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 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!”

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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 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”!

12 02 2014

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!”





Transitions Lenses – Experience It!

2 02 2014

Experience it!  Experience the world.  There are so many beautiful things to see.  Life is too short to miss it.  Many of us are and we don’t even know it.

For example, when we check young school age children, we occasionally come across one that finds out (usually boys) that he can’t distinguish between the reds/brown/green family of colors.  They just don’t know what they are missing.  To them, everyone sees that way.  You don’t know what you don’t know.   

By the way, I hate the term color blind.  It’s not really accurate since most people who have a color vision problem aren’t blind to colors, they just don’t appreciate all of them as distinctly as others.

However, even people with normal color vision don’t always experience the world with all it’s full glory and color.   The glare of the sun, the haze in the atmosphere, the blue light from electronics…all are causing interference to our vision everyday and sometimes we don’t even realize it.

The new Transitions Signature VII adaptive lenses  have just been released and I have to say I’m impressed. (http://www.transitions.com/en-us/products/transitions-signature )  The lenses are a true dark grey and they get darker in warm weather now, which has been a weakness in the past.  They really make the contrast of colors “pop” more.  I cannot see any tint to it indoors and they change extremely fast.  After seeing it in action and learning more about the new lens technology, I am a bigger believer than ever in this lens now.

We are so careful now days about UV damage to our skin that we now know is a cumulative exposure risk.  The earlier in life we are exposed to damaging UV rays and the longer we are exposed the more risk.  It’s important to start protecting your kids early.  Transitions are sunscreen for the eyes!  Why would you not want you and your kid’s eyes  not protected from harmful UV rays at the earliest age?  And kids are more outside than adults!    I recommend them to all children.

Just like shoes or tools, one lens often doesn’t meet all our vision requirements.  I still recommend sunglasses as a secondary pair while driving for maximum lens darkness.

The new Transitions Signature VII lenses come in all types of lens materials and lens types, including bifocals and progressives.  You can even “test drive” the technology with peel off stickers available at our office that can be placed over your clear lenses to simulate the Transitions Signature 7 lens if you are not sure.  We have sample lenses that we can show you as well.

Come by our office and experience them for yourself!   Don’t miss out on the world.  Experience it to the max with the new Transitions Signature VII adaptive lenses.

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!”





Are School Vision Screenings Good Enough?

30 12 2013

I often get asked by parents of children I am prescribing glasses for, “How come they passed the vision screening at school but still need glasses?”

While school nurses provide a valuable service that sometimes detect serious problems with children’s vision, school vision screenings are an incomplete check of a child’s visual status.

For one, a screening is just that – a screening.  Screenings are looking for a big problem in a large amount of people in a short period of time.  It might catch the big things but it leaves alot of little things hidden.   Kids are masters of manipulation too.  Some can fool the nurse that they can see well while some kids can fail that don’t need glasses.

Secondly, the criteria of what defines reduced vision is generally 20/30 vision or worse looking off into the distance.   For some kids, that is too blurry for their needs.  That is the minimum to get a Texas driver’s license and be able to see road signs adequately.  Most of the time, the near vision of school children is not even tested in a school vision screening.  But that is where they use their vision the most!

The biggest group I find need glasses that have passed a screening are farsighted.  Farsighted children generally can see at all places.  Often they can force their eyes to focus to make their eyes see 20/20 at distance and near.  They generally have headaches or eye strain, are slow readers and do poorly with reading comprehension, don’t do well with their grades, labeled incorrectly “dyslexic”, and get in trouble for not paying attention.

Also, the degree of focusing power or accommodation is not tested as well as eye coordination or how the eyes work as a team either.   The vision system of the eyes is very complex.  You are using two eyes that each have to have clear sight, keep things focused in and work in tandem as they move around.  Can you imagine holding two video cameras steady in each hand and trying to video something moving around and try to make a movie that takes both video feeds, in focus, and produces one single picture on the TV?

Lastly, the health of the child’s eye is not examined.  True, there are not a lot of eye diseases at young ages but they do happen.  Diabetes, blood disorders, genetic problems and most importantly tumors in the eye or brain are some things I have come across without much or any symptoms.

I have occasionally had a nurse that went the extra mile and did more than what the school district recommends and I commend them for that.  They perform a vital role that helps find the big problems sometimes.  But don’t rely on  just a school vision screening.  The future of your child depends so much on how well they do in school.  Why would you not want to ensure your child has a normal vision system and healthy eyes?   They can’t be replaced like teeth.  Don’t skimp on this critical need in your child’s development.  Have your children’s eyes tested by a reputable private practice optometrist and please don’t take them to them a mall doc or Bigmart type place.  There generally is a reason those eyedocs work in those type settings.  You don’t get your teeth or mammogram at Bigmart do you?  At any rate, don’t take any chances with your kids.  Make a point to have your children’s eyes regularly, every year,  in a professional setting.

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!”





For Your Eyes Only

8 11 2013

Ever seen the spy type movies where the government agent puts his eye up against a camera and a laser seems to scan across his eye like a grocery store bar code scanner?  It is for real.  They scan the retina to identify people since the retina in everyone’s eyes is unique, like a fingerprint.  No one looks just the same.  Well, we can do the same thing in our office!  Yes, we can identify you if you are a secret agent!   Just kidding.

However, we can identify various eye diseases and tumors or signs of underlying medical disease such as diabetes, high blood pressure, high cholesterol, or blood disorders when they affect the blood vessels in the eye and leak.

When you look into the Optomap instrument, a digital camera system captures an image of the back of your eye with the help of a mirror and two different colored laser lights.  It is painless and is quicker than you can blink your eye.

An Optomap retinal exam provides:
• A scan to confirm a healthy eye or, to detect the  presence of disease.

• An overview or map of the retina, giving your doctor a more detailed view than can be achieved by other means.

• The opportunity for you to view and discuss the optomap images of your eye with your doctor at the time of your exam.

• A permanent record for your medical file, enabling your doctor to make important comparisons if  potential  problems show themselves at a future examination.

This is an example of the difference between looking inside with just a small pupil versus looking at the retina with an Optomap image.  As you can see, it provides a much better overall picture at one time of the state of the retina.  Much like a satelite picture is good for a broad perspective.  Then if something is noted, we can isolate in on a specific area with higher magnification at the microscope.

It does not replace the need for dilation, it only assists in the total examination of the eye to ensure everything is healthy.

optomap-scan
The Optomap Retinal Exam is fast, easy, and comfortable.  It does not cost very much and I recommend it highly at every visit for everyone, especially young kids.

Come in for a comprehensive eye exam and have your retina mapped.  It’s our mission, not impossible,  to save your vision!

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!”





Eye Myth Busters – #1- Eating Carrots Makes Your Eyes Better

13 09 2013

You may have been told or heard that “carrots are good for your eyes” but not for the reasons that most people think.  Most people when they hear that statement assume it means you won’t need glasses or it reduces the need for them.  The need for glasses is determined by the optics of the eye (how light rays are bent)  which is more related to genetics and eye structure than the nutritional state of the eye tissues.

Carrots are rich in the supply of beta-carotene, a carotenoid, that is made into Vitamin A by your body.  However, if your body doesn’t need Vit. A, it doesn’t make more.

What vitamin A does is help with your ability to see by allowing the receptors in your eye to work more efficiently.  Vitamin A is needed in the chemical processes that occur that change light signals into electrical signals that get sent to the vision center in the brain.    It is especially needed for night vision.  Often times though poor night vision is the result of uncorrected vision problems that glasses would help with.  A state of the art, anti-glare treatment on the lenses also maximizes the sharpness and comfort of the night vision as well.

Actually, other vegetables are probably better for your eye health overall.  Spinach leaves or other dark leafy vegetables like Kale are better due to the amount of lutein and zeazanthin carotenoid pigments as well as vitamins and minerals.  All darker colored fruits and vegetables with red, orange, dark green, yellow and purple colors are going to be great for the eyes.   Pale colored iceberg lettuce doesn’t count, it’s basically fiber.

So while you might think, “A salad a day keeps the eye doctor away, ” this is partially true.  At least in regards to the health of the eye.  If your eye does not refract light correctly, no food in the world will make it focus better.  Only a lens in front will make you see clearly.  So go ahead, eat those carrots and other veggies to help keep the eyes healthy.   Just make sure to leave off the ranch dressing.

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