Does blurry distance vision mean you are short sighted?

Behavioural Optometrist Sally Adams shares Vision Therapy case notes. 

Paul, aged 8 years, came to see me because he could not read what his teacher had written on the board, and he was having headaches. His eye examination showed he was not short sighted, even though his  vision was blurry to the extent he would have failed the driving vision test, and his 3D vision was reduced.

Paul’s focus was not flexing normally and his eye movements for reading were not smooth. So he was not focussed on where he was looking, making reading a struggle.

Vision therapy for Paul was two fold; he started using reading glasses to reduce focusing stress, combined with vision exercises to improve the flexibility and accuracy of his focusing and eye tracking system. Within only a few weeks Paul’s distance vision returned to better than 20/20, his 3D vision returned to normal, and his headaches had reduced.  The next step was to help him maintain this improvement so he would not suffer with the same problems again. He worked through 12 sessions of vision therapy with me for 30 minutes each week, while at home he completed 10 to 15 minutes of vision activities each day. With practice and commitment Paul’s vision system is automatically working efficiently which means he sees clearly and comfortably.

Names have been changed for privacy reasons.

How eye disorders may have influenced the work of famous painters

Visual art invites us to view the world seen through the eyes of the artist or creator. This concept is very familiar to us with modern art, there is a role for interpretation. However a few hundred
years ago, the artists of the day were typically creating more real life images of their subject matter.

There is a long history of scientists and clinicians arguing particular artists were affected by vision disorders, based on signs in their works. Included is the hypothesis that leaders of the Impressionist movement were short- sighted, for instance, and that their blurry distance vision may explain their broad, impetuous style.

The fact that Claude Monet had cataracts is well documented and seen in the changing colours of his paintings. In other cases supporting evidence of such disorders and their influence on artworks is often speculative, and hampered by a lack of clinical records to support the diagnosis. There is still fun in speculating, did El Greco suffer from astigmatism? Perhaps Australian painter Clifton Pugh had a colour vision deficit?

What is an OCT? How does it help in Macular Degeneration and Glaucoma?

OCT stands for scanning technology Optical Coherence Tomography. Scanning lets us ‘see’ tissue behind the visible retina inside the eye. In the past 5 years OCT has become invaluable in assessing eye health, particularly helpful for Macular Degeneration (MD) and Glaucoma.

When we see signs of MD during an eye examination, we take an OCT scan which reveals what is happening in the underlying retina. In particular we want to spot the ‘wet’ form of MD which can cause rapid, devastating vision changes. With a scan we can see if there is fluid in the macula and allows us to make referral for treatment.

The detailed measurements of the nerve fibre layer in the eye are particularly helpful when we are looking for Glaucoma. If there are signs in a regular examination, OCT gives us a way to closely monitor changes over time. These changes are seen before any vision loss.

But OCT is not a stand alone magic bullet. It’s a tool and interpreting the results needs careful consideration along with all other clinical findings. At the end of the day an OCT scanner is not an optometrist.

We are committed to using all our available diagnostic tools and we strongly believe the best place to start is regular eye examinations. The simple, vital step of spending time with you, to collect relevant history, through careful listening, guides us to the best combination of diagnostic testing.

Ortho-K lenses deliver clear result on the touch field

Rodney College student Georgia Brierly has just returned from a touch competition in Europe, where she represented the NZ Barbarians U18 Girls Sevens team against club sides from Sweden and the Netherlands.

Conveniently Georgia has been able to ditch her glasses thanks to her orthokeratology (Ortho-K) lenses that correct her eyesight as she sleeps. Advances in Ortho-K, mean Georgia no longer has to wear glasses or contact lenses during the day.

Ortho-K involves gently reshaping the cornea of the eye to temporarily modify or eliminate refractive error - including short sightedness or myopia.

While the process has been practised for almost 40 years, results were quite variable and unpredictable. However, in the last 10 years new technology has become available to accurately map the corneal shape and manufacture lenses that will achieve a controlled and precise correction in the eye. In addition, new developments in lens materials have been made that enable safe overnight wear to be possible.

Optometrists fitting Ortho-K soon realised that young people wearing these lenses to correct short- sightedness didn’t progress or get worse like those who wore regular glasses or soft contact lenses. Numerous studies confirmed that wearing Ortho-K lenses stopped or slowed kids from getting more short-sighted.

“Rates of short-sightedness have been increasing worldwide; in the US rates of myopia (short-sightedness) have increased from 25 per cent to 42 per cent in 30 years and by 2050 it is predicted that 50 per cent of the population will be short-sighted, doubling what the rate was in 2000,” Claire McDonald says.

“Our concerns are also the more short-sighted you become, there is more risk your eyes will develop cataracts, retinal detachments, macular degeneration and glaucoma. So Ortho-K offers both short term and long term benefits”.

Ortho-k is now a safe, viable and reversible alternative to refractive surgery. The cornea, while being mouldable, will return to its original shape if lens wear is stopped.

“You simply sleep in your lenses, then wake up and remove them, and enjoy clear vision all day.”

Georgia said she enjoys playing touch while being able to see clearly without having to think about using corrective contact lenses, and her mum, Rachel, tells us “Ortho-K has changed Georgia’s life”.

Meditation Linked to Helping Glaucoma Patients

We are always keen to hear ways our lifestyle can positively benefit our health, read on. A study by doctors at the All India Institute of Medical Sciences (AIIMS) has found that lowering eye pressure in people with glaucoma can be achieved by meditating.

Glaucoma, a disease which damages the optic nerve of the eye, is the leading cause of blindness in India, impacting over 12 million people.

“Lowering eye pressure is the only proven therapy for glaucoma and this is currently achieved with eye drops, laser therapy or surgery. Like all medications, eye drops have a cost and side effects, and many struggle with drops as a lifelong therapy,” said Dr. Tanuj Dada, Professor of Ophthalmology at the RP Centre, AIIMS.

90 glaucoma patients were selected and randomly divided into two groups. One group was required to perform meditation and breathing exercises, as instructed by a yoga instructor, for an hour each morning over 21 days as well as take their glaucoma medications. The second group only took glaucoma medications.

After three weeks the results showed significant reduced eye pressure (mean pressure falling from 19 mmHg to 13 mmHg) in the meditation group. Changes to stress hormones and improved wellbeing were also recorded for this group.

Positive changes were also seen in the expression of retinal ganglion cell and optic nerve genes, which could potentially protect the eye from future damage and blindness.

“We know that glaucoma patients have high levels of anxiety and stress as they suffer from a potentially blinding disorder. We also are aware of the fact that stress leads to elevation of blood pressure but seldom think about its impact on eye pressure,” said Dr. Raj Kumar Yadav, Professor in-charge of Integral Health Clinic, Department of Physiology at AIIMS.

“This is the first study in the world which offers robust scientific evidence for lowering eye pressure with meditation, by targeting the brain and improving both the eye condition as well as general health of the patients,” he said.

The meditation technique is simple and can be easily learnt by all glaucoma patients. It is important to remember that patients should not stop using their glaucoma medications, and regular eye checks should continue as usual.

The study was funded by the Ministry of AYUSH.

Don't flush your contact lenses down the sink! Contact lens plastics could be dangerous to aquatic life?

Researchers are advising us to stop flushing used contact lenses (CLs) down the sink. Instead put them out with other solid plastic rubbish.

In the US it is estimated that around 15-20% of the 45 million American contact lens (CL) wearers flush their lenses down the sink or toilet. The result - anywhere from 6 to 10 metric tons of plastic CLs end up in wastewater treatment plants.

CLs are unlike other plastic waste (often made with a combination of polymethylmethacrylate, silicones, and fluoropolymers), so the effect of wastewater treatment on CLs was unknown. This sparked Professor Rolf Halden and colleagues from Arizona State University to find out how CLs break down and whether they pose a threat to aquatic life.

They exposed polymers found in CLs to anaerobic and aerobic micro-organisms (which would be present at wastewater treatment plants).

They reported, “When the plastic loses its structural strength, it will break down physically, leading to smaller plastic particles which would ultimately lead to the formation of microplastics. Aquatic organisms can mistake microplastics for food and since plastics are indigestible, this dramatically affects the marine animals’ digestive system. These animals are part of a long food chain. Some eventually find their way to the human food supply, which could lead to unwanted human exposure to plastic contaminants and pollutants that stick to the surfaces of the plastics.”

The researchers have also called on CL companies to address the way their products are ultimately disposed.