Infant, Toddler & Preschool Vision Testing

Everyone knows the earlier a problem can be identified the more successful will be the outcome.  That is why dental and medical exams are required before going to school.  Despite this understanding, the visual system is often forgotten.  It is the most important system for learning (most researchers indicate 75-80% of learning occurs via the visual system), yet most children do not have a formal visual examination until they are school age.  Due to this lack of care, children often adapt to the level of vision they have.  Parents often never suspect a problem, even a serious one.

Obvious problems such as strabismus (crossed or wall eye) are usually identified by your pediatrician.   However there are too many cases of lazy eye that are NOT detected by pediatrcian screenings.  Many of these problems also are not identified with school screenings.  This results in parents feeling secure that all is fine from a visual perspective.  NOT TRUE!!  The reality is approximately one child in every classroom suffers from lazy eye and associated learning difficulties such a problems with reading comprehension.

InfantSEE® can be the answer for a number of these kids.  This is a national program administered by the American Optometric Association.  It was originally started in partnership with Jimmy Carter.  A one-time, comprehensive eye assessment is provided to infants in their first year of life at no cost regardless of income.  Click on InfantSEE® for further information.  Call us to schedule an exam for your baby.

--James B. Mayer, OD, FCOVD

     Agape Learning & Optometry Center

     Thousand Oaks, CA 

Dry, Scratchy Eyes

We have all felt the occasional dry eye - a gritty and/or sandy feeling.  A burning or sticky feeling is common, as are watery eyes.  Some folks experience these symptoms on a daily basis.  This can be a big problem for them.  It can also result in vision changes that can be devastating because of corneal inflammation and infection.  That is why it is very important to let me know if you experience any of these symptoms on a regular basis.

Dr. John Warren has put together a very nice slide show on this topic.  Click on the link to watch and learn about dry eye.

--James B. Mayer, OD, FCOVD
     Agape Learning & Optometry Center
     Thousand Oaks, CA

How Close Do You Hold Your Smart Phone?

The explosion of smart phone sales are resulting in many visual complaints.  Reading texts and Internet pages with the phone is often done at much closer distances than reading a book.  The implication is more eye strain, fatigue and headache if this activity is done for longer periods of time.

A recent study published in the American Academy of Optometry indicated lens prescriptions will need to be altered for these problems.  Problems can result because of close reading distances and font sizes associated with the smart phone.

Study Findings
The average font size with a smart phone was comparable to that of newspaper print with text messages.  However Internet page fonts were smaller.  The average reading distance (working distance) with text messages was 36 centimeters and 32 centimeters with Internet page viewing.  This compares to an average of 40 centimeters with book reading.  The difference can result in eyestrain and headaches, especially for those over age 40.

Implications
It is important to let me know if you are having eye strain or headache with smart phone viewing.  If so, I can prescribe lenses which optimize your sight at the distance commonly viewed.  This prescription can be a big help for these types of problems.

--James B. Mayer, O.D., F.C.O.V.D.
     Agape Learning & Optometry Center
     Thousand Oaks, CA

Great activity for Sports Vision Therapy

There are a number of important visual skills for success in basketball.  I have reviewed many of them in past blogs.  As I was surfing the web today I came across this article which describes a wonderful activity for the development of:

1. Peripheral vision awareness
2. Eye hand coordination
3. Visual timing
4. Visual tracking

Check out this link to read about the description of this activity.

--James B. Mayer, OD, FCOVD
    Agape Learning & Optometry Center
    Thousand Oaks, CA

Evaporative Dry Eye & LipiFlow

Scratchy, burning, sandy, gritty are ways that many describe dry eye.  Vision can also be variable from this problem.  Approximately 65% of these problems are do to the tears evaporating from the eye too quickly.  The problem for these folks has to do with the meibomian gland production of oil for the tears.  The glands become plugged and the oil concentration in the eye reduces.  Tears evaporate quickly and this process causes many difficulties as noted above.

The current treatment for this problem involves artificial tears containing oil and lid massage with warm compress.  Generally this can work reasonably well but the treatment can be cumbersome.

Enter a new procedure just approved by the F.D.A. but not in eyecare offices yet. 
Lipiflow warms and massages the eyelids, melts the obstructive material clogging the glands and clears the blockage without damage to glands or other delicate structures of the eye.  It’s a 12-minute per eye procedure performed in a doctor’s office.  Opening the blocked eyelid glands allows the body to resume the natural production of lipids (oils) needed for the tear film.


For the first time, the LipiFlow’s single-use eyepiece allows controlled application of warmth and massage to the eyelids, treating the affected meibomian glands in the upper and lower lids simultaneously. The device is designed to facilitate removal of the meibomian gland blockage without damage to glands or negative impact to delicate structures of the eye.

Diabetes & Eyes

As you know the incidence of diabetes is growing out of control.  One in three children born today will face it in their lifetime if current trends continue.  One in four people who currently have it don't know about it yet. 

You may not know how diabetes can rip apart your vision in many different ways.  It is the #1 cause of blindness in adults.  You also may not know that as a California licensed optometrist I am responsible for diagnosing the health of your eyes.  This means, as it relates to diabetes, that I am responsible for recognizing and diagnosing the effects of this disease on your visual system.

Most have heard of "sugar cataracts."  These are a complication of diabetes.  The crystaline lens within the eye becomes hazy and results in blurred vision.  I work with the best cataract surgeons to remove these opacities.

Diabetic retinopathy is another potential complication.  This results in bleeding witthin the eye(s).  Left alone it will cause loss of sight.  Fortunately by teaming with retinal surgeons this complication can be reduced and/or eliminated with early detection.

Inflammation of the cornea, ocular muscles and optic nerve are additional signs of diabetes.  Early treatment can minimize these problems.

Another diabetes complication is glaucoma.  Blood leakage can occur within the eye forcing up eye pressure.  This can also result in loss of vision.

Bottom line - keep your blood sugars in the normal range (symptoms CAN be excessive thirst and urination).  However studies indicate that blood sugar is difficult to sense.  Have yearly physicals with bloodwork (diabetes is often combined with high cholesterol and high blood pressure).  Be sure to have your eyes checked yearly - dilation of the pupils is important to detect subtle problems combined with photography of the tissues.

--James B. Mayer, O.D., F.C.O.V.D.
     Thousand Oaks, CA

Back To School Eye Exams

SOME STATS . . . .
Can you believe that 50% of all kids in the U.S. have never received a comprehensive vision exam???  Many have vision problems that have never been addressed.  Some have eye health issues.  Others have visual skill deficits such a tracking or convergence difficulties.  This is especially troubling because 80% of what kids learn come through their eyes.  Problems can impact school performance.  In fact, 25% of kids have a problem which interferes with their learning.

VISION PROBLEMS & BEHAVIOR . . . . .
Did you know that many kids diagnosed with ADHD or ADD actually have vision problems?  Attention and concentration can improve tremendously with a eye exam!!  CAVEAT - I always do tests for tracking and convergence - others don't.  Vision screenings at school and the pediatrician are especially poor.  I have parents tell me routinely their child passed the school screening despite having problems with tracking and/or convergence.

FREQUENCY . . . . . .
Eyes are as important as teeth, especially with academics!!  Be sure to have yearly eye exams.  They provide peace of mind in our hectic society.

--James B. Mayer, OD, FCOVD
     Agape Learning & Optometry Center

Tips For Choosing Kids Glasses

TIPS FOR MOM & DAD!!

Do your kids need help picking out a new pair of glasses?
Do you need help in helping them?
You're in luck. This crash course in kids' eyewear is just for you.

Shape of Eyeglass Frame
As you probably already know, even kids like to look their best. Shapes that create a "balanced" oval face can help them do just that. You'll want to avoid frames that mimic the shape of your child's face--so, no square frames for square faces, round frames for round faces, etc.

What if you're not sure of the shape?
Ask!!--we're pros at this sort of thing.  But if you want to figure it out on your own, try to picture a dot on either side of your child's brow, cheek, and jaw.  Then, visually connect the dots.  For a really sure fire method, physically draw the same dots on a photograph.  Or, have your child stand in front of the bathroom mirror as you trace his or her outline in soap (this way is the most fun!).

As a general rule of thumb, kids age 2-5 look best in round and oval frames.

Looking to downplay:

Close-set eyes?
Choose frames with a simple bridge color and dramatic temple (side-arm) color.

A long nose?
Select a low-set bridge.

A short nose?
Select a high-set bridge. The top of the frame should follow the brow, without blocking facial expressions.

The frame's width should always match the width of your child's head.

Too many colors to choose from? Use this as a guide:



Here's some eyewear extras that take frames from good to great:

Strap Bridges
If your little one has high cheekbones and a wider, flatter nose, a strap bridge will reduce pressure on the sinus, septum, and developing bones by distributing the frame's weight evenly over a wide area.

Cable Temples
Cable temples are perfect for smaller or younger children (particularly up to 3 years old) because they are soft on the ears and hard to pull off.
Cable temples are also great for active older children who need to keep their glasses from sliding off during sports or play, or for kids who spend alot of time working on the computer.

Spring Hinges
Spring hinges let frames expand as kids grow-getting rid of unwanted pressure that can cause headaches. They resist bending when glasses are taken off with only one hand (something even grown-ups do), so they're more durable too. The payoff? Fewer visits for adjustments.

Gooseneck Nose-Pad Arms
Gooseneck nose-pad arms are easier to adjust than regular nose-pad arms, making it easier to fit the frame to the nose without chafing. They're particularly important for setting the position of bifocal lenses and for fitting very young kids.

PVC Nose Pads
Unlike silicone used on adult frames, PVC nose pads are hypoallergenic and won't cause irritation.

Sun Clip-Ons
Children's eyes need extra protection from the sun's ultraviolet rays. Clips do the job for less than a separate pair of prescription sunglasses.

Storage Cases
Good children's eyewear always comes with a storage case. "If it's not on your face, it's in the case." Remember this rhyme and frames will stay like new.

In the end, it's all about what your child likes. Kids get the final say.

Thanks to Marchon.com for help with this.

James B. Mayer, O.D., F.C.O.V.D.

Agape Learning & Optometry Center