Below you will find some of the questions we recieve concerning eye care and the Doctor’s responses.  If you have a question you would like answered, fill out the form below…

ASK THE EYE DOCTORS

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Question:
At my 10 year old son recent doctor check up, his vision was screened at 20-50, and the doctor recommended a follow up with an official eye exam. Is this serious or normal growth changes in the eye, as this was indicated at his check up last year. A year ago, one of his eyes was 20-20, and the other 20-30, which the doctor said this was normal due to growth and changing of the eye.  Now I’m very concerned.  - K

Answer:

Your son likely has myopia or nearsightedness which means it is difficult to see in the distance.  Approximately 25-30 percent of all people have this condition which is one reason why you see people wear glasses.  He will need a comprehensive eye exam to determine the power he will need in his glasses and as long as his vision is able to be corrected to 20/20 you have nothing to worry about.  I would recommend all children be examined at age 6-12 months and every 1-2 years thereafter depending on the initial findings.  It is very important to have the health of the eyes checked to rule out eye diseases that may not have any symptoms.  Also, the vision screening at a doctors office is often inaccurate and can miss certain vision conditions such as lazy eye or amblyopia.

 - James E. Harris O.D.

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Question:
I had cataracts in both eyes and, together with my cataract surgeon, decided to operate on the eye with the more advanced cataract first. So we scheduled surgery to put in a monofocal IOL. The night before the surgery, I spoke with my brother, who’d had cataract surgery for one eye a few years ago. He told me about monovision and the possibility of not needing reading glasses. This was the first I’d heard of this option.

The next morning, before the surgery, I brought this up with my surgeon. He suggested that we go ahead and do the prepped eye and discuss monovision after the surgery. So we did.

Afterwards, I learned that it’s customary to put the distance lens in the dominant eye. Furthermore, from my medical records I learned that the eye with the monofocal IOL was NOT my dominant eye. So, if I decided on monovision now, the arrangement would not be optimal.

To evaluate my options, over the past three months I have been wearing contact lenses in the eye that still has a cataract. (The cataract is much less advanced, so my vision in the eye is good.) One lens corrects for distance, and the other gives me monovision. I have had no trouble with monovision, other than mildly less sharp distance vision. And, I have decided I like monovision better than the alternative of both eyes having distance implants and using reading glasses for close-up and computer work (which I do a great deal). So now I want to plan the surgery for the other eye.

In light of the fact that the distance lens is already in my non-dominant eye, what things should I take into consideration now? Is there anything I can do to adjust for the fact that the monofocal lenses will be “backwards” from the usual monovision arrangement? Or, am I being overly concerned, with the difference between having the distance lens in the dominant eye vs in the non-dominant eye having inconsequential implications?

Thanks for your advice.

– M

Answer:
Great Question!

Many patients successfully wear monovision contact lenses,with one eye having a distance powered contact lens and the other having a nearpowered contact lens. Although you arelimited to one eye having perfect vision while the other eye remains slightlyblurred, the brain typically fuses these two images together with minimalvision loss. The need for glasses isgreatly diminished or even eliminated with this correction.

You are correct that most of these patients do wear theirdistance contact lens in their dominant eye. Since distance vision is usually more critical and used more for overallvision, the dominant eye is the logical choice for this lens and the brain typicallyadapts better in this circumstance. However, there are many patients who wear their distance contact lens intheir non-dominant eye and do just fine, especially those that find themselvesusing their near vision the majority of the day (ie computer users, etc). The only way to know which way works best iswith trial and error.

Again, with most contact lens wearers, it is easy toexperiment with their vision by trying different lens combinations in differenteyes to find the optimal result. Withcataract surgery, experimentation is obviously not as easy. Since the surgeon has already placed thedistance implant in your non-dominant eye, the only choice you have is to put anear implant in your dominant eye if you wish to end up with monovision afterthe surgery and therefore reduce your dependency on glasses. If you are in fact wearing a near poweredcontact lens in this dominant eye now (with no contact in the non-dominant eyethat has already undergone surgery) and having no problems, there is a goodchance you will have no problems after surgery. Obviously nothing is ever guaranteed, but the chances of adaptationafter surgery are usually really good if it works with the contact lenses.

Regardless of your decision, which should be made inconsultation with your surgeon, keep in mind that the chances of having perfectvision after healing from cataract surgery is lower than with other surgeriessuch as LASIK. Even though the bestoutcome is perfect vision, many people still require a small glassesprescription to give them perfect vision. The best case scenario is your dominant eye will read perfect and youwill not have any problems or a need for glasses/contacts after your eyesheal. The worse case scenario is thatyou will need or want to wear contact lenses again after the surgery to getoptimal vision, and you can always put a distant contact lens over yourdominant eye and a near contact lens over your non-dominant eye if the surgerydoes not produce the desired outcome. – Dr. Dustin Reece

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Question:
I had cataract surgery over 5 years ago and everything has went well-but now am having problems with my reading-especially left eye. went to optometrist for eye check and he said my left lens (intraocular) is a little clouded. after getting my glasses my vision in left eye is still poor. what next? – L.B.

Answer:
Sometimes after cataract surgery, cells from your body can grow over the intraocular lens that has been implanted. Medically, this is termed posterior capsular opacification, and occurs in roughly 25% of all cases. This “haze” will impede the light transmission through the lens thus reducing vision. Glasses will provide very little improvement to the vision. If the vision is bad enough and your optometrists recommends it, the cataract surgeon can perform a simple, painless laser procedure to clear the haze from the intraocular lens. This procedure is called a YAG Laser Capsulotomy. Your vision should immediately improve after this procedure. – Dr. Dustin Reece

Question:
What does it mean when ur eyes are red?  Because I wear eye contacts and I forgot to take them off… – J.

Answer:
Eyes appear red when the blood vessels become inflamed.  This can be due to infection, contact lens problems as you described, environmental conditions, trauma, foreign body, allergic reactions or other conditions.  Some conditions can be serious but most are not. – Dr. James Harris

Question:
I woke up one morning with a swollen eye. Now i Happen to have a little bump in my eyelid about the size of a crumb. What could this be? – A.

Answer:
Unfortunately, there are too many possible answers to be able to diagnose an eyelid bump without examining it. Therefore, I would advise you to have an examination by your eye doctor to determine the nature of the bump.

The good news is most eyelid bumps are benign. However, following the dermatological ABCDEs are a good rule of thumb on most malignant skin lesions, especially melanomas:

A = Assymetry (draw a line down the middle and if the right half is different than the left half you have assymetry; benign lesions are usually symetric)
B = Border (edges are ragged, blurred, or irregular; benign lesions usually have uniform borders)
C = Color (does not have the same color throughout, or has multiple colors such as red, tan, black, brown, blue, or white; benign lesions usually have a uniform color)
D = Diameter (larger than a pencil eraser should be examined; most benign lesions are less than 6mm in diameter)
E = Evolving (shrinking, growing larger, changes color, begins to itch or bleed, grows in height should always be checked)- Dr. Dustin Reece

Question:
I am 41 and nearsighted. I have worn -2.5 for about 15 years. I recently had an eye exam and the doctor wanted to change my prescription to -2.75, even though the difference is extremely minor. Isn’t it better to not wear stronger lenses unless absolutely necessary because it can make the eye weaker? – L.E.

I am nearsighted, why is my close up vision blurry when I have my contacts in? – L.E.

Answer:
You are likely having trouble reading because you are entering what is called presbyopia which affects everybody around age 40. You will have trouble reading due to a gradual weakening in the focusing system of your eyes. When you are born until around age 40, the lens in your eye can contract when you look at near which allows you to read clearly. At age 40, this process starts becoming gradually more difficult over the next 15 years. There are excellent multifocal contact lenses you should ask your doctor about that will allow you to see clearly in the distance and near.

In regards to your question about increasing the power from -2.50 to -2.75, your doctor probably found that the extra power improved your distance vision. However, because you are entering presbyopia, this increase in power will have made your near vision slightly more blurry. This will not make your eyes weaker but can cause symptoms of near blurred vision, headaches , and fatigue if you do not change into multifocals contact lenses, monovision, or wear reading glasses. These are three choices you have available that your eye doctor should discuss with you to determine what best fits your lifestyle. - Dr. James Harris

Question:
How often do I need my eyes checked? – S.H.

Answer:
The standard of care is every year unless you have certain eye diseases of which could be more often.  The health of your eyes needs to be checked even if your vision seems like it has not changed.  Some eye diseases such as glaucoma have no symptoms and can lead to irreversible vision damage if not thoroughly checked for at your annual comprehensive eye exam. – Dr. James Harris

Question:
I have been told that I have astigmatism and cannot wear contact lenses.  Is this true? – P.B.

Answer:
Most  likely you can wear contacts very easily.  Contact lens technology has advanced to the point where most people can comfortably wear contacts that correct for astigmatism.  There are many types of contact lenses that correct for astigmatism ranging from soft torics to RGP lenses to hybrid lenses.  All options would be evaluated and considered with a thorough contact lens fitting, evaluation and follow up care period before determining the best choice of lens for you.  - Dr. James Harris

Question:
My left lens keeps bothering me, I have been through 3 lens and its the same thing. Should I go to the eye doctor? Its like the contact is always uncomfortable and scratchy. – E.B.

Answer:
Yes, there could be several things causing irritation (some serious) that would require treatment by your eye doctor. – Dr. James Harris

Question:
I haven’t had a regular eye exam in roughly five years; I have had a contact lens exam about a year ago. I would like to buy more lenses but am concerned with the length of time that has gone by between eye exams.

Could I get a regular eye exam and still use the predicting contact lens prescription, would that be sufficient? - J.

Answer:
Contact Lenses are medical devices regulated by the FDA, and a Contact Lens Evaluation by your eye doctor must be completed each year in order to renew your contact lens prescription.  Therefore, by law, you can’t reuse an old or expired contact lens prescription.  Even if your vision has not changed, it is very important to have your eyes evaluated yearly for medical changes that could be related to contact lens wear, many of which can be asymptomatic and lead to long term damage of the eyes.

Also, let me explain that one must have a Comprehensive Eye Health and Vision Exam (presumably what you are referring to as a regular eye exam) before being able to undergo the Contact Lens Evaluation.  The components of each type of exam are different, although most doctors will combine the two and refer to them as a Contact Lens Examination.  So technically (and in some cases legally), you must have had a regular eye exam each time you had your contact lens exams.

A Comprehensive Eye Health and Vision Exam usually includes a refraction to determine the glasses prescription, a binocular vision evaluation, and a comprehensive medical examination of the eye.  It does not include contacts or provide a contact lens prescription.  The Contact Lens Evaluation is usually done after the Comprehensive Health and Vision Exam is completed, and the doctor will use trial lenses to determine the most appropriate contact lens for each patient’s optimal vision and comfort. The doctor also exams for potential problems that can be associated with contact lens wear.  Once this is completed the doctor will release the contact lens prescription. - Dr. Dustin Reece

Question:
My 9 year old son had an eye exam at school and they indicated he needs glasses. We went to an optometrist and my son vision is 20/50. The optometrist recommended that he wear glasses when needed. I always thought once you have glasses you need to wear them all the time. My question is if he puts them on and takes them off through out the day, will this make his vision worse? The way the optometrist was putting it, he can wear the glasses in class and take them off during recess. I think the constant adjustment his eyes will make will worsen his eyesight. – J.

Answer:
Without knowing your son’s prescription, it is hard to give you an answer specific for your case. There are definitely certain prescrptions that need to be worn all the time, and there are others that only have to be worn when needed. Your optometrist is well trained and understands these cases, so I would trust his/her opinion.

It is not necessarily true that once you have glasses you have to wear them all the time. Also, the constant adjustment that comes with taking the glasses on/off will not contribute to his vision getting worse. My guess is that your son is mildly near-sighted, as this is what most school screenings detect. He was probably given glasses to help see distance more clearly, but he can read easily without glasses. Vision of 20/50 is also indicates a mild prescription, meaning he needs the glasses to see the small distance details, but when out at recess he can function fine without them in most cases.
– Dr. Dustin Reece

Question:
I am severely nearsighted. Can wearing weaker prescription glasses for close work like computer or reading make me more nearsighted? – M. A.

Answer:
The answer to your question depends on several factors that can only be determined with a thorough eye exam and binocular vision check.  However, I will say that many nearsighted people need special types of computer lenses that sometimes are “not strong enough” for best distance vision.  In other words, having weaker glasses if you are nearsighted is sometimes the solution for eye fatigue and eye strain that can potentially worsen your nearsightedness or myopia.  In your situation, it may be that your weaker glasses are actually helping prevent your nearsightedness from getting worse if you are only using them at the computer. – Dr. James Harris

Question:
My son is 12 years old. He has worn glasses since he was two. His eyes are +7.75 in the left eye (left eye is also lazy but, is corrected when glasses are on) and +7.25 in the right eye. I took him to be fit for contacts today and the eye doctor told me that when kids get older, you should wean their prescription down. She fit him for the contacts  and put him in +6.25 in both eyes. She did this even though his eyes have not inproved. She also said that he now has an astigmatism in the left eye as well. Is this a normal thing for an eye doctor to do?! He didn’t even keep the contacts in because he said he couldn’t see and everything was blury. Should I get a second opinion or is this normal? – B.

Answer:
Thank you for the question.  I think you will have different answers to your son’s situation depending on who you ask.  My answer assumes that your sons is fully corrected to 20/20 with his current glasses.  If not, the actual best corrected vision would be another piece of information I would need.  I personally do not decrease the plus power if someone has adapted into the full power.  I often “cut the plus” power when someone begins wearing glasses or contacts with a prescription as high as his.  This technique is very common among all eye doctors.  Your sons situation is different in that he has been wearing full correction for 10 years.  As far as his contact lens prescription, that may be a matter of going back to your doctor and having a contact lens check.  Often times we have to adjust the power a few times on subsequent contact lens checks.  - Dr. James Harris

*NOTE:  This page does not substitute an annual exam or presume to provide you with medical advice.
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