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Podcast Episode #15: Myopia Management With Esther Rodas

Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.

In this episode, Dr. Nate talks with Optician Esther Rodas about Myopia and the treatment options to control it.

You can listen in the player below or read the transcript. The show is available via Stitcher, Google Play, iTunes, and the webplayer below. You can find all previous episodes here. If you have any questions or suggestions for future episodes, please email office@BrightEyesTampa.com.

Previous relevant episodes:


Full Transcript:

Introduction [00:00:10] Welcome to the Bright Eyes podcast. Advice for healthy vision for all ages. Your hosts are doctor Nate Bonilla-Warford and Dr. Beth Knighton. Residency trained optometrist providing eye care to all ages with exams for glasses and contacts and specialty services including vision therapy, myopia control, Ortho-kertology and sports vision training. Their mission is to empower patients by providing the best in friendly, professional and individualized eyecare.

Dr. Nate [00:00:38] From rainy Tampa Bay. It’s the Bright Eyes podcast.This is episode number 15. I’m Dr. Nate Bonilla-Waford and today’s episode is all about myopia control. I’d like to introduce our special guest today this is Esther Rodas. Esther is an Optician. She works here at Bright Eyes and not only is she an optician, she’s our myopia control coordinator so Hi Esther.

Esther [00:01:05] Hello everyone. So Esther here just like Dr. Nate just mentioned and been here for about a couple of years and usually I will be the one that you talk to if you have any questions on myopia control and scheduling and all of that good stuff.

Dr. Nate [00:01:21] Absolutely. And when Esther joined us she was a student at the Hillsborough Community College in the opticianry program. And now that she’s got her license she works with us full time and we are so lucky to have her and patients just love her and all the staff does too.

Esther [00:01:37] Happy to be here.

Dr. Nate [00:01:38] Excellent. So Esther we introduced myopia in episode six as part of our refractive error episode. And here’s our vision therapist Miriam giving the definition of myopia.

Miriam [00:01:56] Myopia, aka nearsightedness is a condition where objects up close appear clearly while objects far away appear blurry. With myopia, light comes to focus in front of the retina instead of on the retina.

Dr. Nate [00:02:10] So myopia is all about nearsightedness. It’s all about not being able to see very far away without either contacts or glasses or lenses of some sort or for adults they can consider refractive surgery like LASIK. From your perspective Esther when a doctor diagnoses a child with myopia what are some of the most common questions that parents will ask you?

Esther [00:02:36] Definitely first thing they ask is if it’s permanent. If it’ll get better the older that they get?

Dr. Nate [00:02:43] Right. And that’s one of the questions that they ask us doctors are very first thing. They’re like, are they going to outgrow this? Are these glasses that they need? Or is this something that after a while they won’t need anymore? And one of the things about myopia that’s important to understand is while we see it as vision getting blurrier or glasses getting thicker or stronger, what’s really happening in myopia is the eye ball itself is stretching, it’s getting longer and getting bigger and it’s much easier for the eye tissue to stretch and elongate rather than it is to shrink and get smaller. And so for that reason when we’re talking about myopia I like to say it’s a one way street but it doesn’t really get better. And so after they kind of digest that what are the next questions that parents will ask you?

Esther [00:03:40] So once they know what can potentially happen and the inside of the eye they definitely know the options at that point what they can do to limit that progression.

Dr. Nate [00:03:51] Right. And so when I talked to parents, we always talk about myopia as a condition that needs to be managed. It’s not just in one point in time it’s a lifetime of change that we need to think about. We always talk about myopia in the short term and in the long term. So in the short term, kids need to be able to see, they need to be able to see the board at school, they need to be able to see for sports they need to be able to function in everyday life. There’s a variety of different ways that we can help them be able to see clearly and that’s the common things that people are familiar with glasses, contacts, the night time treatment contacts of ortho-K can help people see clearly. So there’s different options and we need to address that first because it’s very important that we make sure that kids have useful vision for living their lives. But, we also need to make sure that we are addressing the long term component. Because myopia tends to worsen and sometimes more dramatically in some patients rather than others- we need to make sure we’re addressing that and offering different kinds of treatments to hopefully reduce the risk of progression. So in our office Esther, what are the three main ways that we use to reduce the progression of myopia?

Esther [00:05:26] We offer here the Atropine medicated eyedrops as one solution. We offer Ortho-keratology which is the night time lenses and we also offer specialty designs soft multi-focal lenses to help with that progression.

Dr. Nate [00:05:46] Right. And we feel very strongly not just with myopia but with all of our patient care that every option needs to be tailored individually to the patient. So it’s not one size fits all. It’s not that every single patient who comes in needs any one particular treatment but it depends on their lifestyle,it depends on their goals,it depends on their genetics,it depends on if they’re more likely to progress. So very briefly we’ll just go over what these options are. The first one which is the most easy to administer are the Atropine eye drops. Now, atropine is a medication that dilate the pupils and it reduces the eyes ability to focus. And for that reason, it hasn’t been widely used in the United States. It’s used for many many conditions but not for myopia control. Until recently when it was discovered that you could use a very low concentration to minimize the side effects. So we have many patients who are on the low concentration atropine treatment to reduce the likelihood of progression. We don’t know exactly how the atropine works, what it’s doing in the eyes but it’s been shown in many many many studies to be effective. So that’s that’s one option. The other option like Esther said was the multifocal contacts.The multi-focal contacts are worn in the daytime just like any other soft contact that you’d be familiar with. But it has a special optical treatment which provides some stimulus to the eye that reduces its need or its inclination to to get worse. We can optically change how the light focus is on the back of the eye to reduce that stimulus to progress and get worse. And so that’s the daytime contacts. The nighttime contacts the Ortho-K does the same thing optically, but it actually reshapes the eyes so that you can see clearly without daytime contacts or glasses. So you get a little bit of a two for one with ortho-K which is great. So once we do the exam and we take lifestyle into account, we look at all of the the treatment options and I will recommend a particular treatment option for a patient. I’ll bring them out and then they will go over the details and the logistics of that treatment option with Esther at that point. What kind of questions do you get?

Esther [00:08:24] So definitely the top question which you kind of touched on right now is their parents are only super interested and intrigued of like the science behind each one and the how is it that the atropine, the multi focal and that the nighttime lends aid in hopefully limiting that progression of the nearsightedness for their child. So anything you can add to what you just said.

Dr. Nate [00:08:48] So the interesting thing about myopia control is even though there are many many scientific papers exploring how well these different options work and how they relate to each other- we don’t thoroughly understand exactly how they work. We have a pretty good idea of how the optical effects of the multi focal contacts on the ortho-K works to reduce that stimulus to progress. We really don’t know as much about how the atropine works. We know that atropine has been used for hundreds and hundreds of years and it’s been used for many many conditions and it’s extremely safe to use. We don’t know what’s exactly going on at the molecular level to help keep the eyes from progressing, but we do know it’s very effective. I know the parents don’t think that that’s a super satisfying answer but it is the honest answer at this point. So what other questions do parents ask you?

Esther [00:09:45] Definitely risks. They want to know what kind of risks are involved and short term risks and long term risk as well. So for example the night time contacts as they are more rigid than the soft lenses. And they always want to know what the risks are for abrasions and things like that. Almost the same for soft contact lenses for short term risks. Long time parents want to know if the ridgid of lenses will affect the kids eligibility to do maybe LASIK in the future. Parents also ask about any effects that that may have on things such as glaucoma and any long term risks in the medicated eye drops. So it’s kind of like a few questions and one.

Dr. Nate [00:10:34] Well I think that that’s really important topic because with any procedure or with any therapy we always need to weigh the benefits and the risks and that’s part of the discussion that always happens between me and the parents when we’re talking about undertaking one of these treatments. Fortunately in the big picture all of these have been proven to be very safe. And that’s why we can feel comfortable doing them. And that’s why I feel comfortable with both of my children using these different methods. My son uses the medicated eyedrops. And my daughter does the night time Ortho-K lenses. Obviously, if I didn’t feel they were very safe I’d be reluctant to use them with my own kids and I know that lots of doctors around the country and around the world have their own children and in myopia control programs similar to these as well. So let’s talk about the different risks with any contacts. There are certainly risks especially if you don’t use proper hygiene, if you don’t care for them properly. If you use them in a way that you shouldn’t be then you increase those risks. Fortunately all of the scientific studies that have shown that with the Ortho-k lenses for night time don’t have any additional risk compared to traditional contact lens wear. And so that that helps us educate patients properly now. The very first question that people ask me is often, well I was told that I shouldn’t sleep in my contacts because it’s not healthy. So why is it healthy to sleep in these contacts. That’s a great question because it’s true that you shouldn’t sleep in your daytime contacts because one- they’re often not intended for that two- if you’re sleeping in them in the nighttime and then wearing them in the daytime then you’re wearing them for a full 24 or multiple cycles. And that can create problems because the lenses never get cleaned with Ortho-k. One, they are super breathable materials. Two, they’re designed specifically to be worn at night and three they’re only worn for about eight hours at night and then they’re being cleaned and stored the rest of the time. Furthermore the Ortho-k lenses rarely or never leave the house. It’s not like the contact lenses that you wear where you get pollen in them you, get dust in them. If you are out and about your eyes can get sweaty you can get sunblock on them if they goes in your eyes etc. Whereas Ortho-k you put them in before you go to bed you take them out in the morning and they’re clean and so the lenses stay very, very clean and we’re very, very clear about the proper method for keeping the lenses clean. Once we have the proper care method established then the risks go way,way down. It is possible in the short term, if the patient doesn’t have good insertion technique for putting the lenses in to lightly scratch or abrade their eye but that’s very, very rare and when it does happen it’s mild and it resolves right away. Now fortunately, we’ve never had any infection for any of our patients and that is incredibly rare with proper care. That’s the same for our for our soft contact lens patients soft contact lenses are healthier than ever before and the risk of infection is is very, very low. I will add here and I always tell patients all the time, that you should never use tap water or you should never clean your lenses with anything other than solutions that have been provided. You shouldn’t shower or swim or go on lakes or hot tubs with your contact lenses on because that can introduce contaminants or bacteria or amoebas that can cause a severe infection. So I was always educating about that.

Dr. Nate [00:14:48] Regarding the atropine, there are known side effects like I mentioned about sensitivity to light and focusing, but by using the lower concentration those are dramatically reduced. Other than that, the only real side effect that can happen with patients sometimes is if the drops come with a certain preservative and the patients are sensitive to that preservative it can cause an allergic like reaction where the eyes get red and irritated. Many of our patients use non preserved drops and that’s not an issue we haven’t found that to be a common problem. But it’s theoretically possible and some patients you it’s hard to know whether they’re they respond to preservatives or not. In the long term, for long term use- atropine has been used for for many years without any problems or side effects.

Esther [00:15:49] We do go through a couple of compounding pharmacies.

Dr. Nate [00:15:53] Yeah, we do have some options and that’s actually an important point. So if you get the high concentration atropine which we don’t use very often except in the very most stubbornly progressive cases, you can get that at almost any pharmacy because that’s the standard formulation that is used to treat eye disease. The lower concentration is only available through compounding pharmacies and we have a variety of options that we can we can help patients acquire that.

Esther [00:16:25] Have you got at all questions about if it’ll affect someone’s eligibility for LASIK in their future or the glaucoma?

Dr. Nate [00:16:33] Yeah and that’s actually a very common question and it’s a great question because sometimes patients are concerned well maybe this reshaping with Ortho-k reshaping of the cornea will adversely affect them for their chances for Lasik and I say you know exactly the opposite. The goal of Ortho-k is to keep the eyes the prescription is stable enough over the long term so that they remain eligible for for LASIK or refractive surgery. What typically happens is people will do Ortho-k starting when they’re when they’re younger maybe you know 10 or 12 years old and they’ll keep doing it until they’re an adult they might stop at 18 or I had a patient just the other day was 12 and she’s now 30 and she’s been doing it continuously. But if she or other patients wanted to stop as an adult they could wait until their eyes go back to their natural shape and once that’s stable and it’s confirmed to be stable with repeated curvature measurements then they are eligible for LASIK just like any other patient will be.

Esther [00:17:44] How about the glaucoma question?

Dr. Nate [00:17:47] So the glaucoma question is interesting because people worry about glaucoma for this reason- they think the Ortho-k lenses press on the eye to reshape the lenses. And if they’re pressing on the eye then that’s going to increase the pressure inside the eye and if you increase the pressure inside the eye that’s going to increase the risk of optic nerve damage called glaucoma. Now the reason why it is not a risk for glaucoma is because Ortho-k lenses don’t actually work by pressing on the eye what they do is they they are kind of a rigid surface that goes over the cornea and then over time the cornea conforms to that lens it- actually kind of expands outwards to meet the shape of the lens so instead of pressing on the eye, the cornea actually reshapes itself or expands to meet the lens. So there’s no reason to think that the pressure inside the eyes increases when we do Ortho-k and therefore there’s no added risk for it for glaucoma. Again kind of like LASIK, nearsightedness itself is a risk factor for glaucoma if you have very high myopia in nearsightedness you have increased risk for for glaucoma. So it may be that doing Ortho-k might actually help reduce the risk long term of glaucoma.

Esther [00:19:25] That’s great information. Thank you. I would say those are the top questions and the last question that I always get at the very end is if these methods are FDA approved?

Dr. Nate [00:19:38] Right. And so here’s the thing about FDA approval all of these methods are FDA approved for a variety of conditions and treatments but not specifically for reducing the progression of myopia. So we’re very clear when we talk to parents and we have it in writing and we explain that while all of these treatments are scientifically valid and there is many studies that talk about the the benefits that the FDA itself has not gotten around to evaluating yet and stating that these methods are specifically approved for the reduction in the progression of nearsightedness. Many other countries have, and there’s lots of scientific evidence to show that it is, but no the FDA hasn’t. Now, all of these things like the atropine eyedrops are approved for treating many, many kinds of conditions including Amblyopia,which is something that we see in the office a lot. A multi-focal contacts are certainly approved for lots of conditions. Specifically, presbyopia for older adults who need to see up close. Ortho-k, the nighttime contacts is approved for treatment of nearsightedness so that people can see clearly throughout the day, but they haven’t gone that extra step yet in approving it specifically for the reduction in the risk of progression. So that’s something that we think it’s important that people understand it doesn’t mean that we shouldn’t do it, but it is in the state of approval right now.

Dr. Nate [00:21:29] Well, hopefully this has been helpful for people who are interested in learning more about myopia control in the future we hope to have some more episodes detailing how each of these methods work. I think it would be kind of fun to have my kids on and they can talk about their experience. That would be that would be interesting to hear it from their own mouth. And we have lots of other topics in mind if you have any suggestions I have topics that you’d like to hear in the future, please let us know. I’d like to thank Esther for joining us and talking to us today. And is there anything else you wanna say before we go now?

Esther [00:22:16] Thanks for having me and to all those listening to this podcast. If there’s any questions if you want to schedule a myopia consultation with Dr. Nate just ask for myself Esther and be more than happy to answer any questions that I can and get you on our schedule right.

Dr. Nate [00:22:34] And if you want to you can call us at 1-813-792-0637. Or you can e-mail the office at office@BrightEyesTampa.com. Until next time,stay dry.

Outro: [00:22:46] Brought to you by Bright Eyes family vision care and Bright Eyes Kids. Find previous episodes and more detailed information at BrightEyesTampa.com. Creative Commons copyright attribution noncommercial use. The only purpose of this podcast is to educate and to inform. There’s no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute a medical or other professional advice or services. Please consult your physician for diagnosis treatment.

Intro/outro music: Lucas Warford of Three For Silver.

Podcast #10: NaturalVue Contact Lenses with Dr. Douglas Benoit

Welcome to The Bright Eyes Podcast: Advice for Healthy Vision for All Ages. Your hosts are Dr. Nate Bonilla-Warford & Dr. Beth Knighton, residency-trained optometrist that provide eye exams for glasses and contacts, and specialty services including vision therapy, myopia control, orthokeratology, and sports vision training. Their mission to empower patients by providing the best in friendly, professional, and individualized eye care.

In this episode, Dr. Nate talks with Dr. Douglas Benoit about contact lenses and NaturalVue spherical and multifocal lenses from Visioneering Technologies, Inc.

 

The Full transcript:

Intro: 00:11 Welcome to the bright eyes podcast, advice for healthy vision for all ages. Your hosts are Dr. Nate Bonilla Warford and Dr. Beth Knighton, residency trained optometrist providing eye care to all ages with exams for glasses and contacts, and specialty services, including vision therapy, Myopia control, orthokeratology, and sports vision training. Their mission is to empower patients by providing the best in friendly, professional, and individualized eye care.

Dr. Nate: 00:42 Not far from Clearwater beach, the number one beach in the nation, It is the Bright Eyes Podcast. This is episode number 10. I am Dr Nate Bonilla- Warford, and I have a special guest with me. Dr. Douglas Benoit.

speaker benoit 300×300

Douglas Benoit, OD

Dr. Benoit: 00:42 Hi Nate.

Dr. Nate: 00:42 Hi, how are you?

Dr. Benoit: 00:55 Doing well, how about yourself?

Dr. Nate: 00:56 I’m great. I’m doing really, really well and I’m excited that you are here with us. We’re going to talk about contact lenses, which you have many years of experience with. Before we get into that, why don’t you tell us a little bit about yourself. I’ll give the basics. You’re an optometrist. You’re a fellow of the American Academy of optometry. You’re the director of professional affairs at Visioneering Technologies, Inc, otherwise known as “VTI”.

Dr. Benoit: 01:21 That is correct. I practiced for 34 years in OD, MD group, we were all sub specialty folks. I had the pleasure of working primarily with contact lens patients, generally the type that had special needs such as GP wearers, people that needed scleral lenses, et Cetera, and I had the opportunity to work with a lot of bifocal patients, which was really a passion of mine. I also, over that period of time did a number of clinical studies, which is actually how I became involved with VTI.

Dr. Nate: 01:53 And you’re originally from New Hampshire, but I gather you get around the country quite a bit these days.

Dr. Benoit: 01:58 Yes. As part of the job I do have to travel quite a bit and with some changes that have occurred recently I’m traveling more much to the chagrin of my wife.

Dr. Nate: 02:08 My Dad actually, he does consulting and speaking in the education field and and he’s on the road a lot, but he’s narrowed down his primary gigs to Hawaii and California.

Dr. Benoit: 02:21 Well that would be a nice goal. My wife would like to travel back to California, I’m sure as it is, sometimes she gets to go with me depending on where it is and how much time I’ll actually get to spend with her.

Dr. Nate: 02:32 Right. Absolutely. So. OK, so for our listeners who are patients, we know that there are many contact lens options, uh, for patients, but a lot of times patients don’t really know what their options are or why they should be interested in them. If you’re like me, you’re probably somewhere, a family gathering or a barbecue or almost anywhere and they find out that you’re an optometrist and they always want to say, oh, you, I was told I cannot wear contacts or uh, you know, I tried contacts 15 years ago, you know, and they didn’t work. Do you feel like things have changed a lot since your, you know, your early days with context?

Dr. Benoit: 03:11 Well, yes, they have changed a large, large amount. When I was first in training a 30 some odd years ago, they had pma lenses and they were just coming out with soft materials. Those were two radically different types of contact lenses and it really took a different approach. Over the years, the old hard lenses have changed slightly, the materials now breathe so that they’re much gentler on the tissue of the eye, but the soft lens is really where the large changes have occurred. In the beginning, these lenses were produced in a vial, they were autoclave for sterility and the lenses were very expensive and you tried to keep them for a year or more using very heroic cleaning methods. Over the intervening years we have gotten smarter about the care, so that has become easier. But in the last 15 or so years, the move has been towards daily disposable lenses so that we can eliminate the problem of solution reactions or just poor cleaning. Anybody that has a question about poor cleaning with a contact lens, just think about your teenage son and his room

Dr. Nate: 04:19 Exactly. That’s something I actually mentioned in the, uh, in the exam chair here at Bright Eyes Kids pretty regularly. What are some reasons that patients might want to consider contacts over glasses

Dr. Benoit: 04:32 Well contact lenses do give you the opportunity to do active things such as working out, riding a bike, golf, things of that nature where glasses sometimes could get in the way either by slipping off or steaming up. So contact lenses are really, really nice in that regard. There are some folks that are into theatrical and in certain situations they might not want to be wearing glasses if they’re doing a period piece. So a contact lens there would give them the opportunity to blend in with their surroundings, so to speak.

Dr. Nate: 05:03 And who is a good candidate for contact lenses?

Dr. Benoit: 05:06 Well, I think anyone that’s motivated and has a healthy eye is a good candidate for contact lenses. At, you know, one point they used to tell folks that they had astigmatism, that they really couldn’t wear a contact lens. Uh, thank goodness that actually is not the case. The original contact lenses which were commercially available in the United States back in 1887 were for severely deformed corneas, primarily a very severe form of astigmatism. So that has evolved over the years. We now have many, many ways to correct both astigmatism and the need for a bifocal in a contact lens and there are some instances where we might actually use a contact lens in youngsters to try and prevent changes in their vision.

Dr. Nate: 05:46 Yes. That’s something that we talk about here a lot at Bright Eyes Kids. Now, you know, you mentioned kids, a lot of parents are very surprised to find that we can do contact lenses at all. A lot of people feel like until children are teenagers contact lenses are just not an option. Do you think that that was true previously that we initially started it at teenagers or do you think that was just a myth that sort of came out of nowhere?

Dr. Benoit: 06:17 I think it’s probably a combination. I think it was the comfort level of the doctor and or the parent as far as getting a contact lens on that particular youngster. What I have found over the years is that it really isn’t an age thing so much so maturity level thing. Some youngsters are ready to wear a contact lens at six years old and some won’t ever be ready again think about that teenage boy.

Dr. Nate: 06:41 I agree completely. I think that a motivation is absolutely everything. The worst case scenario in my opinion is when the parent really wants their kids to wear contacts and the kid really does not because if he doesn’t want the lens in his eye, he’s not going to get it in his eyes. There’s just no way, no way around it, but if there’s, if there’s sports, if it’s cosmetic, if there’s some other motivation than kids who can be very successful at wearing contact lenses. Pretty much independent of the age. That’s my experience for sure.

Dr. Benoit: 07:15 I would agree with that.

Dr. Nate: 07:16 What about people who were either bifocals or reading glasses are contact lenses a good option for them?

Dr. Benoit: 07:23 Yes, they are and there are a number of ways that that can be approached. I mean, one of the simplest ways would be to have contact lenses for distance and then put on a pair of reading glasses when you need it to do something on the computer or to read your cell phone, let’s say. But a lot of folks that are interested in contact lenses really don’t want to be bothered wearing glasses at all. And luckily for them, since about 1949, we have had bifocal contact lens is available and the designs that we have currently are really very, very good at correcting most patients needs as I used to, like to tell my patients if they’re motivated and willing to put up with the adaptation to these different optics in these contact lenses, about eighty percent of the time they’ll be able to function very, very normally and not have to rely on glasses at all.

Dr. Nate: 08:12 Yeah. Some of the happiest patients are ones that are so irritated with their reading glasses, misplacing them, having one in every room in the house except for the room that they’re in. And uh, you know, getting those patients into contacts is extremely rewarding.

Dr. Nate: 08:27 Now, when I first got my first pair of contacts, I was in high school, I got one pair, one for each eye. The pair had to last the entire year and I told all my friends, I’m like, Hey, I’m coming to school tomorrow and I’m going to be in my contacts. I’m not going to be wearing my glasses. And the very first morning I let one go down the drain and that was, I don’t know, $80 worth, you know, or something. Nowadays, you know, it, the idea of a fitting a child in an annual lens is just completely unheard of. I definitely have seen in my practice going to the, uh, the daily disposable or single use lenses has dramatically increased the comfort. Um, but most importantly, the health and safety of lenses. You travel around and talk to docs from, from all over. Do you think that that’s something that every doctor’s reporting?

Dr. Benoit: 09:25 I agree with that, yes, the advent of daily disposables of single use lenses has really improved the health of all patients. It makes it a lot easier for travel. If you do have one go down the drain, which you shouldn’t because the water shouldn’t ever be running when you’re doing your contact lenses, but if you should happen to lose a lens in that fashion, you can just open up another lens and put it in your eye. I don’t have to refer it to wearing glasses until you can order a new lens.

vti differenceDr. Nate: 09:50 One of the things that we see as doctors is companies are, you know, they come out with contact lenses on a very regular basis. Sometimes it’s a little bit overwhelming for doctors because there’s just, there’s so many products. However, um, I was very excited when Brian, our rep from, from VTI, from Visioneering Technologies came in, uh, because I had been trying to get my hands on the natural view of Lens set for patients because I’d heard so many good things about it. So why don’t you tell us just a little bit about what sets Natural View apart from some of the other lenses that are out there.

Dr. Benoit: 10:30 Well, the natural view multi-focal contact lens is a one day Lens. It has a center distance design where the majority of multi-focal soft daily disposable lenses are currently center near designs, a the center distance design also uses what we call an extended depth of focus mechanism to actually create the power for reading, so folks that have the need for a bifocal that are say 42 or someone like myself that is 63 can wear the same lens and not have to worry about having a different add power as we call it. So it’s very, very nice for the doctor because you have one shape, one size and this universal add and you don’t have to worry about trying to pick too many parameters at once. So it really makes it very convenient for the doctor.

Dr. Nate: 11:21 So I’m, I’m very happy and very impressed with the lens and the patients have been too, before we wrap up here today, I appreciate your, your time. I appreciate you coming to the office. It’s always fun to be able to record in person as opposed to to over skype, which we do sometimes. Uh, is there anything else that you’d like to tell a patient? Maybe they’re interested in contact lenses. Anything else that you’d like them to think about that, that maybe they hadn’t thought about before?

Dr. Benoit: 11:51 Well, I think that anyone that’s listening to this podcast, if you haven’t thought about contact lenses, maybe you should. Contact Lenses can work for pretty much anyone as long as you’ve got motivation to where the contact lens and certainly here at a bright eyes, you will get to some of the best care that you will get anywhere.

Dr. Nate: 12:11 Well, thank you for that Dr. Benoit. So to all of our listeners, thank you for listening. If you have any questions, comments, or suggestions, you can email us at office@brighteyestampa.com. Until next time, we’ll all be at the beach,

Exit: 12:30 Brought to you by Bright Eyes Family Vision Care and Bright Eyes Kids. Find previous episodes and more detailed information at brighteyestampa.com, creative Commons, copyright attribution, non-commercial use. The only purpose of this podcast is to educate and to inform. It is no substitute for professional care by a doctor experienced in the area you require. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Please consult your physician for diagnosis treatment.

 

Intro/outro music: Lucas Warford of Three For Silver.

My Daughter’s Ortho-K Journey

I wear glasses. Most people in my family wear glasses or contacts because they cannot see well at a distance. They have myopia, also known as nearsightedness. This story is similar for my wife, Cristina who is also the office manager at Bright Eyes. She and many members of her family are myopic. So it was not surprising that our older child, Nora, has also become nearsighted. She has now started orthokeratology to help keep her from become even more nearsighted. Read on to find out more about her Ortho-K journey.

Nora's First Eye Exam

Nora’s First Exam

Nora is not alone. All over the world, people are becoming more myopic and kids are needing glasses at earlier ages. At Nora’s regular eye exams (see recommendations here), I have been checking her vision carefully. Two years ago it was obvious that she was going to be become nearsighted. We had been implementing several steps to delay her impending myopia.

Finally, the summer before 4th grade during a game of “eye spy” it was evident that she was having trouble seeing clearly far away. An eye exam was scheduled and a prescription for -1.00 D glasses was written. She picked out some lovely and fun glasses before school started. She also had soft daily disposable contacts for occasional use.

Nora before Ortho-K

Nora Before Orthok

By Spring Break, Nora was squinting again even with her glasses. Indeed, her exam showed that her prescription had increased. We were ready to employ some methods to reduce the rate at which her vision was getting worse. This is called myopia control and the basic options are Ortho-k, soft multifocal contacts, and atropine eyedrops. So Cristina and I decided that it was time for Nora to do Ortho-K. We knew this time would come, it was just a matter of when it was convenient to start. We decided Spring Break was the perfect time.

The first step was to get Nora on board. After all, she liked her glasses and was not excited at first about giving them up. Cristina and I talked with her about freedom from glasses for sports and swimming. We also showed her some of these videos from YouTube. She was ready!

Nora came to Bright Eyes Kids for her Ortho-K exam. This includes more vision testing and special testing of the front part of her eyes called corneal topography. This special test allowed me to design custom NightLens Ortho-K lenses for her. They were produced in a specialized contact lens lab and sent to the office.

Nora was very excited when her Ortho-K lenses came in. At this point she was taught how to put them in and take them out safely as well as everything she needed to know about caring for her lenses. That night, she put the contacts in and went to sleep. It was surprisingly easy. The next day she came to Bright Eyes Kids for her 1-day evaluation and she was seeing 20/20! Her vision has been great ever since. She was able to do everything on her Spring Break trip including kayaking, Everglades Airboat rides, and the Trampoline park all without her glasses.

Nora After Orthok

Nora After Orthok

If you think that your child is a candidate for Ortho-K and want to find out more call us at (813)792-0637 or request an appointment.

By the way, Nora’s brother is two years younger than her and he is not nearsighted yet, but we are trying to prevent it with atropine eye drops. You can learn more about that here.

-Dr. Nate

PS – If you are an eye doctor who has employed any myopia control strategies with your kids, I’d love to talk to you about it. Email me at Doc@BrightEyesTampa.com.

 

PeroxiClear Contact Lens Solution Recalled

peroxiclear-box

Recalled product.

Attention patients:

Our office has been informed that Bausch + Lomb is conducting a voluntary recall of PeroxiClear® 3% Hydrogen Peroxide Cleaning & Disinfecting solution in the U.S. and Canada. Although this voluntary recall represents low risk to patients and is unlikely to cause serious health consequences, the company is voluntarily recalling the product from retailers, wholesalers, and eye care professionals. Bausch + Lomb chose to initiate this voluntary action based on internal testing that simulated normal product use. Testing showed occasional occurrences where the residual peroxide remaining in the lens case after neutralization was out of product specification potentially causing temporary symptoms of burning/stinging, irritation, red eye and in rare circumstances other more serious health consequences.

ClearCarePackage

Recommended solution

For all patients who are using PeroxiClear, for more information on the voluntary product recall, Bausch + Lomb has recommended that you contact Stericycle, Inc., the firm conducting this product recall on behalf of Bausch + Lomb, at 1-877-877-0481. If you would like to report a product complaint, please contact the Bausch + Lomb Consumer Affairs team at 1-800-553-5340 or BLCustomerCare@bausch.com in the U.S. or 1-888-459-5000 in Canada.

Dr. Nate and Dr. Beth recommend that patients using PeroxiClear switch to Clear Care hydrogen peroxide solution. Read the package instructions carefully. As with PeroxiClear, do not put Clear Care directly in your eyes. You can find out more from https://www.clearcaresolution.com/ or call us at 813-792-0637.

7 Tips to Survive Allergy Season

The tree pollen counts are sky-high this week in Tampa. According to the American Academy of Allergy, Asthma and Immunology, more than 60 million Americans suffer from allergies. The same yellow dust that is coating all of our cars is also getting into our eyes. Are you suffering this week from itchy, red watery eyes? It may be due to ocular allergies, also known as allergic conjunctivitis. Some people can even have ocular allergies without allergies affecting the nose and throat.

Allergy forecast(from www.pollen.com)

So, what can we do to survive the spring??

  1. Wear sunglasses to help prevent pollen falling into your eyes.
  2. Look up the pollen counts so you can plan your outdoor activities for lower pollen count days. The pollen levels are typically highest on windy, dry, sunny days.
  3. Keep your windows closed to avoid airborne pollens.
  4. Avoid touching or rubbing your eyes.
  5. Shower after outdoor activities to rinse the pollen off your skin and hair. This pollen will continue to irritate your eyes, nose and throat even after coming inside.
  6. Contact lenses can sometimes magnify the itchiness you experience. Some people get relief with daily disposable contact lenses or changing contact lens cleaning during allergy season. Come in for an exam with Drs. Nate or Beth to see what would be best for you.
  7. Consult with your primary care doctor or allergist to see if an allergy medication is right for you.

Call our office to schedule an appointment if you suspect ocular allergies are affecting you.

-Dr. Beth.

Air Optix Colors Contact Lenses Are Here!

AO_home_img2_770x549I will be honest. I have actively discouraged patients from using cosmetic contact lenses. I have done it for years. Not because I have anything against colored lenses, but because the most common lens, Freshlook, was uncomfortable and not as healthy as new lenses i prescribe.

People are familiar with the Freshlook brand of colored lenses, because it’s been around for 18 years! And until now, Freshlook was the leading brands for colored contacts. So some people feel if something works, why bother change? And for 18 years, Freshlook must have been doing something right, right? Well, who can imagine using a cell phone that was made 18 years ago? It is a ridiculous thought. Continue reading

Bright Eyes Kids is Coming Soon!!

Bright Eyes Kids

Bright Eyes Kids is coming soon!

Since we opened Bright Eyes Family Vision Care in 2006, the number of pediatric patients has steadily grown. At first we saw very few, but now almost half of our patients are under 18 years old. And that is no accident. After I completed my Residency in Pediatric Optometry and Binocular Vision in Chicago, I knew I wanted to work with kids. I wondered if I was crazy for moving home to Florida, the retirement capital of the world.

Well, lo and behold, there are children in Florida and many of them need eye care. So we have been planning for the last year to expand our services specifically to children. And I am now very, very happy to announce that in March we will be opening a new location specifically for children’s eye care. Called Bright Eyes Kids, it will bring the skill and care you expect from us at Bright Eyes Family Vision Care to New Tampa and be tailored specifically for children!

Why New Tampa? Well there are many reasons. The first is that we frequently have patients that come from areas such as Gainesville, Winter Haven, and other places east of Tampa. Located near I-75, the new office will be much more accessible for patients because they will not have to drive all the way across town. Another reason is that my family and close relatives actually live in the New Tampa area and it will be great to practice closer to home. The new address is 15303 Amberly Drive, Suite C, Tampa, FL 33647.

What will be offering at Bright Eyes Kids? Eye exams for infants, toddlers, and gradeschoolers and teens. We will be fitting contact lenses and specialty glasses for young kids. We will have an expanded area to offer vision therapy, to help children develop the visual skills they need to be successful at school and life. We will offer orthokeratology for kids who want 20/20 vision all day while not wearing glasses or contacts.

But don’t worry – nothing will change at Bright Eyes Family Vision Care in Westchase. I will still be seeing patients there regularly and we will. Moms, grandpas and other adults are welcome to come see us there!

Now, please. Help us making Bright Eyes Kids the best it can be by completing this very, very short survey. While we are finalizing details about the new office, this is your chance to help us get them right. Click here to take the brief survey.

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
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More on the Dailies Total 1 Contact lens

A few weeks ago I had the pleasure of attending a series of classes about the new contact lens Dailies Total 1. I had written about this when we first tried the lens. Since then I have used it with many patients and believe it to be an extremely comfortable lens. However, I learned a great deal more about the science of the lenses.

I enjoyed the fact that the speaker were not just optometrists, but visual scientists and physicians who could answer questions about the behavior of the lenses and the affects on visual comfort.

Here are a few things that I learned, some of which are a bit technical:

  • Alcon, the company that makes Dailies Total 1, has put 10 years of research and development into this lens. All of this research has been as a single use lens. It is not indicated for multiple days, nor is it approved for overnight wear. We simply do not know what happens when you use contact lens solution or if they are safe to sleep in, so it is not recommended.
  • This lens mimics the human eye. We don’t usually feel our eyelids when we blink because the tears form a “water gradient” cushion. Dailies Total 1 creates a similar tear cushion to allow for lenses that many people simply can’t feel.
  • Many people do feel that their eyes feel better with the lenses in than out. There are many reasons for this, but one of the biggest is that the coefficient of friction is very low – similar to an ice cube sliding on a saucer.
  • While the inside of the lens is a very breathable contact lens, the outside approaches pure water. There has never been a contact lens like this before and for this reason it is available in a small prescription range. Right now it is only available for nearsighted people (myopes). Hopefully soon, it will be available for astigmatism, farsightedness, and people who need multifocal contact lenses.
  • People do need to change how they take out the lenses. Because these are designed to be super low-friction lenses, they will be very slippery with wet fingers. It is extremely important to dry your fingers completely when you take them out.

I do know that personally, Dailies Total 1 is the most comfortable lens I have ever worn. I have dry eyes and cannot usually tolerate lenses for more than 3 or 4 hours, but with this lens, I can go 8 to 10 hours, which is pretty cool.

 

DT1

New Water-Gradient Contact Lenses – Alcon’s Dailies Total 1 Available at Bright Eyes!

dailies total1 (640x419)

Bright Eyes is excited about the newest daily contact lens: Dailies Total 1! Manufactured by Ciba Vision, this new lens is the first to supply the perfect balance between hydration and comfort for daily contact lenses.

Sometimes people find a lens that’s comfortable, but they still experience occasional discomfort during the day. Then, they continue to hear about the newest lens that is the most comfortable and “breathable”one out there. The difference with Dailies Total 1 is the increase in the amount of water-permeability throughout the lens. Unlike the other Silicone Hydrogel lenses, Dailies Total 1 lenses still includes great breathe-ability for the lens, but adds more “wettability” for comfort: > 80% water-content.

At Bright Eyes, we love new technology and we are proud that among the first optometry practices in the nation to offer this premium contact lens. I am very excited to offer it to people who have issues with dryness and discomfort with their normal contact lenses. I personally have dry eyes and I can only tolerate most contact lenses for 3 to 4 hours. I always like to try products before offering them to patients and with Dailies Total 1 I am able to wear them all day. My staff have have also tried these lenses, and find this lens to be the top-class for comfort.

Here is a short video about how comfortable these lenses are:

You can also learn more about Dailies Total 1 by visiting: http://www.dailies.com/products/dailies-total-one.shtml.

Stop by or call us to make an appointment to try theses super comfortable contacts!

 

Dr. Nate

By Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care

 

Want to Wear Contacts? Take the Acuvue 1-Day Moist Contact Lens Challenge!

1DayEvent

Have you always wanted to wear contacts, but never asked your eye doctor if you could? Do your glasses get in the way during sports or other hobbies? Or maybe you already use contacts, but you just find them irritating or inconvenient?

Well, we have the event for you! The Bright Eyes Acuvue 1-Day Contact Lens Challenge! Here is how it works:

Every participant in the 1- day Challenge will receive:

A contact lens exam Healthy, comfortable, clear vision is always our top priority. We want to make sure these contacts are right for you and will work well.
Trial contacts to last for 1 week – We want you to really see the benefits of 1-Day lenses, not only in the office, but it your everyday life. So we give you lenses to use for the week. No contact lens solution needed!
Contact lens training – If you haven’t worn contacts before, we will teach you how to put them in and take them out safely. Of course, there is no care needed – simply throw them away at night.
A 30-Day supply of Acuvue 1-Day Moist contacts After you come back for your follow up appointment, and we agree that everything is awesome, you will receive your 30 supply of contact lenses.
$50 discount towards sunglasses – Acuvue 1 Day Moist contacts have UV protection to help protect your eyes from the sun, but you should still use UV blocking sunglasses to protect the areas around your eyes, which is why we are giving you $50 towards any sunglasses we carry!

All of this for only $100! But only for the month of June!

Why Acuvue 1 Day Moist? Simply put, they are super healthy and convenient. Not only are they incredibly comfortable, but they eliminate the problems from allergies and deposits. Best of all, you do not have to buy and use contact lens cleaning solution, which can bother certain people!

Want to learn more about Johnson & Johnson Acuvue 1-Day Moist Contact Lenses? Visit their website. You can also watch the fun video below to get an idea of how great 1-Day contacts are!

Ready to get started in your new contact lenses? Just call 813-792-0637, or request an appointment online.