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!”





Don’t be in Denial of West Nile

7 10 2015

West Nile Virus disease is here to stay in Dumas, Moore county and the Texas panhandle.  More cases are reported every week most likely due to the wetter than normal summer this year.

Ten years ago, we had never heard of it.  We were more likely to get sleeping sickness or malaria than something esoteric like West Nile Virus.  West Nile is a virus that originated in the Middle East and has made it’s way to the US and is moving westward.  It can infect humans, birds and horses from a mosquito bite and it can be deadly if it gets into the nervous system.   People with weakened immune systems are at most risk but it can even knock down a seemingly healthy person.

It really hit home this last month when one of my employees came down with a brain infection (encephalitis) from a mosquito bite in her backyard here in town.   She is recovering slowly after being unconscious for over a week and on a respirator and feeding tube.   Short of a miraculous healing, it will take many, many months to recover.  I have two patients that I have also seen that have the after effects of the disease.  One doesn’t have any eye problems but the other has damage to his optic nerve of the left eye, leaving him with permanent damage to his vision.

By the time people are having eye problems, they are probably in the hospital.  I have yet to see anyone in my office with early symptoms and I hope not to.  The problems that happen with the eye can have devastating complications to the vision.  Inflammation or infection can occur inside the back chamber of the eye (vitritis), in the retinal tissue (retinitis and choroiditis) as well as inflammation to the optic nerve (optic neuritis).   All can cause permanent vision loss.

Since eye problems from West Nile Virus are usually not the first sign of illness, I write about it more to create awareness of this relatively new disease to our area since it can be devastating to the body and even fatal.

Early signs and symptoms take 2-14 days incubation after a recent mosquito bite.  They vary from person to person such as fever, headaches, neck ache, joint pain, diarrhea, vomiting, fatigue and less commonly a rash on the check, back or legs.   The severe form that affects your nervous system can cause disorientation, seizures, brain infections and even death in 1% of cases.

I would encourage city, county and state agencies as well as school officials to increase awareness of the disease and prevention.  Contact them and ask what they are doing to kill mosquitos to prevent the disease.   Spraying alleys and enforcing ordinances for residences with trash and high weeds around houses and vacant lots are important.   You yourself can make sure to apply insect repellant that contains the chemical DEET when going outside and especially on your children.   Avoid putting on moisturizer creams and fragrances that might attract mosquitos as well as not going out after dark when they are most active.  Consider wearing pants and long sleeve shirts too.  Make sure to remove standing water out of old tires, buckets and flowerpots, etc., which can be used as breeding sites.

If you look at the maps that show incidences of infection, Moore county is not indicated.  ( Centers for Disease Control )   I would speculate that cases are reported from the hospital they are being treated at when diagnosed, not WHERE they were bit and infected.  In the case of my employee, she hadn’t traveled anywhere and knew she had been bit in her backyard garden a few days earlier when she got really sick.   So take care out there.   We don’t have to live in fear, we just need to be aware and be smart to help prevent the spread of the disease.   Even though we live in the middle of nowhere, Moore county is not immune.

 

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!”

10882341_10203593807146544_4781360562286953420_n (1)





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!”

10882341_10203593807146544_4781360562286953420_n (1)





SnackPak 4 Kids and Transitions Lenses Special

17 07 2014

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.

————————————————————————————————————————————————————————————————————————————————————————————————–

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.”

————————————————————————————————————————————————

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…

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!”





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!”





Back to School Time…. Can Your Kids Use Their Eyes Well To Learn?

22 08 2013

c0016751It’s that time again.  Summer is over and time for the routines to start again.  “Get your homework done, get your clothes laid out for tomorrow, do you have lunch money?, get to bed.”  Ah, the joys of parenthood.

We do those things because we love our kids though and we want the best for them.  We  teach them so one day they can be on their own.  To be able to learn and succeed in life.

Have you ever stopped to think that you may be neglecting one of the most important aspects of learning for your kids? Their vision.  Vision consists of more than just seeing 20/20 on an eye chart or having a school nurse check them at school or at the doctor’s office.  Just because they appear to be able to “see things” doesn’t mean their vision functions properly.

Not only does an eyeball have to focus light from far away onto the back of the eyeball (the retina) clearly, it has to use eye muscles for near vision (accommodate), and do this in co-ordination with another eyeball that are both connected with 6 extra-ocular muscles working in tandem.  It then has to send these light signals from the eye to the brain where our brain’s perception interprets what we see.  There is a lot going on there.   Anything that disrupts any of those systems can cause the vision system to be affected and make it harder to see and likewise learn.

Did you know 80% of learning comes from what we see?  (AOA)   Signs that may indicate a child has vision problem include:

  • Frequent eye rubbing or blinking
  • Short attention span
  • Avoiding reading and other close activities
  • Frequent headaches
  • Covering one eye
  • Tilting the head to one side
  • Holding reading materials close to the face
  • An eye turning in or out
  • Seeing double
  • Losing place when reading
  • Difficulty remembering what he or she read

It makes sense that if a child is uncomfortable doing schoolwork or reading because it makes his eyes tired or the letters move around the page or just doesn’t make sense due to a perception problem are not going to do well in school.   I don’t want to do hard work naturally either if I don’t have to!

Many children are mislabeled as ADHD or have poor attention because of this.

Please have your children examined by a reputable eye doctor, not at a quickie, Bigmart store or at the mall, to ensure their complete vision system is working well.   They must be able to ensure you if your child is seeing 20/20,  that they are not farsighted at all.  Also that their focusing is good, their eye coordination is good and eye health is normal at a minimum.   Too many kids are labeled dyslexic as well because of simple, undiagnosed eye problems and then they have that stigma placed on them for no reason as well as delaying their development unnecessarily.

If you haven’t had your children’s eyes examined this year, why wait any longer?   Don’t let them get behind.

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 23 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!”