 14.0 Acuvue
OS (Left) -3.00 8.8 14.0 Acuvue

Here are the definitions of the symbols used:

  • OD - Right Eye
  • OS - Left Eye
  • OU - Both Eyes
  • BC - Base Curve
  • Dia - Diameter

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

  1. 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. 
  2. Your prescription will also contain an expiration date. This is typically two years from the date that the contact lenses were fitted.
  3. 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.
  4. 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.
  5. 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.
  6. Even the power of the lenses is generally not the same as in your eyeglass prescription. This is because:
    1. The contact lens sits on the surface of your eye, while your eyeglasses sit about 12 mm in front of your eye
    2. 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.
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Silicone Hydrogel Contact Lenses

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:

  • Ciba Focus Night & Day which is approved for 30 day continuous wear
  • 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:

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.

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Contact Lens Frequently Asked Questions

We have put together a list of the most common questions received by doctors and staff.

  1. 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.

     

  2. 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.

     

  3. 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.

     

  4. 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.

     

  5. 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.

     

  6. 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.

     

  7. 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.

     

  8. 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.

     

  9. 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.

     

  10. 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.

     

  11. 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.

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Eye Health

Dry Eyes & Contact Lens Wear

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.

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Vision Care /The ACLens.com