I had a patient yesterday who was in the eighth grade. The mom's complaint was that his studies were faltering. The patient was 20/20 at both reading and distance. The eyes also appeared healthy. I did note that there was a problem with the patient coordinating his eyes together. I prescribed a weak power reading prescription which seemed to make a significant difference in his reading comfort.

There are a couple of things I look for during the examination when evaluating kids for learning problems which are visually related. One questions I ask if the patient gets motion sickness, particularly in the back seat of the car as compared to the front seat. Also, I note if the patient has to bring the reading material either very close or far away to read. These findings usually indicate a visual problem that could cause a learning problem.

I had a college age student in my office yesterday. She had two complaints. Her vision was blurred at night. Also, her eyes were bothering her on the computer. Her distant vision was a little less than 20/20. Even though her vision was pretty good, her complaints were significant for her.

In her case, I had to prescribe for both the distance blur as well as for her complaints concerning working with the computer. This required two different small prescriptions. I have seen this type of case quite often. If I were to prescribed for her just the distance prescription, this could actually make the up close vision worse.

Every patient is different. Sometimes the prescription for distance and near is the same and sometimes it's not. The findings are determined during the examination and demonstrating its results to the patient.

Contact lens wearers. should always have a pair of back-up glasses. Most do. I have seen contact lens patients who have extremely poor vision, uncorrected, who don't have any glasses. I had a patient come into the office yesterday with an irritated eye. There was a small bleb on the front surface of the eye which meant she could not wear her contact lenses. She had no glasses. She did wind up getting glasses immediately. Contact lens wearers should always make sure they carry their back-up glasses with them in case their eyes are irritated and they have to remove them at once. Sometimes wearing a contact lens that irritates the eye for a period of time could cause significant infection.

We are now coming to a close of another year. I have now been practicing optometry for 28 years. I've been established here in my own practice in Rancho Cucamonga for over 20 years. I completely enjoy it. There are so many reasons why. For one, it's a people profession. Through my patient base as well as my networking through the community and the chambers of commerce, I have met many interesting people as well as making good friendships. Also, optometry is exciting for me. The patient could almost immediately realize the benefit of what you've done for them. I could also say that there are those who we have definitely changed their lives for the better as a result of out service. Also, there are a few who we could say we possibly have saved their sight or possibly their lives as a result of our services. Finally, looking back over the last 28 years, I am proud to be part of a profession that has advanced so dramatically over the years.

One of the more challenging patients we work with in the office is the long time contact lens wearer who has turned 40 or older and is losing their ability to focus up close with their contact lenses. There are three ways to deal with it. The first way is by far the easiest but sometimes least convenient, that is wearing reading glasses over the contact lenses for near. The second way and successful for some is wearing one eye for reading and one eye for distance. This causes a blur in one of the eyes for reading and blur in the other eye for distance. The issue that is very important here is driving, particularly at night. There are ways to deal with this situation. The third method of fitting this type of patient is with multifocal contact lenses. The technology of these lenses has improved greatly over the last several years. These lenses do not work on everybody but when they work, they work.

Individuals who use computers, particularly desktops, have particular visual needs. I had a patient who was prescribed a progressive lens for distance and near. He noticed that when he viewed the desktop, he wasn't able to view the screen comfortably. Since his computer was at about 22"-24" and he also had to view text at about 16", we prescribed him a bifocal with the top portion set for his computer distance and the bottom portion situated for 16". This worked out for him a lot better. What's important here is that the prescription is set for these distances. You would not be able to see clearly at far away with them. For further information regarding vision and computers, please visit my website at www.wehelpuc.com.

There have been many advances in contact lenses over the years. One of these advances involves the contact lens' ability to transmit oxygen. The more oxygen a contact lens can transmit, the healthier it is for the eye. These lenses are generally a silicone based lens. Basically, it is always safer to take a contact lens out than to sleep in it. Many infections that occur due to contact lens wear involve sleeping in the lenses. Even though I don't condone sleeping in the lenses, if you're going to do this, it is better to do this with a contact lens that transmits a significantly higher amount of oxygen.

I had a 10 year old patient yesterday. His mom's complaint was that his eyes watered. I noted that his lids drooped significantly. The patient was referred from the school for blurred distant vision. I found the patient to have a significant astigmatism as well as a focusing problem up close. I could tell by the responses of the patient that he was a bright kid. The mom said however that he had problems reading. When I put the prescription in front of the patient, his reading was very fluid (normal). The mom stated she never heard him read aloud like this before.

Also, I feel the lid droop could have possibly caused the astigmatism. I referred the patient to a specialist to determine whether it was necessary to have the lid condition treated with possible surgery. He was also prescribed drops for eye allergy.

I visited NYC last week. I took 18 hours of continuing education at the optometry school on 42nd street. The advances in my field are breathtaking, especially with all the technology. My love and passion for the profession has only grown since I graduated in 1981. Optometry is one of the few professions where the patient can realize the improvements almost immediately. It is most gratifying. It is exciting for me. I love to share my knowledge with anyone whom I meet.

Networking is important in any business. I'm fortunate in that I enjoy it. Many of my patients have come to me through networking events with the various chambers of commerce that I belong to. I have worked with some patients whom I met at Twenty-Four Hour Fitness. Over the last several months I've started working with the electronic social medial such as Facebook and Linkedin. As you can also see I enjoy blogging. My other blog is www.newyorkcityhighlights.blogspot.com regarding places of interest in NYC.

I also enjoy talking to different groups from secretarial groups to diabetic support groups to seniors discussing areas of vision as it pertains to them. I am very enthusiastic about the profession I so enjoy practicing.

My first patient this morning came in for her annual vision exam. No complaints. she was wondering why she was coming in since it was just a little over a year since she was last seen. As it turned out, it was a good thing we examined her. Her pressure in her eyes went up significantly. She will be monitored and probably treated for glaucoma. If she would have waited another year, she could have developed a serious loss in her vision.

There have been recent advances in fitting the "over forty crowd" with contact lenses. Many people over forty were fit with one eye for reading and one eye for distance (monovision). This for some individuals works quite well. The other other method used was just fitting reading glasses over contact lenses.

Recently, there has been the development of multifocal contact lenses. They don't work on everybody. However, when they do work, the vision feels very natural. There are a few manufacturers of these particular contact lenses. Sometimes the patient has to return to the office a few times to get the correct lens fitted. I work quite diligently with my patients in trying to get them fit.

I conduct seminars on vision to local groups, teachers, PTA's, business groups and various service organizations. The seminars include such topics as visi0n and computers, vision's affect on learning and sports performance or even the effect of systemic disease (diabetes and hypertension, for example) on the eye. If you are interested, please contact us at (909) 980-3535.

If you're interested in visiting New York City., visit our blog at www.newyorkcityhighlights.blogspot.com. It's quite unique in design and information.

The computer over the last two decades has created a significant demand for optometric services. People starring at screens for hours on end can cause changes in the visual system. Also bifocal wearers have unique problems with the video displays in the sense that their working distance is usually further away than normal reading and the height in which they view the computer (especially a desktop set-up) varies from their normal reading. A lot of times, the prescription for normal reading is different than the one for the computer. This must be taken into consideration in prescribing for the patient. Also contact lens wearers appear to have more problems when viewing the screen due to the constant close-up content as well as the wearer not blinking enough. This could lead to a dry eye situation.

Over the last few years another form of extreme viewing has occurred. Texting. Here the viewing distance is even closer than normal reading and this over time can have an impact on vision.

One of my most interesting cases occurred several years ago. A patient was referred to my office after brain surgery. Her complaint was that she would continuously walk into walls. Her eyesight was clear as she was 20/20 in each eye. Her problem was with her peripheral vision. She was missing the right side of her vision, probably as a result of the surgery. Even though I cannot restore a lost visual field, I was able to shift the lost vision over to the side with prisms. This made the patient more balanced in her visual world. She was able to perform a lot better. To start with, she wasn't walking into walls anymore. Secondly, her outlook toward life improved immeasurably as a result. Also, she was able to read a lot better. The result was immediate.

We got a couple of referrals this week based on the glasses our patients were wearing. The patients coming in commented how much they liked the frames our previous patients were wearing. They asked where they got them and they referred them to our office.

We have a great selection of frames in all price ranges. What's important is that I have a very knowledgeable and professional staff who can choose the appropriate frame and fit it.

I just attended a seminar at the Southern California College of Optometry on aviation and vision. Many issues facing pilots were gone over. Such areas such as contact lenses, color vision, spatial orientation and refractive surgery were gone over. Such issues as when 20/20 vision is not good enough were covered. Information regarding the disappearance of lighted straight ahead objects disappearing when being viewed at night was shared. The course lasted from five to six hours.

We've recently celebrated our 20th anniversary of our office here in Rancho Cucamonga. I couldn't think of a more rewarding career. The most rewarding part of practice is seeing the family members starting out young later bringing their own famiies in. I have one family where we've treated four generations.

Optometry is one of the few health care professions where you literally see immediate results of your treatment. Whether it's glasses, contact lenses or treating eye disease or allergy, the patients almost immediately can see or feel the difference.

Another enjoyable benefit of me being in private practice for 20 years is the close ties I've established with the community. I have long established ties with the various Chambers of Commerce surrounding my office. In addition, it seems no matter where I go, I'm constantly seeing my patients in various locations, from the health clubs, to restaurants, to sporting events.

Computer Vision Syndrome

So, you spend all or part of your day working with computers... Then this article is for you. Relax a little, kick your shoes off, grab a cup of java, and explore the world of vision and computers with me. I have examined many patients who spend part of their time in front of a computer screen. Some patients don't have any problems. However, there is a significant amount of patients who suffer from a variety of symptoms. They include: Headaches Blurred vision while viewing the monitor Increased blur at distance, particularly at night Problems focusing from distance to near or visa versa Increased sensitivity to bright light or fluorescent light Increased losing of one's place Increased dry eye syndrome Pains developing in the neck area There are reasons patients develop these symptoms. In my opinion, the reason that most stands out is that many of my patients who work in front of terminals sit for a long time starring at text. I have seen many patients who did not need any correction for distance (in the form of glasses or contact lenses) become nearsighted. I have seen this in individuals of all ages. Another problem I find is with those patients who haven't had to do much close-up work over an extended period of time and now find themselves in front of a screen all day long. These patients appear to me the most at risk at developing any or all of the above symptoms. It reminds me of the individual who has lived a very sedentary life style and all of a sudden starts to work out. Think of all the problems this individual might develop. What causes the above problems to occur? Simply stated, there are two divisions where the problems lie. The first deals with the issue of ergonomics. Specifically, how do you improve the compatibility between the individual and computer by improving the lighting, the office furniture, the quality of the screen image and the basic comfort of the workstation? The second division deals with how do you improve the individual. This is the area I wish to discuss first. The first area I want to look at is very straightforward. It deals with those patients who need to wear bifocals. Bifocals that are conventionally prescribed for normal reading activity many times do not work well while sitting in front of a screen. There are two reasons for this. The first deals with the fact the computer screen is usually at a different height than the normal reading level, usually significantly higher. The second deals with the distance of the screen from the individual. Usually the distance of the screen is further than normal reading distance. Taking these two factors into account, if an individual were using bifocals prescribed for normal reading on a terminal, he/she would have to lean closer into the screen as well as tilt their head back to see through the bifocal. Think of the neck and back strain. Another area that I feel is often overlooked deals with those individuals working on terminals under the age of forty. Conventional prescribing states that it is unusual for the prescription for distance to be different than the prescription for near. The focusing system should still be strong enough for an individual to use his/her distance prescription for reading. I find this often not to be the case. I have found both kids and young adults who need to have a different prescription for reading than for distance. This is measured for during the examination. Some of the time, all that an individual has to do is take off their distant correction while he/she reads or performs on a terminal. Also, I have examined many young individuals who have 20/20 clear sight at distance and have been helped immeasurably by lenses prescribed for close-up. Here's a clue for those kids or young adults who have undiagnosed vision problems that could be interfering with your reading efficiency. If you see clearly at distance and have to hold your print very close or very far away to comfortably read, you could have a vision problem requiring a prescription for close-up. Coordination of the two eyes together is extremely important in whether an individual will have problems working on a terminal. Basically there are two systems involved when viewing print close up. They are the focusing system, which allows you to see clearly, and the aiming system, which allows you to see items as single (as opposed to having double vision). These two systems work together in allowing us to perform all near tasks. In some individuals, however, they do not team together well. As discussed in the above paragraph, sometimes just prescribing the appropriate correction for near will help significantly. Sometimes we have to look at whether eye exercises or vision training will also help the situation. The goal of training is to help coordinate the aiming and the focusing system together to help achieve single, clear, comfortable vision. Certain considerations should be taken into account when designing a workstation. The most important deals with the screen itself. The more one can minimize reflections, the easier time one will have viewing a screen. Being able to adjust the height and distance of the monitor to a user's liking also is a benefit. Also, one should minimize the difference in distance and direction between hard text and the monitor. This will help minimize fatigue from changing focus. Many times, the environment a worker performs in is dry. This and the fact that some individuals don't blink while viewing text, causes a dry eye syndrome. Be aware of your blink rate and possibly consider artificial tears occasionally. Discuss this first with your eye-care professional. The above is a basic overview of how to improve your performance on a terminal. If you have any questions regarding anything discussed, don't hesitate in contacting us at the following phone number: (909) 980-3535 or visit our website at www.wehelpuc.com