The Part of The Eye Exam Everyone Hates: Is The “Air Puff” Test Necessary?

So…it’s that time of the year to visit your eye doctor.  Maybe you are feeling a little nervous.   You check your vision with your PVT from EyeQue regularly, but you know you should still see your eye doctor for your annual health check. So why are you still apprehensive?  Maybe it’s that darn air puff test.  You think your eye doctor may just like torturing you by blowing air into your eyes.


Well, although it seems like torture, it is actually a very important test of your eye health. The air puff test is called the Non-Contact Tonometer and can only be done at your eye doctor’s office.  The tonometer is critical because it measures the pressure inside of your eye. If you think of your eye as a balloon filled with fluid, where that fluid is continuously pumped to keep the eye inflated, the pressure is a measure of how hard that fluid is being pumped through the eye.  If the pressure in the eye gets too high, damage can be caused to the optic nerve inside your eye.  Your optic nerve is connected to the part of your brain that interprets what you see.  Optic nerve damage as a result of this high pressure is called Glaucoma.

Glaucoma is one of the leading causes of blindness around the world.  This blindness does not just suddenly happen, either– it’s a very slow and progressive eye disease.  Without the tonometer test, Glaucoma is very difficult to detect; in fact, most people with glaucoma do not have any symptoms.  There is usually no pain, no loss of vision, no flashing lights, nothing that would even indicate what was happening. Out of the ten major types of glaucoma, 90% of cases do not show symptoms at all.

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What can you do?  First, understand that it is imperative for you to not skip your annual eye exams and the glaucoma test.  Monitor your vision with your PVT and if you see changes, report them to your eye doctor.  What the research does tell us about glaucoma is that if you are over 40, have diabetes, have had an eye injury or have thin corneas, you are at a higher risk for developing glaucoma.

If you are still nervous about the “air puff” test, remember it’s one of the most important tests that your eye doctor will perform during your eye exam.  Take a few deep breaths and the test will be over in no time.





Your Vision and Road Safety

In the last two decades, a number of studies have focused on the role of vision in driving and many have concentrated on older drivers. This isn’t surprising considering vision impairments are typically far more prevalent in older adults. Most of these studies have assessed the impact of vision impairments on driver safety and performance and some have analyzed specific eye diseases. Several studies have demonstrated quantitative measures such as contrast sensitivity and useful field of view (UFOV) are more accurate than visual acuity for determining the risk level of visually impaired people.

Visual Acuity and Driving

Visual acuity (sharpness of vision) is measured by one’s ability to discern letters or numbers at a given distance according to a fixed standard. A visual acuity test is part of every comprehensive eye exam. It is also the standard vision screening test used by most licensing agencies to assess driving fitness for both initial issuing of driver’s licenses and periodic re-licensure. While visual acuity tests are relevant for clinical diagnosis and monitoring eye disease, they do not reflect the visual complexity and visual functions essential for driving. These include acuity, static acuity, dynamic acuity, visual fields, visual attention, depth perception, and contrast sensitivity. Moreover, driving safety is associated to a large degree with age-related declines in a person’s reaction time and cognition as well as other physical and mental factors.

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The Impact of Eye Disease on Driving

In studies on people with cataracts, contrast sensitivity in the worse eye was more strongly associated with at-fault crash involvement than in the better functioning eye. Similarly, visual field loss in the more severely impacted eye was associated with an increased risk of crash involvement. Drivers with field loss at 70° or 85° in both eyes had two times the rate of crashes, major crashes, and at-fault crash involvement than those without this degree of field loss. Even field loss at 70° or 85° in one eye was associated with major crash involvement.

Research indicates adults with age-related macular degeneration (AMD) report greater difficulty driving than older adults without AMD. In general, driving difficulties increase with the severity of the disease. Yet even in the earliest stages of AMD when acuity remains relatively sharp, driving at night is a common complaint. Multiple studies revealed older drivers with AMD relied on several self-regulating strategies and drove with extreme caution. Strategies included pulling over when a car was passing, relying on memory for highway exit and stop sign locations, asking a passenger to provide verbal cues about the roadway environment, and scanning the road more frequently. 

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State Licensing Requirements

Road signs in the U.S. are designed and placed based on the assumption drivers have a minimum binocular visual acuity of 20/30. If a driver cannot clearly read signs (e.g. speed limit signs, stop signs, exit signs on the interstate, he or she may not be able to make key driving decisions (e.g. lane changes, turns, exiting) at a safe distance.

Most states require a minimum visual acuity of 20/40 and 120-140° total visual field to obtain and renew a driver’s license. When an individual’s visual status starts to fall below this standard, eligibility may be threatened and other options need to be considered. Visual acuity testing requirements vary greatly by state. Eighteen states enforce shorter renewal periods for drivers older than a specified age and the same number require more frequent vision screening/testing for older drivers. In states in which drivers can renew licenses by mail or online, 16 states and the District of Columbia do not allow this option for older drivers. Alabama, Connecticut, Kentucky, Mississippi, Oklahoma, Pennsylvania, Tennessee, and Vermont do not require proof of adequate vision when renewing, regardless of age.

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The Use of Special Visual Aids for Driving

Research shows those who stop driving because of vision loss experience higher levels of depressive symptoms (13% to 38%) than those who continue driving. It’s important to assess visual, cognitive, and motor skills to determine if a person can still drive and whether they might be a candidate for a visual driving aid (bioptics). There are critics and advocates for the use of bioptics, but not enough scientifically robust studies to build a case one way or the other. The use of bioptics while driving can be dangerous in unsuitable candidates or in individuals who have not undergone proper rehabilitation and training

Bioptics include a telescope mounted on top of a standard pair of spectacles or drilled into the upper part of the lenses. The telescopes can be placed in one or both lenses depending on visual acuity, visual field, central scotomas, ocular dominance, pupillary distance, and other physical factors. The device is carefully designed to optimally fit a person’s face and provide an appropriate level of magnification. Currently, 45 states in the U.S. allow bioptic driving when individuals meet certain requirements. Utah, Iowa, Connecticut, Maine, and the District of Columbia explicitly forbid bioptics from being used while driving, and Minnesota permits them on a case-by-case basis.

If you are an older adult or have an aging parent and feel like a decrease in visual acuity is impacting driving, the EyeQue Personal Vision Tracker is an ideal solution. It allows you to test and track your vision as often as you wish in the privacy of your own home. Recording changes over a period of time is a good way to identify trends or irregularities in your vision that can negatively affect your safety on the road.


Charitable and Not for Profit Eye Organizations That Make a Difference

In the U.S. and across the world, hundreds of vision-related charitable and not-for-profit organizations and foundations are dedicated to preventing eye disease, helping to restore sight, groundbreaking research, and far more. A comprehensive summary of all of them would fill many pages. Instead, we’ve put together a short list of 10 top eye organizations that have made significant contributions to preserving sight around the world.


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One billion people in the world suffer from insufficient eyesight easily remedied by wearing a pair of eyeglasses, but 90% of those who could benefit live in low-income countries. Registered in the Netherlands, the   TBE Foundation is committed to helping people around the world receive affordable eyeglasses. TBE developed an elegant solution for delivering quality affordable eyeglasses that can be assembled and adjusted anywhere in the world in under 10 minutes at a cost of $5. TBE selects and trains local people in developing countries to become Vision Collaborators. After training, they are able to perform simple eye exams and assemble glasses independently. When EyeQue launched its Kickstarter campaign in 2016, 3% of all proceeds were donated to this worthy cause.

Volunteer Optometric Services to Humanity/International

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VOSH facilitates the provision and the sustainability of vision care worldwide for people who cannot afford or obtain this care. 

The goal is to increase the global impact whenever possible by supporting sustainable eye clinics, optometry schools, and optometric educators in areas lacking sufficient eye care. VOSH sponsors several programs including eye care clinics in low-income communities, and disaster response eye care. EyeQue

 is currently exploring ways to partner with VOSH to support its admirable mission.

Prevent Blindness America

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Founded in 1908, Prevent Blindness is the nation’s leading volunteer eye health and safety organization dedicated to fighting blindness and saving sight. Programs include vision screenings, training and certification programs, annual Focus on Eye Health National Summits, important collaborative research studies, and the Congressional Vision Caucus (CVC). CVC is a bipartisan coalition of congressional members dedicated to strengthening and stimulating a national dialogue and policy on vision-related problems and disabilities.

Foundation Fighting Blindness

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Founded in 1971, the goal of FFB has always been to drive research leading to prevention, treatment, and vision restoration for           degenerative retinal diseases. These include macular degeneration, retinitis pigmentosa, Usher syndrome, Stargardt disease and Leber congenital amurosis, which together impact millions of people around the world. FFB is the world’s leading private funder of retinal disease research and a driving force behind the progress toward cures. FFB-funded research projects have identified more than 250 genes linked to retinal disease, and launched 20 clinical trials analyzing potential treatments.

SEE International

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Founded in 1974, SEE provides sustainable medical, surgical, and educational services delivered by volunteer ophthalmic surgeons to disadvantaged individuals worldwide. Its core objectives are to restore sight and prevent blindness. SEE provides training, education, and resources to prevent and treat several potentially sight-robbing conditions including cataract, childhood blindness, corneal blindness, diabetic retinopathy, glaucoma, and strabismus. .Since its launch more than 40 years ago, the organization has provided 3.8 million free vision screenings, performed nearly a half million sight-saving eye surgeries, and touched the lives of people in more than 80 countries.

EyeCare America

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An initiative of the American Academy of Ophthalmology, EyeCare America administers two eye care programs through a pool of nearly 6,000 volunteer ophthalmologists. Since 1985, EyeCare America has helped more than 1.8 million people, with 90% of services provided with no out-of-pocket cost to the patient. The Seniors Program is available to eligible adults ages 65 and older. Volunteer ophthalmologists in local communities provide free medical eye exams, and up to one year of physician follow-up care for any condition diagnosed during the initial exam. The Glaucoma Program offers free glaucoma eye exams to uninsured, eligible individuals.

Optometry Cares – the AOA Foundation

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Established in 2006, this foundation is committed to expanding eye health and vision care access to everyone in the U.S. in order to enhance human performance and quality of life. InfantSEE® is a free public health program delivering no-cost comprehensive eye and vision assessments for infants within the first year of life. Delivered by AOA optometrists, the program is available to all families regardless of their income or access to insurance coverage. Established in 1991, VISION USA provides basic eye exams to Americans in need, and is currently available in 40 states and the District of Columbia. AOA member optometrists donate their services at no cost.

American Foundation for the Blind

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Since 1921, the American Foundation for the Blind has helped ensure individuals who are blind or visually impaired have access to necessary information, technology, education, and legal resources to live independent and productive lives. Esther’s Place at the AFB Center on Vision Loss in Dallas, Texas is one of many innovative programs. It is a fully furnished model home fitted with simple adaptations and products designed to make daily life more manageable for individuals with vision loss. The AFB Center on Vision Loss provides life-changing information and more than 500 products and devices on display to assist people with vision impairments.

BrightFocus Foundation

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This unique organization is dedicated to both brain and eye health. They provide initial funding for highly innovative experimental investigator-initiated research dedicated to Alzheimer’s disease, macular degeneration, and glaucoma. Since 1999, Macular Degeneration Research has awarded more than $24 million to support
research into the causes and potential prevention strategies and treatments of this disease. Since its inception in 1978, National Glaucoma Research has awarded nearly $31 million to support research projects analyzing causes and potential prevention and treatment of this disease.

Vision Health International

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By invitation, VHI recruits ophthalmologists, optometrists, anesthesiologists, registered nurses, professional operating room technicians, and clinic personnel to conduct as many as three annual, one-week field programs. Since 1985, VHI has conducted 46 field programs. In that time, VHI volunteers have provided more than 27,000 eye exams, dispensed more than 22,000 pairs of eyeglasses and protective eyewear, conducted 23 teaching seminars, and performed 6,086 sight-restoring and life-altering surgeries in nine countries.

If Your Child is Nearsighted, Don’t Wait to Get Glasses for Them! Here’s Why.

If you have children, it’s important to follow national guidelines to protect their precious gift of sight. Vision screenings and comprehensive eye examinations are recommended at regular intervals, even if there are no signs of trouble. Any child who appears to have difficulties seeing or exhibits potential symptoms, such as squinting and frequent eye rubbing, should receive a comprehensive eye exam by an optometrist or ophthalmologist.

Uncorrected myopia (nearsightedness) in children may negatively impact their development and increase refractive error progression over time.

What is Myopia?

Myopia (nearsightedness) is a type of refractive error in which close vision is sharp, but objects farther away appear blurred. Nearsightedness occurs when the eyeball is too long, the cornea is steeply curved, the lens stays focused on near vision, or a combination of all these factors. This causes light rays to focus at a point near the front of the retina rather than directly on its surface, resulting in distant objects being out of focus.

Myopia affects 4% of children ages 6 months to 72 months and 9% of children ages 5 to 17. In about 10% of people with myopia, the condition progresses in severity. Recent studies show the prevalence of myopia is rising at an alarming rate. It is one of the five eye conditions considered an immediate priority by the World Health Organization’s Global Initiative for the Elimination of Avoidable Blindness. In all age groups, an estimated one-third of the population has myopia, however, the incidence rate is as high as 90% in some parts of East Asia. According to the latest data, an estimated 80% to 90% of students in China, Taiwan, and South Korea who completed secondary school are myopic, while 20% are highly myopic.

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Risk Factors for Myopia

If you have myopia, this increases the risk of your children developing it. A 2017 meta-analysis looked at 16 studies from four continents (seven from Asia, four from Europe, three from the U.S. and two from Australia) and 8,393 cases of myopia. Researchers confirmed parental myopia has a significant positive association with a child’s risk of developing myopia. If two parents have myopia, the risk is even greater. Genetic and environmental factors or gene-environment interactions are possible explanations for the connection.

A recent Dutch study on 5,711 children who had been followed from birth to age 6 revealed important findings. Children who spent less time outdoors, had lower levels of vitamin D, had a higher body mass index, and were less likely to play sports were more likely to be nearsighted. Being of non-European descent, having a mother with a low education level, and low family income were also associated with myopia, however, lifestyle factors presented the greatest risks. Most eye experts agree that the genetic predisposition for myopia is exacerbated by behavioral habits, including excessive screen time, close reading (e.g. tablets and smartphones), and eyestrain at a young age.

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Myopia and Uncorrected Refractive Errors

Uncorrected refractive errors in children can result in significant cognitive, neurological, social, behavioral, and economic effects. The consequences of being complacent about a child’s refractive errors can negatively impact their development, learning performance, self-esteem, social/emotional behavior, academic achievement, high school drop-out rates and juvenile delinquency. Children whose myopia progresses beyond -5 diopters may be at greater risk as adults for glaucoma, cataracts, macular degeneration, retinal holes and tears, as well as detachments of the vitreous and retina. In some cases, even properly treated myopia may progress and lead to sight-threatening complications.

A study on 76 people with myopia (ages 11-19: 61, ages 20-33: 15) analyzed the impact of myopia under-correction. A significant positive correlation was found between under-correction of refractive error and myopia progression. The degree of under-correction was associated with the degree of progression, however, gender and age did not appear to play a statistically important role. Full correction of refractive error did not result in myopia progression.

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Potential Treatments to Stop Myopia Progression

Studies on children have demonstrated the efficacy of orthokeratology (ortho-k) and bifocal contact lenses for stopping the progression of myopia to some degree. Ortho-k uses specially designed GP contact lenses to temporarily reshape the contour of the cornea to reduce myopia. This may be a viable option for children, adolescents, and young adults with low to mild nearsightedness (-4 diopters or less). Children ages 8 to 12 with progressive myopia may be the best candidates for this procedure. Four studies found atropine eye drops produced on average, an 81% reduction in myopia progression among nearsighted children. Unfortunately, this reduction did not appear to be long lasting based on subsequent studies.

In the majority of cases, prompt intervention and proper treatment for myopia can help prevent this common refractive error from impeding a child’s development and future success. And remember – it’s important to encourage children to spend time outdoors engaging in physical activities, away from computer screens and their smartphones!


What Does it Mean to See “20/20”?

20/20 vision is a term that is used a lot these days to describe anything from eyesight to TV shows and current events. While we all know “seeing 20/20” is a good thing, you may not know exactly what it means when it’s used to describe your eyesight.

The term 20/20 describes normal visual acuity (the clarity or sharpness of vision) measured at a distance of 20 feet. If you have 20/20 vision, you can see clearly at 20 feet what should normally be seen at that distance by the human eye. If you have 20/40 vision, you can see clearly at 20 feet what should be normally be seen at the distance of 40 feet by the human eye (meaning that your eyesight is not as sharp).

When you visit your eye doctor, visual acuity is one of the first tests that is performed, usually done with an eye chart of letters or other characters. The acuity test is one of the most important gauges of your vision, and additionally, your overall eye health.


When doctors check your visual acuity, they test your vision one eye at a time and then with both eyes together. Since acuity is a gauge of how sharp we can see, each eye is tested separately at first. Whether you can see 20/20 out of each eye or both eyes mean different things:

If one of your eyes cannot see 20/20, it means that you might benefit from wearing glasses. In some instances, not being able to see 20/20 can be an indication that there is a health issue with your eye. Glaucoma, macular degeneration, and cataracts are all common eye health issues that may cause a change in visual acuity. Additionally, diabetes, high blood pressure and high cholesterol can also impact our ability to see clearly.

In young children, not being able to achieve 20/20 vision in one eye can be a sign of amblyopia, often called a “lazy eye”. Amblyopia may be hard to detect if each eye is not tested separately because children may not recognize that one of their eyes is blurry. If amblyopia is not treated in time, that eye may not ever be able to achieve 20/20 vision. If one eye cannot see 20/20, depth perception (3D vision) decreases, which can affect a person’s ability to play sports, drive a car, fly a plane, or even have a certain career.

Separate eye testing (monocular testing) is, therefore, critical in knowing the visual status of each eye.

Screenshot 2017-10-02 15.30.18Checking both eyes together (binocular testing), however, is more of a screening test and less specific than monocular testing. When you get your driver’s license, you have to have a minimum visual acuity in order to drive without corrective lenses. Almost all states base the minimum vision to drive without lenses on the binocular test.

As you can see, visual acuity testing is extremely important for many reasons.  Numerous studies and research have proven the benefits of getting our vision checked regularly. School districts, pediatricians, family physicians, and even sports teams routinely test visual acuity. If problems are discovered, referrals to eye care professionals are made for further evaluation. Hopefully, not seeing 20/20 is simply about wearing corrective lenses and not a more serious health issue. Routine annual eye examinations which include an eye health check are strongly recommended.

In summary, check your visual acuity often, report concerns to your doctor, and even if there are no changes in your vision an annual eye health exam is still an important part of caring for your eyes.

About The Author: Dr. Jay Kaufman

Dr. Jay Kaufman is member of EyeQue’s Optometry Advisory Board. He graduated with his Doctor of Optometry degree from Nova Southeastern University, College of Optometry, in Florida in 1994. He graduated from the University of California, Santa Barbara with a degree in Communication

Screenshot 2017-09-07 12.07.50Studies in 1989. Dr. Kaufman is in private practice in the Seattle area where he specializes in family eye care, contact lens fitting, ocular disease detection, and LASIK surgery co-management.

Dr. Kaufman is a Board Certified Optometrist licensed to treat many ocular conditions using the latest drug therapies. His background includes working in Ophthalmology practices, Laser Refractive Surgery clinics, nursing homes, and his own practice where he has seen patients for the last 15 years. Dr. Kaufman has combined his love of Optometry with his studies in Communications to be an active and well respected member of his community. He has helped school-age children with vision and sports screenings and has served on the Board of his local Chamber of Commerce.










Advances in Cataract Surgery

A cataract is a clouding of the eye’s natural lens, and in fact, is similar to looking through a cloudy piece of glass. As many as 50% of people in the U.S. have cataracts by the time they reach age 75 and this figure increases to more than 70% by age 85. Congenital cataracts are present at birth, impacting an estimated 1-6 in 10,000 infants born in the US. About 5% of blindness in developed countries is attributed to cataracts, however, this number soars to 33-48% worldwide. An increasing number of people in their 40s are undergoing cataract surgery. Surgeons estimate 1-2% of surgeries in the U.S. are currently performed on patients in their 40s.

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Cataract Risk Factors

As part of the aging process, normal proteins in the lens begin to break down, which leads to an opaque lens or cloudiness. Ultraviolet radiation is a preventable cataract risk factor, however, professions in which a person is exposed repeatedly to radiation increases the risk. For example, a study on 2,559 interventional cardiologists found the opacity of the posterior lens was significantly higher compared to the control group due to frequent exposure to ionizing radiation. Common risk factors include:

  •    Ultraviolet radiation from sunlight and other sources
  •    Diabetes
  •    Hypertension
  •    Obesity
  •    Smoking
  •    Prolonged use of corticosteroid medications
  •    Statin medicines used to reduce cholesterol
  •    Previous eye injury or inflammation
  •    Prior eye surgery
  •    Hormone replacement therapy
  •    Significant alcohol consumption
  •    High myopia (nearsightedness)
  •    Family history

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Cataract Surgery

Cataract blindness is preventable and surgical intervention effectively restores visual impairment the vast majority of time. During surgery, the clouded lens is removed and replaced with an artificial lens. In 2015 alone, 9,000 ophthalmic surgeons in the U.S. performed 3.6 million cataract surgeries. In terms of numbers, cataract surgery is the most common surgical procedure in the U.S. In a few select countries, only the number of extracted teeth exceeds the number of implanted intraocular lens (IOLs)! Advances in cataract surgery have reduced the risks and complications and led to many people opting for correction of lifelong refractive errors in one outpatient visit.

Improvements in Multifocal Lenses

A multifocal IOL is considered a premium lens. It uses advanced technology called diffractive and refractive optics. Unlike a traditional monocular vision IOL, a multifocal IOL helps patients see at varying distances using different points of focus. Some patients decide to have this surgery done prior to needing cataract surgery, a procedure called refractive lens exchange (RLE). Others opt to have this done at the same time as cataract surgery. Multifocal lenses have been available for at least a decade, however, advances in technology have enabled more patients to be candidates for implantation.

Whether it is done as a standalone procedure or during cataract surgery, patient selection is key to achieving positive outcomes. For example, a person with dry eye, uncontrolled glaucoma, keratoconus, or prior refractive surgery is typically not a good candidate. Beyond those factors, a patient’s lifestyle and expectations play an important role. For many people who have relied on contact lenses or glasses for most of their entire life, multifocal lenses are a great solution. Their refractive error is corrected and they are ecstatically happy about not having to wear corrective eyewear.

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Aspheric and Toric IOLs

Traditional IOLs have a spherical optical design, so the front surface is uniformly curved from the center of the lens to its outer portion. This can impact the ability to see in dim light (e.g. night driving). Premium aspheric IOLs closely match the shape and optical quality of the eye’s natural lens. They provide sharper vision for people with large pupils, especially in low light conditions. A toric IOL corrects astigmatism and nearsightedness or farsightedness because of the different powers in the lenses’ meridians. Alignment markings on the outer portion of the lenses enable the eye surgeon to adjust the orientation of the IOL inside the eye for optimal astigmatism correction.

Femtosecond Laser Cataract Surgery

Femtosecond laser (FSL) systems were introduced in 2001 for creation of corneal flaps in LASIK surgery. The capability of the femtosecond laser to deliver safe, precise, and reproducible corneal flaps is well documented. In 2008, this groundbreaking technology was utilized for the first time in cataract surgery. FSL is contraindicated in patients with corneal scarring, mature cataracts, and small, non-dilating pupils. The main indications for FSL cataract surgery include:

  •    Anterior capsulotomy creation
  •    Laser fragmentation and liquefaction of hard and soft lenses, respectively
  •    Single plane or multiplane corneal incisions
  •    Bowed corneal incisions to control preoperative corneal astigmatism

FSL complications are rare and the technology may be safer than traditional methods in challenging cases. FSL has been performed successfully in patients with ocular injury, secondary angle-closure glaucoma associated with the cataract, penetrating keratoplasty, keratoconus, Marfan syndrome, and in children with cataracts. Overall benefits include improved precision and accuracy. FSL also reduces the energy expended and time required to perform phacoemulsification, the process used to liquefy and aspirate the natural lens from the eye.

Half the World Will Be Nearsighted by 2050

Myopia (nearsighted, reduced distance vision) is increasing worldwide at an alarming rate. In the US alone, myopia has doubled in the last 30 years, affecting one in four people over the age of 40. By the year 2020, it is estimated that 2.5 billion people or one-third of the world’s population will have myopia. Further global projections predict myopia to reach almost one-half of the world’s population by 2050. Currently, some East Asian countries have myopia prevalence of 70-80% of the population.

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Why is this cause for concern?

Myopia is the most frequent cause of distance impairment in the world. Left uncorrected, it leads to a reduction in the quality of life of an individual and associated economic consequences. Additionally, myopia increases the risk of serious ocular disorders including myopic macular degeneration, retinal detachment, glaucoma and cataracts. Another concern is myopia is starting at younger ages, which typically leads to more rapid progression and likelihood of developing high myopia; a degenerative condition with increased risk of vision loss.

How does lifestyle and family history impact myopia prevalence?

Myopia development is influenced by both environmental and genetic factors. Several studies show an association between education, socioeconomic status and occupation with myopia prevalence. A higher prevalence of myopia in urban areas has also been documented in multiple studies. In general, these all indirectly represent the effects of reading or near work activity on the visual system. While behavior and environment play an important role in myopia development, hereditable factors are also significantly associated. Children of myopic parents are more likely to develop myopia in childhood or adolescence from anatomically heritable longer eyes. Even stronger associations exist for children if parents have higher levels of myopia. It is estimated that 50-90% of myopic refractive errors originate from family history.

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What lifestyle changes can protect against myopia development?

While little can be done to change genetic factors in myopia development, changes in certain environmental factors show a protective effect. Specifically, participation in sports and time spent outdoors is associated with a decreased risk of myopia. Planning outdoor activities on the weekends, taking walking breaks at work or joining an outdoor team sport are all lifestyle changes with visual benefit. Because of the earlier onset of myopia, it is also important to frequently monitor the eye for any refractive error change to reduce risks associated with myopia and seek treatment options. Along with annual eye exams with an eye care professional, in-home monitoring is also encouraged in-between visits for those at increased familial risk of myopia development.

About The Author: Dr. Careen Caputo

Dr. Careen Caputo graduated with her Doctor of Optometry degree from the Southern California College of Optometry (SCCO) in Fullerton, California,

Screenshot 2017-08-29 15.19.38after completing a BS in Visual Science. Dr. Caputo received specialized training in low vision at the Center for the Partially Sighted in Santa Monica as well as rotations in ocular diseases. Dr. Caputo will complete her Master’s in Public Health in Global Health Leadership at the Keck School of Medicine of the University of Southern California in 2017, where she conducted research in an underserved community to inform and develop educational materials to increase awareness of diabetic retinopathy in a Latino population with diabetes. Dr. Caputo was awarded the Delta Omega Honorary Society in Public Health. She volunteers her time at community clinics giving eye exams to the underserved, working to increase access to quality affordable eye care. Her aspiration is to reduce the burden of vision loss through increasing awareness and access to timely, acceptable and quality eye care to vulnerable populations both locally and globally.