Introducing a New Treatment to Slow Childhood Myopia - Red Light Therapy

A new treatment option in the myopia control space at Bay Eye Care is the Myproclear Red Light device.

In New Zealand myopia affects approximately ~30% of young people. It is increasing at a concerning rate in all developing countries. It is predicted that by 2050, 5 billion people will be short-sighted which accounts for 50% of the world's population. All levels of myopia (short-sightedness) lead to an increase in the eyes axial length. In addition, the chance of developing blinding conditions such as retinal detachment, cataracts, glaucoma and myopia retinal degeneration increase. A person with a higher degree of myopia has a higher chance of developing these sight threatening conditions.

The Myproclear red light therapy device, taken home to use by children each day.

A new treatment option to control the progression of myopia in children is Red Light Therapy, provided by the Myproclear Red Light device, designed by Eyerising International, based in Melbourne, Australia.

Myproclear Red Light Therapy is a non-invasive, quick and easy to use home myopia control treatment for children involving children looking into the red light the machine emits, for just three minutes of treatment time twice per day. The low-level single wavelength red light gently stimulates blood flow in the back of the eye to help slow the axial growth of the eye and control myopia progression. Research suggests Myproclear Red Light Therapy results in approximately 75% reduction in axial elongation compared to children wearing standard single vision spectacles over a two year period. In patients that showed a high compliance to the treatment schedule a 87% reduction in axial elongation was found.

It is a great myopia control option for the following young patients:

• children who cannot tolerate contact lens wear or eye drops.

• children already wearing Orthokeratology contact lenses or myopia control spectacles but require further myopia control measures.

• Those wanting to explore adjunct (combination) therapy if they have aggressive myopia progression when first assessed.

Bay Eye Care has a myopia control option to suit every patient’s lifestyle and clinical needs. Please book in for a myopia control assessment today to discuss with our optometrists which option will work best for you and your child, to slow their myopia progression to keep their eyes as healthy as they can be for the rest of their life!

Healthy Eyes are Beautiful Eyes - Cosmetic Considerations in Eye Health

Beauty is timeless, but unfortunately, eye cosmetics and skincare products are not. In many cases, placing cosmetic products on and around the surface of the eye is part of an individual's daily routine. Unfortunately, when these products are not used with care and attention they can negatively impact the comfort of our eyes and cause eye infections, allergic reactions and even injuries.

A few simple tips for keeping your eyes clear, comfortable and beautiful are:

• Replace

  It is important to remember that all cosmetic products have a shelf life. It is easy to lose track of how long your favourite product has been open. An older product has more potential for bacteria and fungus to build up and then be transferred to the eye. A good replacement schedule is replacing mascara every 1-3 months, liquid eye makeup every 3 months and powders every 6-9 months.

• Keep it Clean

  It is essential to keep any object that comes close to the eye clean and absent of bacteria and other irritants. Ensure you clean your hands thoroughly before applying cosmetic products. Ensure make-up brushes and other tools are routinely cleaned and never moisten with saliva or water. In addition, ensure that cosmetic products and utensils are never shared.

• Location, Location, Location.

  Location plays a significant role in the harmony between cosmetics and the ocular surface. It is vital to avoid “tight-lining”, which is applying makeup to the waterline (the inner rim of the eyelids). It blocks the glands of the eye which produce a component of the tear film. It is strongly linked to signs and symptoms of dry eye.

• Formulations

  Cosmetic products come in many shapes, sizes and formulations, some of which can impact your eye health. For example loose eyeshadow can end up in the eye, it is helpful to choose cream over powders. Glitters and sparkles can further stir up the eye and the tear film. Finally, the use of primer can lead to a more stable makeup application. A few ingredients to look out for and avoid are:

  Benzalkonium Chloride (BAK), Phenoxyethanol, Chlorphenesin, Sodium Lauryl Sulphate , Formaldehyde and Formaldehyde Donors (eg. Quaternium 15), Prostaglandin Analogues (e.g. Isopropyl Cloprostenate), Isopropyl or denatured Alcohol, Fragrances, Argiriline (acetyyl hexapeptinde-3 or Acetyl hexapeptide-8), Retinoids, Salicylic Acid, Parabens, Phenoxyethanol

Finally, remember, if you wear contact lenses, put these in before you apply make-up and take them out before taking your make-up off. If you use drops as part of dry eye management, put these in 15-30 minutes before doing your makeup.

Bay Eye Care has state of the art technology to diagnose and treat dry eye, blepharitis and ocular surface conditions. Please get in touch with us to book an appointment.

By Aidan Quinlan. Thanks to Cornea and Contact Lens Society of NZ for some of the content of this blog.

COVID-19 and its impact on myopia. What can a parent do to protect their kids' eyes?

The COVID-19 lock down in New Zealand has forced school, malls, parks and other outdoor activities to close.  This has meant children are stuck at home, needing to find ways to entertain themselves. And what do many children do when trapped at home?  They play video games, read books or use their computers for hours and hours.  Lack of outdoor time and extensive near work are both serious risk factors for increasing myopia (short-sightedness) in children, a condition that increases the risk of permanent sight-threatening disease later in life. Learn more about myopia here.

Will we see a large increase in kids developing short-sightedness in the next year?  Will myopic kids find that their prescription increases in strength at a faster rate in the coming year due to the COVID-19 lifestyle restrictions?  It is very possible.

So what can a parent do to lessen these serious challenges posed by government instructions to shelter at home?

1.  Ensure that your child goes outdoors for 1 hour every day. This could involve a walk in your local neighbourhood - good for parents’ sanity too!

2.  Invent interesting outdoor activities (like an obstacle course, or Easter egg hunt - good for next weekend!) and get involved yourselves to make it fun (as group activities with other kids are not possible right now due to social distancing requirements).

3.  Allow your child to read or work on their devices outdoors. High light levels are thought to be a key protective factor of outdoor time in regards to myopia. Even under a shade umbrella or with a hat and sunglasses, the light levels typically reaching a child’s eye will exceed that of indoors. If they cant get outdoors for this due to weather or apartment living, do this near natural lighting, for example by a large window.

4. Ensure that kids take a 10 minute break for every 30 minutes of screen time and try and limit the screen time to only 1-2 hours per day during the lock down.

5.  The internet has lots of other ideas to help you protect your child's future sight:

• Supporting Kids During the Coronavirus Crisis | Child Mind Institute

• https://loganhealth.org/prod/wp-content/uploads/2020/03/What-to-do-at-home-with-your-kids-during-COVID-2019.pdf

• 250+ Creative Ways to Keep Your Family Sane During the COVID-19 Crisis

Good luck and stay safe (and sane!) during the COVID-19 crisis. Bay Eye Care will hopefully be open soon if you are concerned about your child’s eye sight or want to learn more about how we can limit myopia progression as they get older. In the meantime feel free to get in touch with our optometrist Mr Alex Petty via email on info@bayeyecare.co.nz.

Thanks to our colleague Dr Caroline Guerrero Cauchi for the inspiration and content for this blog article!

Over 40 and needing reading glasses? There are other options!

Feeling your arms need to be longer? There are surgical and contact lens options to give you your visual freedom back!

By far the most frustrated patients in we see in the practice are those in their 5th decade of life who are struggling to see things up close – their arms are just not long enough! ‘Presbyopia’ happens to everyone as the eye’s lens becomes stiff and cannot change focus. Reading glasses are a simple and affordable solution but many people get annoyed always having to find them, being blurry when looking up, or having them get in the way during work or leisure tasks.

Fortunately there are alternatives: Surgical options include laser eye surgery to make one eye better for near vision, leaving the other for long distance – this is called ‘blended vision’ or ‘monovision’. Alternatively ‘refractive lens exchange’ – essentially an early cataract surgery, can also be considered, either with blended vision or with multifocal lens implants to given a range of vision in each eye. All surgery has risks however and as surgery is permanent there is no guarantee that the vision will remain stable as patients get older. Our optometrist Mr Alex Petty has had laser eye correction himself so can offer sound advice and refer you to the appropriate surgeon for an assessment if you are a suitable candidate.

Use orthoK contact lenses overnight to change your corneal shape and improve your day-time vision!

Contact lenses can create the same vision results as surgery, with a blended vision approach or using multifocal lenses. The advantage of contact lenses includes being able to alter the prescription with time, people being able to choose when and when to use them instead of their glasses, and having a lower upfront cost. Alternatively orthokeratology (orthoK) lenses are a novel type of contact lens that are only worn overnight. These gently mould the cornea to give clear unaided vision during the day. Contact lenses are safe, comfortable and easy to use with correct fitting and training with our experienced optometrist Mr Alex Petty.

So if you are sick of loosing your reading glasses book into see us at Bay Eye Care in the New Year to discuss your vision correction options! We are closed over the Christmas and New Year period but the clinic reopens for 2020 in Monday 6th January. Have a safe holiday season!

Could you have a cone in your cornea?

Have you or someone you know had problems with blurry vision, even with the help of glasses? You may have undiagnosed keratoconus, a condition more common in New Zealand than anywhere else in the world. Keratoconus occurs most often in people of Maori or Pacific Island descent, those with a family history of the condition, and those who are prone to eye-rubbing, often due to allergies.

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Using corneal topography to detect keratoconus.

Keratoconus means ‘cone-shaped cornea’ and occurs when the front layer of the eye becomes thin and bulges into an irregular shape. This may only be detectable with specialist optometry equipment that can map the shape of the eye. Even with glasses vision may appear blurred, ghosted or double, and is often worse in one eye that the other.

Generally the best vision for someone with keratoconus can be achieved with the use of specialty contact lenses. The newest type of contact lens for keratoconus, a scleral lens, offers more comfort, stability and quality of vision than traditional smaller rigid lenses or soft lenses.

Normally keratoconus starts in the teens, and tends to get worsen with age. Eventually this may lead to scarring and poor vision, meaning a corneal transplant may be required. These days a special strengthening procedure called corneal-crosslinking can be performed to prevent further keratoconus progression.

A scleral lens for providing clear vision for someone with keratoconus.

If think you or someone in your family may have keratoconus see Bay Eye Care as our optometrists specialise in managing the condition and have access to all the best tools and treatments for optimal results. Remember that early diagnosis is key to ensure the best quality vision is maintained into the future, so have any children and younger relatives screened for the condition if they are in the high-risk groups mentioned above.

Have your child’s vision assessed to detect hidden eye problems

With Easter holiday’s coming up now is the perfect time to make sure your little one does not have an eye condition that may be affecting their learning, or possibly causing permanent vision loss. These conditions can be present without any symptoms or complaints from your child, so all too often will go undetected for years.

Correction of children’s focusing problems with glasses can improve concentration at school and prevent permanent vision loss caused by amblyopia.

Common eye conditions that can affect children includes hyperopia and astigmatism, which are different errors of the eye’s focus. Hyperopia, also know as long or far-sightedness, means that excessive effort is needed to focus on reading and near-work, sometimes leading to fatigue, headaches, inattention at school and behavioural problems.

If just one eye has a focusing error this can affect how well that eye develops its connections with the brain. If undetected this can lead to permanent vision loss later as an adult, even with correction with glasses or contact lenses. This is known as amblyopia. Therapy to improve amblyopia is possible if it detected early enough, generally before the age of 7-8 years.

Even if our eyes are seeing well there can also be issues with co-ordination and accuracy of eye alignment and focus. This to can lead to discomfort and fatigue when using the eyes for reading or school work, double vision, and even amblyopia in some cases.

Early detection of these hidden eye conditions gives the best chance of improving sight. If your child has not seen an optometrist before they started school arrange a thorough vision assessment with our therapeutic optometrist Mr Alex Petty at Bay Eye Care this Autumn before it’s too late!

Are you at risk of macular degeneration?

Signs of a retina of an eye with macular degeneration.

As we get older the part of the eye that is responsible for our sharp central vision, the macula, can start to become sick. This condition is called age-related macular degeneration (AMD), which is the leading cause of blindness in New Zealand. 1 in 7 of all people over the age of 50 will get AMD. If you have a family history of macular degeneration or if have been a smoker in the past then you have a significantly higher chance of getting AMD.

How your vision can look with AMD. (From Macular Degeneration NZ, www.mdnz.org.nz)

Key symptoms of AMD include problems with reading or fine vision work, distortion, trouble recognising faces or empty spaces in the vision. It is recommended that everyone over the age of 50 be regularly checked for macular degeneration. These days most optometrists have access to advanced OCT retinal scanning equipment that can detect the earliest signs of AMD, and also spot blood or fluid within the retina that requires prompt surgical treatment to restore your sight.

It is recommended that everyone over the age of 50 be regularly checked for macular degeneration. Bay Eye Care has invested in advanced OCT retinal scanning equipment that can detect the earliest signs of AMD, and also spot blood or fluid within the retina that our therapeutic optometrist Mr Alex Petty can promptly refer for surgical treatment to restore your sight.

Follow this macular degeneration eye health checklist to reduce the risk of blindness from AMD:

• Have your eyes tested by Alex at Bay Eye Care, with a macula OCT scan, every 2 years.
• Keep a healthy lifestyle, control your weight, exercise regularly on the golf course, and stop smoking.
• Eat a healthy, well-balanced diet. Limit your intake of fats, eat fish two or three times a week, eat dark green leafy vegetables and fresh fruit daily and a handful of nuts a week.
• In consultation with your optometrist and/or doctor, consider taking a zinc and antioxidant supplement, as this can slow the progression of the condition.
• Provide adequate protection for your eyes from sunlight exposure, with sunglasses and a hat, especially when young.

Have you considered contact lenses to see clearly?

Although spectacles provide an easy and cost effective way to correct your vision problem they can be a real inconvenience. Glasses are not great in the rain, they make going to the gym a hassle, and they are pain to find when you need them to read the paper. These days there are a wide range of modern contact lens options to provide a convenient vision alternative to suit your lifestyle.

Many of my patients have been told that ‘their eyes are not suitable for contact lenses’. The reality is that almost everyone can be fitted successfully with contact lenses. The safest and most convenient contact lens modality is the daily soft contact lens, which are replaced each day. A fresh lens each morning improves comfort and decreases the risk of infection. These daily lenses can now correct a range of vision problems like astigmatism and presbyopia (the need to using reading glasses when we hit our 40s). Multifocal contact lenses work a little like bifocal or progressive glasses – providing vision for distance and near tasks, meaning you are never to old to benefit from contact lenses.

Modern contact lens materials are also more comfortable than ever – perfect for people that get dry eye or have challenging work environments. This is due to advanced technologies keeping the lens surface wet all day long and allowing high oxygen flow to the eye. Most people don’t even feel them when worn. Our experienced optometrist Mr Alex Petty will be able to teach you how to effortlessly insert and remove your lenses with the minimum of hassle.

Another great option is Ortho-K overnight vision correction. These special contact lenses are only worn when you sleep, and provide clear unaided vision throughout the day.

If you are sick of your glasses arrange an assessment with Alex to discuss which modern contact lens option can give you your visual freedom back!

Slow your child’s short-sightedness early to prevent blindness

Around the world more of our children are becoming short-sighted (myopia). This means they have difficulties seeing clearly in the distance and require glasses or contact lenses to see. It is thought that a combination of genetics (if a child’s parents are also myopic) and environmental factors (including lack of outdoor light exposure and increased device usage) are leading to this rising tsunami of myopia.

Wearing glasses to see clearly is an inconvenience. However many people do not realise that there is an increased risk of blinding eye disease associated with short-sightedness. Scarily conditions such as retinal detachment, glaucoma, cataract and macular degeneration are more common the more short-sighted we become. This is because in myopia the eye grows longer and become structurally weaker. Due to his own myopia our optometrist Mr Alex Petty has already had three retinal detachments requiring emergency surgery to save his sight!

Normal glasses or contact lenses do nothing to slow the progression of myopia in children and teenagers. Fortunately these days optometrists have access to specialty myopia control treatments (including specialty contact lens options and therapeutic eye drops) which are proven to slow eye growth by at least 50%. This will decrease the risk of blinding eye disease later in life.

If your child is not yet short-sighted it is recommended they spend at least an hour of outdoor time a day, and have regular breaks from digital devices, to prevent the onset of myopia.

Book a myopia control assessment at Bay Eye Care sooner rather than later to limit your child's risk of ocular disease later in life.

Eyes getting itchy? Ocular allergies are likely to blame.

The days are becoming longer and temperatures are on the rise: Spring is here! However the change of season brings with it a bothersome common eye condition: allergic eye disease.

Allergies affect about 30% of New Zealanders at some point in our lives. Seasonal allergies occurs when our body’s immune system over-reacts to certain things (allergens) in the environment such as dust mites, pets, pollen and mould spores. These allergens cause skin rashes, hay-fever, asthma and eye irritation.

Allergens cause a chemical called histamine to be released into the eye tissues that causes swelling, redness, wateriness and itching. The insatiable need to itch the eyes is very typical for allergy sufferers. Unfortunately itching will make symptoms worse as this releases more histamine. Itching and rubbing the eyes can also lead to permanent eye damage, especially in children, so this should be actively discouraged.

If you have symptoms of eye itching, redness, swelling or wateriness you should visit our therapeutic optometrist Mr Alex Petty to ensure this is not caused by other conditions like dry eye syndrome, infectious conjunctivitis or anterior blepharitis.

Management options for allergic eye disease include avoiding the offending allergen with wrap-around sunglasses, bathing the eye tissues with cool compresses, using non-preserved lubricant eye drops to wash out the eye, and using prescription anti-histamine/mast-cell stabiliser eye drops. You should only use eye drops that are recommended by your optometrist because over-the-counter allergy drops may not be as effective and some can lead to rebound redness when they are ceased.

If you think you are suffering from eye allergies contact the team at Bay Eye Care to ensure you manage this condition properly.

When did you last have your eyes checked for glaucoma?

The eye condition glaucoma is the leading cause of preventable blindness in New Zealand, with the prevalence increasing to 10% for those of us over the age of 70. Glaucoma can occur in people of all ages however and is more common if someone in our family also has the condition.

Glaucoma causes progressive and irreversible vision loss due to damage to the optic nerve in the back of the eye. Glaucoma is a painless condition and only affects your ability to see details like words and faces after significant nerve damage has occurred. For this reason it is known as the ‘silent thief of sight’ as many people with the condition are unaware of any symptoms.

The vision of someone with glaucoma.

Early diagnosis is important to limit the damage glaucoma will cause to your vision. A thorough eye check for glaucoma should involve checking a number of factors, including the pressure of the fluid in the eye (the main risk for glaucoma is a higher than normal eye pressure), a 3D inspection of the optic nerve, assessment of the fluid drainage angle in the eye, measurement of corneal thickness, testing of peripheral vision, and a retinal and optic nerve OCT scan to look for early damage to the nerve fibres.

With proper care only 2% of people with glaucoma will go blind in their lifetime. Your optometrist is the best person to visit for a glaucoma check. Some therapeutic optometrists, including our very own Mr Alex Petty, are also accredited to manage and treat glaucoma. If you or someone you know has not had their eyes checked for glaucoma in the last two years arrange a consultation before any potential damage is done.

Do your eyes get sore, burn or become red or watery? You may have dry eye syndrome.

It is estimated that up to 20% of kiwis suffer from some form of dry eye, a condition that can have a profound effect on quality of life. The drying effects of air-conditioning and decreased blink-rate associated with computer screen use can exacerbate this syndrome making simply keeping the eyes open intolerable for many.

The green speckled area shows a patch of dryness on the surface of an eye with MGD

The term ‘dry eye’ is used when someone's tears do not keep their eyeball wet enough throughout the day. Rather than not producing enough tears, the majority of dry eye sufferers have dry eye due to excessive evaporation of their tears. The most common cause of this evaporation is Meibomian Gland Dysfunction, or MGD. This condition occurs when the oil producing glands in the eyelids stop functioning correctly. The oils that these glands normally produce prevent the watery component of our tears from evaporating.

Unfortunately simply using lubricant eye drops does not change the underlying gland dysfunction and is only a short-term fix. There are a range of treatments that can decrease meibomian gland inflammation and improve function, including anti-inflammatory ointments, oral omega 3 supplements and anti-inflammatory medications and digital gland expression. The most exciting treatment to be recently available in Tauranga for MGD is intense pulsed light (IPL) therapy which offers lasting improvement of meibomian gland function and a reduction on dry eye symptoms. It is best to have the cause and severity of your dry eye syndrome professionally evaluated by a dry eye specialist so that they can determine the optimal treatment plan for your condition.