Frame Selection and Adjustment

On occasion, a patient will receive their glasses and they will report something isn't right, even if the prescription is the same as the old one. I have seen if the frame is a different size and shape, the patient might have a problem adjusting. This does occur occasionally. Just changing the size of the frame can make a difference to the patient.

The other variable that needs to be looked at is the adjustment of the frame. This is especially true of strong prescriptions. I have learned that how the frame is tilted and wrapped around a patient's head could make a big difference in how a patient sees.

Also if a patient has been wearing contact lenses for a long time and hasn't tried on their glasses for a while, this could cause a problem. This is because glasses magnify or minify what you're seeing more than contact lenses do.

Medications taken could certainly effect one's vision

The general health of a patient as well as medications taken could certainly effect one's vision. There has been several times that patients came in when a sudden change occurred in their vision. In these cases it was undiagnosed diabetes. The vision returned to the patients previous prescription when the condition was treated. Long term diabetes or hypertension could certainly have a dramatic effect on a patient's vision if not treated. Many times the vision worsens and the loss becomes irreversible. Any condition that can affect the body including the heart, liver or kidneys could certainly affect the eyes.

He spends a good part of his day looking with one eye through a telescope

I had a 29 year old patient who came into the office yesterday. His chief complaint was that he noticed an increase in headaches, especially over the left eye. He spends a good part of his day looking with one eye through a telescope. He also mentioned that he had more trouble focusing his left eye from near to distance. There was a very small far sighted prescription found for distance for the left eye and the right eye had no prescription. When I put this prescription in front of him, he found an immediate, significant relief.

What's interesting is that many of my patients wouldn't have noticed the difference with this small a prescription. However, there are a number who do. Even at this young age, the patient even needed more prescription to be able to read comfortably. Thus, we prescribed a bifocal. Helping this type of patient, in part, is what makes optometry such an interesting and rewarding profession.

It Isn't Work

I was just reviewing some of the testimonials listed on my website, http://www.wehelpuc.com. It has been said that when you have a passion for what you do and you're able to help people and affect their lives positively, it isn't work. I just celebrated my 30th anniversary of practicing optometry. I'm more excited about practicing optometry than ever. My skills area in more demand than ever in that there's more near viewing with video devices especially those utilizing 3-D. In addition, our scope of being able to treat certain eye diseases is expanding. Also, I will be moving into my expanded facility around the middle of January, 2012. With this and a great staff, I have a lot to be thankful for.

Reading Efficiency

Although seeing clearly is very important in reading, there are other visual skills that are come into play when reading. Two such skills are being able to focus efficiently, especially when viewing both a monitor and hard copy and also being able to aim the eyes together. These two skills are not a given. When they're not working well together, visual fatigue, headaches, frustration and mistakes can be made. With more of our work and leisure time being spent on monitors or hand-held devices, visual efficiency is very important. For more information, please view the different topics on binocular vision at www.wehelpuc.com.

Powerful Books

There are so many great books out there that I've so enjoyed through the years. Dale Carnegie has two of them: How to Win Friends and Influence People and the second one is How to Stop Worrying and Start Living. Napolean Hill's book which was written about the same time, Think and Grow Rich is a classic and has sold about 15,000,000 copies. Rhonda Byrne's book, The Secret, I've also enjoyed, immensely. I am a subscriber to Success Magazine. In the magazine, there are usually different books cited which are very positive in nature. The books Get Motivated and Zappos.com are just a couple of examples. Many of the books I've come across I've read numerous times. This isn't because I'm a slow learner but I feel so great after reading them. Here's a hint. If you you can read a great book while riding on a stationary bike, you'll get more enjoyment as the endorphins will further kick in.

Desktop or Laptop?

For years, when examining patients, I would be concerned whether they were working on a computer. This always presented unique challenges in prescribing glasses for those older than 40. The reason for this was the computer was usually stationed a lot higher than normal reading material. Also, the viewing distance for the computer was usually at a different distance than normal text. At times we'd have to prescribe a separate pair for the computer depending on the factors of its height as well as distance.

More recently, individuals are working with laptops. The good news is that the laptop is usually at the same height and distance as normal reading or perhaps a bit further. Again, special consideration needs to be given. Then you have the office worker who is working with both laptop and desktop computers simultaneously. The unique working demands of the patient need to be met with unique methods of prescribing.

Desktop or Laptop?

For years, when examining patients, I would be concerned whether they were working on a computer. This always presented unique challenges in prescribing glasses for those older than 40. The reason for this was the computer was usually stationed a lot higher than normal reading material. Also, the viewing distance for the computer was usually at a different distance than normal text. At times we'd have to prescribe a separate pair for the computer depending on the factors of its height as well as distance.

More recently, individuals are working with laptops. The good news is that the laptop is usually at the same height and distance as normal reading or perhaps a bit further. Again, special consideration needs to be given. Then you have the office worker who is working with both laptop and desktop computers simultaneously. The unique working demands of the patient need to be met with unique methods of prescribing.

Contact Lenses for the Over 40 Year Olds

Patients who are over 40 who want contact lenses present interesting challenges. The main challenge for these patients is being able to read and see distance through the contact lenses. There are generally three options. The easiest one is to fit the contact lenses for distance and fit reading glasses over them for reading. The second option is to fit one eye for reading and the other eye for distance. Surprisingly, this works quite well for many patients but not everyone. However, there are some limitations in fitting a patient this way. Limitations may include blur at night or the eyes feel strained when doing a lot of reading. Sometimes we fit glasses over the contacts at times to help compensate for the blur. The third way of fitting patients in this age group is multifocal contact lenses. When they work, they really work. If you're a bifocal wearer, you notice that when you're viewing something closeup with glasses that is at eye level or above. you have to tilt your head back. This does not occur with bifocal contacts. However, bifocal contacts don't work for everyone. There is sometimes a reported blur and reading or distance no matter what lens you fit. I've worked with patients who I have fit the first time they came in; others who were fit on the second or third time and others who couldn't be fit at all with the multifocal lenses. What's great is that the technology of the lenses is improving all the time.

30th Reunion

It's hard to believe it's been 30 years since I graduated from optometry school. I attended my 30th reunion in Forest Grove Oregon this past weekend. It was nice meeting with 29 of my fellow graduates from Pacific University, College of Optometry, Class of 1981. The school and curriculum has expanded greatly. I took four hours of continuing education. One of the courses in sports vision went into the topic of 3D. The university opened a clinic specifically dealing with this area. As discussed earlier, there are a significant amount of patients who would have trouble viewing 3D items such as movies and seminars. Also the ability to perceive depth is so important in areas of life such as driving and sports performance. This area of vision can be enhanced through appropriate contact lenses or glasses and also vision training.

One of My Most Interesting Cases

Several years ago a patient was referred to me by a friend of hers. The patient had brain surgery and afterwards, started walking into walls. In other words, she couldn't walk in a straight line. During my examination, the patient had clear sight at distance and near. Also, the eyes appeared to be healthy. There was one finding that was terribly abnormal. That was the patient's peripheral vision. With the right eye closed, the patient couldn't see anything on the right side. With the left eye closed, the patient wasn't able to seen anything on the right side. This condition is called a right field hemianopsia. Apparently, the surgery interfered with the visual fibers going back to the part of the brain that deals with vision.

One of the problems was that the patient did not realize she had a vision problem of any type. Also, according to the patient, the doctor who performed the surgery thought she was faking her condition.

Fortunately, she responded to a treatment that I have yet to use since I was in optometry school. I placed prisms in front of both eyes and shifted the world to the side. Immediately the patient was able to walk straight. This had profound effects on her life. She immediately was able to read better. She subsequently went back to work. Most importantly, her outlook on life was tremendously improved as she was no longer depressed.

A Life Possibly Saved

Last year, a patient came in complaining of headaches and blurred vision. These are not uncommon symptoms for many of the patients whom I see. The patient was relatively young, 41 years old.

When I examined her, I noted that the optic nerve of the left eye appeared abnormal. Also the best vision the patient was able to obtain in that eye with glasses was about 20/40. The right eye was correctable to 20/20 with glasses.

When I checked the patient's peripheral vision, both eyes showed a defect. With both eyes showing an identical defect, the problem probably lied somewhere within the brain.

We referred the patient immediately. Unfortunately it took two weeks for the patient to see the specialist. Once the specialist saw the patient, he immediately ordered imaging of the eyes and brain to help determine the etiology of the problem.

Many times when a visual field problem in both eyes is found, you think of a tumor. This was not the case. Instead, an aneurysm was found, a very large one at that.

Surgery was performed on the patient.

The patient came back to my office relating the above story several months after I originally referred her to the specialist She did lose sight in the left eye. She stated she almost died on the operating table. She also relayed what her surgeon said: "You should hug the eye doctor who referred you. If you waited any longer, the aneurysm would have probably ruptured and you would have died."

You can see the patient's brief letter in the "testimonial" section of the website, www.wehelpuc.com. I've been practicing optometry for 30 years and I am more passionate now about the profession than ever.

Continuing Education Seminar

I attended a tremendous continuing education seminar in Pasadena this weekend. It covered areas of retinal disease and surgery, cataract surgery and even areas of visual processing. The lecturers were top notch.

New Office

Construction on our new office should start within the next two weeks. We're really looking forward to our new office which should open right after the new year.

As an optometrist, I view myself as a quarterback

As an optometrist, I view myself as a quarterback, strategizing how to best deliver approptiate vision care to my patients. Many vision problems, I could treat very well. Other types of vision problems, I feel could be better treated by other professionals. For example many of patients ask if I could see their infants as patients. I tell them that the local optometry school has a tremendous pediatrics department and could well serve them. Certain types of pathologies or extreme visual needs are better met by doctors specializing in these areas. I find the patients referred are most receptive to this.

Our plans for the new office

Our plans for the new office were approved by the City of Rancho Cucamonga. I am fortunate that I have a staff that is both talented and enthusiastic in the development of our new office. We'll keep you posted about the new construction.

Seven Videos Now Ready

We now have seven videos uploaded to our website, www.wehelpuc.com. They deal with different aspects of care. Visit the "video library" portion of our website to view the videos.

Expansion of Office

We are excited. Our office is planning on expanding. The construction should be well underway or completed by the end of the year. We will keep you informed.

Release of Sixth Video

For informative videos regarding vision, please visit the "video library" section of our website, www.wehelpuc.com. We just released the sixth video.

Virtual Reality in 3D

A recent ophthalmological report discussed the use of virtual reality in 3D especially in schools. It was stated that about 25% of the kids have binocular vision problems that would make it difficult, if not impossible, for them to view the image. Difficulites include headaches or eye strain Of course this applies to adults too. For a discussion of binocular vision problems visit our website at www.wehelpuc.com.

We Are Planning Our Move into a Larger Suite

We are planning our move into a larger suite by the end of the year. We will still be located in the Ralph's Shopping Center at Baseline and Haven. We will be moving into a larger location. After being in the same location for 22 years it will be neat to move into a larger, more up-to-date office. We will let you know about the timing of this.

One of the neatest aspects of optometry is that we usually get immediate feedback from patients regarding our treatment. It's really neat to see a child's reaction when you first put glasses on them as they could see clearly, possibly for the first time. One of the most heartening reactions is when you had a child who struggles with reading and you put on a pair of glasses and their reading is more fluid.

If you go to my website, www.wehelpuc.com, you can scroll to the testimonial section and read what happened to a couple of our patients.

Relocation News

Our office is scheduled to relocate toward another part of the same shopping center at Baseline and Haven in Rancho Cucamonga. Our office will be about 50% larger in space. The move will occur toward the end of the year. We will keep you posted.

We Help UC.com

Keep visiting our website, www.wehelpuc.com, where new videos are being posted concerning different areas of optometry under the "Dr Bob's video Library."

Julie John of Human Interface

I want to thank Julie John of Human Interface for the great job she and her husband did in putting out my video series, "Eye Talk" Two of the videos have already been released, with the rest of them scheduled to be released every two weeks. There will be a total of seven (as of now) videos showing. They could be seen at my website, www.wehelpuc.com under Dr. Bob's video library.

Eye Talk series

Our new video in our Eye Talk series was just released. It deals with vision and sports. You can see it by visiting

Radial Keratomy (RK)

Recently, I had a couple of patients who had gone through radial keratotomy (RK) over 20 years ago. These patients are sometimes challenging to correct with glasses. For one, their prescription could vary during the course of the day. Secondly, they sometimes have a very high farsighted prescription where they were usually nearsighted before the surgery. This leads to problems of distortion and magnification. This is especially true when the patient's two eyes have a different prescription.

Videos

Over the next several weeks, several videos that Human Interface and I shot at my office will start appearing on Youtube.com under RobertRothbardOD (no spaces). Even though they were all produced last week, they will be gradually released over the next several weeks via Youtube or my website, www.wehelpuc.com.

Videos

I just finished shooting videos on multiple topics related to vision and my practice. As they're developed and edited, they will appear in multiple locations including my website, http://www.wehelpuc.com/videos.html. I am most excited about this.

If You're Active In Sports

If you're active in sports, particularly where a ball is involved, it's advisable not to get glasses that have glass lenses. Polycarbonate lenses are by far more shatter resistant. I actually had a patient who was stuck in the eye with a golfball. Fortunately he was wearing glasses made with polycarbonate lenses. The lens popped out of the frame and he was knocked down but the lens did not shatter and they probably saved his vision.

Refer My Patients

One of the benefits I enjoy of working in private practice is the ability to refer my patients to an appropriate professional whom I feel would be better in caring for a patient with a particular problem or situation. I generally don't work with infants but I inform my adult patients that they should have their infants evaluated visually by another eyecare professional who specializes with this patient population. Patients who have diabetes who are manifesting eye problems such as hemorrhaging in the back of the eyes are also referred. Patients who have extremely poor vision, even with glasses or contacts lenses, are referred to doctors who specialize in an area of optometry called "low vision."

Expanding Our Office

I have been in my current location in Rancho Cucamonga for 22 years. We will be expanding our office by the end of the year. I am really looking forward to this. I am fortunate that I have a staff that will greatly assist me in this expansion. Stay tuned for future details. Thanks.

Kids Participate In That Should Require Eye Wear Protection

There are many sports that kids participate in that should require eye wear protection. Although it doesn't occur often, a soccer ball striking the eye can have devastating consequences including loss of vision. Many feel that since the soccer ball is so big, it cannot injure the individual if it hits the eye. The injury can actually lead to a detached retina or even a hole in the back of the eye.

Met With Students And Staff At San Joaquin Valley College In Rancho Cucamonga

A few employers including myself within the community met with students and staff at San Joaquin Valley College in Rancho Cucamonga, California. We went over ways for their students to improve their abilities in securing employment. Ideas, concerning appearance, enthusiasm, learning about social media and knowledge in general were discussed.

I had a child patient ...

I had a child patient who needed glasses consisting of a significant prescription in the right eye and very little prescription in the left eye. The patient who was able to express herself extremely well said she couldn't skim the material as easily with the glasses on as without. I was able to determine that the patient, when she read without the glasses, was not using her right eye. With the prescription on, she was using both eyes. The glasses were making her better able to use both eyes. However, the patient was use to not using her right eye when she read. For her this is easier. We'll see what happens over the next couple of weeks.

I have come across a number of patients who have motion sickness when driving in a car. There are various reasons for motion sickness. It's interesting to me that many of my patients who have this experience more problems when sitting in the back seat of a car as compared to the front seat. More importantly, the problem is significantly reduced when they're actually driving.

I feel some component of this is visual. There's a lot more visual information an individual has to assimilate in the back seat. The passenger is looking at distances two feet away and also things that are very far away. In the front seat they're viewing things mostly at distance. When they're driving, they're actually holding onto the steering wheel so they know where they're going and the tactual sense is reinforcing the visual sense, therefore less problem.

A previous patient of mine brought her mother in for an examination. She had stated thank you for "saving my son's life." Her son wasn't sick or anything like that. He had a lazy eye and was undergoing patching for at least a couple of years with no results. The boy was introverted and did not participate in sports. I put a contact lens in his lazy eye. Even though he couldn't see much better than 20/200 in that eye, he was now able to use that eye and have depth perception. The change in behavior was dramatic. He was doing better in school, participated in sports and is generally more outgoing. His mother says he's a lot happier.

As an optometrist and an owner of my own business, networking with others is very important. At this time I'm not talking about online, social networking. I'm talking about live person to person networking. I belong to multiple chambers of commerce and I'm active in them. Even at the gym, by talking about what I do enthusiastically, I've been able to generate patients coming into the office. It's quite easy to incorporate what I do into general discussion, especially the fact that I'm passionate in what I do.

Fitting contact lenses is usually straightforward. The prescription usually follows closely to the glasses' prescription. Sometimes, however, the tears between the contact lens and the eye affects one's vision. I had a patient like this earlier today. I tried three different (different manufacturers) contact lenses, each with the same prescription, until the patient was satisfied with what she saw. The patient was a long time patient here.

One of the great joys I get out of my practice is being involved with the community, particularly the chamber of commerce. I belong to three chambers in the surrounding area of my practice. I am actually on the board of directors of one chambers. In addition to the enjoyment I get meeting with other business people and officials of the city, the chambers have been a good source of referral to my practice.

I've been practicing optometry for nearly 30 years. It's interesting where the source of useful information regarding my field will come from. I had a bifocal contact lens patient who came into my office. He was wearing a type of bifocal contact lens that I stock. This lens is the type that is usually given to a patient in their early 40s. With a little modification, this patient gave me the idea to start fitting this lens to patients in their 50s and above. I had not thought of this before. I have met with very good success for this population of patients who want to wear bifocal contact lenses.

Even though optometry is generally not a life or death profession, I had a very rewarding experience happen to me in my office. I had a patient whom I saw around August, 2010. She had a headache, uncorrected vision in one of her eyes(about to 20/50) and changes in her peripheral vision. I immediately referred her to an ophthalmologist. They immediately referred her to neurology in which surgery was performed.

The patient came back in December, 2010 and told me what happened. She stated that the emergency room surgeon told her it was a good thing that the referrals occurred. She had an aneurysm the size of which the surgeon said was huge. The surgeon related to her that if she had waited a month, she very well could have died.

The patient was most thankful when she came in (with her sister). This is what helps to make optometry such a rewarding profession.