Many of these questions were submitted by patients of Dr. Rabins.
If you have a question you would like us to answer, please submit it through our Ask Dr. Rabins page.
All soft contact lenses require a certain amount of water to provide optimum vision. They remain properly hydrated by pulling water from the eye. So don’t be fooled -- all soft lenses will tend to dry the eye. Fortunately there are new contact lens materials designed to be better for dry eyes. These are water-retaining materials that don’t pull as much water from the eye during the day. Ask your optometrist which material might be best for your eyes.
For Americans, age-related macular degeneration (ARMD) owns this distinction, affecting 2% of the population over 60. ARMD involves destruction of the photoreceptors at the macula, the area of the retina involved with central viewing. When we look right at something, we’re using the macula. Since free radicals hasten the progression of certain degenerative processes (such as cataracts and ARMD), it makes some sense to protect our eyes from the harmful ultra-violet rays when we’re outside, and supplement our diets with anti-oxidants (your optometrist can be helpful here).
Glaucoma. This is a symptomless disease that typically involves elevated pressure in the eye that eventually does damage to the optic nerve, resulting in irreversibly decreased vision. Fortunately pressures can be lowered with medicines, thereby slowing the disease’s progression. Often glaucoma is first discovered during a routine eye exam, much to the surprise of the unwary patient. This is just one of many reasons that routine eye care is so vitally important.
This may seem a bit surprising, but I’m not a big fan – there’s still way too much that is unknown about the long-term prognoses for me to feel comfortable with the procedures. You may recall the very first refractive surgery – radial keratotomy (RK) – which involved making radial slices into the cornea (the outer surface of the eye) in order to change its shape. It worked, but at great expense for some folks. Many today suffer intolerable glare from headlights at night. Others have experienced corneas that continue to adversely change shape over time due to structural integrity problems. Unfortunately for some of these, they cannot be corrected to 20/20 with conventional eyewear. RK is not performed anymore, for good reason. So I must ask -- is it possible that we don’t know some things about the latest surgeries that may, in fact, contraindicate the procedures 20 years down the road?
Briefly, an ophthalmologist is a medical doctor who has graduated from medical school and who has completed a residency in ophthalmology. He or she is uniquely trained to perform surgery on the eye, although training also includes refraction (determining glasses prescriptions) and treating and managing various ocular diseases. An optometrist has been to optometry school and is highly trained to determine glasses and contact lens prescriptions. Over the past 10 or 15 years, the field of optometry has grown beyond refraction to include the treatment and management of many ocular diseases, including Glaucoma. One can immediately see some overlap in these disciplines. An optician is an expert when it comes to glasses, including their fabrication, materials, and frame selection. Opticians work closely with optometrists and ophthalmologists to find the most suitable eyewear for patients.
Most people seeking an eye doctor are interested in seeing better. Now I readily admit that I’m biased, but my recommendation is that they visit an optometrist, since refraction (the art of properly determining glasses prescriptions) is what our profession has been doing so well for over a hundred years. Good optometrists not only perform good refractions, but also recognize when a patient should be referred to a specialist for surgery, treatment of disease, or simply because his/her level of expertise has been surpassed. Even though the field of optometry has opened up dramatically to include the treatment and management of ocular disease, including Glaucoma, I (for one) am not interested in being everything to everyone. I’d rather do a number of things very well rather than a whole bunch of things adequately (or marginally). Neither ophthalmology nor optometry should feel threatened by the other – there’s plenty of room for both.
Astigmatism is generally a result of the cornea (the front surface of the eye) being shaped oval like a football instead of spherical like a basketball. Astigmatic corneas have two curves -- a steeper curve and a flatter curve. This causes light to focus at more than one point in the eye, resulting in blurred vision at distance and/or near. Astigmatism often occurs in conjunction with myopia (near-sightedness) or hyperopia (far-sightedness). Contrary to popular belief, astigmatism is not some sort of disease, and most patients have at least a small amount of astigmatism.
If you think all glasses are the same, and cost is the only variable, think again. Just as there is a difference between a Mercedes and a Yugo, there is a huge difference in lens materials, designs and fabrication laboratories. We don’t apologize for our pricing structure. As is so often true in life, you get what you pay for -- if you want it cheap, you get it cheap. Of note is that we use only high-quality materials and designs, some of which cannot be obtained through many commercial vendors. Another good reason to shop here is that if there is a problem, we’re committed to fixing it -- we want you to be delighted with your purchase. Ask us about our materials, laboratory, and quality control measures.