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Aging Eyes and Driving Safety 

woman shielding eyes from light

Even if you don’t have any eye or vision problems, the natural process of aging affects your ability to see and react to visual stimuli. It’s important to know the impact that aging can have on your eyes and vision so you can take the necessary precautions to stay safe and protect your eyes.

Driving is one activity that can pose a high risk as safe driving requires not only good vision, but also intact cognition and motor response. As we age, reflexes, reaction time and vision begin to deteriorate, which can impair one’s ability to drive safely, particularly under conditions such as bad weather, twilight glare, or nighttime darkness. Here are some ways that your ability to drive can be impaired as you age and some safety tips to help you to stay safe on the roads.

The Aging Eye

As we age, the eye and vision naturally begin to experience a decline. The pupils in the eye, which allow light to enter, begin to shrink and dilate less, allowing less light to enter the retina. This causes reduced night vision. Additionally, some of our peripheral vision diminishes along with our ability to see moving objects.

Due to deterioration of the cornea and clouding of the lens of the eye, glare becomes more disruptive and contrast sensitivity is reduced, making it harder to perceive images clearly. General imperfections in vision called higher-order aberrations cause a general decline in vision that can’t be corrected with glasses or contact lenses. Additionally, our reaction times slow, adding motor complications to the visual ones. Dry eyes also becomes a bigger problem with age as the lacrimal glands don’t produce as many tears to keep the eyes moist. Many of these symptoms may be present without the individual even noticing a decline and can all contribute to increased risk – for the driver, and others on the road.

If you add in any other vision problems such as cataracts, glaucoma or macular degeneration which are age-related diseases that gradually reduce vision, you can have a serious danger on your hands.

Avoid Distractions

The biggest driving distraction in our day and age is cell phone usage. While many states and provinces have created laws which forbid driving and texting or holding a phone, it is not universal, and this still causes countless accidents and deaths that could be easily avoided. Even hands-free options distract you from the road and put you at risk. If you must use your phone to speak, dial or text, pull over first.

Plan Ahead

If you can avoid driving at night or on hazardous roads with sharp turns, inadequate lighting or that are unfamiliar to you, you will be better off. Plan to make first time trips during the day when you can clearly see street signs and landmarks or take a practice trip with a loved one.

Purchase Night Vision Glasses

There are glasses available that can help to reduce the glare at night and enable better night time vision. Speak to your optometrist about whether this is a good option for you.

Turn Vents Down

Car vents can also cause discomfort, eye irritation and create greater vision hazard, as the air blowing at the eyes can impair vision or cause watering, especially when the eye are already dry.

Maintain Good Eye Health

Make sure that you get your eyes checked on a regular basis and that any eye conditions you have are being treated and monitored. Good nutrition, exercise and overall healthy habits will help to protect and heal your eyes as well. Further, listen to your instincts, if you feel unsafe driving or if your doctor (or family members) tell you it’s time to hand in the keys, think about utilizing other means of transportation to get around.

Many times people are able to pass their vision test at the driver’s license bureau which gives them a false sense of security, but in reality they are not seeing well, especially at night or in bad weather. In many areas there are courses available for senior citizens to test out driving skills with instructors who do an evaluation and give feedback on their real abilities. It’s critical for seniors to speak to their eye doctors about their true vision level and any restrictions that they recommend.

The key to eye health and safety is awareness. You can’t stop your eyes from aging but you can take the necessary precautions to ensure that you are protecting your eyes, yourself and those around you by knowing how your eyes and vision are affected.

Is Your Teen Ready for Contacts?

teenage girl smiling

Many teens who wear glasses are eager to try out contact lenses for convenience, fashion or to just provide another option for vision correction. For teens who feel self-conscious in their glasses, contact lenses can be a way to improve self-esteem. Young athletes and swimmers find that contacts are an excellent option for sports, especially as younger kids are becoming involved in travel sports and club teams outside of school.

While contacts might appear to be the perfect solution for teens that need corrective eyewear, they are a convenience that comes with a lot of responsibility so it’s not a decision to take lightly. Improper use of contact lenses can cause severe discomfort, infections, irritation and, in the worst cases, eye damage or even permanent vision loss.

“With Privilege Comes Responsibility”

Contact lenses are a medical device and should always be treated as such. They should never be obtained without a valid contact lens prescription from an eye doctor, and always purchased from an authorized seller. Among other issues, poor fitting contact lenses bought from illegitimate sources have been known to cause micro-abrasions to the eyes that can increase the risk of eye infection and corneal ulcers in worst case scenarios.

Particularly when it comes to kids and teens, it is best to purchase contact lenses from an eye doctor as they possess the expertise to properly fit contact lenses based on the shape of the eye, the prescription, the lifestyle of the child and other factors that may influence the comfort, health and convenience of contact lens use.

There is some debate over the recommended age for kids to start considering contact lenses. While some experts will say the ideal age is between 11 and 14, there are many responsible children as young as 8 or even younger who have begun to successfully use them. When children are motivated and responsible, and parents are able to ensure follow-up to the daily regimen, earlier contact lens use can be a success. A good measure of whether your child is responsible enough to use contacts is whether they are able to keep their room clean, or maintain basic hygiene like brushing teeth regularly and effectively.

When you think your child might be ready, you should schedule an appointment with your eye doctor for a contact lens exam and fitting. The process will take a few visits to perform the exam, complete a training session on how to insert, remove and care for lenses, then to try out the lenses at home and finally reassess the comfort and fit of the contacts. You may try out a few varieties before you find the best fit.

What Kind of Contact Lens Is Best for My Teen?

The good news is that contact lens use has become easier than ever, with safety, health and convenience being more accessible as technology improves. There are a number of options including the material used to make the lenses (soft or rigid gas permeable), the replacement schedule (if disposable, how often you replace the pair – daily, weekly, biweekly or monthly) and the wear schedule (daily or extended overnight wear).

Single use, daily disposable lenses have become very popular, particularly with younger users, because they are easy to use, requiring no cleaning or storing, and therefore they reduce the risk of infection and misuse. You simply throw out the lenses at night and open a new one in the morning. Your eye doctor will be able to help you and your teen determine the best option.

Tips for Contact Lens Wearers

Following are some basic contact lens safety tips. If your teen is responsible enough to follow these guidelines, he or she may be ready for contact lens use:

  1. Always follow the wearing schedule prescribed by your doctor.
  2. Always wash your hands with soap before applying or removing contact lenses.
  3. Never use any substance other than contact lens rinse or solution to clean contacts (even tap water is a no-no).
  4. Never reuse contact lens solution
  5. Follow the eye doctor’s advice about swimming or showering in your lenses
  6. Always remove your lenses if they are bothering you or causing irritation.
  7. Never sleep in your lenses unless they are extended wear.
  8. Never use any contact lenses that were not acquired with a prescription at an authorized source. Never purchase cosmetic lenses without a prescription!

Contact lens use is an ongoing process. As a child grows, the lens fit may change as well, so it is important to have annual contact lens assessments. Plus, new technology is always being developed to improve comfort and quality of contact lenses.

Contact lenses are a wonderful invention but they must be used with proper care. Before you let your teen take the plunge into contact lens use, make sure you review the dangers and safety guidelines.

Inside a Life With Color Vision Deficiency

While we do not offer these services, we are presenting the following information for your knowledge.

paint brushes as seen with Color Vision Deficiency

What’s it like to be color blind? Contrary to what the name implies, color blindness usually does not actually mean that you don’t see any color, but rather that you have difficulty perceiving or distinguishing between certain colors. This is why many prefer the term color vision deficiency or CVD to describe the condition. CVD affects men more than women, appearing in approximately 8% of men (1 in 12) and .5% of women (1 in 200) worldwide.

Having color vision deficiency means that you perceive color in a more limited way than those with normal color vision. This ranges from mild, in which you may not even be aware that you are experiencing color differently, to severe, which is perhaps the more appropriate from to be called “color blind” and involves the inability to see certain colors.

CVD can be inherited; it is caused by abnormalities in the genes that produce photopigments located in the cone cells in your eyes. The eyes contain different cone cells that fire in response to a specific color, blue, green or red and together allow you to see the depth and range of colors that the normal eye can see. The type of color blindness and therefore the type of color vision that is impaired, is based on which photopigments are abnormal. The most common form of CVD is red-green, followed by blue-yellow. Total color blindness or the complete inability to perceive color is quite rare. About 7% of males have congenital color blindness that they inherit from the mother’s X-chromosome.

Color blindness can also be the result of eye damage, specifically to the optic nerve, or to the area in the brain that processes color. Sometimes an eye disease, such as cataracts, can also impact one’s ability to perceive color. Systemic diseases such as diabetes or multiple sclerosis can also cause acquired CVD.

Living with CVD

Red-green color blindness does not mean only that you can’t tell the difference between red and green, but rather that any color that has some red or green (such as purple, orange, brown, pink, some shades of gray, etc) in it is affected.

You many not realize all of the ways you use even subtle distinctions in color in your daily life. Here are some examples of ways that CVD can impact your life and make seemingly everyday tasks challenging:

  • You may not be able to cook meat to the desired temperature based on color.
  • Most of the colors in a box of crayons will be indistinguishable.
  • You may not be able to distinguish between red and green LED displays on electronic devices that indicate power on and off.
  • You may not be able to tell between a ripe and unripe fruit or vegetable such as bananas (green vs. yellow) or tomatoes (red vs green).
  • Chocolate sauce, barbecue sauce and ketchup may all look the same.
  • Bright green vegetables can look unappealing as they appear greenish, brown or grey.
  • You may not be able to distinguish color coded pie charts or graphs (which can cause difficulty in school or work).
  • Selecting an outfit that matches can be difficult.

Knowing that one is color blind is important for some occupations that require good color discrimination such as the police officers, railway workers, pilots, electricians etc. These are just a few of the ways that CVD can impact one’s daily life. So is there a cure? Not yet.

While there is no cure for CVD, there is research being done into gene therapies and in the meantime there are corrective devices available including color vision glasses (such as the Enchroma brand) and color filtering contacts that for some can help to enhance color for some people. If you think you might have CVD, your optometrist can perform some tests to diagnose it or rule it out. If you have CVD, you can speak to your eye doctor about options that might be able to help you experience your world in full color.

Are Your Eyes Sensitive to Light?

Sunshine in a field

Light sensitivity, also known as photophobia, is a condition in which bright light – either natural sunlight or artificial light – can cause significant discomfort, pain and intolerance. People that experience light sensitivity will find themselves needing to close their eyes or squint when exposed to light and often experience headaches and nausea as well. In mild cases, the discomfort accompanies exposure to bright lights or harsh sunlight, but in severe cases even a small amount of light can cause pain and discomfort.

Photophobia is more common in individuals with light eyes. This is because the greater amounts of pigment in darker eyes help to protect the eye from the harsh rays of light. The darker pigment of the iris and choroid absorbs the light, rather than reflecting the light and causing internal reflection or glare experienced by those with lighter eyes. People with albinism, which is a total lack of eye pigment, also experience significant light sensitivity for this reason.

Acute photophobia is usually a symptom that accompanies a condition such as an eye infection or irritation (such as conjunctivitis or dry eyes), a virus, or a migraine (light sensitivity is one of the most common symptoms of migraines). It could also be caused by something more serious such as an eye condition like a corneal abrasion, a detached retina, uveitis or iritis or a systemic disease like meningitis or encephalitis. Light sensitivity is also a side effect of refractive surgery (such as LASIK) and some medications (such as tetracycline and doxycycline).

How to Deal with Photophobia

The most effective way to reduce the discomfort caused by photophobia is to stay out of sunlight and dim indoor lights as much as possible while you are experiencing symptoms. Wearing dark sunglasses and keeping your eyes closed may also provide some relief.

In the summer it is more common for UV to trigger corneal inflammation (keratitis) and cause photosensitivity as well. Wind and eye dryness can also set off photosensitivity, which are more good reasons to wear sunglasses.

If the sensitivity is new and the cause is unknown, you should seek medical attention immediately, especially if you experience any of the following symptoms:

  • Blurry vision
  • Burning or pain in the eye
  • Fever and chills
  • Confusion and irritability
  • Severe headache
  • Drowsiness
  • Stiff neck
  • Nausea and vomiting
  • Numbness
  • Foreign body sensation

In cases where the photophobia is a symptom of an underlying issue, treating the issue will likely cause relief in your sensitivity. This will vary depending on the ailment but could include pain medications, eye drops or antibiotics, or anti-inflammatory medications. If the sensitivity is mild due to your genetic predisposition or a result of surgery, make sure you take your sunglasses every time you leave the house. People who wear prescription eyeglasses may consider photochromic lenses which automatically darken when exposed to light.

If you are uncomfortable, speak to your eye doctor about the best options for your condition.

Got a Shiner!

boy with black eye

What Exactly Is a Black Eye?

A black eye, also known as a periorbital hematoma, is usually not an injury of the actual eye (which is why it is called “periorbital”- around the eye). It typically occurs when there is an injury to the face or the eye socket which causes bleeding beneath the skin and bruising. The term, “black eye” comes from the dark coloring of the bruising that occurs underneath the skin around the eye.

When a blunt force hits the eye socket, this can cause capillaries in the area to burst, causing hemorrhaging, also known as a hematoma. This blood can accumulate in the eye socket and as it begins to be reabsorbed into the surrounding tissues, the colors of the bruising begin to change. That’s why you will often notice the coloring of the black eye to go from a dark purplish-red color to brownish and then yellow.

Sometimes along with the external bruising, you might also notice a small amount of bleeding on the white surface of the eye, which is called a subconjunctival hemorrhage. This is when the tiny blood vessels on the white sclera are broken and leak blood. It’s generally harmless but sometimes looks scarier to the patient than the black eye does. This condition will also reabsorb on its own and is nothing to be concerned about.

While most black eyes can look pretty serious due to the dramatic color, an uncomplicated black eye will typically heal within a week to ten days. If it doesn’t, there could be a more serious issue such as a bone fracture or an orbital blowout fracture.This could present with restricted eye movement, especially if looking up or down, and numbness of the cheek and/or upper lip on the same side as the black eye. The eye may even appear sunken in. Further, if there is bleeding within the actual eye (called a hyphema) or floaters or flashes in the vision, then it is definitely advisable to see your eye doctor as soon as possible. These could be signs of more serious damage such a corneal or retinal damage and can lead to vision loss.

Treatment for a Black Eye

Usually, the best treatment for a black eye is to apply a cold compress (or even better, a bag of frozen vegetables, which is more flexible and can conform to the contours of the face) directly on the area. The cold will reduce swelling and constrict capillaries to reduce internal bleeding as well. Apply the cold for about 15-20 minutes every hour. If there is pain, over the counter pain medications can help.

If however, you experience any of the following symptoms, you should seek medical attention:

  • Blood on the surface of the eye or a visible incision on the eye
  • Vision changes such as double vision, blurred vision, loss of vision or the appearance of floaters
  • Loss of consciousness, dizziness or fainting
  • Loss of eye movement
  • Persistent headaches
  • Blood or fluids coming from the ears or nose
  • Vomiting
  • Signs of infection such as excessive swelling, pus, redness or a fever
  • Severe pain

In addition to blunt trauma, black eyes can be caused by sinus infections, nasal or eye surgery or other infections in the area such as the teeth infections or cellulitis (a serious infection that can occur around the eyes). A skull fracture can also cause both eyes to turn black, sometimes known as raccoon eyes.

Unless you notice any severe symptoms you can rest assured that your black eye is a bruise just like anywhere else on the body and with a little care, rest and patience, it will clear up in no time.

Cataract Awareness and Prevention

elderly man with cataracts looking into distance

It’s National Cataract Awareness Month

According to the World Health Organization, cataracts are responsible for 51% of cases of blindness worldwide – although this blindness is preventable with treatment. In fact, research shows that in industrialized countries about 50% of individuals over the age of 70 have had a cataract in at least one eye. This is partially because cataracts are a natural part of the aging process of the eye, so as people in general live longer, the incidence of cataracts continue to increase.

What are Cataracts?

Cataracts occur when the natural lens in the eye begins to cloud, causing blurred vision that progressively gets worse. In addition to age, cataracts can be caused or accelerated by a number of factors including physical trauma or injury to the eye, poor nutrition, smoking, diabetes, certain medications (such as corticosteroids), long-term exposure to radiation and certain eye conditions such as uveitis. Cataracts can also be congenital (present at birth).

The eye’s lens is responsible for the passage of light into the eye and focusing that light onto the retina. It is responsible for the eye’s ability to focus and see clearly. That’s why when the lens is not working effectively, the eye loses it’s clear focus and objects appear blurred. In addition to increasingly blurred vision, symptoms of cataracts include:

“Washed Out” Vision or Double Vision:

People and objects appear hazy, blurred or “washed out” with less definition, depth and color. Many describe this as being similar to looking out of a dirty window. This makes many activities of daily living a challenge including reading, watching television, driving or doing basic chores.

Increased Glare Sensitivity:

This can happen both from outdoor sunlight or light reflected off of shiny objects indoors. Glare sensitivity causes problems with driving, particularly at night and generally seeing our surroundings clearly and comfortably.

Dulled Colors:

Often colors won’t appear as vibrant as they once did, often having a brown undertone. Color distinction may become difficult as well.

Compromised Contrast and Depth Perception:

These eye skills are greatly affected by the damage to the lens.

Darkened Vision:

Often individuals with cataracts find that they require more light than they used to, to be able to see clearly and perform basic activities.

Cataract Treatment

Early stage cataracts may be able to be treated with glasses or lifestyle changes, such as using brighter lights, but if they are hindering the ability to function in daily life, it might mean it is time for cataract surgery.

Cataract surgery is one of the most common surgeries performed today and it involves removing the natural lens and replacing it with an artificial lens, called an implant or an intraocular lens. Typically the standard implants correct the patient’s distance vision but reading glasses are still needed. However as technology has gotten more sophisticated you can now get multifocal implants that can reduce or eliminate the need for glasses altogether. Usually the procedure is an outpatient procedure (you will go home the same day) and 95% of patients experience improved vision almost immediately.

Cataract Prevention

While doctors still don’t know exactly how much each risk factor leads to cataracts there are a few ways you can keep your eyes healthy and reduce your risks:

  • Refrain from smoking and high alcohol consumption
  • Exercise and eat well, including lots of fruits and vegetables that contain antioxidants
  • Protect your eyes from UV radiation like from sunlight
  • Control diabetes and hypertension

Most importantly, see your eye doctor regularly for a comprehensive eye exam. If you are over 40 or at risk, make sure to schedule a yearly eye exam.

Bifocal and Multifocal Contact Lenses 

senior 20couple 20in 20orange 20and 20white

If you are over 40 and have difficulty seeing close up, you probably have a common age-related condition called presbyopia which is when the eye’s natural lens loses the ability to focus on close objects. Presbyopia is a natural process that occurs as the eye ages and affects the majority of people from age 40 and upward. Individuals with presbyopia are often familiar with the need to hold reading materials such as newspapers an arm’s length away from their eyes in order to see clearly, yet reading glasses with bifocal or multifocal (such as progressive) lenses can help.

Fortunately for those who don’t like the look, feel or inconvenience of reading glasses, there is another option. Bifocal and multifocal lenses are also available in contact lenses in both soft and Rigid Gas Permeable (RGP) varieties.

Multifocal contact lenses give you added freedom over glasses and they allow you to be able to view any direction – up, down and to the sides – with similar vision. People wearing progressive lenses in glasses on the other hand have to look over their glasses if they want to view upwards or into the distance.

Multifocal contact lenses are generally designed in one of two ways, as either simultaneous vision lenses or alternating vision lenses.

Simultaneous Vision Lenses

The most popular version of multifocal contact lenses, simultaneous vision lenses present the distance and near vision zones of the lens at the same time. Typically after a short adjustment period your eyes learn to utilize the segment of the lens that they need to focus on the desired object and essentially ignore the other.

Translating or Alternating Vision lenses

Similar to bifocal eyeglass lenses, these contacts are divided into distinct areas or zones and your pupil will move to the desired zone depending on your vision needs. Typically the top of the lens, which is what you look through when looking straight ahead is for distance vision and the bottom area (what you look through when you look down) is for near vision. However, this can be reversed according to unique vision needs.

An Alternative Option to Multifocal Contact Lenses: Monovision

Monovision is another contact lens alternative for presbyopia particularly if you are having difficulty adapting to multifocal lenses. Monovision splits your distance and near vision between your eyes, using your dominant eye for distance vision and your non-dominant eye for near vision.

Typically you will use single vision lenses in each eye however sometimes the dominant eye will use a single vision lens while a multifocal lens will be used in the other eye for intermediate and near vision. This is called modified monovision. Your eye doctor will perform a test to determine which type of lens is best suited for each eye and optimal vision.

Are Contact Lenses Right for You?

If you have presbyopia, contact lenses may be a great option for you. Many people prefer the look and convenience of contact lenses over traditional reading glasses. Speak to your eye doctor about the options available to you.

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