Evil bunny sippy-cup attacks babies' eyes - reminds us that eye injuries are the leading cause of blindness in kids

This evil-looking sippy cup lives up to its sinister appearance.  Imported by Target, this little menace has attacked the eyes of six babies, causing cuts and bruises to three of them.  Luckily, are no reports of any babies going blind. Apparently, the bent ear of the vicious rabbit poked the kids in the eye.

The incident reminds us that eye injuries are the leading cause of blindness in children.  Most of these injuries happen while playing sports.

Eye injuries are the leading cause of blindness in kids

Eye injuries are the leading cause of blindness in kids and most eye injuries among kids 11 to 14 occur while playing sports. While hockey is definitely a leading cause of eye injuries, other sports which are commonly thought of as safer and not as rough as hockey are also leading causes of eye injuries in children. Chief among these are baseball and basketball.

Baseball is a leading cause of eye injuries in children 14 and under. Research from the United Sates shows that Basketball is the leading cause of eye injuries among 15 to 24 year-olds.

The sports with the highest rates of eye injuries are baseball/softball, ice hockey, racquet sports, basketball, fencing, lacrosse, paintball and boxing .

Boys are more at risk than girls

Parents have to keep a closer eye on their boys than their girls. Boys 11-15 are five times more likely to end up in the emergency room with an eye injury than girls of the same age. Most of these injuries are sports related and related to projectiles including toys, guns, darts, sticks, stones and air guns.

What can I do to prevent the risk of eye injuries?

The first thing you can do is wear protective eye wear. The proper eye wear, made of the right materials, can prevent 90% of eye injuries. Some athletes will even play better with protective eye wear because they are less afraid of getting injured.  Polycarbonate lenses are the best for impact resistance and when they are inserted into a sports eye-wear frame your child is well protected.  Learn more about protective eye wear for children.

One of the most important things you can do is to see your optometrist for a comprehensive eye health examination. This examination can reveal pre-existing conditions that can put a child (or any athlete- even an adult) at higher risk of blindness or vision loss in the event of an impact to the eye. When you know of the risk, you can take effective precautions to mitigate it and keep your kid's eyes healthy.

Read more about the sinister sippy cup here.

68% of women say that over-the-counter eye drops don't work for dry eye and half of all adults have dry eye symptoms- survey

Dry eye or dry eye syndrome is common and often chronic problem, especially in older adults, women and people who have had LASIK eye surgery. However, a survey titled the "Allergan Dry Eye Survey" conducted by Harris Interactive, suggests that dry eye syndrome may be even more common than previously believed.

The highlights of the survey are that nearly half of adults have dry eye symptoms and most people don't think that their over-the-counter eye drops are very effective in treating dry eye.  In fact, 68% of women don't think that over-the-counter drops work.  The findings suggest in order to get effective relief that more people will be moving to prescription dry eye medication or other options that require more doctor involvement such as punctal plugs.  The sruvey also found that around 20% of  women over 55 have had dry eye for over 10 years.  That's quite shocking!

And, of course, 69% of people who have dry eye have not gone to see their eye doctor about it.  Maybe people just don't know that there are many highly effective treatment options available beyond over the counter eye drops.

Here are the survey's findings

• 48 percent experience one or more dry eye symptom(s) regularly
• 52 percent of women experience one or more dry eye symptom(s) regularly
• 45 to 54 percent of women who suffer from dry eye symptoms (42 percent) experience blurred vision
• 30 percent of men 55 and older have experienced dry eye symptoms for more than 10 years
• 19 percent of women age 55 and older have experienced dry eye symptoms for more than 10 years
• Women are more likely than men to report experiencing difficulty using the computer as a result of their dry eye symptoms (62 percent vs. 44 percent)
• Approximately two out of five U.S. adults (43 percent) report experiencing difficulty reading as a result of their dry eye symptoms
• Nearly one out of five U.S. adults (19 percent) report using over-the-counter eyedrops to treat symptoms at least five times per week
• 48 percent of U.S. adults who use over-the-counter eyedrops to manage their dry eye symptoms state that their eye care professional or pharmacist influenced their decision to use  over-the-counter drops
• 63 percent  of U.S. adults who use  over-the-counter eyedrops to manage their dry eye symptoms () state that the  over-the-counter drops are only somewhat or not at all successful in managing their dry eye symptoms
• Women who use  over-the-counter eyedrops to manage their dry eye symptoms are more likely than men to state their  over-the-counter drops are only somewhat or not at all successful in managing their dry eye symptoms (68 percent vs. 54 percent)
• 69 percent of U.S. adults who experience one or more dry eye symptom(s) have not visited a eye care professional to treat symptoms
• 41 percent  of five U.S. adults who visited an eye care professional to treat their dry eye symptoms stated that they visited more than once before finding relief (19 percent); or that they still have not found relief (22 percent)

Learn more about dry eye syndrome

• Learn the basics of dry eye syndrome and download the dry eye quiz and dry eye questionnaire to complete and show to your optometrist
• Eye makeup makes dry eye syndrome worse
• Pregnancy and menopause makes dry eye worse
• Caffeine improves dry eye syndrome
• Dry eye syndrome can cause anxiety and depression

Menopausal women are at high risk of developing dry eye disease

Dry eye disease affects menopausal women more than other groups

Dry Eye Disease affects women more than men. And it affects women approaching menopause at a greater rate than younger women because of the hormonal changes that women experience when approaching menopause. Hormonal changes are also the reason why pregnant women suffer dry eye disease more than women who are not pregnant.

A study titled Impact of dry eye syndrome on vision-related quality of life published in the American Journal of Ophthalmology in March 2007 showed that about 7.8% of women over 50 develop significantly dry eyes, compared to only 4.7% of males in the same age group.

Hormonal changes are a factor in developing dry eye

Hormones are natural chemicals that your body uses to regulate itself and are transported through the body to targeted cells. As we age hormone levels change and in many women this change cantrigger dry eye. A decreased level of a group of hormones known as androgen (which are often referred to as "male hormones" because they are responsible for typically male physical characteristics - testosterone is an androgen) are the main culprits in dry eye disease because the regulate both lacrimal and meibomian gland function. These glands are responsible for tear production and retention.

Signs that indicate that you may have low or deficient testosterone or androgen levels:

Low androgen levels in men:

lowered libido and erectile dysfunction;
loss of motivation, energy and general well-being;
depression ;
less muscle mass and strength;
loss of bone density;
weight gain – especially around the abdomen.

Low androgen levels in women:

lowered libido;
depression;
less muscle mass and strength;
loss of bone density;
sudden absence of menstruation;
hot flashes;
over-prescribed use of oral contraceptives;
weight gain – especially around the abdomen.

There are various treatments for dry eye syndrome and your eye doctor can tell you which ones offer the highest chance of success for you.

Image courtesy of "Idea go" / FreeDigitalPhotos.net

Study proves that vision problems interfere with learning to read and cause dyslexia

Researchers from the fields of optometry and neuroscience continue to be at the forefront of understanding the connection between vision and learning and the ways that brain-related visual problems such as visual information processing deficits affect reading and learning - and learning how to read. 

A new study published in the journal Current Biology in April 2012 has proven a causal connection between visual attention deficits and problems learning to read (dyslexia).  The study suggests that since visual attention deficits predict who will develop dyslexia, testing and treating these deficits in children may be a way to prevent dyslexia.  


Optometrists have been diagnosing and treating visual information processing deficits (visual attention is one component of visual information processing) for decades with vision therapy and have observed improved reading and learning in patients.  It's nice to have a study that objectively proves these clinical observations.

Here is a short summary of the study taken from Science Direct:

Reading is a unique, cognitive human skill crucial to life in modern societies, but, for about 10% of the children, learning to read is extremely difficult. They are affected by a neurodevelopmental disorder called dyslexia. Although impaired auditory and speech sound processing is widely assumed to characterize dyslexic individuals, emerging evidence suggests that dyslexia could arise from a more basic cross-modal letter-to-speech sound integration deficit . Letters have to be precisely selected from irrelevant and cluttering letters by rapid orienting of visual attention before the correct letter-to-speech sound integration applies. Here we ask whether prereading visual parietal-attention functioning may explain future reading emergence and development. The present 3 year longitudinal study shows that prereading attentional orienting—assessed by serial search performance and spatial cueing facilitation—captures future reading acquisition skills in grades 1 and 2 after controlling for age, nonverbal IQ, speech-sound processing, and nonalphabetic cross-modal mapping. Our findings provide the first evidence that visual spatial attention in preschoolers specifically predicts future reading acquisition, suggesting new approaches for early identification and efficient prevention of dyslexia.

Here are the highlights of the study:

► Poor readers show impaired visual search and spatial cueing when prereaders
► About 60% of poor readers displayed visual-attention deficit when prereaders
► Visual attention in preschoolers specifically predicts future reading acquisition
► Efficient visual-attention is crucial for learning to read independently of phonology

The study's findings highlight the need for parents to see a developmental optometrist who will do detailed testing for visual attention deficits.  If you don't live in the metro Vancouver area where our clinic is located, you can go to www.covd.org, which is the website of the College of Optometrists in Vision Development, to find a doctor near you. 

Not all health care professionals are trained to be aware of visual attention problems and how to diagnose and test for them.  In particular, one study from the neuroscience literature cautioned that an opthalmologists eye exam is focused on the physiology of the eye and not on brain-vision problems that are routinely diagnosed and treated by an optometrist. 


For example, in study published by Raymond et al. in the journal NeuroRehabilitation, the authors recommend the assessment of visual information processing should be done by an optometrist – not an ophthalmologist. The ophthalmologist, according to the authors, does not have the expertise to make the assessment. The study authors note that patients:

should be referred to a behavioral or neuro-optometrist. It was also noted that referrals made to an ophthalmologist may be insufficient, as they are primarily concerned with the health of the eye only, and ophthalmologists are mostly experienced with acute medical problems rather than rehabilitation issues. This assertion is supported by considering the typical components of an ophthalmologic exam, which may yield a lack of specificity, and/or provide information which is inadequately defined in terms of rehabilitation consequence. Trobe, Acosta, Kirscher and Trick identify a lack of measurement in areas of distance and near acuities, contrast sensitivity and confrontation, while Gianutsos and Matheson describe a need for greater quantification in terms of field gradations and boundaries, and binocularity conditions. A more thorough investigation is important for the rehabilitative efforts of all patients who demonstrate visual processing deficits.

There are other studies on the link between visual information processing deficits and learning problems. One example is a 2005 study by Goldstand et al. published in The American Journal of Occupational Therapy entitled "Vision, Visual-Information Processing, and Academic Performance Among Seventh-Grade Schoolchildren: A More Significant Relationship Than We Thought?" The researchers (consisting of professors of optometry and occupational therapy), set out to compare visual and visual-information processing skills between children with and without mild reading and academic problems and examine the incidence of visual deficits among them. They found that visual function significantly distinguishes between children with and without mild academic problems, as well as on visual-perception scores.


Another study published in Optometry and Vision Science in 2002 by Kulup et al. found that poor visual memory (one component of visual information processing) as significantly related to below-average reading decoding, math, and overall academic achievement (as measured by the Stanford Achievement Test) in second- through fourth-grade children, while controlling for age and verbal ability.

Mad Cow Disease - visual symptoms - glasses won't help blurry vision caused by brain diseases

Mad Cow disease, also called Creutzfeldt-Jakob disease, is back in the news. The initial symptoms of this disease in humans include:

• Personality changes 
• Anxiety 
• Depression 
• Memory loss 
• Impaired thinking 
• Blurred vision 
• Insomnia 
• Difficulty speaking 
• Difficulty swallowing 
• Sudden jerky movements 

Mad Cow disease causes deterioration in the brain and all of the above are products of a brain that is no longer able to adequately control the body, including the visual system.

For an optometrist, this is an opportunity to highlight a fact hat most people probably do not consider. Their blurry vision may be the product of a problem in the brain such as a tumor or some rare disease like mad cow.

People that respond to blurry vision by simply buying some off-the-shelf reading glasses without going to the eye doctor first don't really know if their blurry vision is just a refractive error easily corrected with glasses or something more serious and life threatening. Remember our slogan: See an eye doctor, see for life. Its good advice.

Here is our favorite news anchor, Dianne Sawyer on ABC News, presenting the mad cow story:

Saving on Eye Care: Bargains and Risks

In a feature article WebMD explains why why cutting costs on eye care sometimes goes too far.  Learn about the dangers of skipping annual eye exams and the the safety and quality issues associated with online eye wear.  In case you haven't heard, research shows that half the eye wear sold online is junk and even unsafe.

The WebMD article is worth reading but here is a nice quote to give you a taste:

"Never equate how well you see with how healthy your eyes are," Pierce says. "That is the biggest misconception out there." 

Ophthalmologist Mark Fromer, MD, agrees. 

"There are all kinds of systemic diseases, but people like to think it is all about eyeglasses and don't see the bigger picture," says Fromer, who practices at Lenox Hill Hospital in New York and is the eye surgeon for the New York Rangers hockey team. 

Fromer says that patient education plays a big role in how often people see the eye doctor, but budget is an important factor as well. When he talks to patients, he puts eye health in perspective by comparing it to skydiving and brain surgery. 

"You don't want a budget parachute or a budget neurologist, do you?" Fromer says. 

The American Optometric Association recommends adults ages 18-60 who have no risks for eye disease have an eye examination every two years. Adults 18-60 at risk for eye disease should get an eye exam every one to two years or as recommended by your eye doctor. Those who are ages 61 and older should get an eye exam annually or as recommended by your eye doctor. 

"There are lots of blinding diseases without symptoms up front," Fromer says. "That's why it is so important to come in early and be tested."

More information on buying online eye wear

Here is a video of Vision Source Vancouver Optometrist, Dr. Mini Randhawa talking about the problems you may experience with online eye wear.

Here is a link to a cool info-graphic on the results of the Pacific University study showing that half the eye wear sold online is junk: http://seeforlife.blogspot.ca/2012/04/study-proves-that-half-eyewear-sold.html

To read the Pacific University study on online eyewaer, click here: http://optometrists.bc.ca/upload/documents/Speak_Out/Safety_and_compliance_of_prescription_spectacles_ordered_by_the_public_via_the_Internet.pdf

Here is the link to the WebMD article: http://www.webmd.com/eye-health/features/saving-eye-care-bargains-risks?src=RSS_PUBLIC

Vision therapy for visual attention skills significantly improves reading comprehension

The connection between vision and reading is well known to optometrists, all of whom study visual information processing (sometimes called visual skills) in optometry school along with treatments like vision therapy for deficiencies in visual imformation processing skills.

That body of knowledge is often not taught to other health professionals.  This makes it important to frequently talk about studies that prove the connection between visual skills and reading so that patients get the information they need to get the right help for themselves or their children who, although intelligent, have difficualty learning, reading or doing schoolwork efficiently. Researchers have commented that patients should be referred to an optometrist for assessment of visual information processing deficits because other professionals are likely to not test for them (see page 234 of this article from the journal NeuroReahbilitation).

Many people may be mistakenly diagnosed for learning disabilities or ADHD when the problem is actually a visual one.  At the very least, people who are suspected of ADHD or learning disabilities should see a developmental optometrist to be tested for visual information processing deficits to ensure that they are being treated for the right disorder.

One study on the connection between visual attention skills and reading was conducted by Harold A. Sloan, John Shelley-Tremblay, Anthony Ficarra, Michael Silverman, and Steven Larson and published in the Journal of Learning Disabilities in 2003.

In the study 15 moderately disabled readers received 12 hours of vision attention therapy. Significant improvement in reading comprehension and attention scores were seen in the group who received therapy, but not in the control group who received no therapy.

Here is the abstract that was published the the study:

This study quantified the influence of visual attention therapy on the reading comprehension of Grade 6 children with moderate reading disabilities (RD) in the absence of specific reading remediation. Thirty students with below-average reading scores were identified using standardized reading comprehension tests. Fifteen children were placed randomly in the experimental group and 15 in the control group. The Attention Battery of the Cognitive Assessment System was administered to all participants. The experimental group received 12 one-hour sessions of individually monitored, computer-based attention therapy programs; the control group received no therapy during their 12-week period. Each group was retested on attention and reading comprehension measures. In order to stimulate selective and sustained visual attention, the vision therapy stressed various aspects of arousal, activation, and vigilance. At the completion of attention therapy, the mean standard attention and reading comprehension scores of the experimental group had improved significantly. The control group, however, showed no significant improvement in reading comprehension scores after 12 weeks. Although uncertainties still exist, this investigation supports the notion that visual attention is malleable and that attention therapy has a significant effect on reading comprehension in this often neglected population.

The study is evidence of the connection between visual attention skills and reading ability as well as the efficacy of vision therapy in treating visual attention deficits and achieving a corresponding improvement in reading ability.

The mystery of Tupac's Eyeglasses

Tupac Shakur is back in the news with the Tupac Hologram performance.  If you have not seen it yet, the video is at the end of this post.

Mystery surrounds Tupac.  Who killed Tupac?  Is Tupac Still alive?  Those are real questions for millions of Tupac fans.  We at Vision Source Vancouver Optometrists also have a question.

What eye glasses did Tupac wear?  They are unique and distinctive but as far as we can tell, no one knows the answer to this question.

If you have any idea, let us know.

How to get the edge in Diablo 3

How can you get an edge playing Diablo 3?  Well, an optometrist may not be an expert gamer but we know what you can do to make gaming easier on your eyes.

One of the best things you can do is to wear Gunnar eye wear   or some other computer glasses which are specifically designed with gamers in mind.  Gunnar lenses are specially designed by optmetrists to make it easier to view computer screens by changing the frequency of light that comes from the screen so that it is easier for the eye to absorb.

Gunnars also have precise wrap that increases the humidity in front of your eyes.  That fights dry eye, which is a problem for gamers because you blink less when playing video games causing your tear film to evaporate faster and your eyes to dry out.  Vision Source Vancouver optometrists carry Gunnars and we let you try them on and view a computer screen.  You see the difference right way and its quite an improvement.

All of this adds up to less visual fatigue, healthier eyes and greater endurance and more hours of video game enjoyment. After all Gunnars are the official eye wear of the world series of gaming (or at least they used to be).  Incidentally, the visual discomfort video game players experience is called computer vision syndrome and is a medical problem that is on the rise.  Computer eye wear like Gunnars can fight computer vision syndrome and is more than just video game eye wear.  We tell our patients to think of it as eye wear for a digital lifestyle.  Use it with your computer, smart phone and tablet for more visual comfort and a better life.

Don't like 3D movies? You may have 3D Vision Syndrome.

Some people are watching Titanic 3D without 3D glasses.  Why would they do that?  They may have an emerging vision disorder.  To go with it, a new medical term is emerging: "3D vision syndrome".

3D vision syndrome applies to a collection of symptoms that some people (some estimates peg the number at millions of people) suffer when exposed to 3D media content.  3D vision syndrome is coming to attention now because 3D movies, television, and video-games and other 3D media devices and applications have recently proliferated and many people are discovering that they cannot comfortably experience 3D.

3D media has significantly affected how we interact with our world. New mechanisms for delivering 3D content appear frequently from movies to television to video games.  Can the 3D internet be far behind? 3D has come into our theaters, hour homes and now even our schools.  Many schools are now using 3D content to improve their ability to teach a subject and studies show that 3D is very effective in the classroom.  One study found that the use of 3D in school increased test results by 17%.

Unfortunately, many people have a hard time seeing simulated 3D.  Chances are you know someone like this.  When viewing 3D content many people suffer from a number of symptoms during viewing such as blurred vision, headache, double vision, dizziness and vision induced motion sickness.

Binocular vision dysfunctions are the usual culprit when someone has problems with 3D.  And the impact of binocular vision dysfunction is not just restricted to 3D.  Studies have show that people with binocular vision dysfunctions have lower academic performance. Fortunately, binocular vision problems are effectively treated with vision therapy.

A famous case of vision therapy treatment for inability to see in 3D is the that of "Stereo Sue", or Dr. Susan Barry, a neuroscientist who wrote the book Fixing my Gaze about how vision therapy cured her stereoblindness and enable to see in 3D for the first time in her life at the age of 48.  Her story was also the subject of an article in the New Yorker written by Oliver Sacks.  She also gave a TED talk on vision therapy:

Vision Source Vancouver optometrists have successfully treated a number of patients who have had little or no depth perception. For some of these patients, their stereoblindness was caused by strabismus (eye turn) and persisted despite 2-3 surgeries that attempted to fix the problem. First vision therapy was used to straighten the eyes (vision therapy has a 87% success rate in treating strabismus) and then a completely different course of therapy is prescribed to establish 3D vision and depth perception.

For more information on 3D vision, click here.

The best online resource for 3D vision and health is the American Optometric Association's 3D vision website at   http://www.3deyehealth.org/ .

Depressed? Anxious? Maybe your eyes are too dry. Dry eye syndrome linked to depression and anxiety.

A study published in the journal Current Eye Research examined anxiety and depression in patients with dry eye syndrome.  The authors of the study concluded that “anxiety and depression are correlated with Dry Eye Disease, demonstrating that [it] is an important public health
problem that merits increased attention and research.”


Vision Source Vancouver optometrists see the effects of dry eye syndrome on patients every day.  Sometimes it is an irritating thing in the background.  However, dry eye syndrome can get so bad that it can wreck your life by taking away the things you love to do and ruin your relationships with your loved ones.


Dry eyes may seem trivial but for chronic sufferers of dry eye syndrome, their dry eyes significantly decrease their quality of life.  Many of these people are not able to drive, work on the computer for very long or even watch TV with family because their eyes will not tolerate the activity for more than a few minutes. Dealing with the discomfort, burning, scratching, and pain of dry eye syndrome can make your life bad enough that you may become clinically depressed.


People who are older and who have had dry eye syndrome for longer are most at risk of depression and anxiety.  This suggests that the earlier you seek treatment the better it is for your mental health. 


For dry eye sufferers, the best advice is to go see your eye doctor as soon as possible because a wide variety of effective treatments are available for dry eye syndrome and one of them can probably improve your dry eye symptoms.  For most dry eye sufferers, it is possible to avoid the spiral of discomfort, pain, burning and eventual depression and anxiety that can come from dry eye syndrome. 


For some more information about dry eye syndrome read these posts:

• Caffeine improves dry eye syndrome
• Women make dry eye worse with makeup
• The basic facts about dry eye syndrome
• Dry eye can come from computer use (because you blink less)

How to choose a children's optometrist - tips from a pediatric optometrist in Vancouver, BC

Children need to see the optometrist every year starting at six months of age.  That's because children are at risk of a number of vision and eye health problems that can cause lasting damage if not caught and treated early.  Vision problems can also negatively impact child development and grow into adult problems (like poor educational and vocational achievement, social problems and increased rates of incarceration).

I have a thriving pediatric optometry practice in Vancouver, BC.  Parents bring their kids in from all over Metro Vancouver and Surrey mostly because of word-of-mouth referrals.  But what about my children's optometry practice gets parents talking and recommending me to other parents?  Here are some of the things that I think an optometry clinic must have to provide excellent eye health care for children.

Optometrists that have a personality that kids love

Nothing beats an eye doctor that loves kids and has children of his or her own.  Not only do I have two very young children, but I love kids and have always devoted a significant part of my life to children.  A kid- friendly personality comes through when you meet an optometrist.  You can do a personality test on a prospective optometrist by having an eye exam before you bring in your  kids to get a sense of what the doctor is like. Are they warm, friendly and energetic?  Kids love that.  Or are they cold, distant, excessively analytical.  Kids are likely to be unimpressed with that.  If a doctor can engage a kid's attention, the visit is bound to be fun, informative and, most importantly, medically useful.

Demonstrated interest in children

As an example of this factor, in optometry school, one of my projects was to develop a children's book tittled Iris Goes to the Optometrist that parents could use to teach and prepare their kids for going to the optometrist.  You can find it on Google Books, just click here.  Optometrists that are the best with children have things like this in their professional or educational experience that show their love, concern for and interest in children.

A member of the College of Optometrists in Vision Development

Ask if the optometrist is a member of the College of Optometrists in Vision Development or visit http://www.covd.org/ to search for their name.  So many children's vision problems are developmental in nature and some optometrists who are focused on an adult population may not test for disorders like binocular dysfunction, convergence insufficiency, amblyopia, visual information processing.  These disorders can make if very difficult for kids to success in school and may affect their self esteem and other aspects of their lives.  An optometrist that is alive to these disorders and has a vision therapy practice (like I do) to treat them can make a huge difference in a child's life. 

Sometimes when these visual disorders go undetected, children may be misdiagnosed with attention deficit hyperactivity disorder, or ADHD, because the symptoms of the vision disorders are similar to ADHD symptoms.  Children should not be medicated for a condition that they don't have and you can avoid that risk by finding an appropriate children's optometrist.

Does the clinic have a children's play area?

One of the things parents love about our new Vancouver clinic space is that we've devoted a good chunk of space for a children's play area, packed with toys and books.  I know that cranky kids, bored in a waiting room, are a challenge to deal with because I deal with it when I take my kids to the doctor.  I put in my clinic what I wish my dentist and GP would put in their clinic.  Choose an optometrist that has done the same.

Does the clinic have a good selection of frames and eye-wear for children?

If a child needs glasses, its nice to be at a clinic that caters to that need.  At our Vision Source Vancouver optometry clinic, we have a very good selection of kids frames and eye-wear and I'm always surprised by the reaction of parents.  They are not used to having so much to choose from.  Kids are often neglected by optical dispensaries.  Choose an optometrist that has a good selection of kids frames.  Parents are busy enough.  It's very nice if you can reduce your running around and get what you need at one place.

By Dr. M.K. Randhawa

Caffeine improves dry eye syndrome - according to new study from Tokyo researchers

Caffeine intake can significantly increase the eye's ability to produce tears, a finding that could improve treatment of dry eye syndrome.  This is according to a new study published in the journal Ophthalmology by researchers at the University of Tokyo's School of Medicine.

Dry eye syndrome affects millions of people.  Depending on the study you read, between 5% and 30% of the population will experience dry eye syndrome at some point in their lives.  The severity of dry eye syndrome ranges from an annoyance to a debilitating, vision threatening illness that can ruin lives by making it impossible for the sufferer to hold down a job or drive a car.  Women and people who have had LASIK surgery are more at risk of dry eye syndrome although it can affect anyone.

All of the 78 participants in the study produced significantly more tears after consuming caffeine than after taking a placebo.

Dry eye syndrome has a number of different causes that include slower than normal of tear production, tear quality that is worse than normal or tears evaporating faster than normal from the surface of the eye.  Dry eye syndrome is sometimes called tear dysfunction syndrome to focus attention on the chief culprit of the disease: some sort of problem with tears. 

Caffeine is known to increase the secretions of various glads in the body.  For example, caffeine increases the secretion of saliva and digestive juices.  The study suggests that it may stimulate the gland the produces tears.

Dry eye can negatively impact the quality of your life.  If you think you have it, go see your optometrist.  A number of different treatments are available and it is likely that one of them can help you.

Here is a recent post we did on dry eye syndrome:

• Women make dry eye worse with makeup

In a city like Vancouver BC, where our clinic is located, there is a Starbucks on every corner.  I wonder if optometrists write fewer per capita prescriptions for dry eye medication.  If public health researchers do a study on that, you will here about it here first! 

The image at the top of this post is the chemical structure of caffeine.

Motion sickness and vision therapy - see sick syndrome

MSNBC recently did a story on adult onset motion sickness. One of the doctors interviewed for the article was optometrist, Dan L. Fortenbacher, O.D., FCOVD, who treats motion sickness using vision therapy.

Here is an excerpt from the article that mentions one of Dr. Fortenbacher's patients:

Yet other hazards await adults. One often overlooked cause of persistent motion sickness may be a visual disorder -- also known as “see-sick syndrome,” says Dan Fortenbacher, O.D., who treats the disorder at his practice in St. Joseph, MI. In these cases, an eye problem such as decreased depth perception or muscle control sends miscues to our vestibular system, a part of the inner ear and brain responsible for keeping us in balance as we go about our lives.
In many cases, patients have had vision issues since childhood, but age-related changes make it harder to compensate, Fortenbacher says. It doesn’t take a car trip to set things off; patients may feel sick watching a movie, scanning the aisles while grocery shopping, even looking at stripes on a shirt.
Treatment for see-sick syndrome involves eye exercises and special lenses. For the rest of us whose motion sickness is not serious enough to require a doctor's intervention, avoiding bumpy seats, a pre-trip heavy meal and reading can ward off the occasional travel queasiness. And if you can, drive the car yourself because driving yourself significantly reduces motion sickness compared to if you were a passenger.

In our Vancouver optometry clinic we have seen some patients who became nauseous from things as common or minor as going shopping or looking at stripes on a shirt. These people definitely had vision problems but in their case the problems were caused by minor brain injuries they suffered in car accident.

But it does not take something as obvious as a car accident to cause brain related vision problems like this. Something as innocent and forgettable as a sports impact or a fall ( can cause a mild traumatic brain injury which can produce visual symptoms like motion sickness.

Sometimes impacts to the head happen in childhood and are never medically investigated and are quickly forgotten only to cause symptoms later leaving doctors and patients to wonder about their origin.

For those that like research studies, a recent study by researchers at the Centre for Eye Research, School of Optometry, Queensland University of Technology found that visual information was more important that vestibular stimulation (balance) in producing motion sickness symptoms.

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Study proves that half the eyewear sold online is junk. Why read the study when you can enjoy this cool infographic?

It is becomming more well known that a recent research study from Pacific University has proven  that half the eyeglasses sold online are junk.  This blog wrote about the study just yesterday. 

Today, the BC Doctors of Optometry have come out with this infographic on the topic.  The information is in line with what we actually see in our Vancouver optometry clinic with patients comming in with headches, blurry vision and glasses that just don't work, fit or suit the patient's needs. 

Product of the year - Optifog anti-fog lenses

Can we call 'em or what?  This blog has written before about Optifog anti-fog lenses and how much we love them. 

Now, Canadian consumers have proven us right and voted Optifog lenses the product of the year in the personal comfort category.

Apart form the fact that Optifog lenses work so well (you can hold them up to a steaming cup of coffee and they won't fog up) they have a hilarious advertising campaign.

Read the press release announcing Optifog as the winner here.  Here are some interesting facts and stats about foggy lenses from the press release:

Over half (52 per cent) of survey respondents admitted that they had experienced an embarrassing – and potentially dangerous – moment when their glasses have fogged. This includes walking into something (27 per cent), failing to recognize a familiar face (21 per cent) and tripping or falling down due to foggy lenses (14 per cent). Despite still needing to see, 33 per cent of respondents have removed their glasses while walking due to their lenses fogging up, while 19 per cent did so while working.

Finding a solution to foggy lenses is critical to continued safety and productivity, no matter the activity.  “Fog can be a problem for glasses wearers year-round. Foggy lenses can occur when drinking a hot beverage or even working, especially in jobs where safety or precision are important, such as a surgeon wearing a mask,” said Dr. Lawrence MacAulay, of Armstrong Optometry in Armstrong, B.C.  “Initial consumer feedback about Optifog™ has been incredible. It’s given glasses wearers a new found freedom; they love being able to see clearly without worrying about fog.” 

Optifog has been quite popular in the few months that we have carried it at our Vancouver optometry clinic.  Patients seem satisfied and they are exited to konw that there is an option for them to avoid those embarassing moments when their lenses fog up while on a date, with colleagues at work or in any number of situations.  In a city like Vancouver, where it is usually cold outside and warm inside, fog is a daily battle.

Studies show that half the glasses sold online are junk. What kind of problems might I experience?

A research study from Pacific University has proven what most eye doctors have already been told by their patients, that half the eyeglasses sold online are junk and can cause lots of problems. 

But how might substandard eyeglasses affect you and what problems might you experience if you were the unfortunate owner of a pair of substandard eyeglasses? 

Dr. M.K. Randhawa, of Vision Source Vancouver optometrists, talks about this problem in this video:



Here is a link to the study from Pacific University:   http://optometrists.bc.ca/upload/documents/Speak_Out/Safety_and_compliance_of_prescription_spectacles_ordered_by_the_public_via_the_Internet.pdf

Incidentally, studies have also found that half of ready-made reading glasses are junk. 

I'll be on RJ 1200 today at 2:00 p.m.

Tune in to RJ 1200 AM today at 2:00 p.m. to hear Dr. Randhawa talking about vision and eye health!

Is LASIK safe? Questions linger amid horror stories in the news and experts advocating on both sides

LASIK is vision correction through laser surgery.  Millions of people have had it done.  But there are lingering questions about its safety and side effects. There are also many stories emerging of people who have had their lives ruined by LASIK surgery.

If the people we see at Vision Source Vancouver Optometrists are any indication, most people who have laser vision correction, be it LASIK or PRK, are satisfied with the results.  That is not to say that they have no side effects. 

Dry eye is a common side effect of the procedure (among others like halo's starbursts, double vision and more) and many people experience dry eye for years.  However, they are able to manage their dry eye by using drops or prescription dry eye medications.  And for people whose glasses prescription was very high and were essentially debilitated without glasses, the side effects of LASIK are a price they are willing to pay for the benefits of the procedure.  Compared to their horrible pre-LASIK eyesight, many these patients view the LASIK side effects as a minor, manageable nuisance. 

However, every optometrist has heard form some people for whom LASIK was a disaster.  One patient at our clinic was unable to work following LASIK.  He lost his job.  His eyes were so painfully dry that he need to use drops every few minutes.   While horror stories like this appear to be far outweighed by satisfied patients, people thinking of LASIK should hear both sides of the story.  In the interests providing a balanced view of LASIK, here are some news reports that do a good job of exploring both sides.

Dianne Sawyer interviewed Dr. Morris Wexler, a former FDA official who was involved in approving the procedure back in the mid-1990's.  He now regrets that decision, saying that the procedure should never have been approved by the FDA:

 Here is another ABC News report on the problems with LASIK:

Katie Couric of CBS news also reports of debilitating side effects from LASIK and we hear from patients who say that LASIK ruined their lives. A CBS reporter also spoke with an ophthalmologist who thinks that LASIK is a terrible idea.

While most people are satisfied wtih LASIK, there can and are problems which can be very serious and can ruin your life.  Medical ethics and common sense demand that patients contemplating LASIK must have a clear appreciation of the risks and side effects of the procedure so that they can make an informed decision that is in accord with their own values, interests and desires. 

Patients also need to be informed of the non-surgical alternatives to LASIK.  Yes, there are are other ways to get out of glasses and contact lenses that do not involve surgery.  One option is orthokeratology, which involves wearing a comfortable eye retainer during sleep and having clear vision the next day without the need for surgery, glasses or contact lenses.

April is women's eye health and safety month

Prevent Blindness America (PBA) has designated April as Women’s Eye Health and Safety Month.


Why have a special month just to highlight women's eye health and safety issues?  Because women are more susceptible than men to vision problems and diseases because they live longer, making age-related vision diseases a concern.  Women also have more hormonal factors that can impact vision and eye health. 


More women than men receive diagnoses of eye diseases or conditions such as cataracts, dry eye, Fuchs’ dystrophy, glaucoma, macular degeneration, diabetic retinopathy, and Sjögren’s syndrome. A study from Prevent Blindness America and the National Eye Institute titled “Vision Problems in the U.S.” found that of the more than 3.6 million Americans aged at least 40 years who suffer from visual impairment, including blindness, 2.3 million are women - a stunning 64%.


It is important for both men and women  to take the necessary steps today to keep their eyes healthy in the future as they age.  However, women must be more vigilant because they have a greater risk of vision loss than men, and they face different risks than men.


Here are some tips that Prevent Blindness America (which the optometrists at Vision Source Vancouver completely agree with) has published that will women to keep their eyes healthy:


• Get an eye exam. An annual eye exam is an easy routine and can make a big difference in your eye and overall health.


• Know your family history. Genetics plays a key role in eye disease. Recommend that your patients research their families’ health histories and notify you of any eye diseases that run in their families.

• Eat healthy. A diet rich in beta carotene, lutein, zeaxanthin, zinc, and omega-3 fatty acids also can help guard against vision loss from eye disease.

• Take supplements. Antioxidants have been shown to reduce the progression of some eye illnesses, including age-related macular degeneration. Vitamin A, riboflavin (vitamin B2), vitamin C, and zinc are good sources to help maintain eye health.

• Quit smoking. Smoking, even second-hand smoke, increases the risk of eye disease.

• Wear ultraviolet (UV) ray eye protection. When venturing outdoors, PBA recommends wearing brimmed hats in conjunction with UV-rated sunglasses.  This is where eyeglass wearers have an edge of those who get LASIK or those who have perfect vision.  Almost all lenses on the market in North America have 100% UV protection.  That means that an eyeglasses wearer is protected all the time, even if they are not wearing sunglasses.

We have done a number of posts on women's eye health issues lately.  You can check them out at the following links:

• In women, future dementia shows up in the eyes first - maybe early enough to do something about it
• Women, already the worst sufferers of dry eye, make it worse with makeup
• The basic facts about dry eye syndrome

The work and wisdom of Dr. Frederick W. Brock

Dr. Susan Barry, Professor of Biological Sciences and Neuroscience and author of the book Fixing My Gaze (on how vision therapy cured her stereoblindness) wrote an excellent piece in the Journal of Behavioral Optometry on the work of Dr. Frederick W. Brock, inventor of the widely used "Brock String" and a leading mind in the treatment of strabismus and the development of optometric vision therapy.  Here is part of her introduction:  

"Frederick W. Brock understood strabismus better than any other individual, yet most vision care professionals have never heard of his work. If they do recognize his name, it is probably in association with the Brock string. That is how I first heard of Dr. Brock. I was a 48-year-old patient in optometric vision therapy who had been esotropic since early infancy.  Although I had undergone three childhood surgeries, I continued to alternately fixate, was stereoblind, and had a poor sense of the visual periphery. All of this changed as a result of vision therapy provided by my optometrist, Dr. Theresa Ruggiero. Fascinated by the power of the Brock string and other vision therapy tools, I wanted to learn more about Dr. Brock but discovered that many of his publications were difficult to obtain."

To read more, visit her website at http://www.stereosue.com/ or click on the following link to go straight to the article:


http://www.stereosue.com/wp-content/uploads/2011/04/The-Work-and-Wisdom-of-Dr.-Frederick-W.-Brock.pdf


Susan Barry also recently gave TED Talk on how vision therapy cured her stereoblindness and allowed her to have depth perception for the first time in her life at the age of 48 (and after three ineffective strabismus eye-muscle surgeries):

In women, future dementia shows up in the eyes first - maybe early enough to do something about it

April is women's eye health and safety month.  That makes the results of a new study  reported in the March 14, 2012, online issue of Neurology timely because the results have important implications for women over age 65.


Retinopathy, a disease of the blood vessels in the retina (which as at the back of the eye) was found to be an important marker for the later development of dementia in women who are 65 and older. Even mild retinopathy in women in this age group could be a marker of cognitive decline and related vascular changes in the brain, according to the study.


Retinopathy is usually caused by Type II diabetes or hypertension.


The study's results suggest that retinopathy may be useful as a clinical tool if it can be shown to be an early marker related to neurologic outcomes. If retinopathy is detected early enough, there may be room for the patient to make lifestyle changes or participate in medical interventions that can slow the onset of cognitive decline.  As with many diseases, early diagnosis and treatment can make a big difference in quality of life.



It seems that brain health is in the eye of the beholder.  The study is an other example of why eye exams by an optometrist (which routinely include an examination of the blood vessels in the retina) are one of the best things you can do for your overall health.  Not only can they detect markers of future cognitive decline, eye exams can diagnose, diabetes, hypertension, multiple sclerosis, cancer and other diseases that show up first int he eyes.  In fact, eye exams are often the first to detect chronic diseases.

While the study discussed above involves changes in the physiology of the eye as an early marker of cognitive decline, other studies have shown a connection between uncorrected visual impairments and cognitive decline.  The latter studies seem to indicate that older people who lack proper visual stimulation are more prone to cognitive diseases like Alzheimer's and dementia.  Increasingly, science is making the link between vision and eye health on the one hand and brain health on the other.  That's why it's important to see the optometrists regularly as we age.

Women, already the worst sufferers of dry eye, make it worse with makeup

Attention women! Open your eyes to the eye health risks that come from improper makeup use. Women already have more than their fair share of eye problems. They suffer from dry eye syndrome more commonly then men and some women make it worse on themselves by using makeup improperly which causes additional eye health problems.

Wearing makeup can dry out your eyes or make your dry eye syndrome worse. There are many reasons for this. Mascara can block your tear ducts, eye shadow can get into your eyes causing a sandy sensation that dry eye sufferers are all too familiar with. The list goes on.

Here is what you can and should do for the sake of your eyes.

Check for product validity or expiry date
Makeup contains certain ingredients that will not last forever. Most makeup products last between 6 months to a year unless printed otherwise.

Be extra careful with eye shadow and mascara.

These two products get contaminated easily and once contaminated they introduce fungal and bacterial infections into your eyes. Mascara is particularly susceptible to this type of contamination because it is is water based and the wand goes into your eye and back in the tube many times giving bacteria many chances to grow in the cozy environment of the mascara tube only to be gently transported into your eyes with the wand.

Avoid the inside of your eye

When makeup accumulates around the eye and is not properly removed, it can get into the eye and cause damage the cornea and cause eye infections.

If you have noticed that big chunks of makeup tend to accumulate in the corners of your eyes, you are at risk. Bits of makeup can make their way into your eye overnight. It is a hassle and can be time consuming to remove makeup - and no one wants to do it after a night out when all you want is sleep - but not removing makeup properly can lead to a trip to the optometrist for treatment.

Don't share your makeup

Every person has different skin bacteria and germs and sharing makeup is a way for germs to go from one person to another, causing infection. For this reason, it's a good idea to be careful when you try makeup at cosmetic stores. Make sure that fresh applicators are used.

Diluting makeup?

Do not add water or saliva to dilute your makeup because water and saliva carry bacteria that can get into your eye and give you problems.

Dry Eye Disease

Makeup precautions are useful for all women but especially for those who suffer from dry eye syndrome because infections caused by improper makeup use can greatly worsen your dry eye symptoms.


The image accompanying this post is from the "Open your Eyes" public awareness campaign put on by the Canadian Association of Optometrists. Click here to learn more.