Diabetes is one of the leading causes of blindness. I just examined a 43 year old who has a 20 year history of diabetes. He stated that his sugar has not been under the best of control and has not his eyes checked for about five years. The patient did have a small amount of diabetic change in the back of the eye for which we referred. Diabetics should have their eyes examined no less than once per year and more if eye problems are discovered. It could make the difference of possibly saving one's vision.

I recently had follow-up information on a patient whom I treated several years ago. This was an individual who after brain surgery could not walk straight and would walk into walls. She now works for a friend (who is the patient relating the information to me yesterday), has a drivers license and is in a wonderful state of mind. Before we helped to remedy the situation with glasses, she wasn't able to work, couldn't drive and was depressed. It's cases like this why I enjoy practicing so much.

There are often various symptoms of vision problems. Over my years of practice, I've come across a certain type of patient who has trouble using their eyes together. In addition to having problems with reading including loss of place, fatigue and headaches, the is one more symptom. They have motion sickness when sitting in the back seat of a car. What's interesting is that there's often significantly less motion sickness when driving in the front seat of a car and almost no problem when driving. I equate this to that there's more visual processing in the back seat where you see things off to the side, things two feet away and things at distance. In the front seat you only notice basically things in front of you far away and when driving, you have tactual back up (with holding the steering wheel) to the vision.

Refractive surgery has now been around for almost thirty years. The advances in technology over the period has been astounding. An area of vision that is being given considerable attention deals with patients who have lost the ability to focus up close. Various surgical strategies dealing with both the cornea and lens of the eye are helping individuals over forty see both distance and near. Depending on the individual and the type of near work being performed, a particular surgery and device will be used. It is important to know that at this time there are limitations as to having the patient be able to see perfectly at all distances. However, these surgeries are a great advancement compared to what was available to patients just a few years ago.

A topic I want to discuss is prescribing bifocals for kids. If a kid needs reading glasses, chances are the prescription will blur the distance. Even if the child has perfect distance vision we might want to prescribe a bifocal so the child can look up from their book and still have clear vision. Sometimes, however, the bifocal could be counterproductive in the child is gazing at a desktop (eye level) computer.

Quite often, when a child complains of distance vision, the child is prescribed glasses for distance. Sometimes the prescription for distance will be the same as it is for near. Sometimes, though, it is not. In fact, sometimes the prescription for distance could make reading worse.

Of course there are ways to actually measure this. It could have a significant effect on a child's ability to perform in school.

I had a patient referred to me from a corneal specialist. The patient has a history of a corneal transplant in the right eye and some corneal dystrophy in the left eye. The transplant looked great. There was a significant difference in prescription between the two eyes. She was already wearing rigid gas permeable lenses. They worked well. The patient needed a back-up pair of glasses. It's fortunate the patient is able to wear glasses. Sometimes when there is a significant difference in prescription between the two eyes, the patient can't function well with glasses. This is due to a difference in image size between the two eyes generated by the glasses. This generally does not occur with contact lenses. This is a situation when contact lenses are a lot better solution than glasses.