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What Is Low Vision?

By: Jacquelyn Cosgrove, OD

Low vision is any reduction in vision, that limits a person from performing their daily tasks due to a condition or disease, that cannot be improved by conventional glasses or medical treatment. Trauma or eye disease can cause a person to have reduced vision. Low vision is typically diagnosed when one eye is worse than 20/70 in vision. Any person who is having problems functioning independently due to their vision should have a low vision evaluation. There are devices that can be utilized to help improve a person’s useable vision.

lv eye disease

How is it different than a regular eye exam?

A low vision exam is different than a comprehensive eye exam. The goal of a low vision evaluation is to help the patient better navigate their daily life with devices such as magnifiers, telescopes, specialized tints, or lights. The evaluation is goal-oriented. The patient describes the visual tasks that are causing difficulties, and devices are trialed to help achieve those tasks.

For example, if a patient is struggling to read the newspaper, a stand magnifier with light could help them to enjoy their Sunday paper again. Just like every patient is not the same, not all devices and techniques work for every patient. Many factors contribute to which devices will work best including severity/type of vision loss, dexterity, and adaptability.

woman eye exam

After a patient’s visual goals have been established, vision will be assessed. Standard refraction or a trial frame refraction will be performed to assess if a new pair of glasses would be beneficial. Alternative strategies for maximizing the patient’s vision will be discussed. Most patients with low vision have damaged areas on the eye or along the visual pathway that no longer function the way they should. The goal is for the patient to learn adaptative methods to help use the parts of the eye or visual pathway that are still functioning.

These adaptive methods can include the use of visual devices such as magnifiers, additional lighting, auditory cues, contrast enhancement, and much more. A low vision examination cannot restore the vision that has already been damaged but it can help to make certain visual tasks easier and improve quality of life. Education, counseling, and additional resources for the patient and the family will be discussed throughout the examination.

If you or a loved one is interested in a low vision examination, please call Clearvue Vision Center in Kent, WA at 425-251-9200 or schedule online at http://www.clearvuevision.com/.

A Guide to Multifocal Contact Lenses

By: Dr. Allison Moy, O.D., F.A.A.O, F.S.L.S

 The onset of presbyopia, the progressively worsening ability to focus clearly on close objects, typically becomes noticeable after age 40. Patients who are interested in a contact lens option that provides clear vision at both distance and near may benefit from multifocal contact lenses. This design is available in both a soft lens and gas permeable lens type.

How Multifocal Contact Lenses Work

There are various designs of multifocal contact lenses depending on the brand. The designs fall into two basic groups:

  1. Simultaneous vision designs. These multifocal contact lenses have a blend of prescription for far and near (and sometimes intermediate) viewing. When looking at distance or near the wearer’s eye uses the designated prescription that provides the clearest vision. There are two types of simultaneous vision designs: concentric and aspheric.
  2. Segmented designs. This design is reserved for gas permeable multifocal lenses and mimic the set up like bifocal or trifocal eyeglasses: the top portion of the lens contains the appropriate power for viewing distant objects, and the lower portion of the lens has a reading power for viewing near objects. Segmented designs are sometimes are called alternating or translating designs. 

Will Multifocal Contact Lenses Work For Me?

Today, new technology has produced more successful designs, as well as a greater variety of designs. The optics in a multifocal contact lens is different than that in eyeglasses. Depending on how the wearer’s eyes adapt will determine the success of the multifocal contact lens. So if one design doesn't work for you, another might.

Your eye doctor may also try these related techniques:

  • Monovision involves using a single-vision lens to put your near prescription on one eye and your distance prescription on the other.
  • Modified monovision uses a single-vision lens on one eye and a multifocal lens on the other

If multifocal contact lenses or monovision don't provide adequate vision at all distances for you, it may be necessary to wear low power reading glasses overtop the contact lenses when needed.

 

Multifocal contact lenses

Which Multifocal Contact Lens Is Right For Me?

Your eye care practitioner will guide you in deciding which design will be the best for you based on your vision needs and prescription. When fitting contact lenses to correct both distance and near it is important to find the right balance between achieving overall functional vision so that distance vision is maintained while near vision is improved. You may need to try different multifocal contact lens designs before finding the one that’s right for you. Keep in mind that the multifocal contact lens fitting process is typically more time-consuming than a regular contact lens fitting given the more advanced design of these lenses.

If you are interested in multifocal lenses, please call Clearvue Vision Center at (425)251-9200 to schedule an eye exam or schedule an appointment online.

Orthokeratology-Reshaping Your Vision and Controlling Myopia

By: Dr. Allison Moy, O.D., F.A.A.O, F.S.L.S

Clearvue Vision Center proudly serving Kent, WA and Renton, WA.

Orthokeratology is a non-surgical treatment option that corrects myopia (nearsightedness) and mild astigmatism. This specially designed gas permeable contact lens reshapes the cornea while you sleep. Upon waking and removing the lenses, you will experience clearer vision without glasses or contact lenses throughout the day.

This treatment option is ideal for anyone interested in minimizing corrective wear during the day time.

Why Orthokeratology?

  • Myopia progression (reduce increase in nearsightedness)
  • Active lifestyle (ie swimming, hiking, running)
  • Dry eyes/allergies
  • Reversible alternative to LASIK
  • Decrease reliance on glasses/contact lens wear during the day

Myopia Control

Normal Eye Vs. Myopic Eye, Kent, WA Ortho-K

Orthokeratology has been around for many years but recent studies have shown that these specially design contact lenses aid in reducing myopia progression. Myopia (nearsightedness) in children occurs due to elongation of the eye leading to increased risk of retinal detachment, glaucoma, cataracts, and increased floaters. Myopia is becoming increasingly common as the NEI reports that prevalence in the United States has almost doubled in 30 years. Research shows Ortho-K slows down eye growth by more than 50% compared to soft lenses and glasses.

how orthok lens works kent wa

By reshaping the corneal tissue, orthokeratology lenses function similar to orthodontists’ use of braces for teeth, holding the shape of the cornea and altering how light is refracted to reduce the optical factors that are thought to cause an increase in myopia. Once the lenses are removed in the morning, the slight change in the curvature of the corneal surface results in clear vision during waking hours, thus reducing the need of daytime contact lenses or glasses.

If you or a family member is interested in orthokeratology, please call Clearvue Vision Center at (425)251-9200 or schedule online at http://www.clearvuevision.com/.

Five Interesting Facts about Scleral Contact Lenses

By: Dr. Allison Moy, O.D., F.A.A.O, F.S.L.S

Clearvue Vision Center proudly serving Kent, WA and Renton, WA.

Have you experienced difficulty achieving adequate vision or comfort in traditional soft or gas permeable contact lenses? New innovations in scleral contact lenses have provided a great alternative for those seeking contact lenses for either cosmetic or medical vision correction reasons.

While for some, soft or gas permeable lenses solve their vision difficulties, for others—specifically those with irregular corneas or hard-to- fit-eyes, these lenses may not be optimal. These special cases require special contact lenses. Each set is custom-made for a patient’s particular eye needs.

If this sounds like you, contact our Renton office for more information about scleral contact lenses for your unique vision needs.

scleral lenses renton wa
Left: Scleral Contact Lens Right: Traditional Gas Permeable Len

1. What are scleral contact lenses?

Scleral contacts are large-diameter gas permeable contact lenses specially designed to vault over the
entire corneal surface and rest on the “white” of the eye (the sclera). In doing so, scleral lenses mask the irregular cornea and create a smooth optical surface resulting in sharper vision. Since the lens does not touch the cornea, these lenses are very comfortable.

2. Scleral contact lenses were the first contact lenses made.

Scleral contact lenses date back to the early 1880s and were first made from blown glass. Early scleral
lenses were not oxygen permeable and became unhealthy for the cornea, ultimately falling into disuse.
With new digital processes for manufacturing custom contoured scleral lenses and advancements in
breathable lens materials, there has been a recent resurgence in scleral lenses.

3. Scleral contacts, although very large, are actually very comfortable.

Scleral lenses have a diameter equal to or greater than that of soft lenses. It may seem daunting to imagine placing a large diameter lens on your eye, but the honest truth is that sclerals are very comfortable. The scleral lenses rest on the sclera, which is not as sensitive as the cornea.

4. Scleral contact lenses provide consistent vision and improved stability.

Another great advantage to wearing scleral contact lenses is stability. The lenses sit very stable on the eye with minimal irritating movement as can be experienced with standard gas permeable lenses. Also, scleral contact lenses provide a tear film between the cornea and the back surface of the lens. This tear film—the fluid between the eye and lens—keeps the cornea consistently moist, providing enhanced comfort and consistent vision.

5. Scleral contacts are ideal for irregular corneas, hard-to-fit eyes, and dry eyes.

While anyone interested in wearing scleral contact lenses may do so, scleral lenses are particularly recommended for the following eye conditions:

Irregular corneas: An irregular shaped cornea – this includes eye conditions such as Keratoconus– usually cannot be fully corrected with glasses or soft lenses. Compared to sclerals, soft lenses are really not ideal for irregular cornea patients because the lenses drape over the corneal irregularity. Plus, vision in soft lenses can be disrupted when the lenses rotate, while the vision provided by rigid scleral lenses is not affected by lens rotation. Other causes for irregular cornea include Pellucid Marginal Degeneration, Post-LASIK complications, and corneal transplants. Scleral contact lenses are a great lens for irregular corneas.

Hard-to-fit-eyes: Sometimes eyes cannot be fitted with normal GP lenses because of the shape of the eye. The smaller GP lenses may also tend to pop out during athletic activities. Scleral contact lenses can provide a more comfortable and secure fit.

Dry eyes: Scleral contact lenses do not absorb moisture as soft lenses do. The tear film that sits between the scleral lens and cornea provide consistent hydration to the surface of the eye and welcome relief for dryness.

To find out more information about scleral lenses, visit http://www.sclerallens.org/.

If you suffer from irregular corneas, dry eyes or hard to fit eyes, find out if scleral lenses are right for you: schedule an eye exam at Clearvue Vision Center in Renton, WA by calling (425)251-9200 or schedule online at http://www.clearvuevision.com/.