Night driving and your Vision

Dark winter months make night driving a challenge. It is a physiological fact that our vision is best in daylight- so our eyes need all the help we can give them while driving at night. Furthermore our eyes require a full 5 minutes to adapt to the dark. While driving at night, light conditions are variable and can change rapidly. This ability to adapt to differing light levels will slow as we get older and some eye conditions impede this process.

How to maximise your night driving experience;

Get your eyes tested- regular eye exams ensure your vision is at its best. Even small focussing errors can have great effect on night vision- so even if you meet the minimum vision requirement to drive without glasses, you may still experience difficulty with night driving. Conditions such as cataract can increase glare sensitivity while driving at night, but also decrease your contrast of vision.

Check your glasses- Visit Eyes of Howick for a free glasses WOF including fit adjustment and ultrasonic cleaning. We can inspect the lenses for any lens defects which may impact  your vision. Clean your lenses daily with cool to luke-warm water and a soft, clean cloth to keep them smudge free. Or better yet, use recommended products such as our lens spray cleaner, wipes of peeps- the carbon lens cleaner. See our online store for our lens cleaning options.

Choose the right lens-Ensure your lenses have an antireflective coating- this improves light transmissibility through the lens and reduces disabling glare while night driving. Crizal Sapphire HR lenses are the most transparent anti-reflective lenses. Furthermore, Crizal Prevencia blue blocking lenses are reported to reduce glare discomfort for night drivers.

Clean your windscreen- on the inside and out! That greasy film can be a real distraction, particularly with oncoming headlights and sun strike through the day. Replace your wiper blades as required and keep the washer bottle topped up.

Clean your headlights- any dirt will reduce their effectiveness at night. Also check for yellowing of any polycarbonate headlamp covers- this can be cleaned off with the appropriate product.

Use your headlights effectively – from 30 minutes before sundown and 30 minutes after sunrise. Don't be hesitant to use high beam while travelling at night except for when approaching and following other vehicles and this can cause disabling glare for other drivers.

Avoid the glare -If you find glare of oncoming traffic a problem- avert your eyes to the left side of the road to avoid this direct glare source while at the same time remain aware of oncoming vehicles. Also don't travel at night with the internal vehicle light on as this will cause extra visual fatigue.

Slow down-Drive at a speed so you can see the road at least 2 seconds ahead.

Remember if you have any queries about your vision difficulties or your eyewear, we are always happy to help at Eyes of Howick. Here's to happy and safe driving!

An Eye on Melanoma

What is melanoma?

Melanoma occurs when Melanocytes- the pigment-producing cells that give colour to the skin become cancerous. Melanomas can occur anywhere on the body, with the eye being the second most common site after the skin.

Signs may include a new, unusual growth or a change in an existing mole or naevus. Treatment may involve surgery, radiation, medication or in some cases, chemotherapy.

Ocular melanoma

As an optometrist, I frequently note pigmented spots and lesions in eyes of my patient’s. These can range from benign iris freckles (small pigmented spots on the surface of the coloured part of the eye), through to large choroidal naevi (large moles situated beneath the retina at the back of the eye).

Posterior uveal melanoma- choroid and ciliary body

Being the most common site for ocular melanoma and occuring inside the eye, they are only detected during an eye examination. Symptoms may include blurred vision or blind spots, new floaters or flashes- however, these usually occur when the melanoma is well advanced.

Conjunctival melanoma

The conjunctiva is the delicate, vascularised tissue that overlays the sclera (white of the eye). Accounting for 10 percent of eye melanomas, treatment outcomes are favourable. However, recurrence is high so regular reviews are important.

Iris melanoma

Generally found during routine eye examinations and often occurring from pre-existing iris naevi- New Zealand has the highest known incidence in the world. If caught early, treatment options are favourable.

Risk factors

·        Fair skin- although 4% of Uveal Melanoma in an Auckland Clinic occurred in Maori patients

·        Light coloured eyes

·        Having a pre-existing mole within the eye

·        Ultraviolet light exposure

·        Older age

Recommendations

Wear sunglasses, ensuring they provide 100 percent UV protection. A hat is also beneficial to further shield ambient light exposure around the eye.

My strongest recommendation would be to those who have never had an eye examination to book one! This enables the Optometrist to screen you for any risk factors of eye cancers and advise a time frame for any further reviews. As mentioned, as many of these lesions are not visible to the naked eye, it is only during a routine eye exam that they may be detected.  

Tips and Tricks for Contact Lens Wearers

Whether it’s your first-time wearing contact lenses or you are a seasoned wearer but you are still trying to find the best techniques, here are some insertion, removal tips and the dos and don’ts of contact lens wear. 

Insertion tips

• Insert the same lens first – this is to avoid confusion and inserting a lens into the wrong eye!.

• Ensure the lens is moist from the contact lens solution – a dehydrated contact lens will not adhere to the eye, will be uncomfortable and may compromise your vision.

• Check the lens is not inside out – look at the side profile of the lens as it balances on the tip of your finger. If it is the correct way the lens will appear spherical as opposed to having a fluted edge like a pudding bowl. Alternatively, gently squeeze the lens between your thumb and forefinger. If it touches, the lens is the correct way. This is known as the ‘taco test’

• Place the contact lens on the tip of your index finger and with with the middle finger of the same hand pull down your lower lid

• Use your free hand to pull the top eye lid up right at the edge of the lid near the lashes – this will help to stop the blink reflex

• Keep looking straight ahead while bringing the lens towards the eye – this helps to centre the lens on the cornea

• Once the lens is on the eye, gently move your eyes around and close them – this helps to displace any air bubbles and makes ensures the lens is centered

Removal tips

If you feel your contact lens is a bit dry apply a lubricating eye drop to the eye – this will help the lens slide of the eye

Pull down your lower eyelid with your middle finger and look either up or to the side

·Using the index finger of the same hand slide the lens to the white part of the eye ( the sclera)

Using your thumb and index finger carefully pinch the lens and remove it from the eye – the contact has remained on your eye for the whole day so don’t be afraid to apply a bit of pressure  

Dos

• Trim your nails- particularly on your thumb and index finger- this reduces the risk of scratching your eye!

• Always wash your hands with soap and water and dry with a lint-free towel or tissue before handling your lenses

• Discontinue contact lens wear if you experience persistent discomfort, redness or blurred vision – contact your optometrist for advice

• Insert and remove your contact lenses before applying or removing your make up

• Clean your lenses thoroughly – follow the instructions given by your optometrist. If you are wearing daily disposable contact lenses, there is no cleaning routine required.

• Clean your contact lens case – this is just as important as cleaning your contact lenses. In fact a dirty lens case is the most common source of eye infections.

• Use contact lens solution to rub and rinse it. Or once per week wash with hot soapy water and allow it to air dry. It is recommended to replace your case every 3 months- a bit like your tooth brush!

• Always purchase your lenses from an eye care professional to ensure your lenses are legitimate and have not been involved in any industry safety recalls. Evidence shows a higher incidence of contact lens related complications in people who simply buy their lenses of the internet.

• Return to your optometrist on an annual basis to ensure your eyes remain healthy and your lenses are still the best option for you and your lifestyle.

Don’ts

• Use tap water to store, clean or rinse your contact lenses – water can have a variety of microorganisms that can cause serious infection to the eye.

• Take care around water based activities such as showering, swimming in pools, hot tubs or saunas. When swimming keep your eyes closed or wear goggles. Daily replacement contact lenses are the safest for water sports.

• ·Wear your lenses sleeping – unless advised by your optometrist. It has been shown to increase the risk of an eye infection by up to 8 times.

• Use the lens if the pack is open or damaged or if the lens itself is damaged

• Use expired lenses or solutions

 No matter what type of contact lens you wear, remember that contact lens care and safety are crucial to maintaining good eye health and an enjoyable contact lens wearing experience.

Complementary therapy for glaucoma patients

When I last attended the International Glaucoma Symposium, one of the presentations which resonated with me was by Professor and Ophthalmologist, Tanuj Dada from the All India Institute of Medical Sciences.

Through his pioneering research on meditation and its impact on glaucoma patients he offers an alternative but complementary therapy for those already on conventional treatment for their eye disease.

His talk offered compelling reasons for all of us to adopt the practice of meditation, yogic or deep nasal breathing.

Physiological benefits 

• Helping to increase cerebral and ocular blood flow 

• Increasing blood oxygenation

• Reduces cortisol (stress hormone ) release

• Increase in nitric oxide-a natural vasodilator which is released by most cells in our body, including the eye

• Activation of the parasympathetic nervous system and reduction in  sympathetic nervous system activity ( therefore, helping to mediate our fight or flight response)

How this helps our physical and mental well-being

• Promotes brain health and neural plasticity along with synthesis of grey and white matter in the cerebral cortex 

• Reduction in intraocular pressure – may be a useful adjunctive therapy for those diagnosed with glaucoma

• Reduction in blood pressure 

• Meditation creates a relaxation response thus helps to reduce stress and anxiety

• Promotes quality sleep

• Helps to activate our pre-frontal cortex (our thinking brain) and deactivates our reptilian (reactive) brain. This helps us return to a mental state of learning 

As an Optometrist who manages glaucoma, I look forward to discussing possible lifestyle changes with my patients which may have a positive effect on their eye condition. For some time I have recommended a healthy diet and moderate exercise but meditation and yogic breathing will now be included in our conversation. 

If you have glaucoma it is important to continue your eye medication as this is the best and most proven way to keep your eye pressure in check. Furthermore, if you have been told you are at risk of glaucoma it is important to always attend your regular eye health reviews with your optometrist or ophthalmologist. Always consult with your eye care professional if you are considering making lifestyle changes which may have an impact on your glaucoma management.

Hand Sanitiser harming Children's Eyes

Who knew something as effective as hand sanitisers which help us avoid the spread of COVID-19 could be harming our children’s eyes?

Well during the COVID-19 pandemic we have all seen a rise in access to hand sanitisers at various public spaces. They are everywhere now; in shopping malls, schools, cafes and restaurants. The hand sanitisers which are automatic are frequently positioned at an average face height for a child of 3.5 years old. This creates opportunity for our children’s eyes to become exposed.

This could explain why eye health professionals are seeing an increase in alcohol-based hand sanitiser (ABHS) related ocular exposures in children, as reported by the French Poison Control Centre.

What we can take from this is while ABHS are a useful part of our armament against COVID-19, we should be careful with these agents around children. If the hand sanitiser is effective enough to kill a virus, it is effective enough to cause severe damage to the eye.

To limit the risks of ABHS induced ocular injuries parents are recommended to promote their children to wash their hands with soap and warm water, rather than alcohol-based agents. Also teaching your children how to correctly use sanitisers could help reduce the risks of ABHS related ocular exposures.

As with any chemical splash in the eye, it is recommended to irrigate the eye with water or saline and seek medical advice.

Migraine

What is migraine?

It is a neurovascular headache, meaning it manifests as a result of complex events and interactions between both the central and peripheral nervous system and blood supply to the brain.

Migraine is often inherited and is considered the 3rd most common disabling event for those under the age of 50 years.

Symptoms of migraine

Warning stage – You may experience subtle clues that you will develop a migraine which may include neck stiffness, mood changes, constipation, fatigue, thirst or craving of sweet foods

Aura- Visual disturbance which may include light flashes, zig-zags, spots or tunnel vision. But may also cause numbness or tingling on one side of the face or body, hearing or speech disturbance, memory loss, confusion, dizziness or even fainting. The Aura usually occurs before the headache and most commonly persists for 5-20 minutes. Some people will experience the aura only; without the headache developing.

The Headache- throbbing pain, usually on one side of the head. This may be accompanied by nausea, vomiting, and sensitivity to light, sound or head movement.

Resolution & Hangover- Symptoms usually gradually fade but a ‘hangover ‘effect can persist for hours to several days. Symptoms may be similar to the early warning stage or can be the opposite, ie. If appetite was initially lost you may be incredibly hungry.

What causes migraine?

Genetics- sufferers often have a first degree relative with migraine

Sensory overload- sensitivity to light, patterns, sound and even smells

Foods and food additives- certain foods may trigger a migraine such as cheese and chocolate. MSG and some artificial sweeteners may also be implicated.

Sleep disturbance- either too much or not enough

Hormonal fluctuations

Stress or Anxiety

Physical Exertion

What you should do

First of all, if you experience regular headaches, or any significant headache event it is paramount you visit your family doctor for a thorough general health assessment and diagnosis.

A headache diary can be useful to help pinpoint any trigger to your headache.

What can help?

Medication can be prescribed to reduce the pain and even prevent events from occurring. Some patients require referral to a neurologist to help manage their symptoms.

Lifestyle changes including regular sleep, exercise and a healthy diet. Limit alcohol.

Consider an eye examination. In my experience, those with migraine, benefit from correction of even small vision imperfections. We often recommend lenses to reduce light intensity, blue-light exposure, reflection and glare indoors. Prescription sunglasses are helpful in brighter light conditions. I have also recently experienced success with a migraine patient who has found relief from light sensitivity with the new Acuvue Transition Contact Lenses. These lenses, incredibly incorporate the adaptive tint technology of traditional Transitions spectacle lenses but within a contact lens. They can even be helpful to reduce glare when night driving.

Feel free to contact us if you have any queries about your vision or light sensitivity.

COVID-19 and your eyes-what you need to know

Coronavirus and your eyes

COVID-19 is a new illness that can affect your lungs and airways. It’s caused by a type of Coronavirus. Symptoms are fever (at least 38°C), cough and shortness of breath. These symptoms may appear 2-10 days after a person has been infected.

Coronavirus can spread through the eyes

When a sick person coughs, sneezes or talks, virus particles may infect another person through their mouth, nose or eyes. Droplets of the virus may land on surfaces such as counter tops and door knobs, so it is important to wash your hands before touching your face or eating.

Coronavirus and conjunctivitis

Like any virus, COVID-19 can lead to inflammation of the eye- known as viral conjunctivitis. While it is thought to only occur in 1-3% of cases, like any conjunctivitis, it is important to practice good hygiene to avoid infecting others- so always wash your hands after touching your eyes or your tears.

Contact lenses or glasses?

If you are a contact lens wearer, you tend to touch your face and eyes more regularly so now would be a good time to wear your glasses more regularly. It would be a good idea to ensure your glasses are up to date so you can still enjoy clear vision. Furthermore, glasses or sunglasses may also add a layer of protection.

Eye drops

Ensure you have an adequate supply of eye drop medication such as glaucoma drops as it is important to continue with these drops on a daily basis and you don’t want to get caught short if you had to self-quarantine. Please don’t hesitate to phone or email us if you need a repeat prescription. Many pharmacies offer a delivery service.

Avoid eye rubbing

We all do this more often than we realise but try and become aware of this habit and avoid it whenever possible. If you need to rub your eyes, ensure your hands are washed first or use the edge of a tissue instead of your fingers.

Dry eyes and allergy can lead to more eye irritation so keep up with your dry eye drops and treatment and talk to us about prescription eye drops to control your allergy symptoms.

By taking some simple hygiene measures and being sensible if you are unwell, we can all get through this together and stay safe and healthy.

Presbyopia- vision after 40

Change- to vision after 40

Ch- ch- changes turn and face the strain.

Pretty soon you’re gonna get a little older

Time may change me

But I can’t trace time

If you know the rest of the words to this David Bowie song, chances are you are over 40! Speaking of change, an inevitable one to occur around this age is the reduced ability to see near print and objects clearly. 

If you have never required glasses or contacts to correct distance vision, this loss of near vision can be concerning and frustrating. You may feel like you have abruptly lost the ability to read that restaurant menu, your mobile phone or even the DVD screen on that last plane trip. 

In reality, your vision has been undergoing gradual change since childhood but it is only now that your eyes don’t have enough focusing power to see clearly for closer work- this is known as presbyopia. A result of the lens inside the eye losing its flexibility which allows the eye to change focus from objects that are far away to objects that are near. 

Another inevitability is that we all approach change differently. Some of us resist it, while others embrace it, or likely just gradually resign ourselves to things being different. When your vision starts to change, the unknown is scary. However, presbyopia is normal and there are several solutions to enhance your vision. 

While some people resort to cheap over the counter glasses; they are just getting by. Furthermore as we get older, we also need to look after our health. Medically speaking, from the age of 40, is when our risk increases for eye conditions like glaucoma – conditions that with early detection and treatment mean that you can maintain good vision for your lifetime. So the change in near vision focus after 40 could be said to be telling you that it’s time to see your optometrist, and start having regular eye examinations.  

People with presbyopia have several options to regain clear near vision. They include;

 Glasses; with a personalised prescription and quality lenses your vision can be as sharp as ever and depending on your lifestyle, occupation, hobbies and daily visual demands there are several lens options to ensure glasses work well for you. 

Furthermore, don’t underestimate the importance of a perfectly fitting spectacle frame. Frames are not unlike shoes: they not only have to look good but they must fit well for the glasses to work their best. Quality does feel better and will last the distance meaning you can often reuse your frame even if your prescription lenses require updating. 

Contact lenses; including multifocal to provide both clear distance and near vision simultaneously. 

Surgery; such as LASIK or other refractive surgeries

 Initially, presbyopia becomes more advanced. You may notice that you need to change your glasses or contact lens prescription more frequently than you used to. Around age 60, these changes in near vision reduce, and prescription changes should occur less often.

Presbyopia can't be prevented or cured, but most people should be able to regain clear, comfortable near vision for all of their lifestyle needs. So if it is you or someone in your family, experiencing changing vision, help them to embrace the change and book in for a comprehensive eye examination at your local optometrist. And just in case you are wondering, David Bowie’s song Changes, was released on the Hunky Dory album in 1971.