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E-learning Without Eyestrain: Guide for Visual Health For Students During the COVID-19 Pandemic

TL;DR: If your child is e-learning, be proactive to help prevent vision problems. If your child appears to be having screen-related eye fatigue, see your optometrist first and discuss it – your child may have underlying problems made worse by excessive screen time.

(Downloadable PDF of this guide can be found here.)

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Credit: Sandra Schoen

There is one topic that comes up over and over in the exam room right now and that is school. Let’s face it, school is challenging this year for everyone – students, parents, teachers, administrators, and everyone who knows any of these people. Every child’s case is unique and they need to do what is best for them. I get a lot of questions about vision specifically from parents whose children are e-learning.

I know this well, because not only do I help my patients every day, I have two e-learners of my own: Nora, an 8th grader, and Javier, a 5th grader. As a family, we are experiencing this right now!

E-learning can be the most visually stressful type of education because it is a set schedule of screen use for a large portion of the day, every day. In a classroom setting, there is a lot moving around and looking up at the board and at friends to provide visual novelty. In a Virtual School and homeschool setting, the schedule can be much more flexible to allow for visual breaks. Teachers are working as hard as they can right now, but they are not children’s vision experts.

Based on my knowledge of children’s vision and the research I have done, I list some helpful guidelines below to ensure that your children can get the most out of E-learning this fall, without as much eyestrain.

Why is this important?

For many years, Optometrists have helped office workers who suffered from Computer Vision Syndrome (CVS), a collection of eye and vision problems related to excessive computer use. It was originally thought that CVS was an adult problem, but now research has shown that children can (and do!) experience this problem, too. This can be compounded by the increased screen time and the general stress of e-learning during the COVID-19 pandemic.

Common symptoms from long-term computer use are:

  • Eyestrain
  • Headaches
  • Blurred vision
  • Dry eyes
  • Neck and shoulder pain

It is not hard to imagine how any or all of these can make learning difficult for a child who has to be in front of a computer or laptop most of the week.

What can you do?

1. Have The Right Set up


Nora’s Workstation

My personal preference for my children is that their workstations are in public areas of the house, like the living room and dining room. This has several advantages. One is that we can easily check on them and help them if needed. Another is that it is a psychological distinction of their “work area” from their “personal area.” Also, it is just nice to see our kids during the day. 🙂

  • Selecting a screen – Bigger is better! The larger the screen, the easier it is to focus on details.
  • Screen settings – Often selecting 110% or 125% magnification helps. Also, white print on black background can be more comfortable.
  • Position the screen – Position the center of screen straight ahead so head doesn’t need to tilt back or to side. Position screen further back on the desk. Allow for at least Elbow Distance from the eyes to screen.
  • Chairs – should be firm with back support.
  • Foot rest – If the child’s feet can’t touch the ground, a foot rest can stabilize them.
  • Lighting – You don’t want it to be too dark or too bright. Being near a window is great for natural light, as long as the direct sun is not shining in the child’s eyes or directly on the screen.
  • Water – Designate a place for a water bottle or cup so kids stay hydrated.
  • Clutter – Keeping the environment clear of visual distraction can help your child focused on class content.

Here is a cute comic about setting up a work station for kids.


2. Posture

We all know that it can be difficult to get kids to maintain any particular position, specifically if they are little. However, showing them the proper posture and reminding them often can go a long way to helping them stay comfortable during work.

Here are recommendations for efficient posture for kids at the computer.

  • Their back should be against the chair for support.
  • The chair seat should not compress behind the knees and cut off circulation.
  • Their feet should rest firmly on a floor or footrest (no dangling)
  • The head should be balanced on neck (not tilted back or too far forwards)
  • The upper arms close to body and relaxed
  • The elbow should angle >90° (forearm below horizontal)
  • The wrist should be neutral (not flexed)

(Adapted from Workstation Ergonomics Guidelines for Computer Use by Children.)

Here is an illustration from the American Optometric Association: Body Posture AdobeStock 144114992

3. Do Children Need Computer Glasses?

For adults like me who have “joined the club”, we need glasses to see small print up close. Children, however, have more visual focusing ability so they don’t usually complain of not being able to see the screen. However, many children do have functional issues and benefit from wearing glasses at the computer.

Some of these conditions are:

  • Refractive problems – Conditions such as farsightedness (hyperopia) and astigmatism can make it more difficult to see the screen. Even a low prescription can cause a child to have headaches if they are not wearing eyeglasses.
  • Focusing problems – If children’s eyes do not focus accurately on the screen, glasses can help make it easier. Having glasses can make the difference between working comfortably and headaches and blurry vision.
  • Rapid Fatigue – Some children can see the screen clearly for the first 15 or 20 minutes then start to lose interest because they can’t sustain focus on it.
  • Convergence problems – Some children have issues where their eyes either tend to over-converge (tend to turn in) or under-converge (don’t turn in enough). In both instances having the right glasses helps keep the image of the screen clear and single and makes reading easier.
  • Specialized prescriptions – Some children have unique vision problems and require alternate prescriptions such as prism or bifocals, these should definitely be taken into account.


4. What About Blue Light?!?

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Javier’s Workstation

Blue light is a very popular topic in 2020. As I tell patients, it really is the Wild West right now when it comes to blue light protection and companies can say just about anything to sell their lenses. We need more scientific study in this area about which frequencies of light matter, how much filtering is needed, and what are the effects. But after following the research for years, I can say these things:

  • There is very little reason to think that light from computers and devices is going to cause permanent eye disease. (UV light from the sun is a much, much greater concern and that is why we recommend UV-blocking sunglasses for all ages.)
  • Blue light can interfere with circadian rhythm and sleep cycles. There absolutely is evidence that blue light exposure especially at night will affect sleep . The best bet is no screen use a couple of hours before bedtime. But if that is not possible, then blue light protection in glasses, as well as night-mode device settings, can help.
  • There is a lot of anecdotal evidence that patients have less eyestrain and fatigue by limiting the scatter of blue light. The only people who seems to dislike blue light filters are people who need to see colors extremely precisely, such as a digital designer.

In short, I do not believe that every single person requires blue light blocking glasses. I think it can help some people feel more comfortable. If your child appears to be having screen-related fatigue see your optometrist first and discuss it – there may be other visual problems that should be addressed first.

For many patients (including children) a low prescription to reduce fatigue, as well as blue light filter and anti-glare treatment, can be the best combination for reducing eyestrain in front of the computer. Buying a blue light filter is only one part of reducing visual eyestrain. At Bright Eyes and most optometry offices, we can custom make the best glasses for your child!

5. Taking Breaks.

If using digital devices is the problem, then stopping using them is part of the solution. Optometrists refer to proper working distance and taking breaks as “visual hygiene” – like dental hygiene but for your visual comfort. Keep in mind, looking away from the computer only to check messages on a phone doesn’t really count as a visual break! The important thing to remember is that breaking up long sessions into shorter sessions helps a lot to release tension in the eyes. There are some suggestions that are helpful.break time

  • Before classes start – Do a few deep blinks and eye stretches (we often call these Eye Yoga)
  • 20/20/20 Rule – Every twenty minutes, look 20 feet away for 20 seconds This lets the focus of the eyes relax.
  • 1/5 Rule – Every hour take at least a 5 minute break and move around. This wakes these eyes, body, and brain up, especially if they go outside (see #6).

I know that you do not have perfect control of your children’s schedule, but by setting reminders you can try to develop these habits. (See Dr. Beth’s video below.)

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6. Getting Outdoors!

What is even better than looking out a window? Actually getting outside and moving around. Children’s brains (and mood!) function better with some good old physical activity. When I am at home with my e-learning kids, I make a point of scheduling a time for us all to go for a run together, but this is not always possible (darn rain!). Even if they can’t exercise, just being outdoors is great for them. The change of scenery will help break up the routine.

Even if it just a short walk of the dog, or just standing in the yard or back porch, there are big visual benefits. First, the eyes get to fully relax when they look very far away. Instead of the space of just 5 or 10 feet in the room, outside we can 100 or 1000 feet away. Second, the natural light contains the full spectrum of light frequencies. Also, we tend to blink a lot more when we are outside moving around than we are just looking at a screen “in the zone” of e-learning. This keeps the eyes moist and comfortable. And there is a lot of research that shows that taking young children outside is one of the best ways to reduce the chances of them becoming myopic (nearsighted).

Of course, if you are outside in sun, wear sunglasses to protect the eyes from UV light!


7. When To Check With Your Children’s Eye Doctor.

Extensive computer use more difficult for all patients, but some children are at greater risk. Here are some situations when you should schedule an eye and vision evaluation for your child who is e-learning:

  • Pre-existing visual problems – If your child has on-going visual dysfunction, definitely have an evaluation and discuss all the options to limit the visual stress of e-learning.
  • Symptoms – Any symptoms of fatigue or eyestrain should be evaluated.
  • Overdue – Many patients are overdue for visits due to offices being closed in the spring. Children’s vision can change extremely rapidly, so we recommend annual exams for children in school. This is especially true if they are e-learning.

I want to highlight one specific symptom – blurry vision when looking far away. This can happen for several reasons but there are 2 important reasons to consider:

  1. Recently developed myopia (AKA nearsightedness).
  2. Eyestrain up-close is causing a focusing spasm (a red flag)

Both of these are on the rise around the world generally due to increased screen time and decreased outdoor time. Both of them have management options that can reduce future problems, including good habits, glasses, and vision therapy. Make sure you discuss this with your child’s eye doctor at their appointment.


And that’s it. I know it was kind of long, but it is important. As different as it is from classroom education, e-learning can be be very effective. And it certainly is beneficial in social distancing and keeping everyone safer from COVID-19. With the information above you can help make sure that e-learning does not cause vision problems as well.

Good luck this year! We are cheering for you. If we can help in any way, please reach out at or (813) 792-0637.

-Dr. Nate



The Bright Eyes Lego Glasses Challenge!

If you have ever been to Bright Eyes Family Vision Care or Bright Eyes Kids, you have probably noticed the various Lego sculptures around. My kids and I are big Lego fans! And although we have 65 billion Lego bricks at home (low estimate), after one week of Virtual School, my daughter was already asking for a new Lego set. Your kids probably have been asking for Lego sets as well. While not every set is as expensive as the Imperial Star Destroyer, we know parents are not excited about spending money on toys right now either.

Bright Eyes is here to help with the #LEGOGLASSESCHALLENGE! Think of it as your child being on an episode of Lego Masters where they make Lego Glasses, but not, you know, actually on TV.

Skinny: Make Lego glasses and win one of two (2) $50 Lego gift cards.

Here is how to enter:

Step one:

Have your child (under 18 years of age) build some glasses with Lego bricks. They do not need to be functional glasses like mine, but they do need to be wearable, at least for a minute or two.

Step two:

Take a picture of your child wearing their Lego glasses.

Step three:

Post the picture as a comment on THIS FACEBOOK POST. Have your child write a sentence or more about what the idea is behind their Lego glasses on or before April 30th, 2020.


On May 1st, 2020, the Bright Eyes Staff will vote on the entries. These are the criteria we will be judging:

  • The creativity of the Lego glasses build. Go crazy and have fun!
  • The story behind the inspiration of the design. The more imaginative, the better!
  • The number of Likes their entry gets on Facebook. Get friends and family to vote!

On May 2nd, we will announce the two winners!!! We would LOVE to personally deliver the Lego sets to you, but we think that it is safer to just mail you a $50 gift card.

We cannot wait to see what you come up with!!!! 🙂

-Dr. Nate

Fine print: No purchase necessary to enter. By commenting on the Facebook post, you are entering the contest. Bright Eyes will not save, screenshot, download, or use the entries, nor identify the entrants in any way. Entrants must be younger than 18 years old. Entrants do not need to be established patients of Bright Eyes Family Vision Care or Bright Eyes Kids. Winners do not receive Lego sets or money. Two winners will receive a Gift Card redeemable for $50 at or a Lego Store. Bright Eyes is not associated with Lego in any way. Lego is copyright Lego Group, Inc. If you have any questions or concerns about the Lego Glasses Challenge contest, please contact us directly.


Dr. Beth’s Screen Time Tips

Between Virtual School, Facetime with family and friends, and (yes) the occasional video game, screen time is off the charts right now in our house. Maybe yours, too. To help, Dr. Beth made this 1-minute video to remind people about visual hygiene, a fancy word that means “keeping your eyes from getting tired.”

Dr. Beth’s top 4 recommendations for comfortable screen time.

  • Remember the 20/20/20 Rule. Every 20 minutes look 20 feet away for 20 seconds to relax the eyes.
  • Smaller screens cause more eyestrain than larger screens, so use the TV instead of phones or tablets when you can.
  • Remember Elbow Distance, the distance from our first to the elbow.
  • Use reading or close work glasses if they have been prescribed for you.

If you have any questions, let us know. If you or your children have symptoms such as blurry vision, headaches, or double vision, definitely let us know.

-Dr. Nate



Ray Ban Sale and Show Event

Ray Ban is one of the most popular lines we carry, so we are extra excited about the…..

Big Ray-Ban Event for Adults and Children

Only at our New Tampa Location

Saturday June 30th 2018

9 am to 1 pm

20% off Prescription Frames and Lenses

25% off Non-Prescription Sunglasses

RayBan Show square

Podcast #11 – Colorblindness and EnChroma Glasses with Dr. Jeff Goodhew

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. Jeff Goodhew of Abbey Eye Care about color vision deficiency (AKA colorblindness) and EnChroma glasses.

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

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 & Dr. Beth Knighton, two doctors who really see eye to eye. They can help you get perspective of the latest visual scientific evidence for improving your vision and helping you keep your eye on the ball. We have real facts and aqueous humor, without making spectacles of ourselves. And don’t worry, the jokes don’t get any cornea than this, we promise!

Dr. Nate: 00:39 Hello, this is Dr Nate and this is the first international episode of the Bright Eyes Podcast. Today’s episode is all about color deficiency and EnChroma Lenses. And I have special guest. His name is Dr Jeff Goodhew and he practices at Abby Eye Care in Toronto, well outside of Toronto. Where exactly are you, Jeff?

Dr. Jeff: 00:59 I’m in a suburb I guess a small town called Oakville were about half an hour outside of outside of Toronto.

Dr. Nate: 01:04 And in my understanding, you were the first practice in Ontario to provide Enchroma lenses. We were also the first in Florida.

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Dr. Jeff: 01:15 Ontario is a province, Florida is a state, so they’re just similar, similar entities. Ontario is probably 15 million people and we were the first retailers and the demand for this product is, has been huge. I think a lot of color vision or color blind people out there have known about this product and of course it’s sold from the US. So here in Canada, people were a little bit leery about ordering something online. What if it didn’t work? So there was this huge pent-up demand, uh, in our area and once we flip the switch and went live, we had always people phoning and emailing and stopping by. It’s been, it’s been crazy. It’s been good. It’s been awesome.

Dr. Nate: 01:52 Yeah, EnChrome is one of those things that I had been following for quite awhile and I had talked to other doctors and I had heard great things and I really am thankful that you took the time to talk to us about color vision and what EnChroma is. And I think this will be a great conversation. So Jeff, let’s just start off with the basics. When we say somebody is colorblind or we say they have a color vision deficiency, we don’t necessarily mean that they see the world in black and white, but they may see color differently than other people. When you see somebody in the exam room who has problems with color vision, how do you explain that to them?

Dr. Jeff: 02:28 Right. So, so patients, patients think of it as, as colorblindness. That’s the term that they’ve heard. And like you, I’m not a huge fan of the word colorblind because people think, oh, they’re going to see in black and white. I kind of changed the conversation and say it’s more color confusion. So certain reds and Greens are going to look kind of a muddy brown. So they’re, they’re, they’re gonna think right in green are the same. So I try to frame it as confusion here, your Color Palette is not as big as other people. Um, cause, cause colorblindness, I carries kind of a scary connotation for people at least that’s, that’s what I find. I try to turn it into something that’s not as scary as that.

Dr. Nate: 03:08 Yeah, I agree. And I think that that’s a great approach. I also think it’s actually more accurate even though the term colorblind is what people usually use a shorthand. I think your color confusion term is a great way to approach it. I have two practices. One that’s for all ages and the other one is exclusively for kids and so often I’m the first person to do an eye exam for these younger patients and I’m definitely the first person to detect color vision problems. And so it comes down to educating them about school and occupational options and other factors. I’m not exactly sure when you graduated from school, but you went to Waterloo, one of the two optometry schools in Canada, if I’m correct?

Dr. Jeff: 03:08 Yes.

Dr. Nate: 03:47 And when I was in school, there weren’t a lot of options for people who had color vision problems. We took a lot of classes and we learned a whole lot about how your eyes work and how we see color, but in terms of what we could actually offer or patients, there weren’t really a lot of options. There issomething called an X-Chrome lens where you wear a colored lens in one eye and it helps people detect colors that they might not normally have seen, but it wasn’t really a very natural or helpful option.

Dr. Jeff: 04:13 No, exactly. The, you know, the X-Chrome lens was a was a contact lens that you could wear in one eye, it was deep, deep red, so cosmetically looked a little strange, but all it did was allow certain people to pass some of the standardized color vision test so maybe they could get into the police force or become an electrician or a commercial pilot. So they would wear this lens just for that color vision test and then never wear it again. This is the first product that’s out there that can actually enhance a person’s, you know, quality of life. What I’ve observed about EnChroma is unlike the X-Chrome Lens, you can’t get patients to take them off. Yes, even though they’re tinted, they become their full-time glasses. Agree completely.

Dr. Nate: 04:53 Yeah. There was a patient who just happened to be the husband of one of our staff members and the first day that we got EnChroma, he had come in for his eye exam, so he put on the EnChroma, fit over testing glasses and he went outside and it’s Florida, so we always go outside and look at the plants and the flowers and look at the buildings stuff.

Dr. Jeff: 05:15 Stop rubbing it in. The flowers are just starting to come out as we as we record this.

Dr. Nate: 05:20 Well good. Yeah, but it’s something that really helps them see the subtle differences between the bright leaves and the more orangy ones and the green. And he was really excited about being able to see the different colors and he actually took those fit over years with them and we had an event where we’re going to, as a staff, go to the Tampa Bay lightening game and I saw him later that day and he wore them the whole game and now he’s got his own prescription pair and he wears them all the time. I never seen him without them. You know, he really likes him, but I think we’re getting a little bit ahead of ourselves. We’ve mentioned EnChroma several times, and these are glasses that people can where they can get them in their lenses, their prescription glasses in different frames, but why don’t you talk just briefly about what they are and what they do.

how eyes see color enchroma logo purpleDr. Jeff: 06:09 We need to back up a little bit and go back to your first question about what is colorblindness? I think for the lay person, we’ve got three color receptors I guess at the back of the eye in your retina, sort of a blue sensor, that green sensor in a red sensor, and normally with folks who have have colorblindness, the lights, the colors of the red and green receptors can pick up they overlap so they don’t get that differentiation between the reds and the greens because those two sensors aren’t doing their jobs the way they should. And with EnChroma Lens, it’s got a special filters that that knock out very specific wavelengths are very specific colors of light and what that does is it separates what the green and red receptors can now detect, so it makes them more kind of a normal, what a normal color vision person would would would see. So yeah these lenses, they’re tinted so they look like normal sunglasses, but they’re much higher tech than that. They’re blocking very, very specific colors that allow those color sensors at the back of the eye to do the job that they’re normally supposed to do.

Dr. Nate: 07:21 Yeah It’s really elegant because I think that if you just look at the lenses themselves, they look like sunglasses, but it’s so precise and so specific when they’re filtering out that muddy, confusing overlap that you’re talking about, you know, you need some pretty sophisticated equipment to see the specific frequencies that they’re filtering out. You wouldn’t necessarily know what they’re doing if you just look at them. You know, it’s interesting because our brains are fascinating things and you know, in my experience when I go outside with patients and we’re talking with them and they’re looking around and everything, it almost never works instantaneously. It does take them a few moments to sort of compare and contrast and sort of realize what’s going on. And then they get kind of quiet, they get that sort of smile and their mouth kind of drops a little bit and then they’ll say like, oh, I thought this was that color, or now I realized it’s a totally different color. I see this whole pattern of things going on.

Dr. Jeff: 08:19 I would agree. We’ve had a couple of those kind of, you know, over the top Internet YouTube moments. But most people, it’s almost like sensory overload. They put the glasses on and they get to see these things for the very first time and their brain, their eyes or they’re just overwhelmed. They really don’t know what to do. So. they kind of go quiet, like, like you said, it’s almost like their demeanor changes and some of them get, you know, start to get excited. Some of them get quite emotional. So, um, we, we try not to hover over them and say, you know, what color is, what color is that? We just let them absorb, you know, to experience it because it’s, you know, we take this for granted for them it’s, it’s completely new and we just like, you, I just like to stand back and just watch the reaction, each patient’s different. But it’s, you’re right, it doesn’t get old and super fun to be part of that.

Dr. Nate: 09:10 You know, the closest think I think I’ve ever experienced to that is we provide vision therapy for a range of visual problems and I’ve worked with patients who’ve developed 3D vision for the first time in their life and when they’re trying to take it all in and they’re looking around and they’re trying to make sense of the things that, that they see. It’s just, it’s just really cool. You know, they don’t, uh, they don’t always have words to describe what they’re experiencing. And it really is an interesting thing.

Dr. Jeff: 09:41 We had a patient probably two months ago who drove about 90 minutes to come to our practice, came in with his wife, and I don’t know if you’ve found this, but they never come in by themselves ever.

Dr. Nate: 09:51 Right. It’s often the whole family, but it’s usually at least a spouse or a brother.

Dr. Jeff: 09:56 Yes, exactly. So it’s kind of a big outing for, for these folks when they come, when they come to our practice and this gentlemen put the glasses on and for 25, 30 years, the number of years he’d been married to his wife, he thought her eyes were blue and they actually weren’t blue, they were Hazel, so they had, you know, Brown with a better green and he just couldn’t see the green. So the first time ever he could see the true color of his, of his wife eyes and that was emotional for, you know, everybody in the whole office. So he, he ordered a pair of prescription EnChroma because he needs prescription, so that takes a couple of weeks to come in. So this was on a Saturday. Um, try the glass on, Love them Monday morning he drives all the way back to our practice, another 90 minutes, so three hours both ways just to try the Fittovers, just to try the samples again. He knew his glasses wouldn’t come in for another couple of weeks. He just wanted that experience again. And then two weeks later his glasses came in and we called him and it’s like he was sitting by the phone, 90 minutes later he was there like, this guy is so excited and like the other, you know, the spouse of your staff member. This patient hasn’t taken them off, they’ve become as regular eyeglasses.

Dr. Nate: 11:10 Yeah, that’s a, that’s a cool story for sure.

Dr. Jeff: 11:16 So here’s one thing I’ve noticed, and maybe it’s just me, but you’re a fellow optometrists or fellow eye doctor. But um, we’ve got some flower arrangements, unlike you, we need fake flowers for six months, six months of the year. So I’ve got some blue flowers next to some purple flowers and purple of course really is just blue with some red in it. And for some folks who can’t really see, red those blue and purple flowers look the same. They put the glasses on, all of a sudden they can see purple and they’ll actually call it purple. And for me I’m like, OK, you’ve never seen before. How the heck do you know that purple? So I think there’s a lot we still don’t know, but for me that’s always been interesting. How can you name colors that you’ve never seen it.

Dr. Nate: 12:00 Yeah, it’s, it’s fascinating. I think it’s really been an exciting and interesting experience. The other thing I’ve noticed just working with these patients is that everybody comes in with slightly different things that irritate them or you know, they have, they have different goals, you know, I mean, no, no two people are the same. So I think it’s very important for them to come in and try them personally and everybody has a different story and his different lifestyles and different goals.

Dr. Jeff: 12:28 I like, you know, patients will often tell their story on social media, you know, a couple days later maybe it will post on facebook about these Enchroma glasses that they’ve got and they’ll, they’ll, they’ll tag our office most times because their best where they got the glasses from.

Dr. Nate: 12:43 Right, right. Yes.

Dr. Jeff: 12:45 So it’s really fun to read what they talk about. It could be, you know, how overwhelmed they were. They saw how vivid red cars on the road look like on the drive home. They stop at the grocery store and they could, they did not have to ask somebody OK, can you tell me when she was the red pepper and the green pepper? Because to them they always look the same. Bananas don’t look all, you know, rotten anymore that you can, you can see the yellow. No peanut butter looks brown not green. So it’s really neat to see them document their first couple of days, uh, after having the EnChroma eyewear and then just to see the, how happy their friends and family are for them. Like they’ll get, you know, 40, 50 likes, I’ll have all these comments like I’m so happy for you. And everyone’s really emotional, like they’re so happy that this person, um, get some of the, the color world back I guess. Um, so that’s been, that’s been super, super cool is just to, just to kind of sit back and just read the stories that people are posting and how it’s affected their lives because every, you know, it’s one in 12 males of color vision problems. So we all, everyone knows somebody who has a color vision problem. So there’s lots of folks out there who can benefit from this, so I think, you know, helping spread the word about this exciting technology is, uh, is great.

Dr. Nate: 13:58 Well, Jeff, I appreciate you taking your time to help us out. Do you have any other thoughts and anything else you want to share before we go?

Dr. Jeff: 14:05 No, well, I guess I maybe just managing people’s expectations like this does not cure colorblindness. You can’t all of a sudden you don’t pass the test to become a policrainbow fencee officer.

Dr. Nate: 14:05 Yeah. Right.

Dr. Jeff: 14:17 That being said, there’s still huge benefits in this, um, in this product in the sense that it improves your color fidelity, your color Palette expand. So, um, yeah but that, and we do tell patients that and they’re fine with that. They know that. But the funny thing is it, and you’ll probably find this, they all want to say the color vision test again.

Dr. Nate: 14:35 Yeah, you’re exactly right.

Dr. Jeff: 14:37 The glasses on every single one, even though we tell them you’re not going to pass the test, they all want to take it.

Dr. Nate: 14:42 So Jeff, I really want to thank you for your time and sharing your experience and your expertise and that’s been really wonderful and thanks to all of our patients and listeners we’ll post some information about EnChroma on the website in the show notes so you can follow that online. There’s information, there’s an online color vision test that you can take. There’s different things you can do. As always, if you have any questions, comments, or suggestions about our podcast, you can email us at Until next time, this is Dr Nate. Thanks for listening.

Outro: 15:13 Brought to you by Bright Eyes Family Vision Care and Bright Eyes Kids. Find previous episodes and more detailed information at 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 country.


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

Bright Eyes Family Vision Care Becomes Only Tampa Bay Retailer of Enchroma Color Deficiency Eyewear

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Our Bright Eyes Family Vision Care optometric practice and Bright Eyes Kids pediatric optometry practice in Tampa, Florida have become exclusive retailers of an advanced eyewear product for patients with color deficiency. Bright Eyes now offers Enchroma glasses for individuals who have difficulty distinguishing colors correctly.

I am very excited about offering this new option to patients. Frequently Dr. Beth and I are the first doctors to diagnose color deficiency in young patients. We know that patients and parents alike have concerns about how they see colors and, if there is a deficiency, how it will affect their lives. These glasses can prove extremely helpful for individuals suffering from the most common forms of Red-Green color deficiency. When you think about just how important color perception is in our everyday lives, you can see what an enormous difference corrective lenses for color deficiency can make for people who need them.

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I have been following Enchroma for several years and I was excited when the company reached out to us. I should note that Enchroma glasses should not be thought of as “color blind glasses.” Color deficiency does not usually involve a complete inability to see colors. Achromatopsia, which presents the world as a black-and-white image, is very rare. The majority of people with color deficiency have trouble either distinguishing between red and green shades or distinguishing between blue and yellow, with the Red-Green deficiency proving most common among the general population. Color Vision Deficiency affects millions of people across the world, affecting 1 in 12 men (8%) and 1 in 200 women (0.5%). A majority of people with the genetic disorder typically inherit the condition from their mother (X-linked trait).

Enchroma glasses are designed to help improve a person’s ability to distinguish colors while wearing the glasses. The lenses employ a specialized filter technology, the patent to which is currently pending. The filters in the lenses help to boost the differences between red and green as perceived by the eye, allowing for more normal color perception. In talking with other doctors who have used Enchroma glasses with their patients, I have heard many positive stories about patients amazed by experience when trying Enchroma glasses for the first time, watching patients smile and feel awestruck by the colors they discover with the glasses.

We will soon be able to have Enchroma lenses made to suit any corrective vision prescription in most frame options, with no extra delay in the fabrication process. We will let you know when we are ready to accept appointments for Enchroma Lenses. Not every person with color vision deficiency will have the kind of improvement in the video below, so a consultation is a good idea. You can read more and take the online test at:

-Dr. Nate

PS: Listen to the Enchroma episode of the Bright Eyes Podcast here:



Podcast Episode #7: Myopia and Outdoor Time

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. Beth about recent research that supports the idea that spending more time outside will reduce the likelihood of children becoming nearsighted.

Note: See these related episodes: #4 UV Protection and #6 Refractive Error (Myopia and others).

Full Trascript:
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Dr. Nate: 00:18 Hi, this is Dr Nate. This episode was actually recorded in the summer of 2017 before Dr. Knighton went on maternity leave and then we got so busy it took me this long to put the episode up. That’s why even though it’s cold and rainy in Florida right now, we are outside at a park where it’s sunny and kids are playing. Enjoy.

Intro: 00:49 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 care

Dr. Nate: 01:19 From sunny Tampa Bay. It’s the bright eyes podcast. This is episode number seven and I’m Dr. Nate Bonilla- Warford.

Dr. Beth: 01:19 And I’m Dr Beth Knighton

Dr. Nate: 01:30 And today’s episode is all about going outside and why that’s important. So why do you think were outside?

Dr. Beth: 01:39 Well, today is about as lovely as the day as you get in the summertime in Florida. So we thought it’d be nice to just get out of the office. Occasionally we go for walks at lunch and what not just to get out.

Dr. Nate: 01:54 And that’s totally true, and that is completely important, and it is very nice even though it’s a little warm, but it’s still very nice out here. Um, but there’s also another reason why we’re outside. Now, we already talked about getting outside once in episode number four. Can you remind what our listeners, what that was all about?

Dr. Beth: 02:15 Well, we reminding you all about why it’s so important to have UV protection for your eyes when you’re outdoors.

Dr. Nate: 02:22 Absolutely. And I’m still blown away when I ask people about their sunglasses and they say like “No, I just don’t wear sunglasses, I just don’t really need them”. And in Florida, having sunglasses, prescription sunglasses, is a must, but that’s not what we’re talking about. That episode is all about some of the dangers of going outside if you don’t do it cautiously or carefully. This episode is about the benefits of going outside. And so what we’re talking about is specifically how going for children reduces the likelihood that those kids are going to be near-sighted. Now, for a long time it was thought by many people that nearsightedness, or myopia, or not being able to see far away clearly without glasses, was purely genetic. Are your parents nearsighted?

Dr. Beth: 02:22 Only one of them.

Dr. Nate: 02:22 Only one of them.

Dr. Beth: 02:22 And I am.

Dr. Nate: 03:31 Well, both of my parents are and almost everybody in my family is. And I thought that I was going to be and I am nearsighted and that’s why I have my prescription sunglasses on right now. But there has been a lot of research in the last ten years and even a lot of research just in the first half of this year, which shows that nearsightedness is not purely genetic. And as a matter of fact, what we know is the more time children spend out doors when they’re younger, the less likely they are to become nearsighted and need glasses to see far away. And that is one of the most interesting and exciting developments that somebody like me who is a pediatric optometrist is a reading about right now because this means that we can educate our patients and help them understand why going outside is so important and actually reduce people’s dependence on glasses in the future. But before we get to the details and the studies just kind of in general, do you think going outside is a good idea?

Dr. Beth: 04:52 Well absolutely. I mean we have to stay active, we need to enjoy nature as it is and both Nate and I, our families are outside all the time doing things. So we are very aware of both the dangers and the benefits of being outdoors with everything in moderation is key.

Dr. Nate: 05:13 Absolutely. And what’s so great about this particular subject, the beneficial thing which is going outside is free. It’s easy. It’s convenient because it’s everywhere and it is fun. I tell families probably every day or almost every day, one of the best things you can do is just go for a walk after dinner. If you have a dog, go walk the dog. If you don’t have a dog, just go outside with your family. Some of my best memories from when I was a kid was going for a walk with my family and seeing other people and finding out what’s going on in the community and seeing other people walking their dogs and so now we have lots of evidence that just something as simple as that is really important for children’s eyes and it’s also important for a reducing obesity and just general strength and exercise. There’s so many different reasons.

Dr. Nate: 06:10 So what I brought today were three different studies which have different results, which talk about this relationship between the more children go outside and how likely they are to become nearsighted. So, the first one that I have is from the British Journal of Ophthalmology earlier in 2017. What it says is that of the hundred and thirty seven children that they studied, all of the different factors that they looked at whether or not they became nearsighted was more dependent on environmental factors. Most of those children before the age of six is when you could start to see differences and so environmental factors include all kinds of lifestyle choices like going outside and like the types of different activities that people do, but it also has to do with education and socio economic status, so there’s lots of different factors that are that go into that, but one of them is just exercising going outside and so that’s just the type of study that we see on a very regular basis. When I read the new studies that have come out in, I care, I see studies like that all the time. Twenty or thirty years ago, that would’ve been really surprising. Do you think that that’s surprising now?

Dr. Beth: 07:31 I think that in general, people are paying more attention to what can we do to prevent problems in the future as opposed to reacting once we’ve already got problems and that’s across the board in healthcare. These are very simple, easy ways to help prevent our children from becoming more near sighted because not only does it cause them to have thicker glasses and harder time seeing, but it also can cause a higher risk for eye disease later on. They’re at higher risk for having glaucoma. They’re at higher risk for having retinal issues like a detachment or a hole in the retina. And so if we can prevent those things early on, much better outcome for them.

Dr. Nate: 08:17 And that’s actually a great lead into the next study which was from this year and Acta Ophthalmologica. And the gist of that study was a few different things. This was a review, a Meta analysis of twenty five other studies. What they found was that if children spent seventy six minutes outside each day, there were fifty percent less likely to become nearsighted. So that’s if they are not near-sighted, they’re not myopic at first. And then they spend roughly an hour and fifteen minutes outside each day, they’re fifty percent less likely to become nearsighted, and that corresponds with a lot of the individual studies that we’ve seen. But this is nice because this is twenty five studies all kind of pulled together that held up. What was very interesting though is there really wasn’t much benefit for children who are already near-sighted. So, this doesn’t mean that if you’re already near-sighted, all you got to do is go outside more and then you’re nearsightedness won’t progress.

Dr. Nate: 09:26 We have other ways of controlling the progression, limiting the progression, reducing how quickly vision gets worse, but going outside isn’t one of them. So the key, like Dr Beth just said, is prevention. So the idea is to go outside, do everything you can before kids become nearsighted instead of after. Now, the third study, which was from Investigative Ophthalmologic Vision Sciences, was taken from the Avon Longitudinal study of parents and children, which was a study, they followed children from age two to fifteen. And this was really, really specific. This was a news for me that I thought was very useful. And the conclusion of that was additional time spent outside between the ages of three and nine was associated with the less likelihood of becoming nearsighted at the ages of between ten and fifteen years old. So now we’re starting to zoom in on the really key age of younger than ten, between three and nine, and that really is when kids should be outside recess playing and paying dividends in the form of not becoming nearsighted once they become teenagers. And it’s just amazing how much research is coming out right now. That’s something that as there is more research we will continue to talk about and will continue to educate our patients about.

Dr. Nate: 10:57 The study that you just referenced also was looking at the amount of time spent reading versus the amount of time spent outdoors and just like outdoors had a positive effect. The amount of time indoors reading had a slightly negative affect and not that we want to tell everyone, go live outside and never read a book. Obviously we need to do both, but it was very interesting that both of those things had a correlation on the nearsightedness of the eye. Another interesting thing that came out of that study was parents who were near sided were more likely to have children who spent more time reading and it also said that parents who were not near sighted, were more likely to have children who spend more time outdoors and less time reading, so those things kind of match up as well. It clearly stated that the impact of outdoor time reduce the likelihood of nearsightedness regardless of those other factors.

Dr. Nate: 12:01 So, the main point here is if you have children, make sure that they spend time outdoors, but also remember if they’re going to be outdoors in bright sunlight when UV light is a risk, make sure that they were sunglasses. So thank you for listening. This is one of my favorite topics. We’re going to talk more in the future about what to do after children become nearsighted. Until then, if you have questions, comments, or suggestions, you can email us at office at Until next time, go outside.

Intro: 12:35 Brought to you by bright eyes, family vision care, and bright eyes kids. Find previous episodes and more detailed information at, 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 and treatment.


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

2 Events: Smith Optics Show/Banana Republic Show and Spring Cleaning Eyewear Sale!


Event 1: Spring Eyewear Show!

Wednesday, April 26 – 4 to 8pm

25% OFF 1st pair – 50% Off 2nd Pair

Bright Eyes Family Vision Care – Westchase


Featuring Smith Optics and Banana Republic.

Every style, every color, every size to try on Eyeglasses! Sunglasses! Women! Men!



Event 2: Spring Cleaning Sale

Mon, April 24 – Fri, April 28

One week! Two offices!

Every frame on SALE! $50 – $100 OFF!


Spring Events

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



Top Ten New Years Resolutions for Screen time and Kids Eyes

(Note – You can read my previous Top Ten New Year’s Resolutions for Healthy Vision for Eye Health, Children’s Vision, Saving Money on Eyecare, Myopia Control, and Computer Vision Syndrome, -Dr. Nate)


Did your child receive any gifts with screens this holiday season? Or gifts such as a movie or new video game that are viewed on screens? My kids did. And they are VERY excited about them. They are not alone. The kids that I see in my office beg, whine, wheedle, and cajole their parents into as much screen time as possible. Many of them have their own tablets. And this is incredibly common. In fact, one 2015 study found that three quarters of 4 year-olds had their own devices.

There are obvious benefits for children to use technology. They can watch educational programming, Skype with distant friends and relatives, and download STEM and creative apps. But all of this screen time can come with downsides. One is childhood obesity. Another is social awareness and skill.

Others problem associated with screen time have to do with vision. This is something I talk about all day, every day at Bright Eyes Kids. Increased screen time can put children at risk for myopia (nearsightedness). Games such as Minecraft can be great, but can cause headaches and blurry vision due to eyestrain. In fact, eyestrain from device use can actually contribute to digital eyestrain or other visual problems that can make school work more difficult and require vision therapy to treat.

10 ways to keep your child’s electronic device use healthy:

  1. Set a clear Family Media Use Plan. For example, in my house, my children are not allowed screen time before noon. It is worth reading the American Academy of Pediatrics statement on media use from October 2016 to get some ideas.
  2. Optometrists recommend that people of all ages limit screen time to 20 minute intervals. Teach your child about the 202020 rule, every 20 minutes, take a 20 second break, and focus on something 20 feet away. Every hour, take a longer break.
  3. Buy a blue light reducing screen protector for your child’s phone, computer or tablet. one that reduces by 30%, but they offer through select optometrists 60% reduction.
  4. Mitigate the potential damage of focusing on close images, by having your child spend 2 hours a day outside. A recent study showed a 2% reduction of Myopia progression for every hour a week spent outside, or 28% for 2 hours a day.
  5. Minimize electronic device usage at night, a recent Harvard study showed that blue light at night effects melatonin levels, which effect sleep, blood sugar levels, and may be linked to certain other diseases.
  6. Ask your doctor about computer glasses or contacts which are specially designed to reduce eye strain by reducing the visual focus needed for computer use.
  7. Create fun alternatives to electronic devices, write a list of “cool” activities to do throughout the week. Great alternatives are outdoor time, board games, and creative projects. Even things as simple as walking to grocery store can be more rewarding than most things are your child’s screen.
  8. Role model proper screen use. As always our children learn from us, if we are glued to the screen, they will be less likely to take screen limitations seriously. Make a New Year’s resolution to limit your screen time and be more present for your kids. This is hard, but important!
  9. Make sure your child’s posture is not being affected by the chair or couch they are using while watching TV or on the computer. Adolescents with high computer usage were nearly twice as likely to report neck and back pain than those with moderate use.
  10. Talk to your eye doctor if your child avoids using the computer or complains about blurred vision or eye fatigue when using a screen, as this may signify a larger issue that needs to be addressed.

Happy New Year. May 2017 be better than 2016. 🙂

-Dr. Nate

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