Be safe, be seen on Halloween

29 10 2015

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)

12 05 2015

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!”

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Focus on Archery

31 01 2015

When you hear of famous archers in history, you can almost visualize them in their garb of the time and with different types of bows.  Robin Hood in his green felt hat (doubt he had tights on) and a recurve bow.  William Tell in maybe a Swiss type lederhosen outfit and a crossbow.  Minamoto no Tametomo in a Kyodo obi and kumi bow.  Okay, maybe THAT one doesn’t ring a bell.  He was a famous samurai that legend says sank a ship with an arrow.   More contemporaries are:  Fred Bear, Katniss from “The Hunger Games” and Legolas ( the elf), from the “Lord of the Rings” series also.  Then there is this guy, Lars Anderson.  https://www.youtube.com/watch?v=BEG-ly9tQGk   That is some amazing skill right there.

Modern archers with a compound bow usually depend on being able to use a peep sight on the bow string up close to the eye.  It basically is a little round circle that you can “peep” through.  A front sight pin that extends a little further past the bow is aligned in the peep sight with the target.  Much like a rifle or pistol has a back sight and a front sight, both which have to be aligned with a target.  The human eye can only focus on one point at a time, so it is imperative with archery or firearms to concentrate on the front sight.  The back sight and the target are usually slightly blurred when you do so.

A problem occurs as we age though and we begin to lose our focusing ability up close.  After forty something years old, the crystalline lens in the eye begins to harden and cannot change shape as easily to focus on near  objects.  Sort of like an egg being fried and the protein in the egg yolk begins to change from runny to thick and then hard.  It’s not a muscle that is too weak and needs to be strengthened.  So that is why we ALL eventually have to have some help in the form of bifocals or even better, progressive lenses that can focus in all places (mis-labeled as “no-line bifocals” often times.)

So what do you do when the front sight pins of the bow begin to be more difficult to focus after forty?  The easiest way to compensate (there is a lot of compensating after 40) is to use what is called a “Verifier,” available from Specialty Archery. https://www.youtube.com/watch?v=x_s_lpHqHXo

It is a screw-in lens that is attached to the peep sight and allows for slight magnification to see the sight pins better.  I have not found out it if can be used in competitive archery or not yet but it’s not any different than wearing bifocal glasses to correct your vision so I wouldn’t think it would be against the rules.  It is not a scope to make the target magnified like a different product called a “Clarifier,” to be used with a scope and makes the target easier to see.

I recently prescribed a daily disposable bifocal soft lens to a forty year old competitive archer and he likes it for the time being.  He hasn’t ever worn glasses and still sees 20/20 far away.  He has been noticing it is not as smooth and easy to focus those sight pins quickly like it used to be.  I told him rifle and pistol shooters have the same problem after forty years old with open, iron sights.  The only thing you can do is either use some kind of scope or a peephole sight that extends the depth of focus of the eye.  Peepholes are fine for stationary, target shooting like Olympic shooters would do but are not practical for action shooting or even hunting.  This patient of mine wears the multifocal contact lens on his dominant eye and uses it just for shooting since he still reads fine without glasses…for now at least.   It focuses the sight pins better with a very slight blurring of the distance target but not bad within 50 yards.

So if you are over forty and not seeing those sight pins on your bow quite as well, good news!  There is hope for you in maybe more than one way.   Have your eyes examined for any uncorrected vision problem or eye disease first.  Unless you still want to blame your poor shooting on your eyes or your eye doctor.

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!”

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Why I Care

3 05 2014

So maybe it’s time to share why I care about eyes and saving vision.  I’m asked fairly often why I decided to be an eye doctor.

Why do I care about your eye care?

The biggest reason is that I can empathize.  I have walked in many of your shoes.  Many doctors genuinely care about their patients but they can never know what it is like to not be able to see.  I’ve read about how some physician’s attitudes toward their patients completely changed after they were seriously sick and scared about what was going to happen once it happened to them.  Then they understood and were more empathetic, not just sympathetic.

Well I’m as blind as a bat with a blindfold.  (Bats are really not blind, that’s a wives’ tale but you get my point.)  I’m one of my own worst patients as far as being nearsighted. Glasses like the metaphorical “bottom of glass coke bottles.”

Trust me.  I understand what it’s like!  Spending a few days being totally blurry on summer vacation at your grandma’s house with broken glasses is not fun.  Not when you could be playing in the creek or exploring the woods.  It’s not very fun being teased about being “four eyes” and all that.  Not very reassuring to your self-esteem as you enter puberty either.   Wearing contact lenses changed my life so I will try everything I know how to try to get people to wear contact lenses successfully if they want to.   Perhaps sometimes I don’t know when to say often enough, “Contacts are not going to work for you.”

Being rendered visually impaired is very motivating to make sure it never happens again.  It’s one of the reasons I’m always harping on patients about having spare pairs of glasses, especially contact lens wearers.  It’s like backing up a computer. It’s not if but when it crashes and you need to be prepared.  An eye infection or having broken glasses always happens at the worst times too:  weddings, funerals and vacations.

After doing a research paper in my 9th grade health class about a possible career, I picked optometry as a career.  I knew deep down in my knower that this is what I was born to do.  So much so I started studying eye terms and anatomy that summer.  I mapped out what college courses I would take each year to get me to optometry school. I was like a missile locked on it’s target and had only one goal:   getting into optometry school to help other people to be able to see.  I will always be grateful for one of my mentor’s and coaches, Joe Pat Mowery.   Teachers, you can make such a difference in the path of a student and help change the world.  Thank you.

The other reason is I care personally.   I care about you as a person.   It’s something that God put in me.  The need to help others especially those that can’t help themselves and to give grace and show compassion and love to others.  I’m not perfect at it but I’m a work in progress.

One of the verses from the Bible I claim for myself is Jeremiah 29:11-13.   For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.  Then you will call on me and come and pray to me, and I will listen to you. You will seek me and find me when you seek me with all your heart.”

God has plans for me and for you.  He gives us certain gifts and abilities to help that plan He has for us.  Looking back, He opened so many doors and kept me from taking lots of wrong paths. I haven’t always done what He wants and I’m sure I’ve disappointed Him at times by my actions but His grace is sufficient and covers my sins, past and future.  I know He wants me to be here in Dumas, where I ran from after high school, like the Jonah and the whale story, and as in Esther “for such a time as this.   Paul says  “for God’s gifts and his call are irrevocable.”  Romans 11:29

Yes, there are patients that aren’t always so loveable and hard to work with.  Any business has that.  But we still want to please them as a customer and try to do our best to help them when they aren’t always pleasant.   It reminds me of when Paul writes in Romans 5:8,  “But God demonstrates his own love for us in this: While we were still sinners, Christ died for us.”   Despite how bad we are, how “unloveable” we all are, Jesus died for each one of us in order to make a way to have a real, living relationship with Him.  (click here for more about how to have that relationship)

If He can do that for me, surely I can try to look past how a person behaves and still love and serve them as a person. Once you experience God’s agape love (love without conditions) you have to pass it on.   Despite all the headaches of insurance paperwork and regulations, I know I was born to do this.  And while someday I may slow down a little, I plan to practice optometry until the day I die.  Who says I have to retire if you love what you do?

So, in the end I guess, eyecare because I care.  I care about you and I know what it’s like to not see.

 





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 www.visionsource-dumas.com for more information.   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!”





Snowblind

5 12 2013

 If you live in an area that receives snowfall, you may remember someone in school coming back from a ski trip that didn’t wear sunglasses or goggles on the slopes and ended up with a case of severe snow-blindness or sunburn to their eyes.  Their eyes hurt so bad and were so blurry they couldn’t go back to school for a couple of days.  

We all know how UV light can cause a sunburn to skin.  Well, snow and water are great reflectors of UV light, so that it bounces right up into the face and eyes.    There is more exposure to UV as well at a higher altitude on the mountain.   Without protection, the cornea can develop a “photokeratitis” or corneal inflammation that is extremely painful.  It feels like there are rocks or sand in the eyes.  The cornea becomes covered with lots of micro-blisters that pop open and your eyelid scrapes across those when blinking, causing the foreign body sensation.  Between those and the corneal swelling, the vision can be very blurry.  Depending on various factors, the process of photokeratitis can begin in as quick as 3.5 minutes of UV exposure. (1)   The symptoms are usually delayed, with an average of onset of pain, light sensitivity and tearing after 6-12 hours.

Treatment includes cold, damp compresses or ice packs, non-steroidal and steroid eye drops to reduce the inflammation and pain and possibly antibiotic creams, therapeutic bandage soft contacts or eye patches and oral pain relievers if severe enough.  Typically it will be healed after a few days since the corneal tissue is one of the most fastest growing parts of the body.  Usually, there is no long term damage.  Repeated exposure to UV over your life time can however  lead to early cataracts and possibly macular degeneration.

Prevention is key and very simple.  Wear eye protection in the snow or when on the water!   Polarized sunglasses are ideal to block UV light and improve the vision from the glaring polarized light coming off the snow or water.  There are clear UV blockers in regular eyeglasses too that can block light, much like sunscreen ends up clear on your skin after application.

If you happen to stay too long out on the slopes without eye protection, you CAN come crying to me.   🙂   (But just don’t say I didn’t tell you!)

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!”