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With Kids’ Screen Time at an All-time High, Parents Need to Have an Eye Out for Myopia

boy doing his homework

The pandemic has changed the way we look at working and learning by forcing us to do more of both from home. However, our increased reliance on screens and digital devices for remote work and virtual school might also be altering our actual vision and worsening a worldwide trend that was already reaching its own epidemic proportions.

Over the past 50 years, the number of Americans who are nearsighted has almost doubled to 41.6 percent. The trend is particularly acute among our youth. According to a 2018 study of Southern California children, nearly 60 percent of kids aged 17 to 19 were myopic, along with half of 11- to 13-year-olds. And that was before COVID-19. Doctors were already attributing the rise in nearsightedness to decreased time outdoors and more hours spent inside glued to personal electronic devices. Now, after more than a year of pandemic lockdowns, during which kids have been forced to also get their education through a screen, U.S. children might be facing an unprecedented challenge when it comes to myopia.

In fact, according to a recent study in JAMA Ophthamology, “the prevalence of near-sightedness, or myopia, increased 1.4 to 3 times in children aged 6 to 8 years during COVID-19 quarantine.”

“Kids’ eyes have to work harder doing school on a computer,” says Randall Fuerst, O.D., F.A.A.O., optometrist at EYEcenter Optometric, which serves the Sacramento Valley and Sierra Nevada foothills. “Some kids might rub their eyes and make a connection to the problem being with their vision. But a lot of times, the eyes just simply don’t want to work—they’re tired,” he says.

“If nothing else, it’s the overall intensity and the fatigue that’s being put on the eyes, which are staring at the screen for six or eight hours a day,” says John Coen, O.D.

1kcraThe worry is more than just an oncoming generation of adults forced to wear eyeglasses and contact lenses. With myopia, the eyeball stretches and changes shape. People who experience severe myopia, also known as high myopia, face an increased risk of long-term eye problems, such as cataracts, retinal detachment, and glaucoma.

The earlier myopia sets in, the sooner in life those issues are likely to occur and the worse they are likely to get. Also, adults who have trouble with their vision are generally less productive and may lead less fulfilling lives. That’s why, doctors say, it’s imperative for parents to test and monitor a child’s eyesight early on.

“A spectrum of eye diseases can affect children in various age groups,” says Priscilla Chang, O.D., of EYEcenter Optometric. “The recommended timeline for pediatric eye exams starts at newborn. The goal of an eye exam is to identify and prevent vision impairment at the earliest age possible. And vision screenings at the primary care clinic and at school do not replace a comprehensive eye exam.”

In addition to scheduling regular eye exams for children, parents should also remain vigilant about their kids’ eyesight. This can be difficult because youths aren’t always aware that they’re having difficulties—they don’t know how they are normally supposed to see. With distanced learning, it’s even harder to pick up on drastic changes in vision because, while some children have no problem seeing and reading the computer right in front of them, they might not be able to make out letters, shapes, and words that are further away, an issue that would normally be more apparent in a traditional classroom setting.

kcra1“If a child has one dominant eye and one lazy eye, they may not know this is abnormal,” says Hannah Mikes, O.D. of EYEcenter Optometric. “If a child develops myopia, they can see up close. Much of the time, they can complete schoolwork. They might even find it normal to need to squint to see far away.”

Modern optometrists can do much more than diagnose myopia and prescribe corrective lenses. There are many new technologies doctors can use in the battle against nearsightedness. These include:

  • Eyedrops that curtail the progression of myopia
  • MiSight contact lenses that dramatically slow the progression of nearsightedness
  • Contact lenses that actually flatten the cornea through nightly wear

There are also things parents can do at home to stem the onset of myopia. For instance, they can implement the 20-20-20 rule: Take a 20-second break from computer work every 20 minutes and look at something at least 20 feet away. It’s also important for parents to talk to their children about the amount of time they spend on devices.

“There’s really no set standard of how long the child should be on the computer each day, but it should be limited,” says Linda Rappa, O.D., of EYEcenter Optometric. “For kids, electronics are fun. They watch YouTube, they’re on TikTok, and they play games. For them, it’s entertainment, so they won’t want to stop. Parents should do their best to regulate the amount of time their children spend on these electronics.”

Dr. Rappa also points out that the blue light emitted from phones, tablets, and other devices also inhibits the production of melatonin, which regulates sleep patterns. Therefore, it’s important to discontinue the use of those devices at least an hour before bedtime in order to get a good night’s sleep.

But even with the most diligent parenting, it’s still vital that these children see an optometrist early and often to ensure a lifetime of healthy sight. Children with nearsightedness should be undergoing some sort of treatment until age 25. This will affect them in more ways than just assuring them of a lifetime of improved vision. Nearsightedness can adversely impact a child’s ability to learn, their self-confidence, and their self-esteem. Better eyesight will improve safety and performance during physical activity and sports. And the ability to see clearly, without the long-term complications of myopia will also provide for an overall better quality of life.

“If we can see them early in life, that’s when we can give them something that will really help,” says Dr. Fuerst. “If we can find the issues sooner, if we can catch these deficiencies early, these kids will have the opportunity to do so much better in life.”

Originally published at https://www.htvnativeadsolutions.com/kcra/with-kids-screen-time-at-an-all-time-high-parents-need-to-have-an-eye-out-for-myopia-2/

Digital Devices and Vision Changes

We know schedules can get busy, and seeing your optometrist might not rise to the top of your to-do list. However now in these unprecedented times, keeping tabs on our eyes is more important than ever.

shutterstock 1692056767Besides the typical vision changes that occur as we age, with the lockdown, homeschooling, and working from home, we are all staring at screens, tablets, and mobile phones even more than we already did before the pandemic. Many people also spent endless amounts of time at home, and rarely went outside. Our eyes have been constantly focused on objects in close range indoors, and we’re lacking the benefits of looking into the distance. These factors pose issues for how your eyes and vision function. This threat to vision is especially frightening for children since many lifelong vision issues are determined at an early age.

Early detection is key to managing vision issues and slowing their progression. We want to partner with you for healthy eyes and vision for life. Especially after this year like no other! Click here or give us a call to schedule your exam today. shutterstock 575418841

More information on pandemic vision changes from the American Academy of Ophthalmology: https://www.aoa.org/news/clinical-eye-care/diseases-and-conditions/new-myopia-management-guidance-released?sso=y

Dr. Randall Fuerst, O.D., F.A.A.O. on how digital device use is changing our eyes: https://www.eyecenteroptometric.com/2020/11/24/the-nearsighted-epidemic-how-digital-device-addiction-is-changing-our-world/

Other health benefits of an annual eye exam: https://www.eyecenteroptometric.com/2019/01/30/5-health-issues-you-might-be-missing-if-you-skip-your-annual-eye-exam/

5 Back-to-school rules to help protect your kids’ eyes (Distance Learning Edition)

Many kids are re-entering the classroom with nearly a year of distance learning under their belts. Going from all that screen time into an in-person learning environment might uncover some new visual challenges. Most kids simply don’t realize if their sight is off. So we’ve got a list of need-to-knows for parents aiming to keep their kids’ vision focused and healthy during this “back to school” season.

Kids Eye Exams Are Important Year Round

A whopping 80% of a child’s learning comes through the eyes, yet 1 in 4 school-age children have a vision problem. But often kids don’t even know something is wrong. It’s up to us parents to spot the signs of compromised eyesight and to take precautions against it.

  1. Your student’s digital “classroom” might have changed their vision. Because a computer forces the user to focus and strain more than many other tasks, heavy computer use among kids can lead to early myopia (also known as nearsightedness). According to the American Academy of Ophthalmology, kids who develop myopia early in life have a greater chance of developing vision issues like glaucoma, cataracts, and retinal detachment. Now is the time to have their eyes checked to see what changes might have occurred during distance learning, and address them early.
  2. Screenings aren’t everything. In-school screenings may detect basic problems, but don’t assume total vision health in your student when one of these goes well. In fact, school vision screenings can miss up to 50% of visual issues. A comprehensive eye exam tests your child’s complete visual system and can help gauge how the eyes work together and other functions. Again, now is the time. Early detection is key!
  3. Vision issues can manifest as behavior problems. Because grades may suffer and behavior changes with degrading vision, children who have trouble seeing are often misdiagnosed with behavioral problems like ADHD. If your child has trouble keeping their focus or concentration, it might be time for an eye exam.
  4. Difficulty or disliking reading is the most common issue we see in kids–and it’s often not related to their intelligence level. If your child doesn’t like to read, it may be because they lose their place easily, or the letters are flipped or too fuzzy to detect. This can lead to headaches, fatigue and lightheadedness. Kids naturally want to avoid these and will therefore avoid reading.
  5. Watch out for body or head contortions. Head tilting may look inquisitive and cute, but when it’s a habit while reading, it could signal a potential vision issue in your child. The same goes for kids who rub their eyes a lot, crane their neck closer or farther away from a page, or cover one eye while reading.

Watch to learn more about how distance learning might have affected your students’ vision

All these issues can be identified and addressed with a comprehensive vision exam. If you want your kids to have a comfortable and successful transition return to the classroom, schedule a visit to EYEcenter as part of your back-to-school checklist.

An Eye Opening Lift from a Daily Drop

Randall Fuerst, O.D., F.A.A.O.

Randall Fuerst, O.D., F.A.A.O.

Earlier this month, I had a patient complain about her eyes looking tired. “When I look in the mirror, it really looks like I’m tired—and I’m not!”, she insisted. “I have co-workers asking me if I am tired. It drives me crazy!”

In these days of COVID and social distancing, your body language is reduced to the expressiveness of your eyes.

A wry smile? Gone behind the mask.

Wide grin? Not discernable.

Just your eyes to give meaning to your tone of voice, verbiage, and volume. So we study each other’s eyes—especially if their words are slightly muffled by the mask.

Looking (and feeling tired) is, unfortunately, part of the assault on our skin tone as we age. This is oftentimes caused by mild drooping of the upper eyelids. The elastic, wafer-thin skin around the eyes starts to, in essence, stretch out. The adhesion to the cartilage plate can loosen. The result is that the three muscles tasked with keeping your eyes wide open find it much more difficult.

The medical term for this is called ptosis. According to recent research, approximately 11.5% of adults past 50 years of age have acquired ptosis. Up until now, this has only been able to be corrected surgically. Unless the lid drooping is so bad that your peripheral vision is impacted, insurance companies are loathe to pay for ptosis surgery, considering this cosmetic and only for vanity improvement. Upneeq is a newly FDA-approved eyedrop that stimulates one of the eyelid muscles (Mueller’s muscle) to further open. The results are pretty remarkable.

“So what do you think?“ I asked. I had placed a drop of Upneeq in her two eyes five minutes earlier.

“This is amazing,” she gushed. “They’re noticeably better!”

The drops can be used daily, and the effect lasts all day.

So, if you have some concern regarding your eyelids drooping enough to where it is bothersome to you, and you are not ready for surgery, you may be a great candidate for Upneeq.

Please don’t hesitate to ask your doctor to try Upneeq. If it is right for you, the cost is about $75 for a months’ supply (when bought in a three-month kit). If you don’t choose to use it daily, this results in a per use cost of slightly more than $2.00.

If droopy eyelids make you feel tired, please ask our EYEcenter Optometric about Upneeq!

Read more about Upneeq in this month’s Elle Magazine: https://www.elle.com/beauty/health-fitness/a35607625/ptosis-for-awake-eye/

A Letter to Parents: What to Expect at your Child’s Eye Exam

If you’ve never had your child’s eyes examined or it’s been a while, EYEcenter’s own Dr. Meagan Herring wrote a letter to let you know what you can expect at your child’s next (or first) eye exam…

Dear Parent,

I know you are curious about your child’s first eye exam. Here is what will take place:

I will introduce myself as Dr. Herring, then welcome you and your child into my exam room. I’ll ask if you have any concerns regarding their eyes or vision that you’d like addressed today and we’ll chat about it for a few minutes.

I will ask about their eye and overall health history, including any medications, allergies. family medical and eye histories, so bring any old pairs of glasses they’ve worn in the past.

Then, we will discuss their developmental and educational milestones, as well as any daily habits including digital device use and amount of time spent doing near work.

I will also ask you whether they get enough water, sleep and outdoor play time, in addition to their nutritional patterns. It is my job as a primary care provider to inquire and discuss these aspects of your child’s health as they can each affect their visual system and overall eye health.

I will then begin with my assessment of their visual system by checking both near and far acuities and perform a few preliminary tests. These “games” include assessment of their eye movements, tracking patterns and natural postures, ability to focus, peripheral vision, pupillary assessment, color vision and depth perception.

I may then perform what’s called an ‘objective refraction’ behind the phoropter depending on their age. You know the piece of equipment I’m referring to – the bulky, outer space-like contraption? The phoropter will be placed in front of your child’s face to determine whether a refractive error exists.

I will do this by shining a light from a black, rod-like instrument called a retinoscope in their eyes while turning dials on the phoropter, all the while encouraging your child to sit still and stare at a large letter on a screen across the room.

Your child can sit still, right?

That’s when the fun begins. Depending on how active your child is, my time is limited or I will lose their attention and focus. I also get to decode what your child’s responses mean as I present lens options to them, while encouraging them further down the eye chart to the 20/20 line, (which, by the way, refers to what an average person sees at 20 feet as being the same size object that your child can see at 20 feet.)

By then, I will have a pretty good idea of whether or not your child may need glasses.

Up next, I will assess their binocular vision status, (how well their eyes work together), through the phoropter. Did you know that some children’s difficulties in school can be attributed to poor vision or eye teaming skills?

I will then move on to the health evaluation part of the exam and look at their eyes under a giant microscope called a slit lamp. I can tell identify any ocular allergies, blepharitis or dry eyes. I may need your help holding their head firmly in place and can even show you their eyes through the slit lamp if you are interested.

Dilation of their pupils comes next, and I will do this by gently instilling drops into their eyes. Don’t worry, I have a few tricks up my sleeve, including ‘magic drops’ and the ‘closed eye’ method. They don’t hurt but will make their eyes feel numb for a few minutes and blurry for a few hours after the exam.

Oh, and please don’t ask if this is necessary because they have soccer practice right after the exam or you will probably have to bring them back to finish their exam. Although I am a fan of the retinal photos you had taken at the beginning of the exam, they do not substitute the dilation, in your child’s case. This is because I perform a stronger dilation (aka cycloplegic dilation) necessary for me to fully assess their visual system and finalize their prescription.

You may choose to wait in the waiting area, or try on frames while your child’s eyes dilate. I will call him or her back in 15-20 minutes.

After your child’s eyes are blurry and the pupils are the size of dimes, it’s time for part 2 of the exam, where I will repeat the “better 1, or 2?” test.

I will then have the data I need to recommend or not to recommend glasses, patching or vision therapy.

Onto the final health assessment, where I will take one last look through the giant microscope at the back of their eyes with a small lens. I am not expecting to find anything, but am trained to look for congenital abnormalities, retinal holes or tears and cancerous tumors. I finalize this part with a larger lens and a science-y looking contraption on my head. Very fancy.

And that will conclude your child’s total eye check. I will go over any treatment recommendations and we will discuss any questions you have before making their personalized eye care plan.

Of course, we save the best for last as your child will receive a pair of ever-fashionable, disposable dark-out shades as you leave. And maybe a sticker 😉

Thank you for entrusting me in the care of your child’s eye health.

Sincerely,

Dr. Meagan

Reproduced with permission originally published in https://www.mindfuloptometrist.com/post/a-letter-to-parents-what-to-expect-at-your-child-s-eye-exam

Frequently Asked Questions with Dr. Herring

Q: Can you request lenses made from glass? Is glass still used for lenses?

  • A: Yes. Opticians still sometimes use glass for lenses. However, glass is not used very often because they aren’t as safe. If these glass lenses breaks, they can shatters into many pieces and can injure the eye. Glass lenses are much heavier than plastic lenses, so they can make your eyeglasses less comfortable to wear.

Q: Can a coating be added to eyeglasses to protect them from further scratches?

  • A: A protective coating can’t be added to a lens after it’s scratched. The coating is applied when the lens is manufactured and can’t be put on later.

Quality Frames For Prescription Eyeglasses & Computer Glasses In Sacramento, California. Visit EYEcenter optometric for an eye exam and eyeglasses that match your style.

Is Online Learning Impacting Your Child’s Vision?

Students all over the world are spending more time in front of screens due to the COVID-19 lockdowns. Online learning has helped children keep up with their curriculum while staying safe during the pandemic.

But research has found that near-work, including being on a computer or digital device, comes at a price. Eye doctors everywhere are reporting an increase in the number of children who come in for glasses, either to strengthen their prescription or to get eyeglasses for the first time.

So, if your child has been learning in a virtual setting and you notice that they’ve been squinting more or complaining that their vision isn’t clear — know you are not alone.

At EYEcenter Optometric, we help children just like yours in all matters of ocular and visual health. Call today to schedule your child’s myopia consultation.

Why Does Myopia Matter?

Myopia, or nearsightedness, occurs when the eye grows too long and focuses the light in front of the retina instead of on the retina itself. This causes distant objects to appear blurry.

Myopia is more than just a matter of clear vision — it can significantly increase your child’s risk of developing sight-threatening eye diseases like glaucoma, macular degeneration, cataracts, and retinal detachment — in the future. In fact, children who have rapidly progressing or high levels of myopia are even more at risk.

That’s why it’s important to stop or slow the progression of myopia in children as early as possible.

How Can Online Learning Affect Myopia?

The exact cause of myopia isn’t yet known, but we do know that excessive near work contributes to the onset and progression of myopia. Online learning using a tablet, smartphone, or computer is considered near work since these devices are usually held or placed close to the face.

When researchers studied the effects of the COVID-19 lockdown on about 120,000 Chinese children, they discovered that children aged 6-8 experienced significant visual changes. Their myopia had worsened rapidly over the course of a few months while in lockdown. This was attributed to the increase in near activities like online learning, but also to a lack of outdoor activities.

Previous studies have found that children who spend significant time outdoors playing in the sunshine experience less myopia progression than children who are homebodies.

Is Myopia Treatable?

Here’s the good news: your child’s myopia can be treated! We can halt or slow your child’s myopia progression and minimize their risk of future eye disease.

Advanced EyeCare offers the latest and most effective myopia management treatments that can help preserve your child’s vision for the long term.

To schedule your child’s myopia consultation, call one of our five conveniently located Sacramento area locations today!

For more information on myopic progression in children and to download our free guide to myopia control, click here.

Frequently Asked Questions with Dr. Herring

Q: Can you request lenses made from glass? Is glass still used for lenses?

  • A: Yes. Opticians still sometimes use glass for lenses. However, glass is not used very often because they aren’t as safe. If these glass lenses breaks, they can shatters into many pieces and can injure the eye. Glass lenses are much heavier than plastic lenses, so they can make your eyeglasses less comfortable to wear.

Q: Can a coating be added to eyeglasses to protect them from further scratches?

  • A: A protective coating can’t be added to a lens after it’s scratched. The coating is applied when the lens is manufactured and can’t be put on later.

Quality Frames For Prescription Eyeglasses & Computer Glasses In Sacramento, California. Visit EYEcenter optometric for an eye exam and eyeglasses that match your style.

Our Key to Growth: Cultivating an Attitude of Care

From about the fourth or fifth grade, I knew I wanted to be an optometrist. Being nearsighted, I was at the optometrist’s office often, and I always loved the warm and welcoming staff. Today, replicating that experience for our patients is how we differentiate our five practices, and why after 60 years, we continue to flourish and grow.

When COVID-19 hit, three of our practices stayed partially open for emergency care. After about five weeks, we were able to ramp up again and, following guidelines from the AOA (American Optometric Association), and the COA (California Optometric Association), have been seeing more patients than ever. Because the larger practice locations have several exam rooms, we can accommodate an increased patient flow, providing the same high standard of care while adhering to heightened safety and sanitation protocols.

The ability to help so many patients during this time reflects the guiding principle of our practice – we truly care about our patients as people. We take pride in being heartfelt with our patients, letting them know we truly care about them, and plan to be here for them for many years to come.

These are lifelong relationships, with generations of family members coming into our practice. We listen, have empathy, share in their triumphs and sorrows, and they become part of our extended family.

As we continue to care for patients in need, we are busier than ever and have needed to supplement our staff with additional doctors. Because of the business support we’ve received during our long-standing relationship with VSP Global businesses and the Premier Program, we engaged their OD recruitment and matching service, Premier Pathways, to support our hiring efforts. We work with every VSP line of business, from Marchon to VSPOne labs, and those relationships have been very helpful to us while growing our practices. Premier Pathways was able to increase our exposure to highly qualified candidates, give us credibility due to the affiliation with VSP, and secure candidates who met our specific requirements. Instead of having to navigate and pay for more generalized online employment services, we were able to choose from a list of highly qualified ODs, recommended by a company who knows us, our business, and how to recruit professionals. With the help of Premier Pathways, we selected and hired two optometrists who are highly skilled and share our devotion to patients as people.

In all of our practices, we strive to build relationships with our patients and provide that warmth that I felt as a ten-year-old boy at the optometrist’s office. As I see it, genuinely caring about patients and cultivating an attitude of care throughout the practice is of utmost importance, and hiring staff that share those same values is key to that continuity. Because we feel and demonstrate that genuine care for our patients, they trust us, keep coming back, and together we flourish.

Authored by Dr. John Coen and originally published at https://newsroom.vspglobal.com/aseyeseeit/our-key-to-growth-cultivating-an-attitude-of-care?utm_source=News%20Alert&utm_medium=EyeCarePro.com&utm_campaign=Pathways

The Nearsighted Epidemic – How Digital Device Addiction is Changing our World

dr fuerst

Randall Fuerst O.D., F.A.A.O.

Being nearsighted—otherwise known as myopia, is a growing concern in the eye health industry. It's effects are lifelong, and it's rates of occurrence are increasing drastically. Further, suggested links to digital device use have us looking to the future as more and more kids find focusing up close on a phone or laptop a significant part of daily life.

Earlier this month, the American Academy of Ophthalmology issued a statement regarding a global initiative to address the myopia epidemic. EYEcenter joins the eye health community in heightened concern that the coronavirus pandemic may worsen the epidemic of children at risk of nearsightedness. EYEcenter’s Dr. Randall Fuerst weighs in on the subject below, including suggestions to help your children avoid increased risk.

Last year, the CDC issued a report that stated the average US adult is using digital devices approximately eleven hours per day.  I ask my adult patients how many hours they are using a computer, smartphone, or tablet—and these numbers are certainly borne out. Research is starting to show a strong causative impact between screen time and eye and vision changes for the worse. Newer research is now showing strong links to sight-threatening diseases—macular degeneration, cataracts, glaucoma, and retinal detachments—all of which can lead to blindness.

A recent 2020 report out of South Korea, where military service is compulsory, stated that 95.1% of 19-year-old males in South Korea measured as nearsighted (myopic). On November 11, 2020, the Academy of Ophthalmology in a joint statement with the American Academy of Optometry noted that in the US the number of nearsighted Americans has doubled in the past 50 years—to about 41.6% of our population. In Asia, the numbers are now at between 80-90% nearsighted.

So Why is This a Problem?

The trends suggest that by 2050, half the world’s population will be nearsighted. The bigger problem is not more people needing glasses or contact lenses. It is that those who genetically are destined to be myopic are starting earlier—and ending up significantly more myopic—a condition called high myopia, or pathologic myopia.

“Myopia needs our focus now”, states Richard Abbott, MD, leader of the Academy of Ophthalmology’s Myopia Task Force. “Kids who develop myopia early in life and progress to high myopia face an uncertain future. They have 50% greater risk of glaucoma, they are 17% more likely to need cataract surgery, and have 6 times greater risk of retinal detachment and retinal tears.”

In a study out of Finland that followed myopic progression for 22 years, researchers found that ‘over 80% of those getting their first myopic spectacles at age 9 become highly myopic.’

“Right now, the world’s myopia rates are expected to be closer to Asia’s by 2050. It’s possible—but not inevitable,” said Donald Tan, MD, a director of the Myopia Task Force. “ Public health officials need to recognize that high myopia is a disease and promote interventions to reduce its overall incidence and slow progression. Action now can change the future.”

The challenge with myopia is that in the early years, you don’t need to wear your glasses all the time due to your vision only being minimally challenged. In fact, it is called nearsighted for a very descriptive reason—you can see well at near—possibly better than with glasses. But, as the months slip into years, and the vision loss progresses, we miss an important window for intervention. Like the age-old adage states, the earlier, the better. There have been hundreds of millions of dollars spent researching how we can slow and possibly even stop the progression of myopia. “There are a number of treatments available, which slow myopia progression. They include drops, special contact lenses, and glasses.  Many of these treatments have been around for decades, and some have undergone rigorous clinical trials.  The future for newer and better methods is bright with some newer methods already approved in Europe,” states Jeffrey Cooper, OD, MS, FAAO, professor emeritus, SUNY College of Optometry, and one of the foremost myopia treatment experts.

The key, however, is early intervention – a time when most kids and parents look at nearsightedness as a minor irritation.

There are several common-sense recommendations that we make to parents.

What Has Shown to Be Effective
  1. Limit screen time.
  2. Read and work in good lighting. Lower light levels are adapted to visually by increasing your pupil size. Larger pupils, like camera lenses with larger aperture settings, decrease depth of focus. This, in turn, increases the load on the patient’s focusing system, called accommodation.
  3. Maintain a good working distance from the eyes to the digital device. This should be at least 12”, and preferably, 14-16” away.
  4. 20/20 Rule – it is easy to spend hours working on near tasks. For hours then, the accommodative system is engaged and active. This ‘rule’ suggests that whenever possible, every twenty minutes, take a 20-second break, look at least 20 feet away to relax your eyes focusing muscles, and blink 10-20 times (extended computer use has been shown to decrease blinking).
  5. Go outdoors! There are a number of good studies that show that by being outside in the sunlight, there is a decrease in the progression of myopia.
  6. MiSight Soft Contact lenses—These FDA approved soft contact lenses have been demonstrated to slow the rate of myopic progression by nearly 50%.
  7. Orthokeratology gas permeable contacts. These FDA approved contact lenses are worn during sleep, flattening the corneal and slowing the increase in axial length- the factors that change in myopia.
  8. Low dose atropine—an eye drop that has been shown to be surprisingly effective with slowing nearsighted progression. Atropine is one of the world’s oldest drugs known to man. Eye doctors don’t argue as to whether or not atropine works or not, rather, the argument is on what strength is most effective.

Who would have thought, twenty years ago or so, that we would be so incredibly involved with our digital devices? In the past month, I have had several patients reporting that they are on their devices 16-18 hours a day! Twelve to 14 hours daily is not uncommon. When I asked about sleep and eating and how that factors in, patients just shake their heads.

Optometrists and ophthalmologists are being encouraged to push for greater intervention earlier in children’s lives. The concern is that, by waiting and missing the window when a child has low levels of myopia, you allow the more devasting vision loss causing diseases to, in essence, take root. Noel Brennan, MScOptom, PhD, FAAO, and Clinical Research Fellow at Johnson and Johnson Vision Care wrote recently, Our ability to isolate those myopic children who will not become highly myopic later in life is poor.  And suppose you did identify a child who has progressed by, say, a diopter or a diopter and a half a year—that’s progression you now cannot take back. And every diopter reduction in progression lessens the risk of myopic macular degeneration (MMD) by about 40%. The risks associated with, say, increasing outdoor time and use of daily disposable myopia control contact lenses are minimal compared to those risks associated with myopia-related complications later in life. 

Be sure and ask your EYEcenter doctor about your child’s risks regarding nearsightedness (myopia) and screen time. Our dedication to keeping you and your family seeing and enjoying the world around us to the fullest is our absolute drive and motivation!

Fit & Fog: A Guide for Glasses and Mask Wear

As we all don masks amidst the pandemic, more than just your nose and mouth can be obstructed. Fog caused by your breath escaping your mask causes unwanted fog on your eyewear too. The AARP offers these tips to avoid this annoying side effect.

As more Americans don face masks to venture outside during the COVID-19 pandemic, many of those who wear glasses are finding that their lenses fog up. It’s a problem that bespectacled surgeons, as well as goggle-wearing skiers, have long experienced.

Why does it happen? In a 1996 article in Ophthalmic & Physiological Optics, Tom Margrain, a professor at Cardiff University’s School of Optometry and Vision Sciences, explained that in general “when a spectacle wearer enters a warm environment after having been in a cooler one, his/her spectacles may ‘mist up’ due to the formation of condensation on the lens surface.” He went on to say that polycarbonate lenses demisted more rapidly than those made of glass.

With that in mind, if your eyeglasses are fogging when you put on a face mask, it’s because warm, moist air you exhale is being directed up to your glasses. To stop the fogging, you need to block your breath from reaching the surfaces of your lenses.

The Annals of the Royal College of Surgeons of England published an article in 2011 that offered a simple method to prevent fogging, suggesting that, just before wearing a face mask, people wash their spectacles with soapy water, shake off the excess and then allow the lenses to air-dry.

“Washing the spectacles with soapy water leaves behind a thin surfactant film that reduces this surface tension and causes the water molecules to spread out evenly into a transparent layer,” the article reveals. “This ‘surfactant effect’ is widely utilised to prevent misting of surfaces in many everyday situations.” Antifogging solutions used for scuba masks or ski goggles also accomplish this.

Another tactic is to consider the fit of your face mask, to prevent your exhaled breath from reaching your glasses. An easy hack is to place a folded tissue between your mouth and the mask. The tissue will absorb the warm, moist air, preventing it from reaching your glasses. Also, make sure the top of your mask is tight and the bottom looser, to help direct your exhaled breath away from your eyes.

If you are using a surgical mask with ties, a 2014 article in the Annals of the Royal College of Surgeons of England advises going against your instincts. Tie the mask crisscross so that the top ties come below your ears and the bottom ties go above. It will make for a tighter fit.

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Don’t touch your face! Wiping fog from glasses with your fingers could lead to more dirt, germs, and smudges on your lenses. Read the tips below to keep fog away.

Click here for more information or you can read the full article at https://www.aarp.org/health/conditions-treatments/info-2020/eyewear-face-masks.html?cmp=SNO-ICM-FB-HLTH&socialid=3674304838.

Diabetes in the era of COVID-19

In a recent research article published in the Journal, Metabolism-Clinical and Experimental, a group of researchers from the UK reviewed nearly 338,000 diabetic patients. They evaluated the percentages who had contracted Covid-19, and compared this to their glycemic control measure, known as hemoglobin A1c. This percentage of glucose in the bloodstream , known as glycosolated hemoglobin, gives a more longer term measure of diabetic control, versus the up and down dynamics experienced on a day to day basis.

Normal A1c is between 5.3% and 5.7%. If a patient’s measure falls between 5.8% and 5.99%, the patient is classified as pre-diabetic. At 6.0% and higher, diabetes is diagnosed. The higher the percentage, the more ‘out of control’ the patient’s diabetes is, and the sooner the destructive impact of the disease will be manifested.

This study found that between March 16, 2020 and April 26, 2020, there were 649 cases of Covid-19 serious enough to warrant hospitalization.

Here is from the study’s abstract:

  • Multivariable adjusted analyses demonstrated an increased risk of COVID-19 in persons who had undiagnosed diabetes at baseline (defined as A1C ≥6.5%) and in those with poorly controlled diabetes (defined as A1C ≥8.6%). Relative risk was 2.68 in those with undiagnosed diabetes at baseline and 1.91 in those with poorly controlled diabetes.
  • With increasing A1c—even within the normal range—the risk of COVID-19 increased progressively. Regulation of blood glucose may have a significant role in immune response to COVID-19.

Put in very simplistic terms, the higher the A1c, the greater the risk of not only contracting COVID-19, but experiencing more and more severe complications. So, the take home message for our patients with diabetes is this: Anything you can do to maintain control, and, hopefully in lowering your A1c is worth the effort! Thanks for everything you do to maintain your diet, exercise, sleep and medications in the face of this destructive disease!

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