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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

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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.

Conclusion

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 brighteyestampa.com 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 Lego.com 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

 

 

Why a New Pair of Glasses Is NOT the Best Holiday Gift for Your Child

girl hugging her present 3154363If your child is nearsighted (myopic), it may seem like a great idea to get him or her a new pair of glasses. They will surely improve how well your child sees but, unfortunately, will do nothing to slow myopia progression. You can offer your child MUCH more than a pair of specs — something that will ensure long term vision health care and quality of life: Myopia Management.

Myopia Management is made up of several treatments designed to slow down how quickly myopia, or shortsightedness, progresses. In other words, their prescription will remain the same as they grow older. The treatments include uniquely designed multifocal contact lenses, atropine eye drops, and orthokeratology (“ortho-k”). Evidence suggests that myopia management can reduce the progression of myopia by up to 60% after two years of treatment.

What Makes Myopia Management An Excellent Gift?

Currently, myopia is among the leading causes of permanent vision loss and legal blindness.

As a child quickly develops and their nearsighted vision worsens, the child is at a higher risk of developing dangerous eye diseases later in life, such as retinal detachment, macular degeneration, glaucoma, and cataracts.

To thwart any of these sight-robbing conditions, Bright Eyes Family Vision Care's Myopia Control Center offers evidence-based treatment to prevent the onset or reduce the progression of myopia in our pediatric patients.

Myopia management enables your child to experience a more mild form of myopia than he or she would have otherwise had without treatment. Having mild-degree myopia means that your child’s likelihood of developing retinal detachment or macular degeneration is dramatically reduced.

So why don’t you make this holiday gift a particularly special one by protecting your child’s precious gift of sight. And the best part? It will pay off well after the holidays are over.

On behalf of Dr. Knighton and Dr. Bonilla-Warford and the staff at Bright Eyes Family Vision Care's Myopia Control Center in Tampa, we’d like to wish you all the best for the holiday season and the New Year!

How to Keep Glasses from Getting Foggy

Whether you live in a cold climate or have visited one in the winter, you have probably seen someone who just walked in from the cold outdoors sporting glasses that are no longer transparent, or perhaps you’ve experienced it yourself.

Why Do Glasses Fog Up?

There are several factors that cause your glasses to fog up — one of which is ambient heat, in other words, the actual temperature in your surrounding environment. Eyelashes that touch the lens can cause fogging, as well as tight-fitting frames that touch the cheeks (many plastic frames cause this problem), which impede proper airflow. Lastly, high humidity and the sweat and moisture that accompany overexertion/ exercise can also trigger foggy lenses.

Ultimately, glasses cloud over due to moisture in the air condensing on the cold surface of your lenses.

Now that you know the most common reasons why your glasses fog up, it’s time to read about some possible solutions. Below are a few tips to help keep your lenses clear year-round.

6 Tips to Steer Clear of Cloudy Specs

1. Invest in Anti-Fog Coating

Anti-fog coating blocks out moisture that would normally stick to your lenses, by creating a surface layer that repels water and mist. An optician applies the treatment to both sides of the lens in order to prevent fogging so you can see clearly in any climate or environment.

Ask us about our proven anti-fog treatment for your glasses and be on your way to clearer vision, all the time.

2. Use Anti-Fog Wipes, Sprays, or Creams

Commercial anti-fog products are an alternative to lens coatings. These products, typically sold in either gel or spray form, are specially designed to prevent condensation and moisture from building up on your lenses. Apply the product as directed on the packaging and remove it with the supplied cloth, wipe or towelette. If a cloth wasn’t included in the box, use a scratch-free cloth.

Aside from the gel or spray, you can use anti-fog wipes. These pre-treated napkins are perfect for those who are on the go.

3. Move Your Glasses Further Away from Your Face

Eyeglasses tend to trap moisture and heat, particularly if they are positioned close to your eyes or face, which increases the buildup of fog on your lenses. Consider adjusting the position of your eyewear by pushing your glasses slightly further down your nose. It will stimulate proper air circulation, thereby reducing fog accumulation.

4. Wear Your Seasonal Accessories Wisely

If the weather cools down, try not to wear too many layers, to prevent overheating and producing sweat, which can make your glasses to fog up more. Wear only the necessary amount of clothing to stay warm. If you’re wearing a scarf, consider one with an open weave or a more breathable material to let the air pass through.

5. Avoid Abrupt Temperature Changes

Allow your eyewear to acclimate to changes in temperature. If you are moving from an environment that is cold into one which is warm and humid, try to let your glasses adjust accordingly.

For instance:

  • As you enter a building, stand in the doorway for a minute or two as the temperature slowly transitions from cool to warm.
  • When in the car, gradually adjust the heat, particularly when your hands aren’t free to simply remove your glasses and wipe off the fog.

Fogged up glasses are not only irritating but can also be dangerous, especially for those who drive, ski, or operate machinery. So make sure to take the necessary precautions, especially as the weather changes.

6. Swap Glasses for Contact Lenses

If contacts are an option for you, you might want to wear them on those cold days, to avoid foggy glasses syndrome (yeah, that’s a made-up term).

 

Want to keep your glasses from fogging up? Speak with Dr. Knighton. At Bright Eyes Family Vision Care in Tampa, we can advise you about a variety of contact lenses, anti-fog treatment and other solutions to help you see clearly— any day.

Bright Eyes Now Able to Make Glasses on Location!

3framesTypically when patients order glasses at an independent office such as ours they select they work with an optician to select a frame style that they likes and the lens design that they need. Then the frame is sent to a large optical laboratory where the lenses are edged down and put in the frame. The the complete pair of glasses is sent back to the office to be dispensed to the patient.

We have always wanted to have the ability to make the glasses at the office. Now that we have completed our large expansion, we are pleased to announce that we made this goal a reality. We have a large optical room in the new office with the equipment to complete the manufacture of glasses right at the in the office.

This has a number of advantages for the patients. For one, it allows a wide range of lenses options. But most importantly it allows patients to get their glasses sooner, sometimes in a just a day or two.

Keep in mind that if patients have specialty lenses, such as digital progressives, or Shaw Lenses, those will still need to be sent out to the optical laboratory. But many of the adult and child glasses can now completed on site.

If you are interested in the process of making glasses, here is a video that explains how it is done. It was not made at our office, but we would like to do one some day!

 

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EnChroma gives a more colorful view of the Valspar PGA Tournament

This week, Bright Eyes was excited to partner with the Valspar PGA Tournament and EnChroma color blind glasses to help a young golf fan!

Bright Eyes optometrist Dr. Beth Knighton had the pleasure of assisting 2018 and 2019 Valspar Championship winner Paul Casey surprise her patient Ronan with a new pair of EnChroma glasses for color blindness.

Here is a photo of Dr. Beth, Ronan, and Paul Casey:

Ronan 1

Ronan and his family were so excited to visit different behind-the-scenes tour stops, get autographs from players like Patrick Reed and Sergio Garcia, and the surprise of a lifetime – to play the 18th hole with 2018 Valspar Champion, Paul Casey.

At the end of the hole, Paul pulled the EnChroma glasses to gift to Ronan, along with a complimentary eye exam from Bright Eyes Tampa presented by Dr. Beth. Then the tournament director presented five gallons of Valspar paint to transform Ronan’s room into his “new” favorite color.

Ronan had an immediate, happy reaction to the EnChroma glasses. Some memorable quotes from Ronan after putting on the glasses… “Everything just pops!”… “All of the colors are so much brighter, wow!”… “Mom, can I get a coloring book now?”

Here is an article and video by the PGA about Ronan’s time with Paul Casey and getting the EnChroma glasses.

EnChroma glasses can help 4 out of 5 Red-Green colorblind patients enhance color discrimination. Bright Eyes in Westchase carries several styles of EnChroma, including sunglasses and indoor tint glasses. Patients can try on the glasses for themselves before buying. It is so exciting to help patients see a more “colorful world”! If you would like to try the EnChroma glasses for yourself, call for an appointment with one of our experienced Optical Staff, and we will be happy to answer any questions.

Bright Eyes was very happy to help make this a special experience for Ronan and his family. Dr. Beth had a wonderful time at the Valspar PGA tournament! If you have any questions about EnChroma glasses for colorblindness or sports vision, please call us at 813-792-0637.

-Dr. Nate

Podcast Episode #13: Peter Shaw OD and Shaw Lenses

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 Peter Shaw OD and Shaw Lenses

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

Full Transcript:

Intro: 00:10 Welcome to the Bright Eyes Podcast, advice for healthy vision for all ages. Your hosts are Dr. Nathan Bonilla-Warford and Dr Beth Knighton, residency trained optometrist providing eye care to all ages with exams or glasses and contacts and specialty services including vision therapy, Myopia control, orthokeratology and sports vision training. Their mission is to empower patients by providing the best in friendly, professional and individualized eye care

Dr. Nate: 00:39 On location in Bellevue, Washington. This is Dr Nate Bonilla-Warford at the 2018 College of Optometrists and Vision Development meeting and it is the Bright Eyes podcast. I have a special guest Dr. Peter Shaw with me today. Hi Peter.

Dr. Peter Shaw: 00:58 Hi Nate. Thanks for inviting me to talk to you on this podcast. It’s a great opportunity to talk about lenses.

Dr. Nate: 01:05 Excellent. Yes. I am excited about this because, uh, there’s a, a useful tool that we have in our office called the Shaw Lens and I think that has some relation to you. Why don’t you tell us a little bit about your background first and then we can talk about the Shaw Lenses.

Dr. Peter Shaw: 01:21 So I started life as an optometrist with, with a, with a degree also in physics and computer science and practice for 35 years. But during that time I came across a lot of problems created by glasses that are unique to the fact that the glasses sit away from the eyes and not on the eye. And Shaw lenses is a comprehensive way of designing eyeglass lenses that eliminates the image difference. In other words, the size and image position that’s common with many pairs of glasses made. So what we do is we actually designed lenses based upon exactly where the lenses fit on the face, taking into account both the prescription and the underlying magnification that glasses create. So this fixes is something called Aniseikonia, and Aniseikonia is the optometric word that describes the image difference and the end results in the inability to put images together in the brain.

Dr. Nate: 02:25 So one thing that I really like about the Shaw lenses is, is I’m what I consider myself to be a binocular vision specialist, which means I take measurements and I measure how both eyes work together as a team. And one of the things that is unique about the Shaw lenses is they are not just individual lenses, one for each eye, but they also take into account the way the eyes work together as a team. Do you want to talk about that a little bit?

Dr. Peter Shaw: 02:55 Absolutely. So the way that lenses on ordinary glasses are designed is they make a lens for the left eye. and make lens for the right eye and within the system that the bar too is that manufacturers use. There’s no way that those two features are never correlated. In other words, they don’t take into account the effects that individual lenses have upon the eyes. What we do is we look at the prescription and the way the glasses fit and design a system. That eliminates the obstacles that normal glasses create. These two obstacles come about because of a natural aberration of glasses. They make things look bigger and sometimes smaller. And when the prescription is slightly different, frequently the image size difference and the effect the glasses have upon we call. Gaze direction interfere with the ability of the brain to keep the images together. We call that fusion, so regular glasses often cause a breakdown of images being together and staying together as the eyes look around and Shaw lens design. It’s called iseikonic or sometimes isophoric lenses can be designed to eliminate that image difference and provide comfort and function that regular glasses can’t attend to.

Dr. Nate: 04:22 So what type of patient can benefit from these types of lenses?

Dr. Peter Shaw: 04:30 Well, every patient benefits from having isochronic lenses. Not all patients require the added technology, but it never hurts. Where we do really well are patients that have come across a different eye prescription, due to surgery, like cataract surgery, patients who were born with their eyes a different and just happen to start wearing glasses. Patients that are new to progressive lenses or bifocals, when we hit 40, we have to start wearing glasses full time. We are especially helpful for kids with lazy eye, I would call an Amblyopia. Amblyopia comes about, we think as an active inhibition of one eye because the image is created in an amblyopic child, a different in each eye and they fight for attention. So the kid ignores the one image. What Shaw lens does, it equalizes the images and so the eyes can blend the two images together and they don’t have to fight for attention

Dr. Nate: 05:32 and we’ve seen incredible benefits for a certain patients, especially the younger children who, who might have Amblyopia and as part of our vision therapy program, or even if they’re not enrolled in the vision therapy program. The benefits that we’ve seen, uh, from use of the Shaw lenses has been a really remarkable. It'[s really, really exciting. Tell us what kind of research has been done using the Shaw lenses?

Dr. Peter Shaw: 06:06 well, research has been done both in published papers on isochronic therapy and also on a few cases that we have with our, with our partner universities were currently doing a research project of a double blind study, but our research is a little simpler than that. We’ve been selling and providing optometrists with Shaw Lens now for six years and our market share in treating Amblyopia has dramatically increased from when we started. And I put that down to the fact that doctors see the difference and that’s the best research we can have. It’s unbiased. No one gets paid to use our lenses, there’s no subsidy. It’s, it’s organic, and if the product wasn’t working, it wouldn’t be happening. What we do know is that an Aniseikonia has been known about since the 1850’s, and it’s been talked about routinely, but making what we call iseikonic lenses for some reason hasn’t been done until recently because it’s been an arduous mathematical chore for Optometrists to Design Lenses so it doesn’t get done.

Dr. Peter Shaw: 07:21 What I’ve managed to do is to simplify the process of ordering iseikonic lenses and what a isochronic lens is simply a lens that equalizes the images. Now we can make assumptions about patients, but the bar choice that make glasses are just fulfillment houses. They don’t really design lenses no matter what the marketing says. What they do is they put a prescription lens in a frame that gives clear vision, but no one talks about the interaction between the two eyes. What I’d like to say, what I will say is that the difference in the eye measurement units we call diopters doesn’t have to be very big to disrupt how eyes work together and especially with kids with Amblyopia bear the issues. These kids are really good at shutting off one eye, so any excuse they have to shut one eye down and only use that one become monocular, so to speak is triggered by small differences.

Dr. Peter Shaw: 08:24 So we don’t have to have a very big difference between the two lenses to make a huge impact on how that patient sees.One example is, you know for some reason, traditional eyecare tends to minimize approaches to therapies that they don’t understand. So there is some rule sometimes where what should be three diopters or more to consider iseikonic lenses personally i disagree with that. I think there is no difference small enough, if the optometrist can measure a loss of depth perception or loss of acuity. If the patient’s not functioning well, there’s something wrong. And I think we should use any treatment available to us to try to remedy that situation. And fulfill our role as as doctors to treat the deficit, not pass it off as something that kids should get used to.

Dr. Nate: 09:27 So if you’re a parent or a patient looking, considering Shaw lens is, are there any downsides or other things that that they should know?

Dr. Peter Shaw: 09:41 The only downside is yes, they cost a little bit more and the reason for that is that our lenses are all custom designed like a custom made suit for the for the child. They don’t come out of an envelope already made and that comes apart because cost of production, the lenses are always made in the country where that dispense. So for example, for the US market Shaw lenses as a manufacturing in a US facility, another downside is sometimes one might be a bit thicker, which is similar with any prescription that’s therapeutic. We use prism sometimes that makes the lens thicker, so thicker lenses maybe not as cosmetically attractive, but that hasn’t been an issue because what we’re looking for with our design is a medical therapy for Amblyopia ends to business. I’m making kids more comfortable with their glasses on and I think those are the only two downsides that, I come across. The upside is that it provides a great foundation for better vision and increased efficacy from vision therapy. So what we provide is a good foundation for your vision therapy I doctor to help your child gain better, more efficient vision using both eyes and increase their reading ability.

Dr. Nate: 11:02 Well, I definitely use the Shaw lenses when I think that they, the patients would benefit and I’ve seen a lot of success. Before we wrap up here, is there anything else that you’d like to tell our patients?

Dr. Peter Shaw: 11:16 The most important thing I think to remember is that we’re not a radical treatment. We are, we are irrational treatment. And the vision that you get with the Shaw lens is never worse than you’d get from an ordinary pair of glasses. It can only improve things. We don’t use patching. We don’t use anything that’s not scientifically valid. Our advisory board is made up of ophthalmologists, optometrists and researchers. We don’t have any smoke and mirrors.

Dr. Nate: 11:54 Well, this has been a great meeting here in Washington state. I thank you Peter for giving us your, your time and I hope you have a wonderful meeting as well for all patients who are listening. If you have any questions or comments, you can always reach us at office at BrightEyesTampa.com and we look forward to bringing you the next episode. Thanks Dr Shaw.

Dr. Peter Shaw: 12:15 Thanks, Nate.

Outro : 12:17 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 country.

 

 

 

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

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 office@BrightEyesTampa.com.


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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Simulation

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 office@brighteyestampa.com. 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 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 country.

 

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

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