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What is refraction?

Refraction is the bending of light as it passes through one object to another. Vision occurs when light rays are bent (refracted) as they pass through the cornea and the lens. The light is then focused on the retina. The retina converts the light-rays into messages that are sent through the optic nerve to the brain. The brain interprets these messages into the images we see.

How does astigmatism occur?

Astigmatism occurs when light is bent differently depending on where it strikes the cornea and passes through the eyeball. The cornea of a normal eye is curved like a basketball, with the same degree of roundness in all areas. An eye with astigmatism has a cornea that is curved more like a football/rugby ball shape (see diagram), with some areas that are steeper or more rounded than others. This can cause images to appear blurry and stretched out.

Who is at risk for astigmatism?

Astigmatism can affect both children and adults. Some patients with slight

astigmatism will not notice much change in their vision. It is important to have eye examinations at regular intervals in order to detect any astigmatism early on for children.

What are the signs and symptoms of astigmatism?

Signs and symptoms include:

•  Headaches
• Eyestrain
• Squinting
• Distorted or blurred vision at all distances
• Difficulty driving at night

If you experience any of these symptoms, visit your eye care professional. If you wear glasses or contact lenses and still have these issues, a new prescription might be needed.

 How is astigmatism diagnosed?

Astigmatism is usually found during a comprehensive dilated eye exam. Being aware of any changes in your vision is important. It can help in detecting any common vision problems. If you notice any changes in your vision, visit your eye care professional for a comprehensive eye dilated examination.

Can you have astigmatism and not know it?

It is possible to have mild astigmatism and not know about it. This is especially true for children, who are not aware of their vision being other than normal. Some adults may also have mild astigmatism without any symptoms. It’s important to have comprehensive dilated eye exams to make sure you are seeing your best.

Leo Franken

Licensed Optician – Spectacle Shoppe

Children are most at risk. I would strongly recommend that anyone under 20 years of age wear sunglasses and a hat when outside- actually I would recommend that everyone does but especially small children. After the age of 20 our crystalline lens has hardened and we have some built in protection from the harmful UV rays. This hardening is gradual so the younger the child the more important it is to protect their eyes. The long term effects of this protection could help prevent cataracts. Some of the other conditions that can be minimized with proper sun protect include: pterygium, macular degeneration, photokeratitis, pingueula, and tumors of the eyelids. These conditions can develop at any age.

What should I look for to make sure I’m getting the best protection? Buy from a reputable source. Ask if you are getting 100% UVA and UVB protection. Consider getting polarized lenses if you drive a lot or spend time on the water or snow. Polarization is a process applied to lenses that blocks glare (from cars, snow or water).

What should you look for in a good pair of sunglasses? Full coverage, a really good pair will limit the amount of light coming in from all angles not just the front. 100% UV protection there isn’t much point in getting sunglasses that still transmit that harmful radiation into your eyes. You may want to consider spending the extra money to get polarized lenses. For those with higher light sensitivity it may be worth having a quality anti-reflection coating or mirror coating to reduce internal reflections within the lens. My personal favorite sunglasses are Maui Jim’s they provide amazing coverage, protection, anti-reflection coating, optics and the polarization allows me to spend time on or near the water (my favorite feature of living on the West Coast) without experiencing any interference with my vision.

Morgan Hyde

Licensed Optician – Spectacle Shoppe

As a Licensed Optician I love interacting one-on-one with clients. One of the most common complaints that I hear about is dry eyes from contact lens wear. I’ve got a few handy tips to help with this problem, but in order to get there I need to first tell you about the composition of tears and the role tears play in eye health.

Tear Ducts

Tears are made up of 3 layers: lipid, aqueous and mucin. These 3 layers each have a part to play in preventing dry eye. The lipid (fatty) layer prevents evaporation. The aqueous or lacrimal layer makes up most of the volume of the tear film. This layer carries nutrients, washes away unwanted or dangerous bacteria or foreign objects. The mucin layer is the glue holding the tears to the cornea. If there is a problem with any of these layers which prevents optimal functioning then you end up with dry eyes.

Movement

When I fit contacts, one of the key points to a good fit is good tear flow. I also need to make sure that there is good lens movement, this will ensure that the lens won’t inhibit tear flow over time. Without these it is unlikely that my client will be comfortable. It’s also really important to be aware of client’s history as they can have a big impact on comfort as it relates to dry eyes. Some key information includes: age, medications, environmental factors (a/c or heating systems, dry climates, smoke or dust), hormone fluctuations, blinking problems and diseases can all be problematic. Another way discomfort can arise is when contacts aren’t cared for properly.

Discomfort

Deposits and over wear can lead to discomfort which people interpret as dry eyes. Our eyes don’t have specific receptors to help us differentiate what is causing discomfort so what may feel like dry eyes can actually be caused by discomfort. There are a few variations in the way contacts are manufactured. High water lenses sound like they would be comfortable but one issue that may arise is osmotic shift. This is when the water content of the lens is absorbed by the eye. This will result in the lens sticking to eye.

Tips for Fixing Dry Eyes

Solutions depend on the issues that are causing the discomfort but some tips might include:

1) Using a wetting agent in the form of a drop to extend wear time can work for some, though I caution doing this without talking to your eye health practitioner as it can sometimes mask another problem and lead to more damage. A more frequent replacement schedule can help if the symptoms are a result of lens deposits.

2) Switching to a lens with lower water content or a rigid gas permeable lens if you are prone to dry eyes may help increase comfort.

3) Try a silicone hydrogel lens with a quality wetting agent, this can help those who are experiencing discomfort from lack of oxygen. Some of my top lenses for comfort are the silicon hydrogel lenses including (by order of my favourites)

• Acuvue Oasys –availble in toric for astigmatism and multifocal varieties and is made up of 38% water.

• Biofinity by Cooper Vision which has a 48% water content. Only a toric and spherical option here.

• Air Optix Aqua and Air Optix Night & Day by CIBA Vision are also great. Air Optix come in a multi-focal and an astigmatic option, however, the Night and Day don’t have multi-focal or toric lenses

• Purevision and Purevision 2 by Bausch and Lomb are not my favourites for dry eyes but I know many fitters who do really well with the Bausch and Lomb lenses. They do have a great multi-focal lens for presbyopes and their toric lenses are easy fits for astigmatic patients.

See Your Optician

If you are having symptoms of dry eyes or discomfort when wearing your contact lenses make an appointment to have you optician or eye care professional to get checked and possibly re-fit with a lens better suited to your needs.

Morgan Hyde

Licensed Optician – Spectacle Shoppe