What exactly is a comprehensive eye examination?

When you schedule your eye examination at Ocean Optometry, you can be sure that we are going to take very good care of you and your eyes.  Many people may wonder what is involved in an eye examination and may even be a little nervous about it, so let's try to demystify it a little.

We have designed our comprehensive eye examination to be a flexible approach to gathering a range of baseline measurements to best assess the health of your eyes, the best focus for your eyesight and lifestyle and to provide an opportunity to address any concerns that you may have.

To begin with we will ensure all of the basic information that we have for you is correct, for example your address and contact information and then we will take preliminary assessments prior to your time with one of our optometrists.

There are three main instruments that we currently use for our preliminaries: auto-refractor/keratometer; non-contact tonometer and the digital retinal camera.  This gives a range of information which is useful to gather for most people.  We tend not to use the auto-refractor/keratometer and the non-contact tonometer on people less than 20 years of age as it is not the most reliable way to gather this information on younger eyes.

When we gather any information as part of our eye examinations we want to ensure that the information is good quality information and we want to ensure that there is a real need/reason to gather this information.  Perhaps this is a good example, at a simple level, of what we mean by having a flexible approach.  There is little benefit in doing tests for the sake of doing tests, we are not interested in merely performing the test, but in the information that we gain.

Once the preliminary assessments are carried out, you will be introduced to whichever optometrist is scheduled to see you.  Optometrists Dr. Euan McGinty and Dr. John Wilson are not only our optometrists, but also the owners of Ocean Optometry.  With over 30 years experience in the whole "testing eyes thing", they both have a wealth of experience and knowledge to draw on, however, they are not your stuffy/bossy doctors, so feel free to call them Euan and John.  We're pretty relaxed here!

The first thing our docs will do is review all of the information so far and then have a chat about why you have come in for the eye examination, finding out if you had any specific issues needing addressed or have any specific goals that you'd like to achieve.

From here on in, things are really going to get personal!  We will generally ensure that we assess the quality of your vision and find the optimum focusing requirements for any spectacle lenses you may need. (refraction) We will assess the alignment of the eyes, the way they work individually and as a pair (binocular vision).  At times, however, this may not be appropriate to do at this visit and we will discuss this with you as well.

During your appointment we will also carefully assess the health of your eyes.  We will look at the front of the eyes under high magnification, all the time asking ourselves questions about how healthy they look? Are the eyelids working properly? Are the front tissues quiet and clear?

We will then carefully review the internal health of your eyes, looking at the crystalline lens, the fluids inside the eye and right back to the retina and the optic nerve head.  If this is your first eye examination with us we will be looking to establish baseline assessments for all of these features and considering if the appearance falls within the expected normal variations found within healthy eyes.

If it is not the first eye examination we will further consider how this compares to previous visits and look for any signs of change which could indicate any abnormalities with the eyes or even with your overall general health.  There are also indicators linked to neurological assessments which will be reviewed when we are examining your eyes - for example do the pupil reactions function normally?

Once we are satisfied with all of our findings, we will make appropriate notes and then discuss all of our findings with you, where possible sharing the findings with you when we can review it with our digital instrumentation.

We will make sure that any concerns that you came in with are addressed, that we have discussed any issues that we may have found during our examination and answered any questions which you may have.

Once we are sure that all of the i's are dotted and the t's are crossed, all concerns and questions are covered we will then conclude the eye examination and advise when your next eye examination is recommended.  If it is within a reasonable time we will in fact schedule the appointment there and then, so we know that the clinical time has been set aside for you (don't worry, we can always re-schedule down the line if we need to).

What many find surprising, however, is that John and Euan will then accompany you either to help you choose frames, or to discuss your spectacle requirements with our optician, Mike, or to make sure all matters are taken care of with our front desk.

Even beyond this, though, if you go home and think "Oh, I wish I had asked this ..." then please send us an e-mail, contact us through our website, call us or drop in.

We like to consider that once you choose Ocean Optometry to take care of your eyes, then we're going to take care of them exceptionally well and for a long time.  It's not just about a quick "one/two"; "better/worse" rapid appointment every couple of years, or whenever you remember!  We'll be your go to resource for all things eyes and eye-related!

For further information about our eye examinations, please visit this section of our website: http://www.oceanoptometry.ca/index.php/the-collections/the-examinations

Dry Eye - an interview with our optometrists

Dry eye complaints are something both our optometrists, Dr. John Wilson and Dr. Euan McGinty are seeing more and more of in their day to day consultations.

With people spending more time doing visually intensive tasks, working on computer screens for extended periods and working in environments with controlled atmospheres which are often dry, it is perhaps not surprising that it is becoming an increasingly common complaint.

Therefore, we decided to quiz our doctors a little further about dry eyes.

"While the symptoms of dry eyes can be very frustrating", John says, "the clinical issues associated with it can be equally significant.  A dry eye can often be a compromised eye and therefore more vulnerable to infections or even scar tissue formation.  These both can further complicate the picture and early intervention to provide long term management really is key."

"If you suffer from dry eyes, which can often be recognised through its signs and symptoms, then it is important to have it properly assessed so that we can give you the correct advice specific to your condition."

"This is important", Euan adds, "not all dry eyes are the same.  From that point of view we often have people whose symptoms can range from a burning/gritty sensation, an itchy sensation, to just some discomfort.  What is surprising is we also have patients whose eyes are watering, they can find it strange when we start to talk about 'dry eyes'."

"Looking at the eyes, patients can present with red eyes or inflammation of the tissues of the eye and eyelids, at other times the eye looks quiet and healthy, but the symptoms are all there.  From this point of view dry eyes can be an incorrect label, really we are talking about the tear film not functioning properly."

"When we are performing a dry eye assessment we will be looking at all of these factors, taking into account the symptoms, the appearance of the eye and the tear film and the quality and quantity of tears present.  This will help us to arrive at a care plan which is individual and appropriate for each patient."

"I can't agree more", adds John.  "This really isn't a one-size-fits-all type condition.  With an appropriate manage plan, the condition can often be turned completely around.  It does take effort and commitment from both the patient and ourselves, especially in the early days and weeks.  When we review patients and compare their initial metrics to those after appropriate management, the improvements can be marked."

"This can translate into real world differences, not just in their comfort, but also in their quality of vision."

We asked, is there any general advice which could be helpful?

Euan replied, "It's hard to be general, but there are some things which I do keep going back to.
 Firstly, not all artificial tears are the same.  It is important to find one which works well for you, although I would say that preservative free artificial tears are generally all better than others."

"There may be an element of trial and error to begin with, however, my go-to artificial tear at the moment is one called "Hylo".  This contains an excellent agent for nourishing and protecting the eye, Sodium Hyaluronate, which is found naturally in the tear film.  It comes in unique bottle allowing it to be both preservative free and usable for up to six months from first opening."

We have found this to be so successful we have decided to stock it in our office to make it easier to find, it is available at pharmacies and drug stores, however, some patients did comment that it was difficult to find.

As Hylo is preservative free it is also suitable for contact lens wearers to use, even with their contact lenses in.  So if you find that your contact lenses dry out your eyes or have difficulty in handling your lenses at the end of the day, this may just be the solution you are looking for.

"There are two things I keep coming back to as well," responds John, "Omega-3 fish oils and an eye mask"

Dr. John Wilson using a Thera Pearl Eye Mask

"The Omega-3 supplements have been shown to be useful in helping manage dry eye conditions, it is important to choose the fish oil, however, and not the flax seed oil (which may have other benefits).  There are certain things to look for, so a little research is definitely useful to ensure it will fit in with your needs and lifestyle."

"Eye masks are a great resource for patients with dry eyes.  We recommend the Thera Pearl eye mask and again have decided to always have it available here at Ocean, as we were so impressed.  It can be used for both warm compresses, to help open up the meibomian glands and improve their function, and cold compresses, to help calm down an angry and inflamed eye.  I have been so impressed with this simple product that I have one at home for myself to use!"

John concludes, "While this advice may not be for every patient, it may be beneficial for many patients and, at times, I do wonder if we should all be performing eye-lid cleaning and warm compresses as part of our daily routine, like brushing and flossing our teeth."

One final piece of advice from both or our optometrists: Don't forget the 20/20/20 rule - for every 20 minutes you are using your computer (or tablet/smartphone) you need to look at something 20 feet away for at least 20 seconds.

If you have any concerns about dry eye, please feel free to make an appointment.  The first step is a comprehensive eye examination to rule out other factors and then, if appropriate, we can schedule a dry eye assessment appointment.

Mental Health

This is going to be a slightly difficult blog post to create, it shouldn't be ... and that's part of the problem.

This week actor and comedian Robin Williams ended his battle with mental health issues by taking his own life.  At age 63 he was not going through some sort of growing pains or teenage angst, he was facing the challenges that he did and choose the avenue which seemed correct for him.

What has this got to do with Ocean Optometry?

What has this got to do with eyes?

You may ask these questions, and on a clinical sense vision is simply the neurological processing of data provided by the eyes - themselves, a simple tool for turning light radiation into an electrical signal.

Yet, your overall mental wellbeing may have a huge impact on your perception and therefore your vision.

and this is where the blog could end

but.

both Dr. Euan McGinty and Dr. John Wilson feel that mental wellbeing is much, much more important.

The cold hard facts are undeniable.  You may see stats saying 1 in 5 Canadians suffer from mental health problems, the reality is more like forty percent.  That's two in every five, look around you, how many people do you see?  Now consider that almost half of them face mental health challenges.

Consider this.

Recovery.

Recovery should not be a hope, a goal or an ideal.  Recovery should be the norm.  We should aim for recovery with every single person who suffers from mental health challenges.

If you are not sure ... ask us

Here's some resources:

Canadian Mental Health Association: http://www.cmha.ca/
Recovery: http://ontario.cmha.ca/mental-health/mental-health-conditions/recovery/

If you wish to talk, reach out to Ocean, we're here. info@oceanoptometry.ca  and (902) 446-4470 .  If you know someone with mental ill-health challenges, heck, forget that, if you know someone ... just send them a message to say "hey?".  We are there, you are there, let us move forward on this.

PS  the worst of it ... the very worst of it ... Robin wore some fabulous glasses, here are some of our favourites.

RIP Robin

Tints, mirrors, polarization and other sunwear technology

We've all become much more aware of the need to protect ourselves from the damage that the sun's UV rays can cause.  Powerful campaigns like Slip-Slap-Slop has helped to educate us to the need to make sure we take the necessary precautions.  The importance of the advice from these campaigns can not be ignored and another factor which they help raise is the need to protect our eyes as well.  When it comes to choosing sunglasses, though, the choices can seem a little bewildering.

Nikon's SunStyle lens selections

Standard tinted lenses work by absorbing a portion of the visible light going through a lens, the light allowed to pass through is what gives the colour of the tint we see.  When choosing a tint colour, there is not really a "correct" choice, it all comes down to personal preference and taking in to account when you will be wearing the glasses.

A few things to consider are that a very dark tint will be better for brighter conditions.  Coloured tints like brown, green and blue will alter the apparent colour of objects that you see, grey should not.  The darkness of the tint does not indicate the level of UV protection.

ic! berlin Boombox Noize

Slightly different from absorption tints, are mirror tints.  These tints reflect the light, rather than absorb it, and work by having a thin layer of a metal on the front surface of the lens, often combined with a standard absorption tint within the lens.  Again it is important to check for the UV protection as the reflective surface alone does not guarantee UV protection.

There are many options when it comes to mirror coatings and they can produce dramatically varying effects, dependent on the metals used and the thickness of the coatings. Sports eyewear often includes a subtle flash coating of just a minimal amount of reflectance, fashion ranges include fantastic colours to completement the frames.  Perhaps the current masters of this are ic berlin!

Another common consideration when it comes to sunglass lenses is decide if you would benefit from polarized lenses.  Polarized lenses work like standard sunglass tints, however, have a special filter in them to also remove light which is poloarized.  Sources of polarized light tend to be surfaces which reflect light, like water, snow.

Many outdoor enthusiasts enjoy the benefit of polarized lenses to help reduce distracting glare and have enhanced vision for their hobbies, however, polarized lenses are not always the best option.  Polarized lenses can create issues when trying to read the surface, for example in downhill skiing or golf.  They can also block out light from LED and LCD screens, making smartphones, tablets and even dashboard dials difficult to read.

One newer development with polarized lenses is a trend for lenses which also provide true or even enhanced colour perception.  Examples of this include the Nikon Radiance lens and the Smith Optics Chromapop lens:  

Smith Optics Chromapop

The choice between the different options can seem bewildering and it may not be easy to work out what is the best option for you.  Our best advice is to come in to Ocean and spends some time chatting with us about what you want and how you're going to use your glasses and we'll help guide you through the choices.  Then get outdoors and enjoy the summer!

New York / Vision East Expo ... The Revenge!

After so many wonderful days of eye geekery, it was definitely time to head home.  Day six was done, we had finished with the expo, safely hopped on board the shuttle bus headed to the airport and settled down.  We traversed Manhattan on the way out and managed a last fleeting glimpse of some of the sights, Macy's, The Empire State Building, a last look down Broadway.

Then we were headed through the suburbs and staring out on the rain soaked houses and businesses.  After so many days immersed in the eye world, there is always a sense of reflection at times like this.  Our chat turns to what we had seen, what had excited us.  We talk about the new frames that we had purchased, some of the new clinical instruments.  It also gives an opportunity to discuss what we had been interested in and would earmark as a item to watch for future shows.

Soon enough we arrive at the airport and negotiate our way through check-in, security and find ourselves a quite corner in which to settle for the next few hours until our flight is ready to depart.

Gazing out we are treated to a never ending stream of taxis slowly snaking their way through to pick up new passengers.  It really is a grey and miserable day.  Then again, we were headed home.  We had dodged the bullet of the snowstorm which slammed in to Nova Scotia, the worst of the winter.  Not long to go.

Except, while we are watching the rain slowly drip down the window there is something brewing further north - an ice storm!

We start to receive news about Halifax airport having cancellations and delays due to freezing rain ... you have to be joking!  Apparently not, but our flight looks good.  The time comes to make our way to the gate - "I'm sorry, your flight has been cancelled"!  Seriously?

So it seems like our mammoth trip is not over.  We are sent to a nearby hotel, well, when hotel would be a generous definition!  There are bars on the windows, the corridors slope at an alarming angle and there is a definite sense of not being alone in your room.  You're not!  With a couple of sightings of Porcellio scaber a quickly drawn conclusion of this not going to be the best night's sleep ever is made!  It's hard to believe that we have moved from the rather wonderful Yotel to this!

Ah, well, we all survive the night and get a flight home in the morning!  Phew! What a marathon trek, but it has been so worth it.  We have some fabulous new things to bring back to Ocean, we've full of enthusiasm and energy for the days and months ahead.  With the time spent with Tom Davis our skills with being able to Couture a frame are enhanced and we are sure that people will love the ability to have a custom made frame which fits perfectly.

I hope you've enjoyed this series of blogs about Vision East Expo, New York and adventures of these two optometrists and one optician - eye geeks to the core!