Halloween Safety

Jack-o-latern

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How fondly I remember making my own Halloween costumes, usually with some sort of mask or helmet.  The Star Wars Storm Trooper mask was one of my coolest projects that turned out less than great.  Not only was the mask horribly uncomfortable to wear, I couldn’t see much when I had it on.  That didn’t keep me from wearing it for 2-3 hours while Trick-or-Treating that year though.  Its a miracle that I didn’t run out into traffic, living on a cul-du-sac didn’t hurt that I suppose!

I’m writing this to remind you to be sure that your children can see well out of any masks or costume parts that they wear this year.  And to remind you to insure that they have some form of reflective tape, stitching or design on their costumes.   Especially if the costume is the traditionally popular black.

Witch

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Dr. Warren

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School Screening Season

wpid-afp20070201p361-f1-2010-10-21-10-12.jpgI’m starting to see more and more children in the office who have had problems during a school vision screening. These screenings are a very important step in insuring that your children are seeing adequately in school. They are no substitute for regular eye exams however. Even the best designed and run school screening will miss 7% or more of the children who have a vision problem, some studies found that up to 33% of the children with significant vision problems may pass even well designed and run vision screenings.

I am sharing this information to remind parents that a vision screening at school or your child’s doctor’s office is no substitute for a professional eye examination. Screenings will “catch” children who have significant refractive errors, but will often miss children with significant yet smaller defocus issues. To be sure that you children and those of your loved ones are seeing as well as they can this year in school, be sure to have them get their eyes examined, in addition to any screening that may or may happen.

Here is a link to a great collection of professional journal articles about vision screenings and their benefits and limitations.

Dr. Warren

www.warreneyecarecenter.com

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“At Last” Multifocal Eyeglass Lenses

There is a new type of multifocal lens out, and it shows some real promise.  We don’t have many patients who are unsuccessful wearing progressive multifocal lenses, but there are a few, and some patients need a bifocal due to work considerations.  Pixel Optics has recently released the “At Last” bifocal lens.  It is unique in that while it has a definite line in the lens (which is not visible to people looking at the wearer, its only visible to the person wearing the lens) unlike traditional lined bifocals, in the bifocal zone, the reading power changes gradually from top to bottom.  This gives the wearer a larger and more defined distance and near zones but does create some “image jump” when moving your gaze from the distance to the near portion of the lens.

 

This lens design provides immediate near power below the bifocal line and a bit more reading power at the bottom of the bifocal area.  Here is a link to the manufacturer’s website for more information about how these lenses work.  I’ve been wearing a pair around the office for about a week, and while it took me a few hours to get used to the line in the lens, I really like them around the office.

If you’ve been wearing lined bifocals or trifocals, these lenses will provide you with a wider range of powers for intermediate and near vision.  Stop by the office to learn more about these exciting new lenses.

Dr. Warren

www.warreneyecarecenter.com

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National History and Pride

My family and I made a trip to Washington, DC this past weekend. It was not my first trip to DC, but it was my first trip there as a tourist. We were fortunate enough to have a Capital tour, LIbrary of Congress tour, Bureau of Printing and Engraving tour and we also visited the monuments to Presidents Washington, Lincoln, Jefferson and Kennedy as well as several Smithsonian museums.

I have always been a bit of a history buff, but more 20th century history. I now have a much better understanding of the incredible men and women who freed our country and forged our nation. Its easy to forget that there wasn’t a road map to America, they had to “make it up as they went along” and they did a pretty fine job.

If you ever have a chance to visit Washington, DC, by all means take it. The scenery and attractions are incredible, the people are friendly and the public transportation is first rate.

Dr. Warren
www.warreneyecarecenter.com
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Dry Eye Treatment

Once a diagnosis of Dry Eye has been made, choosing the proper treatment is the next step, and can be a bit complicated. The first step is to make sure that the eyelids and Meibomian Glands are healthy and working well. I usually start with hot compresses, getting the patient more hydrated and when necessary medications that help suppress inflammation in the glands.

I will often recommend over the counter nutritional supplements at this point in my treatment plan. Omega 3 and Omega 6 fatty acids (from fish oil and flax seed oil supplements) often help improve the quality of the secretion from the Meibomian Glands.

Once these steps have been taken, improving the quantity and quality of the tear film are next. The first step is to supplement the natural tears with tear film supplements. Drops such as Systane Ultra and Soothe XP are two of the tear film supplements that I frequently use. Using these drops three to four times per day will improve the quantity and the quality of the tear film. This is usually all the treatment that most patients need.

Some patients need further treatment however, my next step is usually a medication that usually stimulates the Lacrimal Gland to produce more of the watery tear film component. This medication is Restasis, a form of Cyclosporin. The mechanism of action for this medication requires a few months of use before its true efficacy is known.

In the event that Restasis and over the counter tear film supplements don’t adequately treat Dry Eye, I will insert long term punctal plugs. These removable soft plugs slow down the rate that tears are removed from the surface of the eye.

Using this “staged” approach to managing my Dry Eye Patients allows me to adequately treat my patients without over-treating them.

Dr. Warren

www.warreneyecarecenter.com
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Corneal Endothelial Cell Imaging

The cornea has several layers, the outer layer called the epithelium, the central layer referred to as the stroma and the inner (back side of the cornea) layer called the endothelium. Each of these layers has its own function, the epithelium protects the cornea, as somewhat of a buffer. Its cells have a life span of 45-50 days are are constantly being replaced.

wpid-cornea-other_clip_image006-2010-10-4-09-06.jpgThe stroma makes up 95% or more of the corneal thickness and gives the cornea its incredible strength and clarity. The stroma’s level of hydration is critical to its clarity. It is the tissue in the stroma that is removed during LASIK.

The endothelium is a single cell thick. Humans are born with approximately 4,000 of these cells. The cells aren’t regenerated during our life. These cells have a very important job, they control the hydration of the stroma and are responsible for keeping the cornea clear. If these cells fail or too many of them are lost, the stroma will swell and become opaque.

The endothelial cells die as part of the regular life cycle of the cornea, but they do so at a very slow rate. When a cell dies, its neighbors grow larger in order to keep the back side of the stroma covered with endothelial cells. We now have the ability to track the health and wellness of these cells as well as track their death and the size of the remaining cells.

wpid-konan_specular_micro-2010-10-4-09-06.jpgThis information allows me to make much more informed decisions about contact lens wear (as lack of oxygen due to contact lens wear can accelerate the death of these cells) and know much more about the health of my patients’ corneas. Utilizing a “Specular Microscope” I am able to gather baseline information and follow and detect subtle changes in the status of the cornea. As part of our commitment to protecting the vision and visual wellness of our patients, we now perform a screening endothelial examination in all of our eye exams for any patients who are likely to have any issues with their cornea.

Dr. Warren

www.warreneyecarecenter.com

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Party On The Pavement v 8.0

Well, another great community event (article and pictures from Racine Post) has come and gone, as a big success.  Even though Mother Nature didn’t cooperate with the weather, Main and 6th streets were sure full of people yesterday.  Even if a few of them ended up spending a bit more time at the intersection of Main and 6th streets than they had hoped and paid for. Thanks to the Racine Fire Department for getting the unfortunate Ferris Wheel Captives down safe and sound!

Dr. Warren

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