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.