As the Coronavirus pandemic continues, patients continue top ask about aspects of their health pertaining to their every day life, including contact lens wear.  When it comes to contact lens wear, the American Optometric Association (AOA) and the Center For Disease Control (CDC) both state that contact lenses are still a safe and contact lens wearers shows no greater risk from COVID-19 than those wearing glasses. Here are some pointers and myth-busters to guide you through the outbreak. ​

It’s no secret that most of us spend too much time in front of a screen.  Many people spend all day at work staring at a computer monitor, only to come home and spend hours on a phone or tablet.  This kind of extended near work takes a toll on our tear film, the protective layer of hydration on the surface of our eye. 

Our pre-corneal tear film is an extremely complex and important component of our visual system.  It protects our sensitive ocular surface from the environment and any disruption in this layer leads to symptoms ranging from tired eyes to burning, tearing and itching.  The tear layer also serves a very important optical function.  The surface of our eye is rough and uneven… not ideal for focusing light precisely on the retina.   Our pre-corneal tear film fills in these irregularities and creates a smooth and uniform surface for refraction.  This is the reason that the majority of dry eye sufferers present with complaints of blurred and variable vision, not eyes that feel dry or uncomfortable. ​

Corneal Cross Linking

This breakthrough surgery has been a game-changer in keratoconus management since it was FDA approved in late 2017.  Corneal Collagen Cross Linking (CXL, C3R) is a procedure that stabilizes the corneal shape, preventing further progression of keratoconus or other corneal ectasias.  The procedure involves bathing the cornea in riboflavin and then exposing it to UV light.  This causes a reaction that increasing the cross-linking of collagen fibers in the cornea, therefore increasing corneal rigidity and preventing further steeping of the cornea.   It is important to note that this procedure does not get rid of the optical effects of keratoconus, instead it simply stops the progression in an effort to maintain best-corrected visual acuity and prevent corneal scarring or the need for corneal transplantation.  This procedure combined with scleral lens fitting has become an extremely effective management technique for those with keratoconus, pellucid marginal degeneration and post-refractive surgery ectasia.




Intrastromal Corneal Ring Segments

These corneal implants were initially developed to help stop the progression of keratoconus, but studies have since found that they are not effective in doing so.  They are still used by some specialists as a way to flatten the cone in hopes of making rigid contact lens fitting easier.  With the advent of cross-linking and scleral lenses, this procedure has been made largely obsolete.


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Corneal Transplant

A corneal transplant is a last-case scenario for any corneal disease.   Most transplant patients still need a rigid lens (like a scleral lens) in order to see adequately, and chronic steroids are typically needed to prevent rejection.  That said, if a cornea becomes too steep or too scarred to be functionally corrected with scleral lenses, a corneal transplant can be a great option to restore sight.

Presbyopia is a natural process that typically occurs in the 40’s and reduces ones ability to read when vision is corrected for distance.  This problem is a frustrating one, especially for those who enjoy contact lenses.  When contacts are used to correct far away vision in someone who is presbyopic, additional options are needed to allow comfortable reading.  Over-the-counter reading glasses and mono vision are two options that offer both advantages and compromise.  Multifocal contacts continue to improve in viability but typical “one-size-fits-all” lenses don’t offer options for patients with astigmatism. It is important to remember that, unlike bifocal or progressive glasses where distance and near vision can be put in different parts of the lens, contact lenses are stable on the eye and all powers must be contained in a small pupil-sized region, making the task of crisp vision at all distances much more difficult.  Here we will discuss options for patients with astigmatism who need distance and near correction and desire binocular vision free from reading glasses:
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• B&L ultra multifocal toric

This new offering from Bausch and Lomb offers the ability to correct astigmatism and incorporate multifocal optics into a one-size-fits-all monthly disposable lens.  These lenses offer great comfort and vision but have certain “canned” parameters, meaning they cannot accommodate complex prescriptions and parameters cannot be adjusted on fit or optics zone sizes.  They are a great starting point for patients who fall within the set parameter ranges.  For those who have prescriptions or corneal dimensions outside these parameters, or for those who cannot achieve appropriate vision, a custom lens option is the next step.  It is also important to remember that soft lenses for astigmatism must be stabilized to keep the optical correction in proper orientation for good vision, and any lens rotation can result in blurry vision.

• Custom rigid, scleral and hybrid multifocal lenses

The beauty of rigid lenses (gas permeable, scleral and hybrid lenses) is that they “mask” most astigmatism, meaning you don’t have to correct it optically and that lens rotation is a non-issue.  Also, rigid lenses not only offer far superior optics to soft lenses, they are actually more optically pure than the natural corneal surface, meaning that they give the absolute best vision possible, even superior to refractive surgery in many cases.  These lenses are fit to each patient and can be specifically customized to maximize both comfort and vision as they are tailored specifically for your eye.  Originally, only corneal gas permeable lenses occupied this category.  These lenses had significant “awareness” and required adaptation to achieve all day wear.  New options like scleral and hybrid lenses offer comfort that is often superior to soft disposables but with all of the optical benefits of custom rigid lenses.

Custom soft multifocal toric lenses
Unlike one-size-fits all soft contact lenses, custom soft lenses are made based on a patients corneal parameters including diameter, curvature and eccentricity (rate of flattening).  Not only is the fit customized to improve comfort, the optics are also made to specifically match the patients prescription.  These lenses are made-to-order and therefore all specifications are customizable, even the material the lens is made from.

Imagine never squinting and shielding your eyes from blinding sunlight, or feeling the strain of eight-plus hours under fluorescent bulbs. That’s the allure of Acuvue’s anticipated line of light-sensitive, vision-correcting contact lenses, Acuvue Oasys with Transitions. Each contains a filter that senses the amount of light entering your eye and automatically darkens or lightens to maximize comfort. The contacts, which have been in the works for over a decade, received FDA clearance in 2018. They were also voted one of TIME Magazine's Best New Inventions in 2018. Here's why. 

ACUVUE® OASYS with Transitions is a first-of-its-kind contact lens for contact lens wearers. These lenses combine a proven ACUVUE® OASYS (senofilcon A) material with Transitions™ Light Intelligent Technology™. The result is a lens that seamlessly adapts to changing light, providing all-day, soothing vision.​

An annual eye exam is about more than just updating your prescription for contacts or glasses. While this is important to ensure you're seeing to the best of your ability, there are other reasons a visit is crucial at least twice a year. A routine eye exam can detect other serious health problems before you're even experiencing symptoms. Did you know that many people first learn they have serious health conditions like brain tumors, high cholesterol, diabetes, high blood pressure, and even cancer from a routine eye exam?

Our eyes  are a very effective window to our overall health. During a comprehensive eye exam, your doctor can observe and evaluate the health and condition of the blood vessels in your retina. These are a good predictor of the health of the blood vessels throughout your body. Conditions such as diabetes, hypertension and hypercholesterolemia all are visible by changes in the appearance of the retinal blood supply and blood vessels. Your doctor will also look for eye muscle imbalance, vision disorder, and eye disease that could potentially cause future problems.

Many people wait until they notice a change in their vision to see a doctor. But eye problems are often silent - meaning they have no symptoms, which can be dangerous if you are waiting to see a change before making an appointment. 

Annual eye exams are especially important for anyone with diabetes or who might be at risk for the disease (due to obesity, family history, etc). More than 30 million Americans with diabetes and another 84 million are at risk for developing diabetic eye disease which is a leading cause of blindness among adults. In its early stages, diabetic eye disease has zero visible symptoms; only a comprehensive eye exam can detect signs of the disease. The sooner treatment is sought, the likelier the vision can be preserved. If no treatment is given, vision loss will ensue. 

So you've had a vision screening?  It's not the same as a complete exam. Screenings are partial, limited eye evaluations that take place outside an eye doctor's office. While they can be helpful in detecting some problems with vision, it is a limited exam. At your optometrist's office, a thorough eye exam takes deeper look at your vision and how it affects your overall health. Eye history and family history are also considered as a preventative measure to stop eye disease before it begins.

What are you waiting for? Don't put it off any longer. Even if you think you have perfect vision, an annual eye exam can be one of the best things you can do to protect your overall health and wellness. Start the new year right with a visit to Kirkwood Eye Associates. 

​We are excited to be the first practice in the St. Louis area to offer the iLux Dry Eye Treatment System. 

The iLux treats meibomian gland dysfunction (MGD), the leading cause of dry eye disease.   Patients with MGD are unable to properly produce and sustain the vital lipid layer of the tear film, resulting in variable blurred vision, eye strain, irritation and tearing.  This occurs when the oil-producing meibomian glands in the eyelids quit working properly, resulting in solidified and unhealthy oils being released onto the surface of the eye.  The most common cause of MGD is extended near work (i.e. computer, tablet, smartphone).

The iLux device targets the oil-producing meibomian glands in the eyelids.  It uses heat and compression to unblock the glands and clear thickened and unhealthy meibum, allowing the production of clear and healthy secretions that stabilize the tear film and result in improved vision and comfort.   

The treatment takes about 10-15 minutes and can be done in the exam chair.  It is not covered by insurance and costs $335 total for both eyes.  Results can last up to a year but some find it beneficial to repeat 6 months after the initial treatment.  Some patients notice symptom improvement immediately, but improvement can continue for up to 4 weeks as the new oils refill the glands.  

Please see the FDA study results and information video below and feel free to call us with any questions.