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Dr. Nate Gives Lecture on Myopia Control to Optometrists

Recently, Dr. Nate Bonilla-Warford and Dr. Beth Knighton attended the Hillsborough Society of Optometrists annual Fall Classic. They showcased Bright Eyes Family and Bright Kids at the exhibit hall and talked with area optometrists. Additionally, Dr. Nate gave a lecture about the latest research in myopia control and ways that optometrists keep nearsightedness from increasing. As you can see, it was a packed house.

 

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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:
Ad: 00:00 Do you want to improve your view? Biotrue One day daily disposable contact lens feature a bio inspired design providing clear comfortable vision throughout the day. Call us at 813-792-0637 to see if Baush and Lomb Biotrue Oneday contact lenses are right for you.

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 office@brighteyestampa.com. 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 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 and treatment.

 

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

2017 Spring Newsletter:New Hours, Sales, Giveaway, Ortho-K, VR & more!

 

Hello, Bright Eyes Patients! Welcome to our first email update of 2017. We have so much to tell you that we’ll get right to it:

Not One But Two Spring Events

Spring EventsSpring has sprung and we have 2 big events coming up! The first is our Spring Eyewear Show on Wednesday, April 26 from 4 to 8pm. This is a trunk show of all the Banana Republic and Smith Optics eyeglasses, including sunglasses. Win a FREE pair of prescription sunglasses from Smith! The second is the Spring Cleaning Sale Monday April 24 through Friday, April 28. The doctors are away at a conference most of the week, but both offices will be open – all eyeglasses and sunglasses on sale! Read more here.

Hours Reminder

Our Westchase office has new hours: Monday, Tuesday and Thursday 9am-5pm. Wednesday is still 12-8pm, Friday 8:30am-4:30pm and Saturday 9am-2pm. See all the details here.

Big News about Ortho-K!

We have been getting more requests than ever about Ortho-K, the overnight contact lenses that allows for clear, glasses-free vision. You might have seen Dr. Nate on the news! You can read about Dr. Nate’s daughter’s own experience with Orthok-K and also read more about the process here. Treehouse Eyes is an office in Washington DC that specializes in myopia control, and they did a story on Dr. Nate’s daughter.

VR Home Therapy is Live

We are one of the first eye doctors to offer Vivid Vision Virtual Reality Vision Therapytreatment for amblyopia and strabismus, but we are now able to offer this treatment as part of a home Vision Therapy program. This is a game-changer for patients both children and adults. If you are interested, call us at 813-792-0637.

Updated Website

You may have noticed that we’ve been hard at work on our website BrightEyesTampa.com, especially pages on Myopia Control, Ortho-k, Vivid Vision and others. Check it out!

Other topics of interest from our blog

We’ve covered some important topics such as Top 10 For Screentime, Women’s Eye Health & Safety Month, Cleaning Your Glasses, The Importance Blue Light, & Eye Color.

Reviews

Finally, we want to say that we are very thankful for all the Yelp and Google reviews. Most people find us through online reviews or word-of-mouth, and as a small business, we appreciate it! If you haven’t left a review, it would mean a lot if you did.

Thanks and have a great spring! 🙂

-Dr. Nate

Bright Eyes Family and Bright Eyes Kids

A custom uploaded image.

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.

 

TV News Segment on Orthokeratology and Myopia Control

The mission of Bright Eyes Family Vision Care and Bright Eyes Kids is to empower our patients by providing the best vision care possible. One of the most exciting ways that we are able to do this now is called orthokeratology. It is one of the methods used to keep children from getting more and more nearsighted. Like vision therapy, it is complicated, but very, very rewarding.

I am very happy that word of orthok and myopia control is spreading! You can see for yourself from this excellent recent news segment from 10News CBS WTSP did featuring me and a patient of Bright Eyes.

Here it is:

A HUGE THANKS to reporter Courtney Robinson She was great to work with and genuinely interested in children’s vision and the effect of screen time. She took the time to come to the office and ask many fantastic questions. You can read her whole story here.

 

I am also thrilled that my daughter, Nora, has started orthok. I will write a blog post about that next. 🙂

If you have any questions, please let us know. Use the button below or call us at (813) 792-0637. And as a reminder, orthok is not just for kids. We do have adult patients that use orthok to be free from glasses for sports or while reading their phones or other activities.

See Well!

-Dr. Nate

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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. http://health-e.com/offers 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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Happy Orthokeratology Patients at Bright Eyes

Orthokeratology goes by many names…. Ortho-k, corneal refractive therapy, Gentle Vision Shaping, corneal molding, and others. At Bright Eyes Family Vision Care, we tend to call it corneal reshaping or Orthokeratology. But regardless of whatever terms we choose to call it, our patients call it “awesome!”

Watch for yourself:

(Click here to watch on Youtube).

This last weekend I was fortunate enough to attend and speak at the Orthokeratology Academy of America (OAA) educational conference. The OAA is an international organization of orthokeratologists who provide a nonsurgical alternative to refractive surgery for nearsightedness, astigmatism and hyperopia. Current research also shows that Ortho-K can slow myopic progression in children.

The international faculty of presenters covered topics including myopia control (including soft lens technology), corneal reshaping research, safety of corneal reshaping, progressive/hyperopic Ortho-K lens designs, new corneal reshaping techniques. I heard speakers from Australia, Japan, China, Italy, Spain, and from all over the US.

President Dr. Cary Herzberg had the pleasure of announcing the inception of the new International Academy of Orthokeratology(IAO). The IAO brings together ortho-K organizations from the America (OAA) as well and Europe and Asia. This international organization will support, promote and advance corneal reshaping worldwide thru quality education and research presentations at meetings held around the world. For more information about the OAA click here.

At Bright Eyes, we have successfully treated patients from 7 to 59 years old with orthokeratology. This includes pilots, lawyers, retirees, and lots of kids like Christopher (above). If you would like more information about Orthokeratology, call our office in Westchase at 813-792-0637 or visit http://BrightEyesOrthoK.com

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Myopia in the News: A Huge Increase in the US and What Can Be Done

My colleagues and I think and talk about myopia (nearsightedness) every day. We talk about the drawbacks (and rewards) of being myopic. We talk about the causes and treatment options for myopia, both short and long term.

But I have never seen a day like today, with myopia in all the papers and on every major TV news program. Given how quickly news travels today, the total number of people thinking and re-thinking about their eyes and vision is probably higher today than it has ever been!

Yesterday morning, I received an email about a newly released study, “Increased Prevalence of Myopia in the United States Between 1971-1972 and 1999-2004.” While I take it as common knowledge that nearsightedness is increasing in much of the world, including the United States, even I was stunned to see this headline about the study: “Myopia Prevalence Rose 66% over 30-Year Period” There is no way around it, a 66% increase is a lot!

So I posted the link on Twitter and Facebook, but I didn’t really have the time to dedicate to the study until today. And then the really big news hit. There are stories on myopia on NPR, Discover, the LA Times, and video segments on Good Morning America and local affiliates such as these and these.

So since this is such a hot topic today, I’ll share what I tell patients almost every day at the office. But first let me say this: while vision science has advanced tremendously, and we have a better understanding than ever, there still is a lot that we do not know about the details of nearsightedness and its development. And, although this may shock you to read, there are some less-than-ethical people who will claim to have all the answers and will say with a straight face that they have THE ONLY WAY to either prevent or eliminate nearsightedness or glasses. The truth is that we don’t know exactly how this works and we can never make promises because what may work for 1000 people may not work for you.

But we can say some things about myopia more generally. There is a genetic component for sure, but just because you and your spouse are nearsighted is not a guarantee that your children will be . In fact, there may be more commonly a genetic susceptibility than an actual myopia “gene.” And clearly there are other factors involved because while the population is changing (due to aging and immigration) our US genes haven’t changed that much in 30 years, but our eyes have!

So, as many of the links above point out, our lifestyle can have an impact on vision. Our eyes are inherently best-suited for looking off into the distance. This is easy and natural. Yet today we spend an increasing amount of time and effort focusing within arms-length and in some cases just a few inches. And while we have always had (and will continue to have, I hope) kids and adults with their noses buried in bound books, the truth is that intensely playing tiny video games or texting does require more visual effort. And I can attest from seeing patients at Bright Eyes that children are engaged in these activities at younger and younger ages.

So – if a patient has increasing nearsightedness, or seems predisposed to be nearsighted what are the options? Here are the refractive options from least to most aggressive.

  • Do nothing. Some people prefer to not take any action because they do not have need to see better at a distance and they prefer the vision up close. This is totally reasonable, as long as it is an educated choice and not just by default or neglect. However, this is not itself a treatment for myopia and in fact may promote myopia in the long run.
  • Traditional glasses or contacts. This will help a patient see clearly in the distance which is necessary for things like driving or going to school which are important. But it will not address any underlying problems leading to increasing myopia.
  • Bifocal Glasses. This method was more popular in prior decades to slow down myopia progression. The scientific studies have not shown it to be as helpful generally, but may be for a subset of people with specific visual problems.
  • Multifocal soft contact. There is small but growing evidence that multifical contacts, like Proclear EP, can provide clear distance vision and limit the progression of nearsightedness.
  • Orthokeratology (Corneal Reshaping). There is several scientific studies that have shown that this can provide safe, clear daytime vision, and slow or stop progression of myopia. You can read more about this here. And I have written more about this here.
  • Atropine drops. This method of myopia control involved the use of prescription eye drops to keep the eyes dilated. This has been used for years and is more popular in Asia, but has not caught on in the US, due to side effects.

But regardless of which method is employed above, it is wise to take frequent, brief breaks from near work. Looking up and away every 15 minutes or so is a good idea, because there is some evidence that it is not the total time during near work, but the length of the individual periods of work that make a bigger difference. Getting outside more is a good idea, but it is not clear if it is the distance vision, sunlight, or some other benefit. Of course, this is true not just for your eyes, but for your body and mind, too!

As vision professionals, we clearly have much work to do in understanding more about why and how myopia occurs. But it is exciting to know that there are treatment options that can reduce the likelihood of progression.

If you have concerns about your vision or if your children have not been thoroughly evaluated, call us at 813-792-0637 to schedule an appointment. After reviewing the examination findings, we can discuss concerns and treatment options that may be right for you.

Be well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

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(Edited to fix a few typos and add some info left out).

Interview with Nick Despotidis, O.D. about Corneal Reshaping

[ I haven’t written much for the blog in the last couple of weeks. Mostly I’ve been busy with Javier and Nora. You can see some of Javier’s pictures on Flickr here: http://bit.ly/1MFiuw – Dr. B].

I am very excited to bring you this interview with Nick Despotidis, O.D. (Dr. D). He is one of my mentors in the orthokeratology/corneal reshaping field. He has written, researched, lectured on the subject for many years. I have attended several of his lectures and have always been impressed with his insight and enthusiasm. I was even more impressed when I read his book “My Children are Nearsighted, Too.” Dr. D practices in Hamilton Square, New Jersey.

Dr. B. Writing a book takes a lot of effort. What prompted you to write a book and not just a large pamphlet?

Dr. D. : As health professionals, we often get asked similar questions from patients. However, nothing seems to elicit as much emotion as when parents are discussing their children’s vision. Seeing the concern or sheer disappointment on a parent’s face when I tell them their child needs glasses still moves me, even after twenty years in practice.

Parents often ask: “Why so young? Do they have to wear glasses all the time? Is this inherited? Is it going to get worse? What can be done?” My explanation and subsequent recommendations take time, time we often don’t have while in the examination room, yet parents deserve.

So now I actually give my patients a copy of our book and highlight specific sections I want them to read. Then, after they develop a good background and learn the answers to many of their questions, we discuss how to help their son or daughter. It’s worked amazingly well. I’m very proud after parents tell me how much the book has helped them understand vision and given them an arsenal of recommendations.<

As a parent myself I appreciate the frustration of being told my child requires some type of treatment without fully understanding my options. The book was written to empower parents when it comes to their children’s eyesight.


How long did it take for beginning to end?

Two years!

As an early adopter of corneal reshaping, did you initially suspect that myopia control was going to be as successful as it has recently been shown to be?

No. In 1992 when it was first introduced into our office it was just viewed as a substitute for daytime contact lenses or glasses. That’s it. We reserved recommending corneal reshaping for patients who could not wear contacts during the day or required freedom from contact lenses or eyeglasses during their waking hours. So we had a lot of athletes, teachers and executives wearing the lens, but it was a select few.

However, clinically we observed that teenage athletes wearing the lenses did not need changes to their prescription every year like many of our eyeglass or contact lens wearing patients. In 1998 when my own two sons began wearing eyeglasses, that’s when the light turned out. You see, even though I prescribe eyeglasses daily, when my young children needed eyeglasses, I was upset, even distraught. Seeing the success they’ve had with corneal reshaping inspired me to become an “early adopter” or advocate of this technology.

If corneal reshaping is such a positive and exciting technology, one that may help thousands of young children from having their eyesight worsen, why don’t all doctors provide this service?

That’s a great question, one I get asked daily! Most eye doctors are not familiar with corneal reshaping even though Paragon Vision Sciences, the maker of the CRT design, received FDA approval over 9 years ago! Some doctors may base their opinion on outdated information or personal experience.

As a “seasoned” health provider I understand how long new procedures take to enter mainstream medical offices. But that does not make it fair or right. For example, it took over 30 years for data to arise that a child’s eye coordination skills may affect their ability to read and consequently learn. Even though I understood this in my early training days it took decades to become “accepted.” And even today some practitioners are not on board. Corneal reshaping faces the same challenge. In addition to understanding the technology, doctors need to enjoy seeing patients more often than their contact lens and eyeglass wearing patients. This is often not the case.

Lastly, there is a higher level of technology and training required to perform corneal reshaping properly. Doctors may not be interested enough to upgrade their offices to provide this service.

I personally overcame these apprehensions when I saw how well corneal reshaping helped my own sons. Now, literally 10 years after they started wearing these lenses, their eyesight has not gotten worse. Nothing more needs to be said.


What is your next project?

I’m writing a personal development book extolling the life lessons I’ve acquired as a husband, parent, doctor and philanthropist.


Thanks, Dr. Despotidis, for taking the time. I wish yoy, your family, and your patients the best.


You can read more about Dr. Despotidis and orthokeratology at: http://www.gentlevisionshaping.com/. If you have questions about whether or not corneal reshaping is right for your or child, feel free to contact Bright Eyes at the contact info below or call 813-792-0637.

Be Well!

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Dr Nate Google PlusBright Eyes Tampa on Google PlacesBright Eyes Tampa on FacebookBright Eyes Tampa on TwitterBright Eyes Tampa on YelpBright Eyes Tampa on foursquareWestchase Patch

Ortho-K: Possible Method of Slowing the Progression of Myopia in Children (SMART Trial)

Ahah! I was scooped on this story by one of my favorite bloggers, Ann Z. from LittleFourEyes. I was going to write a post about this exciting news today, but since she already has. Check it out here.

I Will leave you with a quote from yesterday’s press release:

According to Dr. S. Barry Eiden the trial will also investigate why these special lenses may be effective in slowing myopia.

“Current thinking suggests that these CRT lenses flatten the cornea but other evidence suggests that these lenses may influence the growth in eyeball length (termed axial length). A major contributor to progressive nearsightedness is axial length elongation. Corneal reshaping may actually result in decreased axial length growth. The exact mechanism by which this happens is still being investigated” said Dr. Eiden.

“The results of the SMART Study so far are very exciting,” said Dr. Davis. “The outcomes of this study may revolutionize how we manage young nearsighted patients from this point forward”.

You can go to the SMART study facebook page to find more information.You can also watch a news report on the study here.

It should also be noted that the SMART study is building on additional recent studies that have also found that Orthokeratology has been successful in slowly the progression of myopia.

To find orthokeratology doctors in Tampa and elsewhere: go to the Orthokeratology Academy of America. If you are curious, feel free to call or come in for our no-cost consultation to determine if you are candidate.

Be Well.

Dr. Nate

Nathan Bonilla-Warford, OD
Bright Eyes Family Vision Care
Located in the Westchase area of Tampa.

Dr Nate Google PlusBright Eyes Tampa on Google PlacesBright Eyes Tampa on FacebookBright Eyes Tampa on TwitterBright Eyes Tampa on YelpBright Eyes Tampa on foursquareWestchase Patch

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