Front Sight

19 03 2014

I love to shoot firearms!  There is something about shooting a pistol, rifle or shotgun that gets in your blood.  It’s exciting, challenging, requires control, discipline and focus.  It is part of our American culture and my family history.   I personally believe everyone should know how to shoot to protect their family and our country.   It is safe if you always treat the firearm with respect and always obey the rules of firearm safety.   Fear of firearms is overcome by knowledge and training, just like learning to drive.

As I enter into the age of “the arms getting shorter” stage or what is known as “presbyopia”, I am becoming more acutely aware how much more difficult it is to shoot with traditional, open (no magnification with a scope)  iron sights on the firearm.

In our forties, the crystalline lens of the eye reaches the stage where it hardens and loses it’s elasticity.  When this happens, the lens of the eye can’t change shape much to help focus on near objects.  The focusing muscle doesn’t weaken, the lens just can’t flex and change shape.  Like a pair of binoculars that has the focusing knob rusted up so you can only see far away.

Pistol shooting is affected the most due to the short distance of the sights from the eye.  Since the eye can only focus at one place at any given time, the key to shooting well with pistols is to concentrate on the front sight.  The rear sight will be blurred some and the target will be blurred some but the front sight is the most critical to focus on.   Especially if you train more realistically to move and shoot.   To “get off the X”  as they say.


Glasses are problematic in that the old-fashioned flat top bifocal is at the bottom of the lens.  If you try to look at the sights through the bifocal, not only is it awkward but it makes the distant target almost impossible to see.  A better option for glasses is a progressive addition lens or “no-line” bifocal.  Since the power is progressively stronger toward the bottom, a smaller head tilt is required and often there is a “sweet spot” that can help focus the front sight without excessive blur on the rear sight and distant target.  Of course this is really only helpful if you are target shooting and standing fairly still.  In a real self defense scenario, you are going to be looking through the top distance portion of your glasses and basically point shooting.  Hopefully, if you regularly practice, even dry firing, your muscle memory will kick in and focus on that front sight.

I personally have had good luck with a multifocal soft contact lens, the Air Optix Multifocal.   It is like a “no-line” bifocal but the bifocal is circumferential, just like a bulls-eye.  It helps to see at all the distances needed at the same time, sort of like a “peep hole’ sight works on certain target rifles.  There are some other brands as well.

Rifles and shotguns are tougher to use at bifocal age but since the front sight is significantly further away from the eye, it is easier to focus on with the top part of the glasses prescription. Of course a red dot scope and ideally, a laser is ideal for sighting at shorter ranges, especially in a home defense scenario.  You know exactly where that bullet is going to with a laser.  red or green (green is better) laser pointing at a bad guy’s chest is very intimidating and can diffuse a dangerous situation often without firing a shot.

Focus on the front sight as you get your sight picture and you will typically hit what you are aiming at.

If you are lamenting the worsening of your vision and how it’s harder to shoot, don’t feel too bad.  If it makes you feel better, even John Wayne in the movie, Big Jake, had to start using a sawed off shotgun due to “short sighted eyes!”

Courtesy of Dumas Vision Source, PLLC and Dr Tory W. Moore, Optometric Glaucoma Specialist.    Serving the Dumas, Texas,  Moore County and upper Texas Panhandle area for 21 years.   Call (806) 935-2020 for appointment or visit our optical gallery without an appointment.  Connect on Twitter @eyedocdumas  and like our Facebook business page:  Dumas Vision Source You also can visit our website for more information.   Tory Moore, OD  – “A Hometown Eye Doctor You Know and Can Trust!”


Oooh baby, baaby…

14 03 2014

Baby baaaby…baby, baaaby….Push it.  Push it good.  Oooh…Baby baaaby.   Yup, got my grove on (in my mind). Who remembers the group Salt N Pepa?  Yes, I’m going back to the 80’s…girls with big hair, Miami Vice,  OP shorts, Member Only jackets…glad that era is over. Almost as bad as the disco 70’s.  But I digress.

Babies.  Just how do we check babies and those little kids eyes?

Well, it’s not easy.  It helps to be quick, creative and sometimes a goof ball to get their attention and help them not be scared.

When we check little children’s eyes, we are looking for three main things:

1. Clear vision in each eye

2. The eyes are aligned straight ahead

3. The ocular health is normal.

While we often can’t be as detailed in the exam data as an adult, we get what information we can.

To determine if the child is seeing clearly, we shine a light streak at the pupils which gives us a red reflection, much like that of a bad photograph where someone’s pupil has got a red reflex.  By moving the light streak in different directions, we can use that red reflex to determine the refractive power of the eye and thus what power of glasses they would need.  If they are old enough to sit for it, a computerized machine called an auto-refractor can read the approximate power of the eye within seconds.  This gives us a second opinion from the manual method.  So if the child is handicapped, won’t speak or too young to respond to questions, we can determine very closely what the refractive status of the eyes are without them saying a word.  When the two readings are close, especially with the help of eye drops that make the focusing system of the eye relax, we can be assured the refractive status of the eye is determined accurately.  That is how we know often times if a child is trying to fake a vision problem.

We usually use pictures instead of letters if they are old enough to speak to help determine what their visual acuity is on the eye chart.  A spinning hand held drum with alternating black and white lines can be used also to get a gross screening of what an infant is capable of seeing.

To determine if the eyes are straight, we cover and uncover the eyes back and forth to see if the covered eye moves to look at a target when the eye is uncovered.  This is called the “Cover Test.”   We also can shine a flashlight toward the eyes and look at the reflection off of the corneal surface and compare it to the pupil location and with the other eye reflection to look for symmetry.  If the reflection differs in one eye, it usually because one is turned a certain direction.  We also use a 3D picture the child looks at with special polarized glasses that makes the picture seem to be floating in the air if they have good stereopsis or depth perception.  If there is an eye turn, usually their depth perception is weak.

Finally, to determine the eye health, we look inside the eye as much as possible.  We try to utilize eye drops that make the pupil dilate and increases the view inside with our special equipment.  At the very least, a good bright red reflection should be coming out of the child’s pupils from the light.  If there is not a good red reflection or especially a white color coming from the pupil, that could indicate a serious eye problem that should be checked immediately by an eye doctor.

I recommend an Optomap Retinal scan be performed on everyone, every year to help see a more complete view of the retina inside the eye.   Even retinal specialists can overlook small things that an Optomap can bring attention to.  It was developed by a Scottish engineer whose 5 year old son had a retinal detachment that was not seen by regular means until it was too late.  Many kids even as young as 2 or 3 years old can often have an Optomap picture taken to see almost the entire back of the eye at one time.

If there is a suspicious finding and the child is just too young or too uncooperative, they can be sedated slightly with medicine that makes them sleepy and just not care or even totally sedated if needed for a more thoroughly internal eye examination.

Since the nerves from the eye to the brain quit developing by age 7-8 years, we want to make sure children are seeing clearly well before that age.   Ideally, children should have an early childhood, wellness eye exam to look for any abnormalities that could affect the eyes development by ages 3-4.  Now with Obamacare, children under the age of 18 are mandated to be covered by a yearly vision exam as a routine procedure.  Check with your insurance provider for specifics.

Don’t assume those big, bright baby eyes are seeing perfectly.  Often the problems are subtle and hard to tell they have a problem.  The child certainly doesn’t know any difference.   We need to correct those problems as early in life as possible so they can develop clear, comfortable,  binocular vision at all distances they are looking at by age 7 or 8. Especially when they look at your old high school yearbook and laugh at your big hair and Madonna outfit.

Don’t gamble with your children’s eyes.  Start checking their eyes by 3-4 years old.  Schedule your kids for an eye exam today.


Courtesy of Dumas Vision Source, PLLC and Dr Tory W. Moore, Optometric Glaucoma Specialist and Diplomate of the American Board of Optometry.    Serving the Dumas, Texas,  Moore County and upper Texas Panhandle area for 23 years.   Call (806) 935-2020 for appointment or visit our optical gallery without an appointment.  Visit our website for more information.  Like our Facebook business page:  Dumas Vision Source  and you can also connect on Twitter @eyedocdumas

Tory Moore, OD  – “A Hometown Eye Doctor You Know and Can Trust!”

Pregnancy and Vision

3 03 2014

I’m going to be a grandpa!  Wow, how did that happen? Weren’t my kids just in school? Yes, it happens that fast. Virtually in the blink of an eye.  Anyway, a new era is about to begin and it got me to thinking about pregnancy and vision.

I see many young mothers to be and they often have many questions about their vision.  Will the pregnancy affect their vision?  Will it make their eyes worse?  The answer is…maybe.

So just what could a new “mother to be” expect to happen with their eyes?  Most of the time, nothing will change. However, since there is a flood of different hormones throughout their body sometimes we can see a few common things.  The most common are:   1. Dry eyes  2. Blurred vision

Dry eyes can cause fluctuating vision, burning and dryness, redness, watering and a sandy, gritty sensation.  This can be helped by a variety of different types of treatments including eye drops and even temporary tear saver plugs that help keep more of your own body’s natural tears.

Blurred vision  can be caused by dry eye but often I see changes in astigmatism and nearsightedness due to corneal shape changes.  With the hormonal changes and water retention, it makes the cornea change it’s shape, thus changing the refractive power of the eye and thus requiring a lens change.

When blurred vision is really a problem, it is because of blood sugar changes.  We never change a prescription on pregnant women until they have had a blood glucose screening to make sure they don’t have gestational diabetes.  If their blood sugar gets higher from the pregnancy, it makes the crystalline lens swell and causes them to become more nearsighted.  The vision usually goes back to where it was once the blood sugar goes back to normal with treatment.  If pregnant women have some relatively small refractive vision changes, it is left alone for the last month of pregnancy and up to one month post part-um since it will usually go back to normal on it’s own.

 Of course if it’s a really big change, we can work with people to help them see with temporary disposable trial lenses until the vision equalizes and we can get a final prescription.  If you are having trouble seeing, please come in and let us help you!  You  don’t want to miss out on such an important time of your life just because your vision is blurry.

It is really important to have  a pair of glasses to wear for when you are in the hospital or if you are laid up in bed and don’t feel like putting on contacts.  You will be plenty tired and worn out both physically and emotionally at times.   A pair of glasses comes in real handy at 3:00 AM in the morning for when that cranky baby is fussing and you just went to sleep.

Rarely, a few more serious eye problems can develop as a result of pregnancy or childbirth.  The main one would be hemorrhages from high blood pressure or from vomiting during preclampsia.   Usually these resolve on their own without any damage as long as the high blood pressure is kept under control.    It is rare they need any surgical intervention.  The worst case scenario would be where the pituitary gland is swollen and putting pressure on the nerves of the eyes.  This is rare but has been known to happen occasionally due to pregnancy hormone changes. Rarely, a blockage or stroke in the eye can occur as well.

While it is extremely rare that pregnant mothers will have any vision problems, there are things that can affect the vision adversely.  The point is to have the eyes examined and make sure it is not anything serious if you are having any kind of trouble with your vision.  Most of the time it is not serious.

Watch for future blogs about how a baby’s eyes develop before they are born and when to start having their eyes examined to make sure they have normal vision and are healthy.  You are taking part in one of God’s most precious creations.  It is not something to take lightly.  Children are a blessing from God so make sure you steward that gift as best as can.  Delight in your children and take joy in them.  Trust me, they grow up way too quickly.

“For you formed my inward parts; you knitted me together in my mother’s womb. I praise you, for I am fearfully and wonderfully made. Wonderful are your works; my soul knows it very well. My frame was not hidden from you, when I was being made in secret, intricately woven in the depths of the earth. Your eyes saw my unformed substance; in your book were written, every one of them, the days that were formed for me, when as yet there was none of them.”   Psalm 139:13-16

Courtesy of Dumas Vision Source, PLLC and Dr Tory W. Moore, Optometric Glaucoma Specialist and Diplomate of the American Board of Optometry.    Serving the Dumas, Texas,  Moore County and upper Texas Panhandle area for 23 years.   Call (806) 935-2020 for appointment or visit our optical gallery without an appointment.  Visit our website for more information.  Like our Facebook business page:  Dumas Vision Source  and you can also connect on Twitter @eyedocdumas

Tory Moore, OD  – “A Hometown Eye Doctor You Know and Can Trust!”