What Does an Optometrist Do All Day? Glasses....Glasses....Glasses....or....

Have you ever wondered what an optometrists does all day?  

Most people know that if they are experiencing blurry vision, they can visit an optometrist who will provide them with a prescription for glasses or contacts.  But did you know that your optometrist does much more during your eye exam than merely prescribing glasses? And that not every cause of blurred vision can be fixed with glasses? That’s why every comprehensive eye exam also includes a thorough health check of your eyes.  Why do your eyes need a health check? And what exactly is your Optometrist looking for?

For us to be able to see, light must travel into and through the eye without difficulty, from front to back. When light enters your eyes, it must pass through several layers before reaching the back of the eye, where visual information is then sent to your brain via the optic nerve.

Your Optometrist needs to examine all of these anatomical layers to evaluate your eye's ability to receive and appreciate the light. To do this, they use an instrument called a "slit lamp", which utilizes a series of lenses and mirrors to magnify your eye, similar to a microscope.

The health of your eyes can change at any time and can be happening without you knowing it. The only way to be sure that your eyes are healthy is to have regular eye health checks. Most optometrists would recommend yearly eye health checks, just like your medical doctor and dentist do.

So what exactly is your optometrist looking for
 during these health checks?  

Let's start by reviewing the anatomy of your eyes!

• The outermost layer of the eye is called the cornea. Many people confuse the cornea with the iris, which is the coloured part of the eye. The cornea is crystal clear and needs to stay that way to optimize the movement of light through its layers. The shape of the cornea is also partly responsible for determining the prescription of your glasses and contacts. For example, if your cornea is not perfectly spherical in shape, then you likely have some degree of astigmatism. Infections and scratches can cloud the cornea, causing a decrease in your vision. The cornea is protected by a tear film layer that is left behind after each blink you take. A compromised tear film can lead to dry eye symptoms such sandiness and grittiness on the front of your eye.
  

• Surrounding the cornea on all sides, the “white of your eyes” is called the sclera. This area is a tough outer layer that acts like a shell to protect the eye from puncture. You might notice that the sclera appears red from time to time. This redness is due to the enlargement of blood vessels sitting on top of the sclera. These blood vessels are normally very thin and difficult to see but become enlarged as a reaction to irritation. This irritation can be caused by many things, including infection, inflammation and dryness.
  

• Sitting behind the cornea is the iris or “coloured part of the eye”. The colour of the iris ranges from dark brown to pale blue depending on the amount of pigmentation present: a tremendous amount of pigment in brown eyes, a tiny bit of pigment in green eyes, and almost no pigment at all in blue eyes! In the middle of the iris, there appears to be a round black dot. However, this dot is actually a hole known as the pupil. You may have noticed that the size of the pupil changes throughout the day. This is normal. The pupil size will be large in dim lighting and small in bright lighting. It is the job of the iris to respond to the surrounding light levels with the appropriate pupil size for optimal vision. Inflammation of the iris, called iritis or uveitis, can affect the function of the iris, and lead to pain and light sensitivity.
  

• Sitting behind the iris is the crystalline lens. "Crystalline" because it is crystal clear the day you are born. Just like the cornea, the lens needs to remain as transparent as possible to allow us to see the world around us. The lens is made up of collagen, is very flexible, and natural movements within the lens allow us to read. The lens becomes less flexible with time, and consequently, our reading ability gets weaker and weaker as we age. Decreased lens flexibility leads to the eventual need for reading glasses or progressive lenses. If the lens becomes cloudy or opacified in any way, whether by ageing, systemic conditions, or as a side effect of certain medications, it becomes what is known as a cataract. A cataract can significantly block the light travelling through the eyes and lead to a decrease in vision.
  

• Sitting between the crystalline lens and the back surface of the eye is the vitreous humour. The vitreous is colourless and clear. It is a jelly-like tissue that is 99% water. The remaining 1% is made up of collagen, proteins, salts, and sugars. The vitreous provides protection to the eye as well as helps it to keep its spherical, or ball-shaped, appearance. With time, the collagen and proteins become "stringy", and the vitreous begins to liquefy. This creates symptoms of "floaters" which are more noticeable when looking at a white wall or a blue sky. Sometimes various health conditions necessitate the removal of the vitreous humour, and this is done through a process known as a "vitrectomy".
  

• Once the light moves from the outside world, through the cornea, into the pupil and through the crystalline lens and vitreous humour, it finally hits the retina. The retina is where all the millions of receptors and nerves that convert the light into vision is located. Therefore it needs to be checked very carefully by your optometrist who will assess the macula, the optic nerve head, the blood vessels, and all other areas of the retina.
  

• The macula is densely packed with photoreceptors and is responsible for your central, high-resolution vision. Damage to the macula can permanently affect your vision, and even cause blindness. Common causes of damage to the macula include smoking cigarettes and excessive sunlight exposure, which can lead to macular degeneration. The macula can also be damaged by uncontrolled diabetes. Permanent loss of vision due to damage to the macula can result in loss of one's driver's license and limited job opportunities.
  

• The optic nerve is a collection site. Photoreceptors from the entire retina carry information to the optic nerve head, which is a direct line from the eye to the brain. Nerve damage from glaucoma is visible at the optic nerve head. Another important problem to rule out is papilledema, or swelling of the optic nerve head. This can cause headaches, blurred vision, and signal possible swelling within the brain itself.
  

• The blood vessels carry oxygenated blood and nutrients to the retina to maintain optimal function. Many systemic problems such as diabetes and high blood pressure can disrupt these blood vessels. It is important that your optometrist assess the blood vessels for leaks and proper blood flow.

Let's look at a few case examples, where your optometrist does a little more then you might think 

Case Study 1:

Debbie Johnson goes to her optometrist, Dr. McKenzie, complaining of pain when opening and closing her left eye. Her left eye is also red and watery. Her right eye feels perfectly fine. Dr. McKenzie uses his slit lamp to examine her cornea. He notices a thin, whitish line on her cornea. It looks like a corneal abrasion, or scratch to the front of the eye. He then uses an orange dye called Sodium Fluorescien to help highlight the cornea and confirms that it is indeed a corneal abrasion

A corneal abrasion is an open wound to the eye and therefore can become infected if not treated. Dr. McKenzie starts Debbie on a course of antibiotics eye drops to fight any infection and to allow the cornea to heal itself. He may also prescribe lubrication eye drops to aid in comfort. It is important to discontinue any contact lens use while the cornea heals.

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Case Study 2:

Ben West goes to his optometrist, Dr. Lim, complaining of cloudy vision. He says it has been steadily getting worse over the last year and now he is noticing changes in his colour vision as well. Dr. Lim uses her slit lamp to evaluate his eyes. She notices a problem with the crystalline lens and recommends dilating Ben's eyes to get a better look at the lens as well as the retina to determine the cause of Ben's complaints. Once Ben's eyes are fully dilated from the diagnostic drops, Dr. Lim uses her slit lamp again. She notices that the crystalline lens has turned light brown in colour. No problems are found at the retina.

Ben's blurry vision and colour vision problem are due to cataracts and Ben will be sent to an Ophthalmologist for cataract surgery. Cataracts cause blurry vision that cannot be corrected by glasses and surgery becomes a necessity to continue daily tasks at the same level as before.

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Case Study 3:

John Jackson goes to his optometrist, Dr. McKenzie, complaining of warped central vision in his right eye. When he looks at something, like a tree, the trunk looks bent and distorted. Dr. McKenzie is very concerned about John's macula based on his complaint and recommends a dilated eye exam. 20 minutes after the dilation drops go in, Dr. McKenzie uses his slit lamp and a high plus lens to examine the macula of John's right eye. He sees a distortion of the macula and fluffy, yellow spots surrounding the macula.

John has signs and symptoms of macular degeneration. John needs to begin taking daily vitamins specially designed to aid the macula and fight off degeneration. If the degeneration continues to progress, John may need surgical intervention such as monthly injections. There are many risk factors that predispose someone to develop macular degeneration. These include excessive sun exposure, smoking, and a fair complexion.

Another common cause of John's symptoms is a macular hole. This can be caused by tugging of the vitreous body on the macula. This may or may not need surgical treatment, but if it does, John may need a vitrectomy, which is a removal of the vitreous body to alleviate the tugging on the macula.

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Case Study #4

Pamela Clark goes to her optometrist, Dr. Randhawa, complaining of a veil-like curtain over her left eye. She is also seeing flashes of light from the corner of her eye and increased number of floaters. Dr. Randhawa is very concerned about Pamela's retina based on her complaints and recommends a dilated eye exam. Once her eye is fully dilated, Dr. Randhawa uses her slit lamp to exam the retina of Pamela's left eye. Dr. Randhawa sees a small horseshoe-shaped tear in the outer retina. Pamela has a retinal tear, and emergent surgery is needed. Dr. Randhawa sends Pamela to the nearest hospital for surgery. Retinal tears and detachments can cause a permanent loss of vision and require immediate attention. It is important that anyone experiencing flashes or floaters be assessed right away by an optometrist.

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Case Study 5:

Jane Fields goes to her optometrist, Dr. McKenzie, complaining of watery eyes throughout the day. Dr. McKenzie uses his slit lamp to exam the front surface of the eye and sees dry corneas. Jane's watery eyes are related to dry eye. This seemed counter-intuitive to Jane as her eyes are too wet, not too dry, but Dr. McKenzie explains to her that her cornea signals to the brain that it is dry and the brain responds by signalling to her glands to produce more tears. That is why a dry eye is a watery eye. Dry eye can be caused by many things including wind and a low humidity environment. It is helpful to wear sunglasses outside as well as to supplement with artificial tears.

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Hopefully, this has given you an insight into the things your optometrist is looking for every time you come in for an eye exam.

Your eye health is essential to the function of your eye and needs to be examined on a regular basis. 

BOOK YOUR NEXT EYE EXAM IN EDMONTON
WITH A STONEWIRE OPTOMETRIST

We Provide Emergency Eye Care in Edmonton

Stonewire Optometry provides emergency eye care services. Whether you’re an established patient or new to our eye care clinic, we are here to help. Our team of optometrists are trained to handle most eye care emergencies that you may experience, and our clinic is equipped with the latest diagnostic equipment to aid in both the diagnosis and education of your eye condition. Our equipment includes optomap ultra-widefield retinal imaging, retinal photography, digital OCT retinal imaging and computerized visual field testing.

Did you know? Emergency eye care services are covered under Alberta Health Care. Simply show your Alberta Health Care card at the time of the examination.

Should your eye care emergency require the immediate services of an ophthalmologist (eye surgeon), our optometrists will ensure that you are referred immediately to the local on-call ophthalmologist. If your eye condition is less urgent but a referral is still required, they will refer you to the appropriate ophthalmologist that specializes in your condition.

As with any medical emergency, it’s important to be proactive. If you feel that you need to be seen by an eye doctor, please don’t wait until the end of the day to call or walk-in. It’s important to contact our clinic as soon as possible to ensure that you get timely appropriate eye care.

Important: If you should experience an eye emergency after regular business hours that you feel is serious and warrants immediate medical attention, please proceed directly to the Royal Alexandra Hospital emergency department. You may also contact Alberta Health Link at their new 811 number to get medical assistance from a registered nurse.

The Clinic: Are you Looking for an Edmonton Eye Doctor?

Many eye conditions are not immediately apparent and don’t have any obvious signs or symptoms. Having a regular eye exam with a Doctor of Optometry provides them an opportunity to examine your eyes for asymptomatic conditions, while ensuring that your eyeglass and contact lens prescription are up to date.

Stonewire Optometry in Kingsway Mall uses the latest diagnostic equipment to evaluate your eye health and eyewear prescriptions. So if you’re looking for a new optometrist in the Edmonton area, look no further! We would love to become your new eye care providers.

Book your next eye exam in Edmonton with a 
Doctor of Optometry at Stonewire in Kingsway Mall.

We Accept Alberta Blue Cross Insurance

Stonewire Optometry and Pearle Vision Optical in Kingsway Mall have the ability to direct bill your Alberta Blue Cross vision insurance plan at the time of your next eye exam or eyewear purchase. If you or your employer has added coverage for optical services/vision care to your Alberta Blue Cross plan, then a portion of or all of your visit or eyewear purchase may be covered.

With so many individuals and local employers offering group coverage through Alberta Blue Cross such as: teachers union (asebp), nurses union and some divisions of the City of Edmonton. Stonewire Optometry in Kingsway Mall is trying to make it more convenient for these people to access their vision care benefits.

How do I know if I have vision coverage?

1. Your card must be from Alberta Blue Cross
2. Your card needs to say ‘vision’ on it

What’s covered under Alberta Blue Cross Vision Care?

1. Eye Exams
2. Contact Lenses
3. Prescription Eyeglasses
4. Prescription Sunglasses

To learn more about the products and services available through Alberta Blue Cross or the coverage on your current plan, please visit their website at: ab.bluecross.ca or call an Alberta Blue Cross customer service representative toll free at 1.800.394.1964

Book Your Next Eye Exam with Stonewire Optometry
Kingsway Mall | Edmonton | Alberta

Back to School Eye Exams

Book your children in for their back to school eye exam at Kingsway Optometry. A comprehensive eye test by one of our optometrists will help to ensure that they are ready for another school year.

Your child’s eye test will include a comprehensive eye health examination along with a complete vision check for eyeglasses. Children should receive their first eye test by 3 years of age or as young as 6 months of age if you or pediatrician have any concerns or there is a family history of vision or medical problems.

Eye health exams and vision testing is covered under Alberta Health Care for children 18 years of age or younger. There is no charge for you child to be seen by an optometrists for annual eye exams and vision tests.

If your child already wears eyeglasses, please talk to us about healthy contact lens options for sports, recreation or school.

Open for Eye Exams

Kingsway Optometry is open early, open late and is now open every Saturday & Sunday. We keep increasing access to our eye care clinic to better serve our growing customers base. With over 70 years of eye care experience we continue to evolve and adapt to our customers needs.

Book your next eye exam with Kingsway Optometry at a time that works for you! Book Now.

School Vision Screenings

School vision screenings are a critical component of our health care system and help to detect gross visual problems in children that may otherwise go undetected. School vision screenings however are not a substitute for a comprehensive eye examination by an optometrist. All children, 3 years of age or older, should receive a complete eye examination at least once a year.

An optometrist can examine your child to ensure that they have the adequate visual skills needed to succeed at school. With almost 80% of all learning being visual, it is critical that your child’s visual system be operating perfectly.

An eye examination by an optometrist is more then about 20/20 vision, it’s also about having proper visual skills. Some of these skills include colour vision, depth perception, focusing, eye teaming, and eye tracking.

Did you know?

Children are covered under Alberta Health Care for a comprehensive eye examination once a year. There is no cost to you as a parent to have your child’s eyes examined.

Children are also covered under Alberta Health Care for emergency eye exam appointments for things such as: pink eye, eye infections, allergies, injuries, etc.

Book your child in today for their back to school eye examination at Kingsway Optometry in Kingsway Mall and protect their ability to learn.

Kingsway Optometry and its eye doctors are proud to be members of the Alberta Association of Optometrists and to participate in the Eye See…Eye Learn program. A partnership between optometrists, private business and the Alberta Government with a focus on ensuring that every child receives an eye exam before starting kindergarten. To learn more about the Eye See…Eye Learn program please refer to the Alberta Association of Optometrists website.

Evening Eye Exams Available

Kingsway Optometry now offers evening eye exam appointments. So if you need to see an optometrist, but you can’t manage traditional doctor hours, then Kingsway Optometry is right for you. Our optometry clinic is now open late until 8pm every Tuesday evening.

Kingsway Optometry also has Saturday and Sunday eye exam appointments available. So to schedule an eye exam at your convenience with one of our optometrist you can either book online, call us, or simply stop by.

Whether you require a routine eye health exam, new eyeglasses or contact lenses, or you have an ocular emergency, Kingsway Optometry has you covered.

Doctor Hours: Mon 9am-6pm / Tues 9am-8pm / Wed 9am-6pm / Thurs 9am-6pm / Fri 9am-5pm / Sat 9am-4pm / Sun 11am-3pm

Have Your Eyes Examined Regularly

Of course! It seems obvious on the surface that one of the best things you can do to prevent vision loss from eye disease is to have your eyes checked regularly. Many eye diseases such as glaucoma, macular degeneration and diabetic retinopathy can be easily controlled if detected early enough, thereby preventing or limiting any loss of vision. It just makes sense that regular eye examinations would be the number 1 thing you could do to prevent vision loss. And yet still, it’s astounding just how few people regularly have their eyes checked.

In a study by the College of Optometrists in Vision Development, it was found that up to 25 percent of school-age children have some form of vision problem that may affect learning, but only a small percentage of children ever receive a comprehensive eye exam. With the new Eye See Eye Learn program by the Alberta Association of Optometrist, our clinic is working to change this by improving patient education and public awareness.

Even people with known eye problems aren’t getting eye exams. A study conducted at Duke University showed that only 70 to 90 percent of patients with glaucoma had a yearly check-up. Glaucoma is an eye disease that can slowly and silently cause blindness over a period of time. These patients often need to be followed at least two to three times a year. And yet a full 10 to 30 percent of them aren’t even going to the eye doctor yearly.

Similar numbers were found in patients with macular degeneration and diabetes. Only 65 to 80 percent of patients with macular degeneration have yearly eye exams and only 50 to 60 percent of patients with diabetes have them. Many of these people will very likely become legally blind from their untreated conditions. With the new medically necessary vision testing under Alberta Health Care your optometrist is able to follow these conditions (glaucoma, diabetes, and macular degeneration) at no charge to yourself.
The evidence speaks for itself – the number one recommendation is to make sure you have your eyes examined regularly!

Who Should I Go to For My Eye Exam?

There is often much confusion regarding whom to see for an eye exam – after all there are three different “O’s” that care for eyes in various ways. Who should you choose? To answer this question, let’s first define who the three “O’s” are:

• Optometrists (O.D.’s) – A doctor of optometry receives his degree after four years of post graduate training in a college of optometry. Optometrists are licensed to perform comprehensive eye exams, prescribe glasses and contact lenses and to treat many types of eye disease including conjunctivitis (pink eye or red eye) and glaucoma. Optometrists typically do not perform surgery. Instead they receive additional training on understanding and treating the functional aspects of vision – how to help people see the best they can in their day to day lives.

• Ophthalmologists – Ophthalmologists are medical doctors (M.D.’s) or osteopaths (D.O.’s) who take a three to five year residency in eye care after they receive their medical degree. In addition to providing comprehensive eye examinations, ophthalmologists are able to prescribe eye medications and perform surgery. Some ophthalmologists go on for additional training and become specialists in certain areas such as retinal, corneal, cataract and glaucoma treatment.

• Opticians – Opticians are professionals specially trained to fit, fabricate and dispense eyeglasses. Many states also allow opticians to dispense contact lenses. Opticians do not perform comprehensive eye health examinations.

Which one should you choose for your routine comprehensive eye exams – an ophthalmologist or an optometrist? Obviously I may be biased, but I know today’s optometrists are well trained and skilled at detecting eye disease. If specialized medical or surgical treatment is ever needed, we will quickly arrange for you to see the right ophthalmologist who specializes in your particular eye care problem.

What Does 20/20 Vision Mean?

This is a common question that people seem to always ask eye doctors at social events. Typically optometrists and ophthalmologists refer to visual acuity in terms of the Snellen acuity eye charts. The Snellen acuity eye charts displays letters which become progressively smaller from the top to the bottom. In terms of Snellen acuity, 20/20 is considered normal vision for most people. From a statistic point of view what does this mean? In basically means that approximately 68.2% of the normal healthy population is able to have their vision corrected to this level. It also however means that approximately 15.9% of the normal healthy population has correctable vision that is better than this and that 15.9% of the normal healthy population has correctable vision that is worse than this.

In general 20/20 means that a person sees the same line of letters at 20 feet that a normal person sees from 20 feet. If a person has 20/40 vision, than this means that they can see the same line of letters at 20 feet that a normal person sees from 40 feet away. Therefore their vision is worse than normal. If a person has 20/15 vision, than this means that they can see the same line of letters at 20 feet that a normal persons sees from 15 feet away. Therefore their vision is better than normal.

Recap:

20/20 – Top number is where you are standing and the bottom number is where a normal person stands to see the same sized object or line of letters.

Now you know!

What is nearsightedness and how is it corrected?

Myopia or nearsightedness is a common vision disorder where by people can see objects up close, but are unable to focus clearly on objects in the distance. 

Nearsightedness is the result of two things, either a person's eye grows too long, or the outside of the eye is too steep or round, causing images to focus in front of the retina.

Symptoms of Nearsightedness

Typically, people will start to notice problems with their distance vision in their school years, but nearsightedness can develop at any age. It may also be a sign of a more serious medical problem, such as diabetes or cataracts, especially if the onset of nearsightedness is very sudden and dramatic.

Initial symptoms of nearsightedness include problems focusing on small objects far away like road signs or the channel guide on TV. People can find themselves squinting or developing frontal headaches from having to squint. Children often complain about being unable to see the board at school, while adults often complain about poor night vision or increased glare. Symptoms almost always worsen in low light level situations.

What Causes Nearsightedness?

There has been increased research in the area of nearsightedness in recent years, as the world has seen a sudden surge in the number of people requiring eyeglasses for distance vision correction. 

Early research studies suggest that nearsightedness may be related to near point stress, and numerous studies show that myopia increases along with a person’s level of education. 

Newer studies out of China also point towards dietary factors and excessive indoor time may play a significant role in the development of nearsightedness. However, these studies are far from complete. 

A study out of the UK at the St. Thomas Hospital also showed the genetics probably plays a significant role in the development of nearsightedness while environmental factors may only play a small or limited role.

Treatment options for nearsightedness

Treatment options for people affected by myopia or nearsightedness are numerous. Traditionally, eyeglasses have been the primary treatment option. However, patients also have access to contact lenses, laser vision correction, and intra-ocular lens implants. It is important to always discuss lifestyle and your work situation with your optometrist or ophthalmologist when determining your best treatment option or options.  It is also recommended that patients with nearsightedness receive regular eye health examinations by an optometrist or ophthalmologist every one to two years to ensure the health of their retina's. 

Meibominitis & Dry Eye

Meibomianitis is an inflammation of the oil glands or meibomian glands along your upper and lower eyelid margins. These oil glands produce the lipid or fat layer of your tear film, which coats the surface of your eye. The purpose of this lipid layer is to help prevent the water layer below from evaporating. When these meibomian glands or oil glands become inflamed, they no longer produce nice smooth clean oil. The oil can come out bubbly or thick, thus improperly coating the front of the eye.

Meibomianitis typically does not cause serious visual problems, but it can cause numerous comfort and cosmetic issues. Meibomianitis can cause your eyes to dry out, burn, itch, and water. All of which can lead to reduced vision, blurred vision, vision that fluctuates or vision that clears up with strong blinks. Meibomianitis can also cause your eyelids to swell or thicken and turn red, which can eventually lead to madarosis (eyelashes falling out). It can also lead to external hordeolums more commonly known as styes, which are simply clogged oil glands that have become inflamed.

TREATMENT OR PREVENTION:

The treatment for meibomianitis is fairly straight forward, and we encourage all of our patients to perform this treatment on a daily basis, regardless of whether or not they have meibomianitis.

Steps:

• Prior to getting in the shower in the morning, take a washcloth and heat it up under the tap with warmwater. Close your eyes, and lightly hold the warm washcloth over your eyes. Hold the cloth there until it cools off. Repeat this process for approximately 2 minutes.
• Than, lightly rub your eyelids with the wash cloth to force out all the old oil
• If you eyelids are really swollen than in the shower, take your washcloth and apply a small amount of baby shampoo to it (baby shampoo is used so that you eyes won’t burn, if they actually come in contact with the soap). Foam it up. Than lightly scrub you eyelid margins to remove any oil build up. Ensure that you thoroughly rinse away any soap residue.

Occasionally meibomianitis can get very bad, and medical therapy may be required. If this is the case, your optometrist or ophthalmologist may provide you with a topical antibiotic ointment. In some situations, oral antibiotics may also be used. 

To learn more about meibomianitis or to find out if meibomianitis is the cause of your vision problems, please contact one of our eye doctors and book and eye exam.