A 54 year old patient came in this morning with a history of a cataract in his left eye for his entire life. His best corrected vision in that eye with glasses was about 20/100. The other eye was corrected to 20/20. I noticed during the examination that his eyes were not aligned vertically. He stated that he had trouble with depth perception. I put in a prism to help compensate
for this misalignment. He noted everything was brighter, closer and clearer. He stated that no doctor had measured him for this before. I do not know at this time whether the lack of vision in the left eye was due to the cataract, the misalignment of the two eyes or a combination of the two problems. I'll be anxious to see him after he receives and wears his glasses.

I've been practicing optometry for over 29 years. I enjoy practicing more now than ever. The advances in the field have been tremendous. I so have enjoyed the interaction with patients and their families over the years. I've had patients whom I've seen as five and six year olds who have brought their own kids in. Also, what's neat is seeing the impact on some of our patients' lives after they've been treated. I can't think of another health care profession where you get such immediate feedback after the conclusion of treatment.

There have been patients who have come into the office with a very high prescription. When these individuals start to look for glasses, they have a lot or problems telling what the frames they're choosing look like. In these cases we offer to put contact lenses into the patients' eyes so they could tell. A lot of times, the patient has never tried a contact lens. They are surprised at the comfort and the clarity of vision. Some of these patients are in their 50's or above and have never been offered contact lenses. I have patients who were glad they had this experience and wind up as a contact lens wearers.

One of the more rewarding experiences I've enjoyed is mentoring a student who is interested in making optometry a career. The individual has been able to shadow me as I examine my patients as well as seeing what's involved in running a practice. It makes me even more proud and passionate about my chosen profession.

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.