In honor of Sjogren’s Awareness month, eye care providers are helping to spread the word to increase awareness about this hard-to-diagnose disease.

Sjogren’s is a systemic autoimmune disorder that can affect the whole body. One of the primary symptoms is excessive dryness particularly in the eyes and mouth. Other serious symptoms include chronic fatigue and pain, specifically in the joints, as well as major organ dysfunction. The syndrome also increases chances of neuropathies and lymphomas.

The severity of the disease varies greatly, ranging from mild discomfort to debilitating symptoms that can seriously impair normal functioning in everyday life. Early diagnosis and treatment can prevent serious complications and improve quality of life. There is currently no cure for Sjogren’s, yet there are treatments for many of the individual symptoms. On average patients are prescribed upwards of 8 medications to treat the wide range of symptoms.

Women are nine times more likely to develop Sjogren’s than men and diagnosis usually occurs around the age of 40. Unfortunately, because the symptoms vary from person to person, and the disease often occurs in the presence of or mimics other diseases (such as lupus, rheumatoid arthritis, menopause, allergies or multiple sclerosis) the disease is often misdiagnosed or overlooked. Further, because the symptoms can affect different parts of the body system such as the teeth, eyes or musculoskeletal system, various health professionals are sought to diagnose or treat specific symptoms (such as rheumatologists, dentists or eye doctors) while the big picture is often missed. On average it takes almost three years to obtain a Sjogren’s diagnosis once symptoms are noticed.

Since dry eye is one of the most common early symptoms of the disease, there has been an effort to educate eye care providers to recognize and to be aware to look for symptoms of the disease. Patients also need to be aware and proactive about speaking to their health care providers about potential diagnosis and treatment. Knowing the risk factors and symptoms can be imperative to a faster diagnosis.

Your eye doctor may be able to detect and diagnose Sjogren’s syndrome from dry eye symptoms as well as other diagnostic tests and review of symptoms. With this diagnosis the treatment will be different from typical dry eye disease. Since it is an autoimmune disease, lubricating eye drops may provide temporary relief but will not address the source of the problem. Your doctor may prescribe newer cyclosporine drops as well to treat the inflammatory response. If you have dry eyes and typical treatments aren’t working, it may be worthwhile to ask about Sjogren’s.

Sjogren’s patients often feel misunderstood because most of the debilitating symptoms are not visible to others and the disease is often not recognized largely due to a lack of awareness. By increasing both public and professional awareness, the goal is to reduce diagnosis time and to advance research on the cure for this disorder.

According to the Vision Council’s 2016 UV (Ultraviolet Radiation) Protection report, parents are more likely to wear sunglasses (56%) than their children (only 29%!). Yet children, who spend much more time outside, are typically exposed to three times the amount of sunlight and UV radiation that adults get. This early exposure can lead to serious eye damage and complications later in life.

Children’s Eyes are More Sensitive

Particularly when it comes to children under 10 years of age, a child’s eye is more vulnerable than an adult’s. This is because, in children, the human lens lets about 70% more UV into the eye than in an adult. Further, once the cells of the lens are damaged they cannot repair themselves so the damage continues to accumulate throughout life. While immediate danger may be minimal, early efforts toward eye protection can prevent problems in adulthood. 

Children Have Greater Exposure to UV

At 20 years of age, the average person has received 80% of their life’s UV exposure. Children spend more time outdoors playing, participating in sports and even during recess at school. Since children have more transparent lenses in their eyes and more sensitive skin on their bodies, they are at great risk of experiencing adverse effects of overexposure to UV light. The effects of overexposure to UV light at a younger age may not show up until later in life, with higher risk of cataracts and age related macular degeneration.  This is why it is critical to effectively protect our eyes from the sun.  

UV exposure doesn’t just come from the sun. Sunlight reflected off of water, snow, sand and even pavement increases UV exposure and therefore wearing a wide-brimmed hat is often not enough to protect the eyes. Additionally, children are often looking upwards directly toward the sun at adults and objects that are taller than they are. 

Children Need to Learn Good Habits

The immediate effects of sun damage, such as sunburns to the eye, often go unnoticed, especially by children. Therefore, unlike a serious and painful sunburn to the skin which can serve as a learned deterrent, the risks and results of eye damage are less obvious. Children need to be taught about the importance of wearing sunglasses. This starts with a good example set by parents who should wear sunglasses every time they go outside. Purchasing a good pair of properly protective sunglasses that are comfortable and fit your child, and encouraging their use and care are also essential. 

Selecting Sunglasses for Kids

UV protection is available in some clear lenses as well as sunglasses. The choice can be confusing if you do not have some background information. Not all lenses are equal in terms of UV protection. For example cheaply made UV400 sunglasses have a spray-on coating that can wear off with cleaning and give you a false sense of security.  Also lens distortion and poor frame quality of discount sunwear may cause eyestrain. Ophthalmic quality lenses that provide UV protection and crisp optics should be made to last with good warranties to back up problems that can occur.

There is a plethora of options for children’s sunglasses and a good pair doesn’t need to break the bank. The first and most important criterion is that the lenses block 100% of UVA and UVB rays. You may want to also consider impact resistant polycarbonate lenses for more durability. For smaller children, look for adjustable sunglasses or a pair that includes a strap to keep the glasses in place. Inviting your child to shop with you will help ensure that the glasses are comfortable, fit right and that the child will like them, which can definitely increase the likelihood of the child agreeing to wear them as needed. 

UV Awareness Month:

This article might scare you, and we hope it does – just enough to motivate you to wear proper eye protection against the sun.

Most people are aware of the dangers ultraviolet (UV)  light from the sun pose to your skin, while the long-term effects of sun exposure on your eyes are less well-known. UV radiation can damage the internal structures of your eye, causing eye damage and vision loss, as well as threaten the delicate skin surrounding the eye and the lids. 

Before you head out into the sun without full eye protection consider the following risks:

Cataracts:

Cataracts or a clouding of the natural clear lens of the eye which is responsible for the eye’s ability to focus for clear vision, is strongly linked to UV exposure. According to the World Health Organization (WHO) up to an estimated 20% of cataracts may be directly linked to UV exposure. Cataracts are the most common cause of treatable blindness around the world. 

Macular Degeneration: 

Macular Degeneration or Age-related Macular Degeneration (AMD) is a leading cause of vision loss in adults aged 50 and older.  The vision loss occurs gradually and often unnoticeably as the macula – which is the center of the retina responsible for clear central vision – breaks down. While total blindness usually does not result, central vision is often lost resulting in a condition called low vision, which seriously impairs independent living and quality of life.  UVA exposure has been shown to be a cause of macular degeneration. 

Eyelid Cancer:

According to the Skin Cancer Foundation, cancers of the eyelid account for 5 -10% of all skin cancers.  Skin cancers of the eyelid which include basal cell carcinomas, squamous cell carcinomas and melanoma, can all spread to the eye and surrounding areas, causing eye and vision damage as well as facial disfigurement. If left untreated, they can eventually spread to the brain. When diagnosed and treated early on these cancers have a positive response rate to surgery and follow-up care.

Early warning signs of eyelid cancer include:

• Chronic infection, red eye, swelling or inflammation that doesn’t respond to medication
• A change in the appearance of the skin on the eyelid
• A lesion that does not heal
• A lump or thickening on the eyelid that may bleed and doesn’t heal
• A sudden loss of eyelashes

If you have any of these symptoms, they may have other causes but it is best to consult with a doctor as soon as possible. 

Keratitis

Keratitis or corneal sunburn occurs when excessive exposure to UV causes burns to the cornea.  The cornea is the part of the eye that reflect light onto the retina allowing vision.  A corneal sunburn can result in temporary vision loss. Keratitis is known to occur from use of tanning beds and while skiing or snowboarding at high altitudes in snowy conditions where the sun rays reflect off of the white snow into the eyes. Proper eye protection is essential for these environments. 

The best step you can take to keep your eyes and vision safe from UV exposure is to ensure that you wear 100% UV blocking sunglasses any time your eyes are exposed to the sun. Larger framed sunglasses and or wide brimmed sunhats that prevent light from entering on the top and sides are even more effective.  Take the time to ensure you have regular comprehensive eye exams as well to help catch any problems early on to prevent deterioration and save your eyes and vision. 

A stye (known by eye doctors as a hordeolum) is an infection of an oil gland which forms a pimple-like bump on the base of the eyelid or within the eyelid itself. Styes can be uncomfortable, causing swelling, pain, redness, discomfort and sometimes excessive tearing or blurred vision if it is large enough to distort the front surface of the eyes.   

What causes a stye?

The oil glands on the eyelid sometimes become blocked with dirt, dead skin or a buildup of oil and when this happens, bacteria can grow inside. Blockage is also commonly from eye cosmetics that block the orifices within the lid. This blockage causes the gland to become infected and inflamed, resulting in a stye. A stye can form on the inside or the outside of the eyelid and can cause swelling around the eye, sometimes affecting the entire eyelid. 

Treating a stye

Styes are treated with antibiotics, often in severe cases with a prescription for oral antibiotics, to reduce the bacteria responsible for the infection. Treatment for a stye is recommended otherwise there is a likelihood of recurrence. Applying a hot compress to the eye for 10-15 minutes a few times throughout the day will bring some relief and speed up the healing process.  

Similar to a pimple, the stye will likely rupture, drain and heal on its own. Occasionally a stye, especially one on the inside of the eye will not resolve itself and may require the assistance of an eye doctor for additional treatment. In such a case the stye is surgically opened and drained to reduce the swelling and cosmetic issues associated with the style. 

You should never pop a stye! This can cause the bacteria to spread and worsen the infection. If a stye is getting worse, more painful or irritated, contact your eye doctor for treatment. 

In cases where styes occur frequently, your eye doctor may decide to prescribe topical antibiotic ointment or a cleansing regimen to prevent recurrence. 

Chalazia: Another type of bump on the eyelid

Similar to a stye, a chalazion is a blocked oil gland on the eyelid that becomes enlarged. The main difference between a chalazion and stye is that the chalazion is non-infectious. Treatment involves lid hygiene, warm compresses and lid massage. If it is persistent, then surgical removal (incision and curettage) would be performed. 

Along with congestion, runny nose, coughing, sneezing, headaches and difficulty breathing, individuals with allergies often suffer from eye allergies or allergic conjunctivitis resulting in red, watery, itchy and sometimes swollen eyes. Just as irritants cause an allergic response in your nasal and respiratory system, your eyes also react with an oversensitive immune response, triggered by an environmental substance that most people’s immune systems ignore. Millions of North Americans are affected by allergies, particularly with seasonal allergic conjunctivitis (SAC) which is common during the spring, summer and fall.

What Causes An Eye Allergy

Eye allergies, or any allergies for that matter, occur when the immune system is hypersensitized to a stimulus in the environment that comes into contact with the eye. The allergen stimulates the antibodies in the cells of your eyes to respond by releasing histamine and other chemicals that cause the eyes and surrounding tissue to become inflamed, red, watery, burning and itchy.

Eye allergens commonly include:

• Airborne substances found in nature such as pollen from flowers, grass or trees.
• Indoor allergens such as pet dander, dust or mold.
• Irritants such as cosmetics, chemicals, cigarette smoke, or perfume.

Tips for Coping With Eye Allergies

To reduce exposure to allergens:

1. Stay indoors and keep windows closed when pollen counts are high, especially in the mid-morning and early evening.
2. Wear sunglasses outside to protect your eyes, not only from UV rays, but also from airborne allergens. Wraparound styles may offer more protection than others.
3. Avoid rubbing your eyes, as this can intensify symptoms and increase irritation. When the eyes get itchy, it is difficult not to rub and scratch them. However, rubbing the eyes can aggravate the allergic cascade response, making them more swollen, red, and uncomfortable.
4. Check and regularly clean your air conditioning filters.
5. Wash your hands after petting an animal that you may be allergic to.
6. Use dust-mite-proof covers on bedding and pillows and wash linens frequently.
7. Clean surfaces with a damp cloth rather than dusting or dry sweeping.
8. Remove any mold in your home.
9. Reducing contact lens wear during allergy season, and make sure to clean them thoroughly at the end of the day, or switch to daily disposable contact lenses.

Treatment for the uncomfortable symptoms of allergic conjunctivitis includes over-the-counter and prescription drops and medications. It is best to know the source of the allergy reaction to avoid symptoms. Often people wait until the allergy response is more severe to take allergy medication, but most allergy medications work best when taken just prior to being exposed to the allergen and it builds up in your system, so it’s best to take allergy medication consistently according to your doctor’s advice, rather than “as needed”. Consult your eye doctor to find out the right treatment for you.

If you are over 40 and have difficulty seeing close up, you probably have a common age-related condition called presbyopia which is when the eye’s natural lens loses the ability to focus on close objects. Presbyopia is a natural process that occurs as the eye ages and affects the majority of people from age 40 and upward. Individuals with presbyopia are often familiar with the need to hold reading materials such as newspapers an arm’s length away from their eyes in order to see clearly, yet reading glasses with bifocal or multifocal (such as progressive) lenses can help.  

Fortunately for those who don’t like the look, feel or inconvenience of reading glasses, there is another option. Bifocal and multifocal lenses are also available in contact lenses in both soft and Rigid Gas Permeable (RGP) varieties.    

Multifocal contact lenses give you added freedom over glasses and they allow you to be able to view any direction – up, down and to the sides – with similar vision. People wearing progressive lenses in glasses on the other hand have to look over their glasses if they want to view upwards or into the distance.

Multifocal contact lenses are generally designed in one of two ways, as either simultaneous vision lenses or alternating vision lenses.

Simultaneous Vision Lenses 

The most popular version of multifocal contact lenses, simultaneous vision lenses present the distance and near vision zones of the lens at the same time. Typically after a short adjustment period your eyes learn to utilize the segment of the lens that they need to focus on the desired object and essentially ignore the other. 

Translating or Alternating Vision lenses

Similar to bifocal eyeglass lenses, these contacts are divided into distinct areas or zones and your pupil will move to the desired zone depending on your vision needs. Typically the top of the lens, which is what you look through when looking straight ahead is for distance vision and the bottom area (what you look through when you look down) is for near vision. However, this can be reversed according to unique vision needs. 

An Alternative Option to Multifocal Contact Lenses: Monovision

Monovision is another contact lens alternative for presbyopia particularly if you are having difficulty adapting to multifocal lenses.  Monovision splits your distance and near vision between your eyes, using your dominant eye for distance vision and your non-dominant  eye for near vision. 

Typically you will use single vision lenses in each eye however sometimes the dominant eye will use a single vision lens while a multifocal lens will be used in the other eye for intermediate and near vision. This is called modified monovision.  Your eye doctor will perform a test to determine which type of lens is best suited for each eye and optimal vision. 

Are Contact Lenses Right for You?

If you have presbyopia, contact lenses may be a great option for you. Many people prefer the look and convenience of contact lenses over traditional reading glasses. Speak to your eye doctor about the options available to you.

When people think of workplace dangers to the eyes, it is usually machinery, chemicals or construction materials that come to mind.  However, a growing danger to the eyes is one that may be less obvious – exposure to blue light from digital devices, television and computer screens and artificial lighting.  

While the long-term effects of blue light or high-energy visible (HEV)  light emission are not yet fully known, what is known is that blue light is a cause of computer vision syndrome (CVS) and sleep disruptions.  60% of people spend more than 6 hours a day in front of a digital device and 70% of adults report some symptoms of computer vision syndrome (CVS) which include eyestrain, headaches, blurred or double vision, physical and mental fatigue, dry or watery eyes, difficulty focusing, sensitivity to light, or neck, shoulder or back pain (caused by compromised posture to adjust to vision difficulty). Most people do nothing to ease their discomfort from these symptoms because they are not aware of the cause. 

In its natural form, blue light from the sun is actually beneficial to your body by helping to regulate your natural sleep and wake cycles – also known as your circadian rhythm.  It can also boost your mood, alertness and overall feeling of well-being. However, prolonged exposure to artificial sources of blue light, such as that found in electronic devices, television and energy-efficient fluorescent and LED lights, has been shown to cause disruptions in the circadian rhythm as well as more serious vision problems. Researchers at Harvard University have linked blue light with damage to the retina at the back of your eyes, indicating that long-term exposure to blue light could be linked to age-related macular degeneration (AMD) and possibly other serious health and vision problems. 

Since 43% of adults work at jobs that require prolonged use of a computer, tablet or other digital monitor, blue light is an increasingly serious threat to your vision, health and productivity. There are a number of options for reducing your exposure to blue light which include computer glasses, specialized lenses and protective coatings. Speak to our eye care professionals to determine which option is best for you.

• Single Vision Computer Glasses: Provide the optimum lens power and field of view for viewing your computer screen without straining or leaning in to reduce symptoms of CVS. These are ideal for when the computer is at a fixed working distance, and work well if the user needs to view multiple screens at the same working distance.
• Office Lenses or Progressive Lenses: No-line multifocal eyewear that can be made to correct near, intermediate and some distance vision with a larger intermediate zone for computer vision if indicated. Perfect for those with presbyopia which is the gradual loss of focusing ability that occurs naturally with age. Office lenses work like progressive lenses but provide a wider field of view for intermediate (1-3 m) viewing distance and near working distance (about 40 cm). 
• Blue-Blocking Lenses: Definitely recommended for this electronic age, blue-blocking lenses block blue light emitted from computer screens that is associated with glare, eye strain and possible sleep disturbances. 
• Anti-glare and filtering coatings (treatments): Eliminate reflections from the surfaces of your lens to reduce eye strain and discomfort from glare. Some coatings can also block blue light emitted from computer screens. 

While all of these are good options for protecting your eyes, the 20/20/20 rule still applies – after every 20 minutes of near tasks, look at something beyond 20 feet away for at least 20 seconds…it’s a good time to stretch the rest of the body too. 

Additionally, diets high in lutein and zeaxanthin, which are carotenoids found in dark, leafy green vegetables like spinach and kale are protective to blue light damage.

A note about children and blue light:

Children are more prone to blue light damage than adults because the natural lenses in their eyes are so clear that blue light passes easily through to reach the retina.  Adults are somewhat less prone since the older we get our natural lenses become more cloudy and blue light does not pass through quite as easily. Pediatricians recommend that young children under the age of two should get ZERO screen time.   They have much better ways of developing their eyesight with activities requiring hand eye coordination with high contrast physical objects.

Technology is advancing the world, and our jobs and daily lives will only continue to rely upon it. Don’t let technology get in the way of your vision and your health. Ask us about the best solution for you. 

Whether you are looking for regular prescription glasses, sunwear or protective sports eyewear, it can be tough choosing the best eyewear for children and teens. On the one hand, they need to be comfortable and provide the optimal fit for improved vision and protection. At the same time, they also need to be durable, especially if your child is active, plays contact sports or tends to drop or lose things. Not to mention, particularly once you get into tween and teenage years, they have to be stylish and look good. When you add in a budget and your child’s opinion, the decision can be truly overwhelming.

Before you begin looking, it is best to narrow down your options by answering the following questions (and consulting your eye doctor when necessary):

1. Does my child need to wear his or her glasses all the time or are they for part time wear?
2. Does my child’s prescription call for a thicker or wide lens requiring a certain type of frame?
3. Does my child have any allergies to frame materials?
4. What type of sports protection does my child need?
5. Would cable (wrap around) temples or a strap be necessary for my child (particularly in toddlers)?
6. Do I have a preference in material or features (such as flexible hinges or adjustable nose pads)?
7. Are there particular colors or shapes that my child prefers or that will look most attractive?

Armed with the answers to those questions and a qualified optician, you can begin your search. Keep the following tips in mind:

1. Including your children in the selection process will greatly enhance the chances of them actually being excited about wearing and caring for their glasses. So make it fun and exciting for them!
2. Polycarbonate or Trivex lenses are impact-resistant lenses that are recommended for children’s eyewear to protect their eyes. Also consider adding a scratch resistant coating. 
3. When trying on options, consult with the optician to ensure proper fit. Make sure the frames don’t slide off the bridge of the nose, cover the eyes, squeeze at the temples or extend too far behind the ears. Proper frame fit is especially important for kids with specialty prescriptions like bifocals or Myovision, and for kids with lazy eye (amblyopia) and high spectacle Rx.
4. If shopping for protective sports eyewear, consider the conditions of the sport your child plays to ensure proper eye protection. They now have much more selection in children’s safety eyewear with cool designs and some glasses even have convertible temples (arms) and straps to become interchangeable dress wear and safety wear.
5. Keep in mind that it may be more cost effective to spend a little more on strong and durable eyewear now than to have to replace a flimsy pair later. Each office differs in the warranties they offer and the length and terms of coverage. Ask your optician about what is and is not covered under their frame and lens coverage policy.
6. If your child is put into bifocal lenses for reading issues or poor focusing issues (commonly used in pediatric vision therapy) they will generally require a deeper frame in order to have enough room for the bifocal, which is often difficult when dealing with smaller frames.
7. Consider a blue light protecting anti-reflective coating. Children are especially prone to damage from blue wavelengths of light because their human lenses are so clear. Blue light is emitted from many of the devices we use such as cell phone screens, tablets, laptops, TVs, and the sun as well.

The great news is that the options in children’s eyewear in terms of style, quality and innovation is progressing rapidly. Rather than dreading the eyewear shopping experience, have a positive attitude. This will have a positive influence on your child’s relationship to eyewear and good vision that can last a lifetime.