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Doctor, I see spots!

If it’s not the patient asking “What are those floaty things in my vision?”, it’s the optometrist asking “Do you see floating spots?”. What are those strange things in my vision that look like fish eggs, hairs, dust, segmented worms or spider webs and which many of us will see if we look carefully enough? Should I be concerned?  Am I crazy to mention it to the optometrist? Maybe it will go away if I ignore it.

Let’s first start with some basic anatomy, followed by some of the common causes. Then we’ll discuss the kind of spots that might represent a “red flag” that should be investigated right away.

eye_diagram

The retina is the “image sensor” of our eye. It begins the visual process of seeing the images of our “outside” world, but  is also a source of images which are not part of our “outside” world. Coloured lights, a grainy pattern of lights, or dancing lights can be noticed, particularly by children, especially in dark rooms or with eyes closed. We tend to ignore this as we get older. These “inner world” images are the result of normal random firing of the neural retina causing an appearance like a dark grainy digital photo. This background visual “noise” is one of the entopic phenomena.  Other entopic phenomena include  lights from mechanical pressure to the eye such as with  eye rubbing, “after images” after looking away from a bright object, arcing dots of light from stimulation by blood cells flowing in the retinal capillaries, “shooting stars” after coughing or bending over, and more. Light passing through closed or semi closed eyelids can produce some interesting light and colour patterns too.

The vitreous is a clear, gel-like substance which fills much of the inside of the eye. It is positioned immediately in front of the retina and light entering into the eye passes through the vitreous before it reaches the retina. Imagine a fly flying in front of a projection screen. It will cast a shadow on the screen. The closer the fly is to the screen, the clearer is the shadow.  Any normal or abnormal irregularities in the vitreous structure can cast a shadow or “floater” onto the retina. It is difficult to look directly at the floater because as we move our eye the vitreous moves with it. Since the vitreous is a bit fluid like, the floater may appear to drift or “slosh” when we move our eyes. As we grow older our vitreous tends to become more liquid like and irregular. We may see more floaters which tend to move or drift more.

As we age into our 50s, 60s and 70s, many of us will develop a posterior vitreous detachment. Because the vitreous is liquefying and shrinking as it ages, it may gradually or suddenly pull away from the retina, where it is most loosely attached. This process frequently causes symptoms of flashes of light and/or new floaters and may include a new large floater, often web-like or “C”  shaped. Often the vitreous detaches without causing any damage to the retina. However, sometimes  the vitreous can cause a tear in the retina which may lead to a retinal detachment. This retinal damage is can threaten vision and needs to be treated promptly.

Some other abnormal causes of floaters include blood in the vitreous, inflammatory cells in the vitreous, and pigment cells released from a retinal detachment. Damage to the central part of the retina called the macula occasionally causes a more fixed spot to appear in the middle of the vision.

Most of us will see spots and unusual patterns in our vision if we look carefully enough. It is good to take an inventory of what you see. This is easier to do when you look at the sky, light colour wall or computer screen. The floaters, if large or numerous, can be annoying but they are not normally treated because of the risks associated with removal.  

If at any time you notice many new spots in your vision that you have never seen before, it is important to call our office right away and have your eyes examined to determine the cause. Early detection of an abnormal cause and treatment can make a significant difference in your visual outcome.

… Oh yes, there is one more rare but documented cause of spots – Rabbititis!

Introducing Dr. Tina Morowat

We are excited to introduce Dr. Tina Morowat, the newest member of our team!

Dr. Tina Morowat completed her Bachelor of Science degree with distinction at the University of Western Ontario followed by earning her Doctor of Optometry degree at the University of Waterloo, where she graduated on the Dean’s Honour List.

Dr. Morowat gained clinical experience in the treatment and management of ocular disease, including the use of ocular therapeutics, on internships in Oklahoma, Ingersoll and London.  She has also volunteered on an eye care mission to southern Mexico and is currently working towards her Fellowship in the American Academy of Optometry.

Outside of the office, Dr. Morowat enjoys traveling, running, hiking and playing in musical ensembles. She is excited to be practicing full scope optometry and enjoys all areas of vision care.

Why am I nearsighted?

Myopia or nearsightedness results in blurred distance vision from imprecise optics of the eye. Light entering the eye, from an object one is looking at, focuses in front of the retina instead of on the retina. Vision is worse far away than it is at near. Often myopia begins in childhood and increases through the growing years but it can advance at any age. Less frequently  myopia can improve with time,  sometimes in our older years.

myopia

Nearsightedness can be corrected with glasses, contact lenses, and refractive surgery. But can we prevent it altogether?

There have been many theories put to rest about the cause of myopia. Reading in the dark, reading too much , playing too many video games, sitting too close to the TV, and wearing glasses  have all been cited as causes. My mother thought my brothers and I became nearsighted because we had the German measles (rubella) as young children. In reality, the true cause of myopia is still a bit of a mystery despite much research.

Myopia has an association with certain genetic disorders, birth defects and early vision deprivation. Some eye disease, such as keratoconus, and advancing cataracts can lead to increased nearsightedness. However, most of us who are nearsighted don’t have any of these conditions.

It is now being acknowledged that myopia is on the rise in the general population as illustrated in this Scientific American info-graphic article.

An obvious question is “Why?” Is it our family genetics, our excessive near work, our diet or something else? Research suggests that the cause is likely multifactorial, a catch-all phrase stating that we’re not really sure and it is likely a combination of factors that differ between individuals.

Some of the more recent research, much of it coming out of Asia where there is an unusually high prevalence of myopia in certain locales, suggests that spending more time outdoors can help reduce the risk for myopia. We have quickly become societies who are spending more and more time indoors. Spending an extra 40 minutes per day outdoors appears to have some benefit in reducing risk.

So the take home message is, have your children spend more time outdoors each day and have regular eye examinations to help them keep seeing their best. If you have questions or concerns about your own vision or that of your children, please don’t hesitate to give us a call.

Seasonal Allergic Conjunctivitis

Spring is a wonderful time of year with the evidence of new life everywhere; wonderful, unless you suffer from allergies. Whether it be pollen in the spring, grass mid-summer or  various weeds late summer, allergic symptoms can vary from mild and infrequent to quite severe throughout the growing season.

Allergic conjunctivitis effects the clear conjunctiva, a thin tissue covering the white of the eye and the inner eyelids.  Itching is the predominant symptom. Itching can be accompanied by watering, redness and puffiness. Allergic conjunctivitis can affect all ages and symptoms can vary in severity from one year to the next. Sometimes the nose and throat linings can be affected too.

Allergic conjunctivitis is an inappropriate “overreaction” response of our immune system to an otherwise harmless substance called an antigen. Antibodies are produced by the body  to try to defend the eye from the antigen. These in turn cause the release of chemicals which cause the itching, watering and swelling.

Allergic conjunctivitis
Allergic conjunctivitis

Symptoms can be reduced by avoiding exposure to the antigen and spending more time indoors with the windows closed, however, this is not always possible or desirable. Washing your hair before bed and laundering bed sheets frequently can reduce the antigen load that otherwise transfers and accumulates on the pillow overnight. Cold compresses will provide temporary relief . The use of eye lubrication drops such a Refresh Tears or Systane Eye Drops  can help dilute the antigen and reduce symptoms. Over the counter anti-histamine drops can be helpful for symptoms lasting just a day or two. If nasal symptoms are also present, oral antihistamine medication can be helpful as well.

If symptoms persist, make an appointment with our office to determine if you do have allergic conjunctivitis or some other eye condition or if there are other associated factors involved such as dry eye. Several effective prescription eye drops are available to help successfully manage mild to several seasonal allergic conjunctivitis and can be prescribed by your optometrist.

Spring should be a season to enjoy without the discomfort of itchy eyes!

The message behind the brand

personalized ec

It’s spring time, and this spring Teeple Optometry also has a fresh new look.  This new “branding” is more than just appearances.  It’s a look that invites you to experience a strength of Teeple Optometry many have come to appreciate, our excellent service. Read More

The Mysterious “Pink Eye”: AKA Conjunctivitis

“Pink eye” or conjunctivitis is a common eye condition that ranges from mild to severe, acute to chronic and has a wide variety of causes. It can affect all age groups and is often misdiagnosed and mistreated. Fortunately, most conjunctivitis gets better on its own. Treatment can be helpful to reduce symptoms and sometimes prevent more serious consequences.

To confuse things, there are other diseases, such as anterior uveitis, episcleritis  and corneal disease, that can make the eye look red but are completely different. It is very important to consider  these conditions in any “pink eye”.

The conjunctiva is the transparent tissue covering the “whites”of the eye and the underside of the eyelids. When this tissue becomes inflamed for any reason, the little blood vessels in the conjunctiva enlarge and the eye looks more pink or red. Often patients correctly or incorrectly equate pink eye with an eye infection.

Important: With any red eye, if you experience significant pain, blurred vision or significant eyelid swelling, call your eye care practitioner right away.

Baterial-Conjunctivitis

There are  four main causes of conjunctivitis: infection, allergy, toxic/irritant and dry eyes.

Infectious conjunctivitis:

Viral is the most common type of infectious conjunctivitis. Many different viruses can affect the eye. Often cold or flu like symptoms are associated with the conjunctivitis and both eyes are usually effected, one more than the other. One particular viral infection, epidemic keratoconjunctivitis, is quite prolonged and very contagious. The eyes are red, weepy, scratchy and  a bit sensitive to light.

Antibiotic drops such as polysporin, allergy drops or “red eye” drops like Visine are ineffective. Supportive measures such as cold compresses, lubricating drops, avoidance of eye rubbing and rest are most helpful.  Good hygiene measures such as frequent hand washing, not sharing towels or pillows, and keeping the hands away from the eyes are most helpful to reduce the spread to others. Eye cosmetics should be discarded and new makeup avoided until the condition clears. Contact lenses should not be worn. Viral conjunctivitis can last up to 3 weeks.

More serious eye infections caused by the herpes simplex virus or the herpes zoster virus can involve the cornea and can lead to permanent scarring and loss of vision. Accurate diagnosis and aggressive treatment is important.

Chlamydial conjunctivitis is sexually transmitted disease and acts a bit like a viral conjunctivitis that doesn’t get better on its own. Accurate diagnosis and appropriate treatment is important.

Bacterial conjunctivitis is less common and can involve one or both eyes. Usually there is more thick and sticky discharge. Often this will clear on its own but antibiotic drops can clear it up faster. Warm compresses and lubricating drops can help with comfort. Again, contact lenses should not be worn and eye makeup discarded. If abnormal pain or blurred vision is present, or it involves a young child who is quite ill, examination by your optometrist is vital to rule out a more serious, vision threatening corneal ulcer, orbital disease or other problem.

Allergic conjunctivitis

Allergic conjunctivitis is a common cause of “pink eye”. Often this is seasonal with symptoms of itchy, stingy, weepy eyes. Both eyes are effected equally. Pollens, animal dander and molds are common triggers of allergic conjunctivitis. Avoidance of the cause, if possible, air filters, good house cleaning and frequent laundering of bed sheets can be helpful. Cold compresses, eye lubricating drops and avoiding eye rubbing are simple solutions. For more persistent allergies, your optometrist may prescribe allergy drops and/or anti-inflammatory drops which can be very effective.

Toxic/Irritant conjunctivitis

Toxic/Irritant conjunctivitis can occur for a variety of reasons. The conjunctiva can be inflamed because of exposure to chemicals such as chlorine in pools, volatile fumes from paints and thinners, soaps and facial cosmetics, nail polish and compounds released from chopping onions. A misdirected eyelash, poor quality eyeliner and masquera, dust exposure, UV exposure, poor eyelid closure and excessive eye rubbing can inflame the conjunctiva. Contact lens wear, contact lens solutions and eye drops sometimes irritate and inflame the eye.

Dry eye related conjunctivitis

Dry eye related conjunctivitis is quite common, especially as we age. It tends to be chronic with symptoms that wax and wane. I discussed the problem of dry eyes  more fully in a previous blog post, “These Cry’n Eyes”.

“Pink eye” is not as simple as it appears. Having a correct diagnosis of the underlying cause is important to properly treat the condition. Check with your optometrist for the most appropriate care.

photo of staff

Congratulations Julie!

Congratulations to Julie for recently earning her Canadian Optometric Assistant certification. She joins Lisa, Cheryl and Jody who are Certified Canadian Optometric Assistants. Pictured from left to right are Jody, Cheryl, Lisa, Tracy, Julie, Morgan and Kaytiee.

Meet Morgan, our newest optometric assistant!

Morgan is the most recent member of our optometric team. She is a recent graduate from the Georgian College Opticianry program and will be writing her national examinations later this year.

It is obvious that Morgan enjoys her work and she brings with her a high level of enthusiasm and expertise. You will likely meet her during specialized testing or helping you in the frame gallery.

Ultrawide field image

Introducing Ultrawide Field Imaging!

New technology has brought about several remarkable transformations in the way we provide eye care since we began our practice in 1979. Equipment has been introduced over time which has allowed us to diagnose eye conditions with greater accuracy and at much earlier stages than ever before.  Utilizing these new technologies allows you to receive more complex and comprehensive care with the aim of maintaining good eye health and vision. In keeping with our mission to provide the best care possible for our community, you will be introduced to an exciting new diagnostic instrument during your next visit to our office.

Ultrawide field imaging is a new technology designed to better assess the health of the entire retina in patients of all ages. Macular disorders, age-related macular degeneration, diabetic retinopathy, retinal holes or tears, peripheral retinal degeneration, retinal detachments, retinal tumours, vascular disorders, glaucoma, and hypertensive retinopathy are some of the conditions that can affect the eye, often without pain or visual symptoms. Children are not exempt from having retinal disease and require a thorough examination too.

Previously, the examination of the retina was best performed by direct examination with ophthalmoscopes and retinal photographs, often through dilated pupils. These techniques allowed a detailed view of a small part of the retina at a time, akin to examining a dark room with a flashlight. These techniques will not be abandoned and are still required for assessment in many situations.

Optos Daytona

The company Optos, has developed an instrument, Daytona Optomap, that uses scanning lasers of 2 different wavelengths to rapidly generate a detailed view of 80+% of the entire retina, far more area than any previous instrument. The procedure is painless and easy for the patient and may lessen the frequency of pupil dilating drops. The doctors are able to immediately view the various images generated during the examination.

Eyemaginations has produced a short video describing ultrawidefield imaging and the Optomap instrument that you can view here.

As doctors and optometric personnel charged with the responsibility of providing you the best in eye care, we are excited to offer you this new service and to answer any questions you may have about it.

Sunglasses and tints – so many choices!

The warm March sun on the snow covered ground, although welcome, can seem a little too bright! With the changing season I find myself reaching for my prescription sunglasses on many occasions and for a variety of activities.

We choose tinted lenses for at least five reasons: comfort, vision enhancement, fashion, concealment and protection. It can be uncomfortable driving into the rising sun on our way to work in the morning. The golf ball can get completely lost against the sky. Sunglasses can equal “cool” or “hot”.  Some tired eyes do better with shades. And the sun’s ultraviolet radiation (UV) and short wavelength blue light (SWBL) can damage eye structures with prolonged exposure.

So how do I choose which tinted lenses are best for me? And what if I wear prescription glasses?

Generally sunglasses tend to be bigger than prescription glasses, providing more coverage of the eye area. This allows a wide field of vision and lets in less peripheral light that can cause glare. Most good sunglasses provide UV protection but not all offer SWBL protection. Other important considerations are impact resistance, scratch resistance, back surface anti-reflection coating to reduce glare and lens optical designs to reduce distortion from the curvature of the lens.

And then there is the myriad of colours! Consider yellow, amber, rose or brown lenses if you want to improve contrast. They work well in activities such as golf, cycling, skiing, running, hunting and driving in “flat” light conditions but do distort colours. Green also helps to improve contrast in tennis, baseball and golf while reducing some blue light. Gray is the best tint for reducing overall light while allowing colours to remain true. And a dark tint is great on a very bright day but not so good when the light levels drop. It is very helpful to see and test the tints of which our office has many samples.

Should sunglasses be polarized? Polarization selectively reduces light reflecting of flat smooth surfaces such as water, asphalt, vehicles surfaces, etc. Polarized lenses can be great for boating, fishing, cycling and driving.

Photochromic lenses lighten and darken in response to light level, particularly UV levels. Convenience is their main benefit. Photochromic lenses darken quickly when exposed to bright light, they are a little slower to clear and they only darken a little behind a windshield or glass. They have good UV protection like other sunglasses. Available colours are gray, brown and green.

Prescription sunglasses are great for those who require corrective lenses. Clip-on sunglasses or fit-over sunglasses can be a less expensive option.

So how best to decide? Of the five reasons highlighted in the second paragraph, which reasons are most important to you? Be prepared to discuss this when you speak to our knowledgeable staff and they will help you find your perfect shades.

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