Chronic Headache Relief for Many!

 

If you are one of the millions that suffer from chronic headaches, especially with neck and shoulder pain, eyestrain, tired eyes, along with dry eye and motion sickness in the car, there may be new hope for you.   Headaches can be a very complex disease diagnosis process and there are so many possible causes.  Some are simple tension headache from stress and anxiety, others are sinus inflammation.  Sometimes patients that have been diagnosed with migraine headaches are not actually migraines.  The patient may have bad vision, high blood pressure, narrow angle glaucoma, Chiari malformation, aneurysms or a brain tumor.   I cannot re-iterate enough, migraines are a diagnosis of exclusion and that diagnosis should not be completely reached until after a CT or MRI scan of the brain to first rule out a very serious medical condition.

We are so excited to add new technology to our office to test and treat those that have constant, chronic headaches.  Neurolens is a new digital, prescription lens technology that incorporates a contoured prism design, never available before.   Neurolenses were developed by an optometrist in conjunction with neurologists after seeing many patients suffering with chronic headache and neck/shoulder pain even after taking medications.

Misalignment of the eyes puts lots of stress on the Trigeminal Nerve, which is the largest of the cranial nerves in the brain and extends down to the upper shoulder region.  When the eyes are working hard to put the two images they see into one image (like using binoculars), it can trigger symptoms like headache, neck/shoulder pain, tired eyes, motion sickness in the car, computer eye strain, and even dry eyes.  This is what is called Trigeminal dysphoria.

Trigeminal dysphoria is a recent discovery between the relationship of eye misalignment and the Trigeminal cranial nerve.   With the invention of the Neurolens eye tracking device, precise measurements of how the eyes work a team can be measured more precisely.  It is a simple and quick screening test involving multiple targets the patient watches on a screen.   Imagine trying to drive a car with two steering wheels for each front wheel to keep the two front wheels straight driving down the road.  You would be a little stressed and arms tired after just a little while trying to control the movement of your vehicle.  Trigeminal dysphoria works in a similar way.  It creates a lot of tension in the nervous system when the eye muscles don’t line up correctly, which can cause a host of symptoms not always linked to the eyes.   With the huge increase in the use of all kinds of digital devices, I am seeing so many people suffering from this condition….and they don’t have to now.  I predict many children labeled dyslexic, not all, but many will be helped from Neurolenses.

Even those that seem to have perfect 20/20 vision can have misalignment of the eye muscles and Trigeminal dysphoria.  Many patients have even had their eyes examined and though the patient sees well with or without glasses and the eyes are healthy, many times the eye misalignment has been missed.  With the new technology in our office to track eye muscles, we can screen you for Trigeminal dysphoria.

Neurolenses are a God send to many, chronic headache suffers I believe.  We are already seeing the results in our office from patients that we have prescribed Neurolenses for.   We believe in them so much, if a patient is a strong candidate for help with them, we will buy them back if the patient doesn’t get relief after 30 days.

If you have bounced from doctor to doctor for headache relief, trying multiple medications that offer slight and temporary relief or see a chiropractor often for back and shoulder pain that keeps coming back, I urge you to seek a Neurolens screening from a qualified Neurolens doctor soon.   Let us help you get relief finally!

Tory Moore, OD

 

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 30 years.   Call (806) 935-2020 for appointment or visit our optical gallery without an appointment.  Visit our website www.visionsource-dumas.com 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!

Be safe, be seen on Halloween

Halloween is here and there will be lots of kids running around  in the dark.  Take precautions with your kids and make sure they are visible to cars.   Here are a few tips:

1. Children should be given a flashlight to help them see where they are going in the dark and also to be seen by others easier.
2. Consider using face paint instead of masks to help children see to get around better.  At least make sure the eye holes are large enough so as not to obstruct their vision.
3. Reflective tape can be attached to costumes and clothing to make them more visible as well.
4. If a sword, cane, or stick is a part of your child’s costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
5. Do not use decorative contact lenses without an eye examination and a prescription from an eye care professional.  While the packaging on decorative lenses will often make claims such as “one size fits all,” or “no need to see an eye specialist,” obtaining decorative contact lenses without a prescription is both dangerous and illegal.  This can cause pain, inflammation, and serious eye disorders and infections, which may lead to permanent vision loss or blindness.
6. Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost.
7. You might want to go out early before total darkness as well to make it safer for your children.
8. And put your pets, especially cats,  somewhere safe.  Unfortunately, people do mean things to animals.  Better to be safe as well as protecting kids from animal bites since there will be lots of pet anxiety that night with all the activity and noise.

For the safest environment and a more positive atmosphere,  instead of trick or treating, consider bringing your kids to the Fall festival at the Moore County Community Building in Dumas  Halloween night.   Activities to include bouncy castles, concession foods, games, crazy cardboard maze, free give aways, prizes, & TONS of CANDY!!  And all the dentists say, “Yes!”

 

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 25 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 www.visionsource-dumas.com for more information.   Tory Moore, OD  – “A Hometown Eye Doctor You Know and Can Trust!”

Retinoblastoma (Cancer of the Retina)

One of the saddest cases I have ever seen was a little girl who was brought in by her father because one eye looked white in the pupil of one eye.  I have seen a white pupil often in adults, usually from an advanced cataract or even a retinal detachment.  But in a child, your first thought is cancer of the eye. You may have seen the story recently about the mother that detected a problem in her child by taking a cell phone picture.  Either on Facebook or CNN:

http://www.cnn.com/videos/us/2015/05/08/pkg-illinois-toddler-eye-cancer.wrex

or ABC News:

http://abcnews.go.com/Health/mom-catches-year-olds-eye-cancer-snapping-photo/story?id=30954695

First of all, the pupil is the window into the eye.   Some say it’s the window to the soul but definitely it is a window into the overall health of the body.  It looks black normally because light doesn’t escape or reflect out easily as in some animals like cats and dogs.   If the pupil is big enough or you get enough light to shine in, you can see a reddish-orange reflection with the right tools.

The retina is the inner back lining of the eyeball that detects light and sends the signals through the optic nerve to our brain in order for us to interpret what we see.   The eye is the camera, the brain is the TV set basically.  I used to say the retina is like film in a camera but with everything digital now, I have changed the analogy to the digital sensors in your phone or digital camera.  Anyway, the retina have ALOT of blood supply.  Between that and the layer of pigment cells on the outer layer, the color generally appears reddish-orange.

Eye doctors use that reddish-orange reflection to determine the amount of refractive error like nearsightedness or astigmatism a person has for glasses.  That is how we can tell what power glasses need to be for little babies or people who can’t talk.  It is also how we know if your child is malingering (faking) the need for glasses.

If that reflection is dim, has shadows, or a different color, that tells us there is something wrong with the pathway for light entering the eye.  Either the lubricating tear film on the front surface, the cornea, the crystalline lens, the vitreous fluid, or the retina could have a problem.

Retinoblastoma is a fairly rare cancer that usually develops in very young children but it is possible for an adult to develop it too.  It is from a genetic mutation of the retinal cells and the risk of passing the gene to offspring can be higher for those families that have had someone affected.  It is very aggressive and can spread to other parts of the body very quickly.  The sooner the eye is removed that better chance of survival.  Yes, the eye needs to be removed quickly.  As tragic as that sounds, children adapt fairly well since they are not seeing out of the affected eye anyway.

I encourage young parents to take a picture of their child with a flash straight on from 3-4 ft away.   I do it to screen children and to help them relax by showing them their picture so they get comfortable with me examining their eyes before I do more.  Both pupils will either be dark if the pupils are too small or both a reddish-orange glow, which is the reflection off the retina. If it is orange, you can enlarge the picture and look for shadows, which could indicate a problem with the surface of the eye or cataracts.   Yes, children can have cataracts, though rare.   If a reflection is white, it could be a refractive error (nearsightedness, astigmatism, etc.), a cataract, a retinal detachment or retinoblastoma possibly and you would want that checked immediately by having the child’s eyes dilated.  They may have to be given a sedative to get them to cooperate and get a good view. If the doctor is not getting a view because the child is not cooperating or crying, the child should be referred to someone who will perform a sedated eye examination, most often a pediatric ophthalmologist.

As a side note, there should also be a little white reflection on the cornea, the front surface of the eye, from the flash.  That white dot from the flash should both be in the same relative position to the pupil of each eye. If not, your child could have an eye turn.

Also, all children under 18 are mandated to be covered for at least a wellness eye exam once a year under the Affordable Care Act (Obamacare).

Please have your kids eyes examined at 3-4 years of age at a minimum and every year after that.   Just because they seem to get around doesn’t mean that both eyes are okay.  If one is not seeing well or turned, the vision won’t develop properly and it is permanent after age 6-7 years old when the optic nerve quits developing.  Don’t take any chances with the vision and the health of your child.

 

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 25 years.   Call (806) 935-2020 for appointment or visit our optical gallery without an appointment.  Visit our website www.visionsource-dumas.com 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!”

Extra, Extra, See All About It!

This time of year during fall when the sun is shifting on the horizon it just seems like the glare is worse than normal at sunrise and evenings.  Especially in the flat, treeless plains of the Texas panhandle where you can see forever.  Sunglasses are a necessity when that sun is coming right down the street in your eyes.

In the past, photochromic lenses that change with the light have limited darkening behind the car windshield so most people would have to have a separate pair of sunglasses that stay dark all the time.  That works great but sometimes it is inconvenient for some people when they walk inside and don’t have their clear pair with them or have no place to put their sunglasses once inside.

Transitions Optical has a newer product available now called Transitions XTRactive.  The basic Transitions Signature lenses are better than ever but still need UV to change them.  Windshield glass blocks UV light and so while they are good, they aren’t the very best option if you drive a lot and want to reduce the brightness of light.

Transitions XTRactive lenses however get dark behind the windshield and yet still get almost perfectly clear inside.  The lens tint once you go inside is almost indiscernible.  So if you are one of those that seem to always be switching glasses or end up wearing your sunglasses inside because you forgot the clear pair, this might be a great option for you.

We have demonstration lenses available to see for yourself how dark and how clear they become.  We even guarantee them if you are not happy with their performance and will exchange them for another type.

Come see what they are all about!

 

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 www.visionsource-dumas.com for more information.  Like our Facebookbusiness page:  Dumas Vision Source  and you can also connect on Twitter @eyedocdumas

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

Headaches

Headaches.

I have had my share of them over the years.  More than average I dare to say.  I have had medical tests, CT and MRI scans, dental visits and special mouth guards to prevent teeth grinding while sleeping and have taken more over the counter and prescription drugs than the local drug addicts during my years.  I still remember my first severe headache on a trip with one of my friends to Six Flags of Texas in Dallas.  What a miserable time.  Ultimately I had sinus surgery ten years ago, which relieved almost all of them.

Believe me, I know how you feel.  When the pain is so bad you wish someone could drill a hole in your skull to relieve the pressure and all you can do is lie on the cold, tile floor with an ice pack on your head after taking tons of medicine and pray “God, please take away the pain.”  I’ve been there.

If I could break down my patient’s main reasons for wanting an eye exam into three categories, they would be in this order:

1. Blurred vision –either just a slight blur or a major blurring at distance or near, with or without lenses.

2. Wellness checkup – they see okay with or without vision correction but want to make sure everything is healthy and maybe update their contact lens prescription while having no apparent problems.  Perhaps previously diagnosed with a medical eye condition and ensuring there is no progression.

3. Headaches – There are so many things that can cause a person to experience a headache, it can give somebody….. well, quite frankly,  a headache trying to find the cause.
Since there are so many causes of a headache, a good patient history is absolutely important.  When did they start, do you have a history of headaches before, how often do they happen, how long do they last, what region of the head do they hurt at, what time of day do they generally happen, are they disabling or can you still function, do you have any vision abnormalities like spots or wavy lines before or during the headache, does medicine help the pain, do you get dizzy or nauseous with the headache, do they seem to happen related to certain activities such as reading or computer use, what other medical problems do you have that you know about, what medicines do you use or recently stopped using?  Doctors have to consider the patients age, sex, family history, history of seasonal allergies, medicines being used or even discontinued recently and any medical conditions you might have.    Your diet, water intake and sleep apnea even can play a large role.  Headaches are perhaps one of the most challenging diagnoses due to the many possible causes.  I will cover the most common in order of prevalence that I often encounter.

1. Uncorrected basic vision

When someone comes in with a complaint of frequent headaches, after the preliminary testing, one of the first tests we do is a refraction of the eyes.  That is the part where we determine how the eye can see and what glasses prescription might be needed to make the patient see more clearly and see more comfortably.  You know, “Which is better, one or two?”

The most common cause of headaches that I see in my office is uncorrected farsightedness, especially in school age children.  If the patient is farsighted, they can see far away easier than up close.  They may be able to see up close too but they have to work twice as hard as normal to do it if their eye is using it’s near focusing ability (accommodation) to help the patient’s far vision.  It does that subconsciously like an auto-focus camera.  The eye should only “focus” or tense up when looking at objects within arm’s reach for the most part.  Uncorrected farsightedness (hyperopia) makes the eye, without even thinking about it; try harder to keep the vision clear while looking far away.  That constant, unneeded focusing causes strain and ultimately headaches in the frontal region of the head or around the eyes usually by the early or late afternoon after focusing the eyes more than average.  Basic single vision glasses worn all the time will typically resolve the headaches even though the vision of the patient has been clear anyway up until this point.  The eyes are just working too hard and the extra muscle tension causes the headache.  So farsighted glasses correction is more for comfort than to help the vision in many cases.

2. Uncorrected near vision after 40 years old

After the dreaded big 4-0, (typically 43 years old) the focusing system of the eye that helps to see up close begins to weaken.  The lens in the eye becomes stiffer and less flexible, which causes the automatic focusing of the eye to strain even more to make your near work activities harder and harder to see.  It’s not a weakening muscle, it’s simply the lens not able to flex anymore very well, like a piece of old rubber that doesn’t flex very well.    At this point, we need extra help to see up close clearly and comfortably.  Whether we need a prescription or not for the far away vision and more power for up close, then at that point a multi-focal lens with multiple focusing powers is recommended so people can see at all distances.  When patients that are 40 years old or over seem to get headaches after reading or other near vision work, quite often this is a sign they need a multifocal lens such as a progressive lens or a bifocal.  This is like using a tool to take the load off the eyes and make them focus better and not to have to strain to see.  If you get headaches after reading or looking up close and your arms seem too short anymore, more than likely you need help with the focusing in the form of a multi-focal lens.  Glasses or contacts can help.

3. Binocular vision disorders

The eyes are separate organs that work as a team (think of a pair of horses yoked together) to give clear, comfortable, binocular single vision.  When the coordination of the two eyes is not optimal, they have to work harder than normal , if they can, to keep the eyes aligned exactly in the same direction in order to not see double.  Imagine someone that slouches or is pigeon toed is told to “straighten up” and they have to exert more muscle effort to get the back or feet lined up straight.  The eyes can do the same thing and it causes a lot of muscle strain and possibly a headache.  Sometimes an eye that turns inward, outward or is higher or lower than the other is not easy to discern.  The uncoordination of the eyes is possibly caused by uncorrected vision but also could be caused by a genetic muscle or nerve problem or even by a medical condition such as diabetes, hypertension or even a stroke.  If basic glasses with or without a bifocal doesn’t’ help, then prism power can sometimes help.   A prism bends light so the muscles don’t have to work so hard to see one picture.

4. Medical eye problems

The most common medical eye problem  that can cause a headache from a more uncommon type of glaucoma called acute angle closure glaucoma.  When the drainage system of the eye is narrow, it can be difficult or even impossible for the inner eye fluid (aqueous humor) to drain properly.  This makes the fluid pressure inside the eye to increase rapidly and often times there is signs of a red eye, blurred vision and a severe headache over the eyebrow to the point of nausea.  There are treatments to relieve the condition.

Inflammation inside the eyeball itself, usually related to an auto-immune condition such as rheumatoid arthritis, can cause pain in and around the eye that can be construed as a headache.  Rarely a corneal abrasion or a bacterial ulcer on the eye’s surface can cause inflammation and pain enough to cause a frontal headache.

5. Eyewear and lens problems

Eyeglasses are precision made devices that must have very exact measurements in order for the brain to see clearly and comfortably at all distances.  If the frame is crooked on the face, it can cause eye strain and eventually a headache.  The same goes for a lens that is not centered in front of the pupillary axes.  Even what the material the lens is made out of can sometimes cause subtle distortion that could cause a headache.

6.  Sinus headaches

Having personal experience in this area, I can attest that these can be extremely painful.  When the air spaces in the bones of the skull that surround the eye called sinuses get inflamed  from infection or irritation from allergens,  the tissues expand and gets congested.  That causes a pressure feeling around and between the eyes but even on the side of the temples and down to the jaw.   It can cause the eye to feel like it’s going to pop out it hurts so badly.  Often times a patient will wake up with sinus pain due to sleeping on one side causing fluid to build up and congest the sinus passages more.  Increased water intake, decongestants (Sudafed), mucous thinning medicines (Mucinex) and sometimes antibiotics and nasal steroid inhalers when needed, can generally help but long term treatments may be needed such as nasal saline rinses, antihistamines, and immunotherapy (allergy shots).  Cysts (fluid filled bubbles) can develop and block off the drainage of sinuses at times building up pressure and pain and are not easily seen on CT or MRI scans.  Frequent severe headaches that are not getting better should be evaluated by an ENT (ear, nose and throat specialist) or neurologist (specialist of the brain and nervous system) if sinus and brain imaging with CT or MRI scans did not reveal any problems.

7. Tension headaches

Tension headaches generally happen later in the day but can happen at any time due to the stress load, work ergonomics (how your body is positioned at work) or anxiety the patient is suffering from, whether they realize it or not.  They tend to make the head hurt like a tight band around the head or start in both temples and work backwards.  They usually happen while at work or school in the afternoons but can wake up a person due to neck or back vertebrae misalignment.  Sleeping wrong on a pillow can cause muscle tightness and a resulting headache.   Resting and using pain reliever medicine usually makes tension headaches better.  Children can often get headaches from internalizing anxiety from bullying, domestic abuse or the stress caused by fighting or divorcing parents.  A child’s home life can impact them severely.

8. Migraines (vascular) headaches

Not all headaches are migraines as some people mistakenly believe.  A migraine headache is generally a severe headache on one side of the head that is preceded by some sort of visual distortion such as spots or wavy lines.   The pain is so severe a patient may experience nausea or dizziness and is usually sensitive to light and sounds.  Over the counter medications generally don’t help very much except for some that have caffeine and so migraine sufferers usually have to lie down and rest in quiet, dark locations until it gets better.  They can happen at any time and can be brought on by menstrual cycles or even certain foods.  Sometimes the cause is never found.  They tend to happen in women more than men.  There are prescription medicines that can help prevent or thwart migraine attacks.   Migraines are considered a diagnosis of exclusion however.  Your doctor needs to be fully confident that all other causes of headaches including tumors and aneurysms have been completely ruled out and excluded before they can be called a true migraine headache.  The International Headache Society has listed specific signs and symptoms that must be present or not present to officially classify your headache as a migraine.   I recommend keeping a journal of your headaches:   date and time when they happen, what you ate and drank that day, associations that made it worse such as reading or computer use, medicines used, menstrual cycles, etc… that might help isolate any specific triggers.

9.  Severe Medical Problems

Very rarely, a very serious medical problem can cause headaches.  The main serious medical problems causing headaches would include:

·         Hypoglycemia (low blood sugar)   Usually happen with poor diet, get a feeling of weakness, shakiness, moodiness and breaking out in a sweat and nausea.

·         Hypertension (high blood pressure)   Usually start at the base of the back of the skull where the head and neck meet, have ringing in the ears, sometimes dizziness.

·         Aneurysm (small area of ballooning outward of blood vessel)  Usually a quick forming, stabbing pain that is incredibly painful.  Often described as the worst headache ever.

·         Benign increased intracranial pressure (higher than normal fluid pressure in the brain and spinal cord caused by poor drainage or reabsorption of fluid)   Often related to females that are considered overweight and over 30-40 years.  Rarely, some people have smaller than average drain openings (foramens) in the skull that keeps fluid from circulating well.

·         Inflammation of cranial arteries – usually hurts on one side of temple, vision decrease in one eye, over 60 years old. It is not normal for someone over 60 years old to have frequent headaches unless they have a long history of them.

·         Poor blood circulation from a blood clot or stroke – usually sudden, associated with numbness or paralysis of facial muscles or limbs, eyelid drooping, sudden loss of vision.

·         Brain tumor – usually very gradual onset of headaches and other symptoms such as vision or hearing loss, behavior changes, depression, and can feel like general sinus pressure in some cases.

If you are experiencing frequent headaches, please see your medical physician for a medical evaluation and a reputable eye doctor for an comprehensive eye and vision examination to find the source and make sure it’s not serious.

SnackPak 4 Kids and Transitions Lenses Special

SnackPak 4 Kids is feeding hungry school age kids this summer and we want to help.   We support this program and we would like to team up for July and August 2014 to help them out.  If a patient brings in a 16 oz (small) jar of peanut butter or a box of Pop Tarts for SnackPak (or better yet Both!) and buys a Transitions lens add-on to their spectacle lenses, we will give them 50% off that price of the Transitions‘ add on cost(about a $45 dollar savings).   A collection container is by our front door.

Even if you do not buy any eyewear, you are welcome to drop off your donation of peanut butter or PopTarts at our office.  

It’s not the kid’s fault that they go hungry.   Studies are showing when the kids are not going hungry, they do better in school.  If they can get through school with a good education and not drop out, perhaps the generational poverty cycle can be broken.

If you have any questions about our offer, you can contact our office at 935-2020 or information about the SnackPak program in Dumas at SnackPak 4 Kids Dumas.  Thanks for your support of SnackPak 4 Kids and Dumas Vision Source.

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The following information is from SnackPak 4 Kids website (http://snackpak4kids.org/history)

“It began with 10 hungry students at Will Rogers Elementary School in Amarillo.  Bushland couple Dyron and Kelly Howell had discovered that Amarillo was the largest city west of Dallas without a weekend backpack program. And yet more than 3,200 children in the Amarillo Independent School District relied only on the meals served to them at school for their weekly food. That meant hundreds of children spent their nights and weekends hungry.

Determined to find some way to address this need, the Howells assembled ten bags of food that could be prepared without adult supervision—juice boxes, peanut butter, sandwich snack crackers, breakfast cereal, Pop-Tarts, fruit cups and more. On Friday, September 3, 2010, the first ten Snack Pak 4 Kids recipients were given those bags, which contained enough food to get them through the weekend. The Howells prepared the bags again the next week, and got others involved. Soon the number of children grew, and then the program expanded to other schools. Teachers began seeing academic improvement, better concentration, and higher attendance among SP4K recipients.
As of early 2014, the program has grown to serve 5,200 students in 30 school districts, Amarillo, Booker, Borger, Bushland, Canadian, Clarendon, Clayton NM, Dalhart, Dimmitt, Dumas, Friona, Fritch, Happy, Hereford, Highland Park, Lockney, Panhandle, Pampa, Perryton, River Road, Spearman, San Antonio, Stratford, Sunray, Tahoka, Texhoma, Texline, Tulia, White Deer, and Wildorado.

Every week, hundreds of volunteers pack 14 regular, nutritious items into plastic bags and deliver these bags to participating schools.  At the schools, officials discreetly place these bags in students’ backpacks on Fridays. Students receiving the bags have each been identified by school staff members (counselors, nurses, teachers or principals) as living in a “food-insecure” household—which means these families don’t always know the source of their next meal. The SP4K program feeds each elementary student and any siblings at home not old enough to attend school.

Our new Snack Shak program currently provides food to middle school and high school students, and is expanding quickly.”

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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 www.visionsource-dumas.com 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!”

“So What is the Right Answer, One….or Two?”

Apparently, for some people going to the eye doctor to have their vision checked is a stressful experience.  It’s not that dreaded air puff test even.  Or even having the eyes dilated with eye drops.  It’s the refraction process where we determine the prescription for glasses.  You know, where the doctor puts up that big pair of glasses that the doctor flips different lenses and says, “Which is better, one….or two?

I think it’s probably harder for some when they are  afraid of getting something wrong.  Perhaps a little high-strung,  Type A personality or someone with some OCD tendencies that needs perfection so it’s hard to commit to an exact answer.   And engineers.  Not there is anything wrong with being a perfectionist, I appreciate things being in order and perfect as possible.  But it’s not anything to stress yourself over because there are multiple double checks to make sure everything is perfect as possible.

You see, when we say “which is better?” we are adding one step more power in the number one lens and one step power less in the number two lens.  Much like if your radio was on 92.5 FM and you went to 92.4 or 92.6 to see which sounded more clear.  We bracket back and forth until the power is just right.  So we start from a certain prescription, either your old prescription or from a computerized reading of what the prescription power is and refine it with your help by adding more or less power  until there is no change ideally.  Sometimes the answer keeps going back and forth and so by that we also have reached our endpoint.  Then looking at the vision from the old glasses and it’s prescription, the preliminary prescription reading and the final refraction reading, we can make sure it makes sense to prescribe exactly what you need to see 20/20 or hopefully even better than that.  So don’t get worked up about getting something wrong or saying the wrong answer.

So the correct answer is ideally……SAME.

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 www.visionsource-dumas.com 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!”

Oooh baby, baaby…

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 www.visionsource-dumas.com 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

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 www.visionsource-dumas.com 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!”

Don’t Get “Bob Costas Eye”!

Don’t get “Bob Costas Eye”.

To tell you the truth, I have not been watching the Sochi Winter Olympics.  In fact, the Westminster Dog Show held my attention more.  But all the media attention on Bob Costas’ eye infection drew my interest to what was going on and so like a bad accident I had to look.  “Whoa! That’s a bad one, hope no one got hurt.”

I’m chuckling as I write this.   You may have seen the Direct TV ads that start with something like “When your cable goes out, you get bored….”, which leads to what seems like a never ending cascade of cause and effect events, like a small version of the legendary “Butterfly Effect.”  Usually ending up with the person who has cable TV trouble not doing well.

I can just picture a scenario like this:   “When you sleep in your contacts, you wake up seeing clearly.  When you wake up seeing clearly, you have more energy and motivation.  When you have more motivation, you perform your job a lot better.  When you perform your job a lot better, you get a promotion.  When you get a promotion, you get a raise.  When you get a raise, you think you can travel to exotic places like the Winter Olympics.  When you travel to exotic places like Sochi, you fly coach next to a big Ukranian man with a cold.  When you sit next to a big Ukranian man with a cold in an airplane, you get “Bob Costas Eye”.  Don’t get “Bob Costas Eye”!”   The morale of the story here would be:  Don’t sleep in your contacts to start with!

In Bob Costas’ case though, it looks like he has a case of a viral eye infection or what lay people would call “pink eye.” Epidemic keratoconjunctivitis or EKC for short is caused by a virus as opposed to bacteria.  Though sometimes similar, the two infections are more like a zebra and a horse.  They look and behave a little different and you treat them differently too.

Bob Costas probably got the infection in the trapped space of the airplane.  It is extremely contagious and usually spreads from one eye to the other.  When I say contagious, I don’t mean it is going to jump off someone else’s eye and into yours like a flea or something.  People think they need to be put in isolation sometimes.  It is normally spread by coughing and sneezing.  It is mostly an airborne virus.  It is a cold virus that settles in your eye.  That is why is spreads so fast at schools or in some small offices.   You can get it from the person that is sneezing two people behind you in line at the supermarket.   That being said, it can last on surfaces for hours also.  So you want to avoid touching things the other person has touched without washing their hands or sanitizing with Clorox wipe or other disinfectant. Definitely avoid sharing towels, pillows, computer keyboards or telephone and the like.

There are no current prescription drops to cure EKC.  It is a cold virus or adenovirus that causes the infection and just like the common cold, there is no cure.  You have to let your own body’s immune system get rid of the infection. Fortunately, just like taking “cold medicine” to help you feel better, there are some treatments we can do to help the infection resolve faster and make you feel better.

In the office, we can anesthetize the eye with some numbing drops and place some 5% Betadine disinfecting solution on the eye’s surface and eyelids to sterilize the surface and get rid of most of the live virus.  With the viral load reduced, the body’s immune system can overcome the infection easier and faster.  The viral particles cause a lot of inflammation, which is what causes the redness, swelling and pain.  We can help that with a non-steroidal and steroid eye drop to calm that down.  And the old standby treatment….chilled wet washcloths or cold packs wrapped with a wet washcloth.  Wet transfers the cold better to the tissue and helps reduce inflammation and pain.

There are no over the counter treatments or home remedies that are going to help a viral conjunctivitis or pink eye.   Instead of putting up with pain and irritation, make an appointment early and we can get you healed up and normal looking again much quicker.   The next time you wake up with the barn cat eye or the eye starts getting red and watering, just remember Bob Costas.

Don’t get “Bob Costas Eye”!

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 www.visionsource-dumas.com 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!”