From Your Doctor: Diabetic Retinopathy

Diabetes is a disease that interferes with the way the body uses and stores sugar. Too much sugar in the bloodstream can cause damage throughout the body, including the eyes. Every part of the eye can be affected, but the most significant and sight-threatening complication occurs from damage to the retina, known as diabetic retinopathy.

The retina is the inside lining of the eye and it requires a steady blood supply to function well. If blood sugar is too high, it causes damage to the blood vessels supplying oxygen to the retina. This damage leads to leakage of blood, called hemorrhages, into the surrounding tissue. This is called non-proliferative diabetic retinopathy. Depending on the severity, non-proliferative diabetic retinopathy is closely monitored anywhere from every couple months to just once per year.

If blood continues to leak from the blood vessels, there is less blood going downstream to the parts of the retina that need it. The body tries to compensate by making new blood vessels. Sounds great, but these new vessels are not as strong and healthy as the originals and are prone to leaking even more. When this happens it’s called retinal neovascularization or proliferative diabetic retinopathy. This is a serious complication that can lead to scarring, retinal detachments, and even blindness. Proliferative diabetic retinopathy requires urgent retinal surgery and/or eye injections to stop these new blood vessels from growing and minimize the risk of blindness.

Other possible complications include:

• Fluctuating vision – If blood sugar levels are high, the crystalline lens inside the eye swells and changes how the eye focuses. When blood sugar levels go down, the swelling will too, and cause yet another change in the focus and glasses prescription.
• Dry eyes – Increased blood sugar in the body changes the composition of the tear film and leads to dryness.
• Slower healing – If there is an eye infection it often takes longer to heal.
• Cataracts – This complication develops when the crystalline lens becomes cloudy and does not allow light through to the retina, causing cloudy, blurred vision.
• Glaucoma – There is an increased risk of glaucoma in patients with diabetes.
• Macular degeneration – There is an increased risk of macular degeneration in patients with diabetes. (2)

The best way to prevent eye complications from diabetes is to closely manage blood sugar levels and have annual diabetic eye examinations to monitor for early changes inside the eyes.

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(1) Diabetic Retinopathy. (n.d.). Retrieved November 18, 2015, from http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/diabetic-retinopathy?sso=y&ct=9c51c9ebdd57c60365283b2ca0ae5c5a808f613337ba332f4c51eb5ad4cd91975a4496841f467931ade84cbccec12f1356a71dd098703ed3ebedffffb75e

(2) Quick Reference Guide: Evidence-Based Clinical Practice Guidelines, First Edition, 2014. American Optometric Association

Dr. Capstick graduated with honors from Pacific University College of Optometry in Forest Grove, Oregon, with a Bachelor of Science in Vision Science and a Doctor of Optometry. She completed her internship training at the Salt Lake City VA Medical Center in Salt Lake City, UT; Pediatric Strabismus Referal Center, Pacific Universtiy College of Optometry in Portland, OR; Lasik co-management at Spivack Vision Center in Denver, CO; and primary care at Alaska EyeCare Centers in Anchorage, AK. She completed a residency in Cornea/ Contact Lens and Ocular Disease at UC Berkeley School of Optometry in Berkeley, CA.

Use it or Lose it!

Don’t wait for December to use you Flex Spending and Health Savings Accounts.

As the year-end approaches and you are considering how to use those funds, we invite you to make your eye health a priority and use those dollars before you lose them.

You may know that your Annual Comprehensive Eye Exam is an eligible expense, but the copay left over after your traditional insurance coverage is also eligible. 

Your eyeglasses are qualified expenses, the lenses and frames, all lens materials
and all lens coatings.  That includes tinted and polarized prescription sun glasses or our blutech pigment computer lenses.

Contact lenses also qualify for HSA and FSA funds. Fit and follow up fees are eligible.  All brands of daily, weekly, bi-weekly and monthly disposable contact lenses are eligible and so are Rigid Gas Permeable lenses and Ortho-K corneal molding lenses and their associated service charges.

If you have chronic dry eye and have considered having tests– like a Lipi-view or Tear Lab to diagnose your specific deficiencies or in-office treatments like a Lipi-Flow to relieve your dry-eye symptoms– those are all qualified expenses that can come out of your pre-tax health accounts.

Latisse and other treatments for insufficient eyelashes qualify.

Costs of Lasik surgery and pre-op/post-op care are eligible.

If you have any questions about what expenses qualify, or need copies of invoices from treatments you paid for out of pocket to submit for reimbursement, contact our office.  We are happy to help!

Every plan is different, and you are ultimately responsible to make sure your expenses are eligible.

Technology, Blue Light, and Sleep (or Lack of it!)

Are You and Your Kids Losing Sleep Due to Blue Light?

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The 2014 Sleep in America Poll conducted by the National Sleep Foundation found that how you interact with electronics influences how your children interact with electronics. Why is this important? Many studies have shown that at night, light disrupts circadian rhythm and suppresses the secretion of the hormone melatonin. Blue light, the light emitted from electronics, shifts circadian rhythm twice as much (3 hours) and suppresses melatonin for twice as long as other lights. This blue light affects teens more than adults . So, if you are checking your email or watching Netflix late into the nights, chances are your kids are too, and it’s hurting them.

In 1998, scientists discovered a new photoreceptor in the eye: melanopsin retinal ganglion cells, found in front of the retina. These cells are more sensitive during evening and nighttime hours and are uniquely sensitive to blue light. Blue light is powerful in elevating body temperature and heart rate, and in reducing sleepiness. It helps keep you more alert which means that while blue light is good for you during the day, it’s bad for you during the night.

Because of the way blue light upsets your circadian rhythm and the release of melatonin, exposure to blue light, especially during evening and night time hours, may be affecting your ability to get enough sleep and good sleep. This can be especially detrimental to kids and teens. Short sleep and upset circadian rhythms have been linked to depression, obesity, diabetes, and various tumoral diseases.

Luckily there are steps you can take to lessen the harmful effects of blue light

1. Expose yourself to lots of bright light during the day. This is going to increase alertness during the day, and it boosts your mood and your ability to sleep at night.
2. Use dim red lights at night if possible. Red light is the least harmful light to your sleep cycle.
3. Put down the phone! Avoid bright screens at least 2-3 hours before bed.
4. Wear blue light blocking lenses. If you cannot cut back the screen time, invest in lenses that block blue light and cancel out a lot of the harmful effects.

Remember, your kids are watching you! You are directly affecting their good (and bad) behaviors. So how you are interacting with technology will influence them. The best thing you can do for them is develop your own good habits.

Shireen Hosseini, InVision Eye Health

Dangerous Lights– Is Blue the new UV?

We’re all pretty familiar with Ultra Violet light, and we know that we need UV protection on our sunglasses.   But what you may not know is that blue light, sometimes called High Energy Visible Light (HEV), is different than UV and also extremely damaging to your eyes.

Ultra Violet light is invisible.  These are the shortest and highest energy waves of light.  As UV light approaches the eye, the majority is absorbed by delicate eyelid skin, the cornea, and crystalline lens at the front of your eye.  Here they can cause skin cancers, corneal diseases, and even cataracts—not good by any means, but generally treatable and you are not likely to go blind due to the effects of UV light.

Blue light is visible.  It is made up of longer waves of light that are not stopped by the outer mechanisms of our eyes because we need them to see color.  So this high energy light is going through your cornea and your lens and landing on the delicate cells of your retina.  In our modern digital world, we are encountering more blue light than ever before.  Blue light is causing us greater eye fatigue, ruining our sleep, giving us migraines, and  accelerating the progression of age related macular degeneration—the leading cause of adult blindness.  (Read more about UV and Blue Light here.)

We have been educated about the dangers of UV light, and we have sunglasses to protect our eyes when we are outdoors.  But when we come inside and sit down under a fluorescent lightbulb  to work at our LCD monitor, binge watch  Netflix on our LCD tablet screens, or browse tumblr on our phones—how are we protecting our retinas?

At InVision, we are committed to providing you with education and resources to help you make good decisions about your eye health.   If you have a family history of macular degeneration or questions about how to protect yourself from blue light, we can help!   Your annual comprehensive exam includes a thorough retinal examination, where we dilate your pupils to
inspect the back of your eye, or take an Optomap image to track changes over time.  We recommend Blutech lenses for indoor wear to filter out both UV and blue light—you can get them without an Rx or we can make them in your prescription, even a progressive lens!  For computer users fifty and over, Dr. White recommends the Blutech office lens.  He absolutely loves his!
We are excited to be giving away a free pair of Blutech lenses in July!  For each new blog and facebook  follower, or for each share, reblog, or pin, you’ll get an entry—so pass it on!  Friends don’t let friends go blind!

July is all about Red, White and Blue Light!

July is all about Red, White and Blue Light!  Blue light contributes to dry eye,  eye fatigue, macular degeneration, sleep disorders and migraines– InVision will be focussing on how blue light affects your life and how to combat those effects this month.

Follow us on our blog, Facebook, Instagram, Twitter, or Pinterest, then Like, Share and tag your friends all month to spread the word and be entered to win a free pair of Blutech Lenses in your prescription!

Fact or Science Fiction?

Ortho-K is the Future of Vision Correction.

Who doesn’t love Science Fiction? It is fun to imagine a future of hover cars, robot maids, and contact lenses that reshape your cornea so you don’t need to wear glasses anymore.   Hold the phone- that last one isn’t fiction!  It is Orthokeratology and Drs. Brenden White and Brittany Capstick at InVision Eye Health are your local experts.

Ortho-K is a non-surgical procedure that eliminates the need for glasses or daytime contact lenses. It improves vision by gently reshaping your eye WHILE YOU SLEEP using specially designed therapeutic contact lenses. You just put the specially fitted lenses in at bedtime, and when you awake, you will have clear, sharp, natural vision for your waking hours.

This safe and effective treatment can correct near-sightedness (including high prescriptions), farsightedness, astigmatism and presbyopia (blurred near vision). It is a great alternative to LASIK for those who don’t want the risk or are not ready for surgery.

Ortho-K is great for kids, 8 years and older, who struggle wearing glasses and contacts– it can even prevent their nearsightedness from worsening as they grow.

Ortho-K is also great for adults who struggle with contact lenses due to dry eye symptoms or allergies.  Maybe  you are tired of being blind without your glasses when you wake up in the morning or in the shower.  Wouldn’t it be great to snorkel and actually see the fish?

If you are interested in Ortho-Ks for yourself or your child, call us or come in for a no charge OrthoK consultation with Dr. White or Dr. Capstick.  They will be happy to answer your questions, explain the fitting and follow up process, and make sure that your eyes and Rx make you a good candidate.

We’re still waiting on the robot maids, but the future of vision correction is already here!

Why Do I Need an Annual Eye Exam? My Vision Hasn’t Changed.

When it comes up in conversation that I work in the Eye Health field, I am often asked, “Do I really need an annual eye exam?  My glasses still work fine, and who has the time for that?”  At InVision Eye Health, we understand how busy you are.  A well checkup for your eyes may not make it to the top of your list if you don’t understand what it is that makes it so vital.  So, let me explain a little of what we are looking for while we are looking into your eyes (Spoiler– It isn’t your soul!).

Checking your vision is a major portion of your eye exam– it is the flashy part with the cool machinery  and the tricky questions (Which looks more clear, 1 or 2? 3 or 4?  How about now?).  But it isn’t the only thing we do and, honestly, it isn’t the most important.

We will check the tiny muscles that control eye movement, and the even tinier muscles that control the focusing power of your eye’s internal lens.

We look at your vascular system. An Eye Doctor dilates your eyes to see your veins intact.  This is the only exam where your healthcare professional can check for cholesterol problems without sticking you with a needle. Odd bends, tears, or kinks in your veins can indicate High Blood Pressure. Diabetic Patients should see their Optometrist regularly to keep watch for Diabetic Retinopathy, or your eye doctor may see signs of retinopathy and encourage you to see your primary care physician for treatment of diabetes.

We look at your nerves.  The optic disc in the back of your retina is where your optic nerve connects your eyes to your brain.  If that connection is discolored, that can indicate a brain tumor.  If your pupils don’t expand and retract normally in response to light, that can also indicate nerve damage.

Excessive redness or irritation can indicate an auto-immune disorder, like Lupus.  Bulging or protruding eyes are a sign of Thyroid disease.

And honestly, your vision probably has changed.  Perhaps not dramatically, small changes over time are hard to notice, but you will appreciate the difference a fresh Rx makes.  Keeping up with incremental steps in your changing eyesight will be easier for you than adjusting to a dramatic change in your glasses Rx.

As your Eye Health team, we absolutely want you to see clearly– for a long, healthy lifetime.  We have looked into the eyes of our patients and seen the first evidence of leukemia and brain tumors.  So come see us regularly, it could save your life!  And it’s not like a it’s trip to the dentist…

Don’t Blink! (Incorrectly)

There are certain areas of our lives where we all feel like we know what we’re doing.  We are competent, capable, and confident in our ability to order a pizza, drive a car, or send an email.  You may have thought that blinking would be on that list of things you know how to do, and do well.

You are wrong!

The vast majority of human beings have no idea they have been blinking both of their eyes incorrectly their entire lives.  How much could this matter you ask? What could you possibly be losing out on with your lack-luster blink technique?   Simple answer, a lot.

Partial blinking is a very common problem in people with evaporative dry eye.  Poor blinking can result in increased eye fatigue and reduced vision.  When we look at our computer or television screens for prolonged periods of time we all blink far less than we should which contributes to eye strain–causing discomfort, decreased vision, and even double vision.

Convinced you have a problem? Good job, that is the first step.

We at InVision are blinking experts with years of experience perfecting our essential blinking technique.  Luckily for you, we are also driven to share that knowledge and improve your quality of life.  What can we say?  We’re givers.

First off– make a commitment to yourself to blink every 20 minutes, 20 times a day.  Frequency and consistency are key. You need 30 days of consistent blinking to achieve optimal results.  Set a reminder on your phone, or an egg timer, especially during tasks that require sustained focus.

Next– close both eyes normally, pause two seconds, and open.  Close the eyes normally again, pause two seconds and then aggressively squeeze the lids together for two seconds.  Now, open your eyes and give yourself a pat on the back.  Repeat every 20 minutes.

Finally– do a self-check.  Place your fingers at the corners of your eyes and blink.  When you are blinking correctly, you should feel no movement under your fingers.  If you feel anything, you are doing it wrong using your defense muscles that run along the side of your head.  Your blinking muscles are above your eyelids.  Try again, practice makes perfect.

Following this technique to consistently and completely blink will stimulate the glands that secrete tears and oils to lubricate your eyes.  You’ll experience less eye fatigue, irritation, redness, and better vision.  If you still have dry eye related symptoms, let us know!  We’re here to help.

We See You!

Great work! You found the shiny new blog of InVision Eye Health!  We hope you’ll stick around– and we’ll make it worth your time with cutting-edge insights into the ever expanding universe of eye health care and technology.  We have the best Optometrists in Utah–with extensive education, unique specialties and charming personalities to guide you through this exciting area of your overall health and well-being.

So, make yourself at home.  We’ll introduce ourselves and our specialties as we get going. Please feel free to comment and ask questions about our purpose, our practitioners, our people, our pupils, or our punctuation.  We’d love to hear from you!