Frequently Asked Questions About Eye Health

The American Optometric Association defines Doctor of Optometry as the independent primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures and identify related systemic conditions affecting the eye.

Doctors of Optometry prescribe medications, low vision rehabilitation, vision therapy, spectacle lenses, and contact lenses.

The frequency of your appointments depends on your visual health. If you don't wear contacts or glasses, then you should schedule appointments every two years. People who wear corrective lenses or who are over the age of 60 should visit annually. More frequent checkups might be needed for certain health conditions, such as diabetes or other eye diseases.

The term "20/20" refers to the sharpness of the vision. The top number is the viewing distance between the eye chart and the patient. The bottom number refers to the line on the chart. It is a measurement of how much a person can read when they are 20 feet away from the chart.

Sometimes, you might see small things that look like cobwebs or spots in your vision. They are protein fibers that can clump together and cause a "floater." Most of the time, 1 or 2 floaters are nothing to worry about; however, if you see a lot of them suddenly or bright flashes of light, you need to see an eye doctor right away.

To better tailor the eye examination to your needs, our doctor may review any current vision problems, your general health, as well as discuss your hobbies and lifestyle requirements.

Why does the doctor ask me, "Which is better, one or two?"

While evaluating your prescription, the doctor will ask you to compare a series of lenses to determine which allows you to see clearer. As the differences become less noticeable, the doctor will be closer to finalizing your prescription. If you're having a hard time choosing between the options, it means you're almost done with this part of the exam!

Over 80% of Type 1 diabetes patients have some form of diabetic eye changes called retinopathy by eye doctors. Of those patients diagnosed with type 2 diabetes, 40% experience some eye changes. The two primary ways are prescription shift and diabetic retinopathy.

Prescription Shift – Large blood sugar changes, either up or down, cause a temporary shift in the actual eyeglass or contact lens prescription. It can be tricky to diagnose because there is often a delay between these two events. That delay, or lag time, can be up to 2 weeks! Similarly, when the blood sugar levels return to normal, the prescription will revert back as well. This can be difficult to manage because many of our patients tell us something as simple as a cold will send their blood sugar levels skyrocketing. Treatment is achieved by managing blood glucose. As the blood sugar levels become stable over time, the prescription will also become stable.

Diabetic Retinopathy –  In simple terms, the blood vessels inside the eye can become "leaky." These tiny blood vessels line the retina, which is the "seeing" part of the eye. The retina can swell due to leakage and cause blurred vision and a host of other complications. When this occurs, we work closely with local retinal specialists to treat and manage the problems that result.

In addition to other health concerns, high blood pressure can affect your eyes' blood vessels, which could lead to future vision problems.

This part of the exam helps determine how your pupils and eye muscles react and assists in gauging neurological function.

Is it necessary for the doctor to dilate my pupils during the exam?

Although pupil dilation is not always necessary, the doctor may make this decision during your exam. If required, this painless process is like opening a door so the doctor can fully examine your retina. Dilation can assist in detecting diseases such as diabetes, high blood pressure, and macular degeneration.

We begin seeing children between 6 months and one year of age. The purpose of this first exam is to detect any issues that might interfere with normal vision development, so that vision problems such as amblyopia (commonly called "lazy eye") can be prevented. After that, it is recommended that children be examined at age three and yearly once they begin school.

A comprehensive eye examination includes determining the prescription for eyeglasses, checking the eyes' visual acuity for reading and other specialized tasks, and examining the eyes for possible diseases, including cataracts, glaucoma, and macular degeneration. There is a fee for these tests that is separate from the tests that need to be done for contact lens wearers.

A contact lens examination requires asking additional history questions, measuring the eye for contact lenses, evaluating the vision with the contact lenses, and ensuring properly fitting lenses using the biomicroscope. Since these tests require expertise, additional equipment, and time there is a fee for these services.

Yes. There are various contact lenses available for patients who need reading glasses and have astigmatism. Proclear Toric Multifocals are now available for once-monthly replacement, which is excellent for patients who suffer from dry eye or heavily deposited lenses.

Base Curve (BC) is a measure of the curvature of the contact lens. This helps it fit your cornea more comfortably since some corneas are "steeper" or "flatter" than others.

A properly fitted contact lens needs to fit over the corneal area of the eye. Therefore the diameter of your cornea determines the diameter of your contact lens. If the lenses are of insufficient diameter, part of the light entering your eye would be focused by two lenses (the contact and your eye's lens), and part of the light would be focused by only one lens (your eye's), resulting in blurring and distortions.

A routine eye exam consists of a number of procedures that are performed to determine the shape, visual acuity, and health of your eyes. Although these tests are performed in various orders depending on your eye doctor preferences, they usually consist of corneal topography, a glaucoma test, a retinoscopy, a refraction test, a cover test, and a dilation of the pupil followed by a slit-lamp examination of the back eye structure. For more information, see our routine eye examination service.

Once your eyes are measured for contact lenses, the doctor must determine what material, base curve, and diameter lens to use for the eyes' best vision, comfort, and health. The doctor places the contact lenses on the eyes and examines them using the biomicroscope to determine if the contact lenses are fitting the eye properly.

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Soft contact lenses must be centered on the cornea and move about one to two millimeters every time the eye blinks. If the contact lens does not move with each blink, it can cause oxygen deprivation to the corneal tissue. Over time this will result in corneal swelling (edema) and a possible reduction of visual acuity. If the contact lens moves too much this can cause an irritation or inflammation and usually results in an uncomfortable feeling when on the eye.

Gas permeable contact lenses should center on the cornea after the eye blinks. The lens should move two to three millimeters every time the eye blinks. A special dye is inserted onto the eye to ensure a constant exchange of tears after each blink. A gas permeable contact lens that is not fitting well could cause corneal scarring.

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Over time the initial contact lenses prescribed may need to be changed to ensure corneal health. This is why contact lenses need to be evaluated on an annual basis to determine if the lenses are fitting properly.

That is a concern expressed by a number of patients, but with proper training and practice, you can learn to overcome this inhibition. The eye has a natural "defense" when anything approaches close to the eye, which results in an involuntary closure of the eyelid. With training, this involuntary reaction can be controlled. First, we teach you to touch your eye with just your fingertip. We ask you to practice in front of a mirror until you are comfortable with this procedure and grow accustomed to the presence of something "in your eye." Once you have acclimated to this, we work with you to place a contact in your eye for the first time in our office. Under this controlled situation, you will quickly feel comfortable with putting the contacts in yourself.

Contact lens follow-up appointments are essential to ensure the eyes' health will not be compromised by wearing contact lenses. The office visit includes a history of how long the contact lenses are in the eyes, whether or not the lenses are kept in at night, what contact lens solutions are being used and how often the lenses are being replaced. The vision is then tested to make sure the lens is not altering the best-corrected vision. The biomicroscope is used to look at the contacts while on the eyes to determine the position and movement. The tissue is also examined for swelling, allergic reactions to the lens, scarring, and engorged blood vessels.

If a problem is discovered at any point of the follow-up appointment, it is addressed by either changing the type of contact lens, the wearing schedule, or the contact lens solutions used to clean the lenses.

Yes, if it is the bifocal or multifocal contact lenses of today. A commonly used contact lens design for people with presbyopia is the concentric bifocal pattern. In this type of contact lens, the near correction is in a small circle at the center of the lens, surrounded by a much larger circle containing the distance correction. Alternatively, the distance correction can be placed in the center, with the near prescription in the outer ring. Progressive contacts can provide good vision for intermediate tasks such as computer screen use. Progressives have a gradually transitioning power for smoother vision transitions at all distances.

Years ago, this wasn't true, but advancements in contact lens technologies means that astigmatism can be corrected not only with eyeglasses but also with contact lenses. Many people with astigmatism believe that only rigid gas permeable (RGPs) contact lenses can correct astigmatism but this is also no longer true. Now there are soft lens designs called toric contact lenses that can correct astigmatism and may also contain a prescription for nearsightedness or farsightedness if you need it as well. While soft torics work well for many people, if you have severe astigmatism, you'll likely do better with RGP contacts or eyeglasses.

Bifocal lenses are usually prescribed for those of us who have presbyopia. Bifocal contact lenses come in all types, RPG, disposable, frequent replacement, or even daily wear. Like eyeglasses, bifocal contact lenses have two powers in the same lens: one for close and the other for distance. There are different lens designs including aspheric, concentric, and translating. The translating lenses have the near power at the bottom of the flat, thus preventing it from rotating when you blink. Other versions have the bottom weighted more than the top to keep the proper alignment.

Concentric lenses have an inner ring and an outer ring, either of which can be for distance or near. The aspheric design has both prescriptions very near the center of the lens. With progressive contact lenses, the distance and near rings are blended together at their edges to soften the transition. This is effective for mild presbyopics.

The terms Daily wear and Extended wear refers to how long you can wear a contact lens. If a contact lens is designated daily wear, it must be removed before retiring for the evening. You cannot sleep with them in your eyes. Extended wear contacts may be worn while sleeping. See sleeping in my contacts. Extended wear contacts have different lengths of time that they can be continuously worn, usually 7 days or 30 days. Contact us if you are unsure about which type of lens you have before attempting to sleep with contacts in your eyes.

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Disposable, Frequent replacement, and Reusable contact lenses refer to the frequency with which the lenses need to be replaced with a new pair of lenses. The term disposable refers to contact lenses that need replacement at least every two weeks. Daily Wear, Weekly, and 14-day designations are common for disposable lenses. Frequent replacement lenses are usually replaced monthly or quarterly, depending on the brand. And what used to be the more traditional reusable lenses are replaced every six months or more.

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You will be asked to sign an informed consent as part of your contact lens examination, explaining the specifics for your particular situation.

That depends on the type of contacts the doctor has prescribed for you. A source of confusion is the difference between the replacement cycle for a contact lens and the wearing schedule. The former refers to how often a contact lens needs to be replaced with a brand new lens. This cycle varies depending on the type of contact lens you wear. See differences in lens types. The later, or wearing schedule, refers to how long you can keep the lens in the eye before having to remove it for eye health reasons. Daily wear designations mean that you remove them at night, and extended wear means you can sleep with them in the eye. Make sure, though, that you do not exceed the extended wear specification designated by the lens manufacturer.

Wearing lenses at night provides an opportunity for potentially harmful bacteria and other organisms to grow under your lenses, especially in the low oxygen conditions experienced at night. Therefore sleeping in contact lenses is not recommended. The risk of eye infection, ulceration, and possible loss of vision is increased dramatically when lenses are left in the eye overnight. Long term wear of overnight contact lenses causes swelling of the corneal tissue, new blood vessel growth, and possible intolerance to contact lenses. If you decide to sleep in your contact lenses, it is imperative that you do not wear them longer than the specified schedule. You also should consider having your eyes checked more frequently to assess any damage that overnight contact lens wear may be causing. If you have any doubts, please call us before sleeping in your lenses.

No. The tissue membrane, called the conjunctiva, prevents this from happening. The conjunctiva attached to the eye socket's sidewalls and the eyelid, preventing anything from "getting lost in the back of the eye." Even though you cannot lose a lens, it sometimes appears that way as lenses migrate under the eyelid and become difficult to locate. A soft lens may even roll up, and hard lens may adhere to the conjunctiva because of suction. If any of these situations happen to you, flush your eye with water or saline, and the lens should float free. In the case of a lens adhering by suction, try to move the lens while gently pressing on one edge. If that doesn't work, try to very gently lift up an edge to break the suction or go see your eye doctor. They will be able to remove it by suctioning it (like a tiny vacuum cleaner) from the conjunctiva. If this happens repeatedly, the contact is most likely not fitted correctly and should be replaced.

Yes, you can use reading glasses on top of your contact lens prescription but why would you want to do that when there are so many good contact lens alternatives. See "Do they make bi-focal contact lenses?"

No, not everyone is a good candidate for contact lenses. Besides medical reasons, there are environmental, cost, and suitability factors that should be considered. There are medical conditions such as the type or severity of vision problems, shape of your eyes, corneal irregularities, dry eyes, allergies, and certain medical disorders such as diabetes or glaucoma, that make you an unsuitable candidate for contact lenses. Other considerations include the ability to manipulate contact lenses and environmental factors such as working in a very dry or windy atmosphere or where there is a lot of dust in the air also makes it difficult to wear contacts.

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Immature children may not be good candidates since wearing contacts requires compliance with specific instructions concerning how many hours they can be worn and how they must be cleaned, handled, and stored. Not adhering to instructions puts the wearer at risk for eye injury and infection. And finally, cost is a factor. Contacts are generally more expensive than eyeglasses. Contact lenses must be disinfected at regular intervals, requiring solutions and equipment that adds considerably to the cost of ownership. So given all these factors, are you a good candidate for contact lenses? If you want more information contact us with specific questions and we will try to answer your concerns.

YES! If you are an established patient and have a written non-expired prescription for contact lenses then you can order your contacts anywhere.

Aspherical lenses are also used to improve the optical quality of an image by focusing the image at a single plane. With a spherical lens, light passing through the edge of the lens doesn't share the same focal plane as the one for light passing through the center of the lens. This is because spherical lenses tend to reflect light more strongly at the edges than in the lens center, thus focusing light in different planes. The effect is more pronounced the more area of the lens that is used such as in low light conditions when the iris aperture is much larger.

This focusing error is known as "spherical aberration." Aspherical lenses correct this optical defect: by constructing the lens with different lens radii (a spherical lens has only one radius r or curvature) thus alleviating the stronger bending of light at the edges.

Contact lenses should be put on before applying any cosmetics. It is always important that hands have been cleaned with an oil-free soap. At the end of the day, remove contact lenses first before removing makeup. Never use oily makeup near your eyes because it tends to travel as your body's warmth melts it down. Avoid liquid or powdered eyeliner so close to the eye; flaking is a real danger. If you line your eyes, use eye pencil only outside the upper lash line. Use powdered eye shadow instead of liquid or cream; if powder gets in your eye, your tears will wash it out more readily than oil-based preparations.

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Aerosol products such as hairspray and deodorant should be used prior to lens insertion. If you must use these products when contacts are in, keep eyes closed and then leave the area since the spray will still be circulating in the air.

Contact lenses should not be worn while swimming or participating in water sports unless goggles or a swim mask is worn. 

This is to prevent water from getting on the contact lens. If water touches the contact lens, there is an increased risk of eye infection, ulceration, and possible loss of vision.

Contact lenses are most comfortable when there is a constant replacement of tears over the lenses. While working at a computer or reading for extended periods, people tend to blink less than normal. For this reason, your eye may dry out, and your contact lenses become uncomfortable. It is recommended to instill a rewetting agent (eye drops) to each eye before you begin working on the computer and as needed thereafter. Remember to blink often and give yourself frequent breaks to alleviate eyestrain.

Contact lenses make eye allergies worse. This is because the contact lens acts like a sponge and holds the eye allergens in the contact lens instead of them being washed away by the tears. If you suffer from eye allergies due to the environment, it is recommended to wear your glasses during times when your eyes are especially bothersome. Prescription eye drops may also be used to alleviate the discomfort.

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 Occasionally you may develop an allergy to contact lens cleaning solutions. If you feel that your contact lenses are uncomfortable, please let us know so that we can determine the problem.

Red-eye is caused by irritation, an infection, an injury, or an allergy. Contact lenses should be removed immediately if a red-eye is present. Keeping the contact lens in the eye may actually make the condition worse. That is why it is important to have a pair of eyeglasses in the current prescription and in a style you would feel comfortable being seen in public. Call our office immediately so that proper treatment can be initiated at once.

Contact lenses are ideal for sports because they provide unlimited peripheral vision and cannot be knocked off the eye like regular eyeglasses. It is important to consider wearing eye protection over the contact lenses to protect the eyeball and surrounding structures from injury. Too often, we hear of someone suffering a retinal detachment or loss of an eye due to a sports-related injury.

Suppose your contact lenses are not feeling comfortable. In that case, you must evaluate if there is something you are doing to cause the discomfort, such as: using the wrong solution to clean the contacts, not cleaning the contacts, not washing your hands prior to insertion or removal, using soap containing lotion to wash your hands, sleeping with your contact lenses, not replacing your contact lenses at the specified time, wearing your contact lenses too long throughout the day or placing a contact lens on the eye that is torn. If you feel your contact lenses are uncomfortable and none of the above possibilities exist call our office immediately.

As the contact lenses become more comfortable and familiar to you, it is easy to become complacent about caring for the lenses. Washing your hands prior to insertion and removal is critical to keeping lenses clean. Many times patients will not properly rinse the contact lenses prior to insertion and/or after removing them for the day. Now contact lens care solutions recommend that you rub the lens for 10 seconds on each side to remove bacteria and debris.

It is also important to discard old solution daily. Rinse the case thoroughly with hot tap water and allow the case to air dry. Do not use saliva or tap water to store your contact lenses. Do not use plain saline to disinfect your lenses; it is not strong enough. Others may forget to keep track of when to discard their disposable lenses. It is important to remember that serious problems can occur if the lenses are not cared for properly.