One of the most challenging situations dealing with my patients is dry eye. It could be due to a number of conditions. Such conditions include overwearing of contact lenses, age related, autoimmune disease, allergies, certain dysfunctions of glands within the eyes and a host of other causes. Remedies may include artificial tears., anti-allergy drops, steroids and plugs, Restasis, or a combination of the above. Sometimes there is a quick response to treatment and other times it takes a long time for the condition to resolve.

Vision has a profound effect on one's ability to perform in sports. In addition to seeing clearly, peripheral awareness and the efficiency for the eyes to be able to aim and focus together are skills that are necessary to be able to perform effectively. It's quite obvious how important depth perception is in most sports.

What's interesting is that a lot of the above vision skills can be enhanced with training. There are a few eye doctors who specialize in this area. Enhancing vision skills is often overlooked as a means to improving one's performance in a particular sport.

One of the most challenging but rewarding types of contact lenses to fit are the bifocal contact lenses. When they work, they really are great. You don't have to adjust your head in order to see things above you as you do with normal bifocal glasses. There are various manufacturers and and styles of bifocal lenses available. The patient and the doctor sometime have to spend a lot of time in getting the appropriate lenses fit. I have had some patients come back several times in order to arrive at the optimal contact lenses.

Sometimes, the older way of fitting the over 40 contact lens wearer is the best. The patient would wear one contact lens for reading and one for distance. The third modality is having the patient wear two single vision contact lenses for distance and then wearing reading glasses over them.

Prescribing contacts for a mildly nearsighted individual around 40 can be a challenge. Most of these patients take their glasses off when they read. It has to be pointed out to the patient that if you prescribe contact lenses for distance, they might have trouble focusing up close. I, as an optometrist, have to discuss this issue with the patient. The remedy may include reading glasses over the contacts, monovision (one eye for reading and one eye for distance) or bifocal contact lenses. This particular patient opted out of contacts completely but was appreciative that I pointed this out first.

I was talking to an individual who is a photographer who wears glasses. I noted that her glasses did not have an antireflective coating. I told her the benefits of it including cosmetic as well as seeing better particularly at night or on a computer. She stated that her husband use to wear them and they smeared. I told her that the coatings now are a lot better and the problems of smearing or the coating coming off have been greatly minimized.

I had a patient about 30 years old come into the office today. He told me his vision was changing. The patient was found to have astigmatism and nearsightedness. The first question out of the patient was whether his vision problem was caused by aging. I told him it was probably due to the type of close-up work he was doing.

Usually, aging problems equate with not being able to see clearly with the same prescription for reading and distance. This usually starts in the late 30's to early 40's.

I am so grateful to be in private practice. Granted, this is not for every optometrist. I've been in my own practice now for over 21 years. I literally enjoy coming into work daily. Some of the patients whom I've seen as kids bring their own kids in now. The office takes on a a real family feeling, both among the employees and the patients. Also, I have been able to network very effectively with the business community, belonging to three local chambers of commerce.