Rancho Cucamonga Optometric

The Sum Is Greater Than The Parts

2012-01-30T09:56:00.000-08:00

My practice has now been in its current location for almost 23 years. Due to a bank wanting our location, we will be moving across the parking lot to a new, larger and more state of the art location. The move was made a lot easier by both my office staff and our landlord, Lewis Homes. My staff was most instrumental in developing the design of the office. This included the lighting, cabinetry, displays and furnishings. I must say that the office looks fantastic.

I certainly feel that we will be better able to meet the needs of our patient. I am certainly looking forward to the opening. It should occur in about two to three weeks.

When Small Prescriptions Make Big Differences

2012-01-24T11:16:00.000-08:00

Optometry is such an interesting profession. One reason is the human element. Some patients can tolerate a lot of blur and be happy while others want everything very sharp. Then there are patients who complain if what they see looks too sharp.

I have found over the years that when a small change in prescription makes a big difference in perceived vision, the patient may have other vision problems. One of these is motion sickness, particularly in the back seat of a car as compared to when the person is actually the driver. Other symptomology may include sensitivity to fluorescent lights or having to hold reading material very closely (even when the patient can see clearly at distance).

Very Sensitive Patient

2012-01-18T10:45:00.000-08:00

I examined a patient this morning. Her complaint was blur at night as well as blur reading. What is interesting about the patient is that the prescription that made a difference to her for far away was extremely small. I checked her in all lighting conditions and with sunglasses and the prescription made a very significant improvement in her vision.

I have found over the years that when a small prescription makes a big difference in vision, there are generally some other problems the patient notices. One of which is motion sickness in a car. What's interesting is that the motion sickness is worst when sitting in the back seat, less when a passenger is in the front seat, and least when driving. I have some theories as to why its this way.

Mentoring Students

2012-01-12T11:21:00.000-08:00

I got to attend an optometric society meeting last night. In a addition to an interesting continuing education meeting, I got to talk to a few optometry school student who will be graduating this year or next. I'm glad to say they appeared quite passionate about their future profession. I was able to convey to them certain aspects of patient care they hadn't come across.

After 30 years of practicing, I was glad I was able to exhibit my own enthusiasm in sharing different concepts of patient care they hadn't come across yet. Their sincere interest in what I had to say was quite rewarding.

New Office Status

2012-01-09T11:56:00.000-08:00

We're getting close to moving into our new office. We should be in there by the second or third week of February. We're just moving across the parking lot within the same center at Baseline and Haven. The office is a lot more spacious and comfortable. I am particularly thankful to my staff for helping in the design of it. Our phone number will still be the same. We're certainly looking forward to the opening.

Metal in the Eye

2012-01-04T19:38:00.000-08:00

I have had patients come into the office who are working around metal who have gotten small pieces embedded in the cornea (the front surface). Many times these could be removed fairly easily. Sometimes a rust ring forms around the metal particle and has to be either picked out with a needle of removed with a bur. Generally, as long as the particle doesn't embed in the line of sight, no loss of vision occurs. If however it does embed centrally. A possible scar could result, possibly leading to a disturbance of vision..

If the impact of the metal is high it could possibly penetrate through the front surface. More heroic measures are necessary to remove the particle and a significant loss of vision could occur.

It is so important that when working in any area where paticles could even remotely have a chance of entering the eye, safety glasses must be worn.

Frame Selection and Adjustment

2011-12-21T15:49:00.000-08:00

On occasion, a patient will receive their glasses and they will report something isn't right, even if the prescription is the same as the old one. I have seen if the frame is a different size and shape, the patient might have a problem adjusting. This does occur occasionally. Just changing the size of the frame can make a difference to the patient.

The other variable that needs to be looked at is the adjustment of the frame. This is especially true of strong prescriptions. I have learned that how the frame is tilted and wrapped around a patient's head could make a big difference in how a patient sees.

Also if a patient has been wearing contact lenses for a long time and hasn't tried on their glasses for a while, this could cause a problem. This is because glasses magnify or minify what you're seeing more than contact lenses do.

Medications taken could certainly effect one's vision

2011-12-14T12:09:00.000-08:00

The general health of a patient as well as medications taken could certainly effect one's vision. There has been several times that patients came in when a sudden change occurred in their vision. In these cases it was undiagnosed diabetes. The vision returned to the patients previous prescription when the condition was treated. Long term diabetes or hypertension could certainly have a dramatic effect on a patient's vision if not treated. Many times the vision worsens and the loss becomes irreversible. Any condition that can affect the body including the heart, liver or kidneys could certainly affect the eyes.

He spends a good part of his day looking with one eye through a telescope

2011-12-08T12:03:00.000-08:00

I had a 29 year old patient who came into the office yesterday. His chief complaint was that he noticed an increase in headaches, especially over the left eye. He spends a good part of his day looking with one eye through a telescope. He also mentioned that he had more trouble focusing his left eye from near to distance. There was a very small far sighted prescription found for distance for the left eye and the right eye had no prescription. When I put this prescription in front of him, he found an immediate, significant relief.

What's interesting is that many of my patients wouldn't have noticed the difference with this small a prescription. However, there are a number who do. Even at this young age, the patient even needed more prescription to be able to read comfortably. Thus, we prescribed a bifocal. Helping this type of patient, in part, is what makes optometry such an interesting and rewarding profession.

It Isn't Work

2011-11-24T15:55:00.000-08:00

I was just reviewing some of the testimonials listed on my website, http://www.wehelpuc.com. It has been said that when you have a passion for what you do and you're able to help people and affect their lives positively, it isn't work. I just celebrated my 30th anniversary of practicing optometry. I'm more excited about practicing optometry than ever. My skills area in more demand than ever in that there's more near viewing with video devices especially those utilizing 3-D. In addition, our scope of being able to treat certain eye diseases is expanding. Also, I will be moving into my expanded facility around the middle of January, 2012. With this and a great staff, I have a lot to be thankful for.

Reading Efficiency

2011-11-23T11:51:00.000-08:00

Although seeing clearly is very important in reading, there are other visual skills that are come into play when reading. Two such skills are being able to focus efficiently, especially when viewing both a monitor and hard copy and also being able to aim the eyes together. These two skills are not a given. When they're not working well together, visual fatigue, headaches, frustration and mistakes can be made. With more of our work and leisure time being spent on monitors or hand-held devices, visual efficiency is very important. For more information, please view the different topics on binocular vision at www.wehelpuc.com.

Powerful Books

2011-11-19T13:36:00.000-08:00

There are so many great books out there that I've so enjoyed through the years. Dale Carnegie has two of them: How to Win Friends and Influence People and the second one is How to Stop Worrying and Start Living. Napolean Hill's book which was written about the same time, Think and Grow Rich is a classic and has sold about 15,000,000 copies. Rhonda Byrne's book, The Secret, I've also enjoyed, immensely. I am a subscriber to Success Magazine. In the magazine, there are usually different books cited which are very positive in nature. The books Get Motivated and Zappos.com are just a couple of examples. Many of the books I've come across I've read numerous times. This isn't because I'm a slow learner but I feel so great after reading them. Here's a hint. If you you can read a great book while riding on a stationary bike, you'll get more enjoyment as the endorphins will further kick in.

Desktop or Laptop?

2011-11-14T11:12:00.000-08:00

For years, when examining patients, I would be concerned whether they were working on a computer. This always presented unique challenges in prescribing glasses for those older than 40. The reason for this was the computer was usually stationed a lot higher than normal reading material. Also, the viewing distance for the computer was usually at a different distance than normal text. At times we'd have to prescribe a separate pair for the computer depending on the factors of its height as well as distance.

More recently, individuals are working with laptops. The good news is that the laptop is usually at the same height and distance as normal reading or perhaps a bit further. Again, special consideration needs to be given. Then you have the office worker who is working with both laptop and desktop computers simultaneously. The unique working demands of the patient need to be met with unique methods of prescribing.

Desktop or Laptop?

2011-11-12T14:11:00.000-08:00

Contact Lenses for the Over 40 Year Olds

2011-11-09T14:41:00.000-08:00

Patients who are over 40 who want contact lenses present interesting challenges. The main challenge for these patients is being able to read and see distance through the contact lenses. There are generally three options. The easiest one is to fit the contact lenses for distance and fit reading glasses over them for reading. The second option is to fit one eye for reading and the other eye for distance. Surprisingly, this works quite well for many patients but not everyone. However, there are some limitations in fitting a patient this way. Limitations may include blur at night or the eyes feel strained when doing a lot of reading. Sometimes we fit glasses over the contacts at times to help compensate for the blur. The third way of fitting patients in this age group is multifocal contact lenses. When they work, they really work. If you're a bifocal wearer, you notice that when you're viewing something closeup with glasses that is at eye level or above. you have to tilt your head back. This does not occur with bifocal contacts. However, bifocal contacts don't work for everyone. There is sometimes a reported blur and reading or distance no matter what lens you fit. I've worked with patients who I have fit the first time they came in; others who were fit on the second or third time and others who couldn't be fit at all with the multifocal lenses. What's great is that the technology of the lenses is improving all the time.

30th Reunion

2011-10-31T17:13:00.000-07:00

It's hard to believe it's been 30 years since I graduated from optometry school. I attended my 30th reunion in Forest Grove Oregon this past weekend. It was nice meeting with 29 of my fellow graduates from Pacific University, College of Optometry, Class of 1981. The school and curriculum has expanded greatly. I took four hours of continuing education. One of the courses in sports vision went into the topic of 3D. The university opened a clinic specifically dealing with this area. As discussed earlier, there are a significant amount of patients who would have trouble viewing 3D items such as movies and seminars. Also the ability to perceive depth is so important in areas of life such as driving and sports performance. This area of vision can be enhanced through appropriate contact lenses or glasses and also vision training.

One of My Most Interesting Cases

2011-10-14T10:04:00.000-07:00

Several years ago a patient was referred to me by a friend of hers. The patient had brain surgery and afterwards, started walking into walls. In other words, she couldn't walk in a straight line. During my examination, the patient had clear sight at distance and near. Also, the eyes appeared to be healthy. There was one finding that was terribly abnormal. That was the patient's peripheral vision. With the right eye closed, the patient couldn't see anything on the right side. With the left eye closed, the patient wasn't able to seen anything on the right side. This condition is called a right field hemianopsia. Apparently, the surgery interfered with the visual fibers going back to the part of the brain that deals with vision.

One of the problems was that the patient did not realize she had a vision problem of any type. Also, according to the patient, the doctor who performed the surgery thought she was faking her condition.

Fortunately, she responded to a treatment that I have yet to use since I was in optometry school. I placed prisms in front of both eyes and shifted the world to the side. Immediately the patient was able to walk straight. This had profound effects on her life. She immediately was able to read better. She subsequently went back to work. Most importantly, her outlook on life was tremendously improved as she was no longer depressed.

A Life Possibly Saved

2011-10-13T17:46:00.000-07:00

Last year, a patient came in complaining of headaches and blurred vision. These are not uncommon symptoms for many of the patients whom I see. The patient was relatively young, 41 years old.

When I examined her, I noted that the optic nerve of the left eye appeared abnormal. Also the best vision the patient was able to obtain in that eye with glasses was about 20/40. The right eye was correctable to 20/20 with glasses.

When I checked the patient's peripheral vision, both eyes showed a defect. With both eyes showing an identical defect, the problem probably lied somewhere within the brain.

We referred the patient immediately. Unfortunately it took two weeks for the patient to see the specialist. Once the specialist saw the patient, he immediately ordered imaging of the eyes and brain to help determine the etiology of the problem.

Many times when a visual field problem in both eyes is found, you think of a tumor. This was not the case. Instead, an aneurysm was found, a very large one at that.

Surgery was performed on the patient.

The patient came back to my office relating the above story several months after I originally referred her to the specialist She did lose sight in the left eye. She stated she almost died on the operating table. She also relayed what her surgeon said: "You should hug the eye doctor who referred you. If you waited any longer, the aneurysm would have probably ruptured and you would have died."

You can see the patient's brief letter in the "testimonial" section of the website, www.wehelpuc.com. I've been practicing optometry for 30 years and I am more passionate now about the profession than ever.

Continuing Education Seminar

2011-10-03T12:17:00.000-07:00

I attended a tremendous continuing education seminar in Pasadena this weekend. It covered areas of retinal disease and surgery, cataract surgery and even areas of visual processing. The lecturers were top notch.

New Office

2011-09-29T09:44:00.000-07:00

Construction on our new office should start within the next two weeks. We're really looking forward to our new office which should open right after the new year.

As an optometrist, I view myself as a quarterback

2011-09-20T14:15:00.000-07:00

As an optometrist, I view myself as a quarterback, strategizing how to best deliver approptiate vision care to my patients. Many vision problems, I could treat very well. Other types of vision problems, I feel could be better treated by other professionals. For example many of patients ask if I could see their infants as patients. I tell them that the local optometry school has a tremendous pediatrics department and could well serve them. Certain types of pathologies or extreme visual needs are better met by doctors specializing in these areas. I find the patients referred are most receptive to this.

Our plans for the new office

2011-09-02T14:48:00.000-07:00

Our plans for the new office were approved by the City of Rancho Cucamonga. I am fortunate that I have a staff that is both talented and enthusiastic in the development of our new office. We'll keep you posted about the new construction.

Seven Videos Now Ready

2011-08-25T11:03:00.000-07:00

We now have seven videos uploaded to our website, www.wehelpuc.com. They deal with different aspects of care. Visit the "video library" portion of our website to view the videos.

Expansion of Office

2011-08-15T17:21:00.000-07:00

We are excited. Our office is planning on expanding. The construction should be well underway or completed by the end of the year. We will keep you informed.

Release of Sixth Video

2011-08-15T17:18:00.000-07:00

For informative videos regarding vision, please visit the "video library" section of our website, www.wehelpuc.com. We just released the sixth video.

Virtual Reality in 3D

2011-08-08T09:37:00.000-07:00

A recent ophthalmological report discussed the use of virtual reality in 3D especially in schools. It was stated that about 25% of the kids have binocular vision problems that would make it difficult, if not impossible, for them to view the image. Difficulites include headaches or eye strain Of course this applies to adults too. For a discussion of binocular vision problems visit our website at www.wehelpuc.com.

We Are Planning Our Move into a Larger Suite

2011-08-06T08:41:00.000-07:00

We are planning our move into a larger suite by the end of the year. We will still be located in the Ralph's Shopping Center at Baseline and Haven. We will be moving into a larger location. After being in the same location for 22 years it will be neat to move into a larger, more up-to-date office. We will let you know about the timing of this.

2011-07-22T15:47:00.000-07:00

One of the neatest aspects of optometry is that we usually get immediate feedback from patients regarding our treatment. It's really neat to see a child's reaction when you first put glasses on them as they could see clearly, possibly for the first time. One of the most heartening reactions is when you had a child who struggles with reading and you put on a pair of glasses and their reading is more fluid.

If you go to my website, www.wehelpuc.com, you can scroll to the testimonial section and read what happened to a couple of our patients.

Relocation News

2011-07-20T10:59:00.000-07:00

Our office is scheduled to relocate toward another part of the same shopping center at Baseline and Haven in Rancho Cucamonga. Our office will be about 50% larger in space. The move will occur toward the end of the year. We will keep you posted.

We Help UC.com

2011-07-02T17:25:00.000-07:00

Keep visiting our website, www.wehelpuc.com, where new videos are being posted concerning different areas of optometry under the "Dr Bob's video Library."

Julie John of Human Interface

2011-06-17T16:36:00.000-07:00

I want to thank Julie John of Human Interface for the great job she and her husband did in putting out my video series, "Eye Talk" Two of the videos have already been released, with the rest of them scheduled to be released every two weeks. There will be a total of seven (as of now) videos showing. They could be seen at my website, www.wehelpuc.com under Dr. Bob's video library.

Eye Talk series

2011-06-14T16:01:00.000-07:00

Our new video in our Eye Talk series was just released. It deals with vision and sports. You can see it by visiting

Radial Keratomy (RK)

2011-06-10T10:09:00.000-07:00

Recently, I had a couple of patients who had gone through radial keratotomy (RK) over 20 years ago. These patients are sometimes challenging to correct with glasses. For one, their prescription could vary during the course of the day. Secondly, they sometimes have a very high farsighted prescription where they were usually nearsighted before the surgery. This leads to problems of distortion and magnification. This is especially true when the patient's two eyes have a different prescription.

Videos

2011-05-31T15:16:00.000-07:00

Over the next several weeks, several videos that Human Interface and I shot at my office will start appearing on Youtube.com under RobertRothbardOD (no spaces). Even though they were all produced last week, they will be gradually released over the next several weeks via Youtube or my website, www.wehelpuc.com.

Videos

2011-05-24T14:55:00.000-07:00

I just finished shooting videos on multiple topics related to vision and my practice. As they're developed and edited, they will appear in multiple locations including my website, http://www.wehelpuc.com/videos.html. I am most excited about this.

If You're Active In Sports

2011-05-14T13:50:00.000-07:00

If you're active in sports, particularly where a ball is involved, it's advisable not to get glasses that have glass lenses. Polycarbonate lenses are by far more shatter resistant. I actually had a patient who was stuck in the eye with a golfball. Fortunately he was wearing glasses made with polycarbonate lenses. The lens popped out of the frame and he was knocked down but the lens did not shatter and they probably saved his vision.

Refer My Patients

2011-05-14T10:58:00.000-07:00

One of the benefits I enjoy of working in private practice is the ability to refer my patients to an appropriate professional whom I feel would be better in caring for a patient with a particular problem or situation. I generally don't work with infants but I inform my adult patients that they should have their infants evaluated visually by another eyecare professional who specializes with this patient population. Patients who have diabetes who are manifesting eye problems such as hemorrhaging in the back of the eyes are also referred. Patients who have extremely poor vision, even with glasses or contacts lenses, are referred to doctors who specialize in an area of optometry called "low vision."

Expanding Our Office

2011-05-14T09:25:00.000-07:00

I have been in my current location in Rancho Cucamonga for 22 years. We will be expanding our office by the end of the year. I am really looking forward to this. I am fortunate that I have a staff that will greatly assist me in this expansion. Stay tuned for future details. Thanks.

Kids Participate In That Should Require Eye Wear Protection

2011-05-02T12:17:00.000-07:00

There are many sports that kids participate in that should require eye wear protection. Although it doesn't occur often, a soccer ball striking the eye can have devastating consequences including loss of vision. Many feel that since the soccer ball is so big, it cannot injure the individual if it hits the eye. The injury can actually lead to a detached retina or even a hole in the back of the eye.

Met With Students And Staff At San Joaquin Valley College In Rancho Cucamonga

2011-04-27T15:56:00.000-07:00

A few employers including myself within the community met with students and staff at San Joaquin Valley College in Rancho Cucamonga, California. We went over ways for their students to improve their abilities in securing employment. Ideas, concerning appearance, enthusiasm, learning about social media and knowledge in general were discussed.

I had a child patient ...

2011-04-12T12:26:00.000-07:00

I had a child patient who needed glasses consisting of a significant prescription in the right eye and very little prescription in the left eye. The patient who was able to express herself extremely well said she couldn't skim the material as easily with the glasses on as without. I was able to determine that the patient, when she read without the glasses, was not using her right eye. With the prescription on, she was using both eyes. The glasses were making her better able to use both eyes. However, the patient was use to not using her right eye when she read. For her this is easier. We'll see what happens over the next couple of weeks.

2011-04-01T12:04:00.000-07:00

I have come across a number of patients who have motion sickness when driving in a car. There are various reasons for motion sickness. It's interesting to me that many of my patients who have this experience more problems when sitting in the back seat of a car as compared to the front seat. More importantly, the problem is significantly reduced when they're actually driving.

I feel some component of this is visual. There's a lot more visual information an individual has to assimilate in the back seat. The passenger is looking at distances two feet away and also things that are very far away. In the front seat they're viewing things mostly at distance. When they're driving, they're actually holding onto the steering wheel so they know where they're going and the tactual sense is reinforcing the visual sense, therefore less problem.

2011-03-15T16:02:00.001-07:00

A previous patient of mine brought her mother in for an examination. She had stated thank you for "saving my son's life." Her son wasn't sick or anything like that. He had a lazy eye and was undergoing patching for at least a couple of years with no results. The boy was introverted and did not participate in sports. I put a contact lens in his lazy eye. Even though he couldn't see much better than 20/200 in that eye, he was now able to use that eye and have depth perception. The change in behavior was dramatic. He was doing better in school, participated in sports and is generally more outgoing. His mother says he's a lot happier.

2011-02-16T16:29:00.000-08:00

As an optometrist and an owner of my own business, networking with others is very important. At this time I'm not talking about online, social networking. I'm talking about live person to person networking. I belong to multiple chambers of commerce and I'm active in them. Even at the gym, by talking about what I do enthusiastically, I've been able to generate patients coming into the office. It's quite easy to incorporate what I do into general discussion, especially the fact that I'm passionate in what I do.

2011-02-04T12:02:00.000-08:00

Fitting contact lenses is usually straightforward. The prescription usually follows closely to the glasses' prescription. Sometimes, however, the tears between the contact lens and the eye affects one's vision. I had a patient like this earlier today. I tried three different (different manufacturers) contact lenses, each with the same prescription, until the patient was satisfied with what she saw. The patient was a long time patient here.

2011-02-02T10:20:00.000-08:00

One of the great joys I get out of my practice is being involved with the community, particularly the chamber of commerce. I belong to three chambers in the surrounding area of my practice. I am actually on the board of directors of one chambers. In addition to the enjoyment I get meeting with other business people and officials of the city, the chambers have been a good source of referral to my practice.

2011-01-11T15:27:00.000-08:00

I've been practicing optometry for nearly 30 years. It's interesting where the source of useful information regarding my field will come from. I had a bifocal contact lens patient who came into my office. He was wearing a type of bifocal contact lens that I stock. This lens is the type that is usually given to a patient in their early 40s. With a little modification, this patient gave me the idea to start fitting this lens to patients in their 50s and above. I had not thought of this before. I have met with very good success for this population of patients who want to wear bifocal contact lenses.

2011-01-09T15:42:00.000-08:00

Even though optometry is generally not a life or death profession, I had a very rewarding experience happen to me in my office. I had a patient whom I saw around August, 2010. She had a headache, uncorrected vision in one of her eyes(about to 20/50) and changes in her peripheral vision. I immediately referred her to an ophthalmologist. They immediately referred her to neurology in which surgery was performed.

The patient came back in December, 2010 and told me what happened. She stated that the emergency room surgeon told her it was a good thing that the referrals occurred. She had an aneurysm the size of which the surgeon said was huge. The surgeon related to her that if she had waited a month, she very well could have died.

The patient was most thankful when she came in (with her sister). This is what helps to make optometry such a rewarding profession.

2010-12-15T12:38:00.000-08:00

One area that's often overlooked in an athlete's ability to perform is their vision. There is more to vision than just seeing clearly. Peripheral awareness, depth perception, ability to focus one's eyes quickly from distance to near and back to distance are all important skills which could have a significant impact on an athlete's success. What's important is that these skills are measurable and more importantly, can be improved upon.

2010-12-13T12:26:00.000-08:00

I received a call from one of my patients this morning at 3:30 A.M. (I am on 24 hour call.) He stated that his eye was in pain and tearing. He told me he was surprised I answered I the cell, I told him I would see him at the office in 15 minutes. (I live 1/2 mile from the office.) I treated him with drops and told him to return in about 5 hours. The pain and tearing subsided and the eye looked less angry (red). The relief that the patient experienced was extremely gratifying to me as a doctor. Anyway, after I saw the patient at 4:00 A.M., I wound up going to the gym and working out.

2010-12-13T12:17:00.000-08:00

A 54 year old patient came in this morning with a history of a cataract in his left eye for his entire life. His best corrected vision in that eye with glasses was about 20/100. The other eye was corrected to 20/20. I noticed during the examination that his eyes were not aligned vertically. He stated that he had trouble with depth perception. I put in a prism to help compensate
for this misalignment. He noted everything was brighter, closer and clearer. He stated that no doctor had measured him for this before. I do not know at this time whether the lack of vision in the left eye was due to the cataract, the misalignment of the two eyes or a combination of the two problems. I'll be anxious to see him after he receives and wears his glasses.

2010-12-06T09:37:00.000-08:00

I've been practicing optometry for over 29 years. I enjoy practicing more now than ever. The advances in the field have been tremendous. I so have enjoyed the interaction with patients and their families over the years. I've had patients whom I've seen as five and six year olds who have brought their own kids in. Also, what's neat is seeing the impact on some of our patients' lives after they've been treated. I can't think of another health care profession where you get such immediate feedback after the conclusion of treatment.

2010-11-29T14:55:00.000-08:00

There have been patients who have come into the office with a very high prescription. When these individuals start to look for glasses, they have a lot or problems telling what the frames they're choosing look like. In these cases we offer to put contact lenses into the patients' eyes so they could tell. A lot of times, the patient has never tried a contact lens. They are surprised at the comfort and the clarity of vision. Some of these patients are in their 50's or above and have never been offered contact lenses. I have patients who were glad they had this experience and wind up as a contact lens wearers.

2010-11-26T21:45:00.000-08:00

One of the more rewarding experiences I've enjoyed is mentoring a student who is interested in making optometry a career. The individual has been able to shadow me as I examine my patients as well as seeing what's involved in running a practice. It makes me even more proud and passionate about my chosen profession.

2010-11-14T16:08:00.000-08:00

One of the most challenging situations dealing with my patients is dry eye. It could be due to a number of conditions. Such conditions include overwearing of contact lenses, age related, autoimmune disease, allergies, certain dysfunctions of glands within the eyes and a host of other causes. Remedies may include artificial tears., anti-allergy drops, steroids and plugs, Restasis, or a combination of the above. Sometimes there is a quick response to treatment and other times it takes a long time for the condition to resolve.

2010-11-10T14:15:00.000-08:00

Vision has a profound effect on one's ability to perform in sports. In addition to seeing clearly, peripheral awareness and the efficiency for the eyes to be able to aim and focus together are skills that are necessary to be able to perform effectively. It's quite obvious how important depth perception is in most sports.

What's interesting is that a lot of the above vision skills can be enhanced with training. There are a few eye doctors who specialize in this area. Enhancing vision skills is often overlooked as a means to improving one's performance in a particular sport.

2010-11-04T15:25:00.000-07:00

One of the most challenging but rewarding types of contact lenses to fit are the bifocal contact lenses. When they work, they really are great. You don't have to adjust your head in order to see things above you as you do with normal bifocal glasses. There are various manufacturers and and styles of bifocal lenses available. The patient and the doctor sometime have to spend a lot of time in getting the appropriate lenses fit. I have had some patients come back several times in order to arrive at the optimal contact lenses.

Sometimes, the older way of fitting the over 40 contact lens wearer is the best. The patient would wear one contact lens for reading and one for distance. The third modality is having the patient wear two single vision contact lenses for distance and then wearing reading glasses over them.

2010-10-29T15:05:00.000-07:00

Prescribing contacts for a mildly nearsighted individual around 40 can be a challenge. Most of these patients take their glasses off when they read. It has to be pointed out to the patient that if you prescribe contact lenses for distance, they might have trouble focusing up close. I, as an optometrist, have to discuss this issue with the patient. The remedy may include reading glasses over the contacts, monovision (one eye for reading and one eye for distance) or bifocal contact lenses. This particular patient opted out of contacts completely but was appreciative that I pointed this out first.

2010-10-20T10:35:00.000-07:00

I was talking to an individual who is a photographer who wears glasses. I noted that her glasses did not have an antireflective coating. I told her the benefits of it including cosmetic as well as seeing better particularly at night or on a computer. She stated that her husband use to wear them and they smeared. I told her that the coatings now are a lot better and the problems of smearing or the coating coming off have been greatly minimized.

2010-10-14T11:58:00.000-07:00

I had a patient about 30 years old come into the office today. He told me his vision was changing. The patient was found to have astigmatism and nearsightedness. The first question out of the patient was whether his vision problem was caused by aging. I told him it was probably due to the type of close-up work he was doing.

Usually, aging problems equate with not being able to see clearly with the same prescription for reading and distance. This usually starts in the late 30's to early 40's.

2010-09-15T10:55:00.000-07:00

I am so grateful to be in private practice. Granted, this is not for every optometrist. I've been in my own practice now for over 21 years. I literally enjoy coming into work daily. Some of the patients whom I've seen as kids bring their own kids in now. The office takes on a a real family feeling, both among the employees and the patients. Also, I have been able to network very effectively with the business community, belonging to three local chambers of commerce.

2010-08-17T15:12:00.000-07:00

I was sitting in my exam room with an adult patient when I noticed that her four year old was being entertained by a video on a cell phone. Over the last few years there has been an explosion of hand held devices with video capability. It will be interesting to see the effects of viewing such detail at such a close distance over an extended period of time. I truly believe that the incidence of nearsightedness and possibly astigmatism can only increase with this.

I could only imagine with time these devices are going to act as "pacifiers" to kids even younger than the one just mentioned.

2010-07-18T13:22:00.001-07:00

I mentioned in earlier posts about the effects of nearwork on vision, especially with young people. One of the more dramatic changes I have seen was with a ten year old boy. He was basically 20/20 last year. Over the last 12 months his vision has dropped to about 20/200. He can achieve 20/20 with glasses. Part of this may be genetic. However, the father states his son is constantly doing a lot of hand held video games. Think how close the device is to the boy's eyes and how small the text is. I am confident that among texting, video games and normal computer viewing, the changes in vision I will see among my patients will be very significant.

2010-07-08T20:58:00.000-07:00

I recently had a teenage patient who had suffered an eye injury playing soccer. He was not wearing any eyewear protection. The ball hit him in the eye and he immediately noticed blurred vision. He visited the ophthalmologist. There was scarring in the back of the eye (retina). If the scarring were 2mm superior, the patient would have lost most of his central vision in that eye, and nothing would have been able to restore it. The sad part about this patient is that he is still hesitant in wearing protective eyewear due to vanity reasons.

2010-06-14T15:18:00.000-07:00

I asked one of my high school patients what percentage of students text. He answered, "100%." when I started practicing almost 30 years ago the pc was coming on the scene. I saw changes of vision in my patients who were staring at screens at work all day. That hasn't changed much. When you text, the phone is a lot closer. It will be interesting to see if this added amount of close-up viewing will affect one's distant vision.

2010-06-03T10:14:00.000-07:00

I had a patient whom I hadn't seen for over 10 years. Upon his eye examination, he commented to me that because we observed possible changes in the retina due to hypertension, I had referred him to his primary care physician. Indeed there was hypertension. His physician also ordered for him at that time a psa and subsequently found out the patient had prostate cancer. His doctor stated that if he would have gone six months longer, he may not have survived.

2010-05-03T11:46:00.001-07:00

I had a patient come in this morning for an eye examination. He had lasik eye surgery to correct his distant vision. He was capable of clear vision at distance and needed reading glasses for up close. One of his main complaints was that he could not read the greens when he was putting while wearing his sunglasses. So he did not use them playing golf. The problem is that his lenses were polarized. Normally polarization helps with the sun particularly when you're on the water. However, some golfers do have problems with polarized lenses, particularly around the greens. The second thing about his sunglasses was that they were made with glass lenses. I had a patient who was struck around the eye with a golf ball while playing. Fortunately, he was wearing lenses made of polycarbonate. The lenses did not shatter. I feel that glasss lenses possilbly would have shattered and done injury to the eyes. Also, by not wearing sunglases while golfing over a long period of time, the patient was exposing himself to increase risks of cataracts and macular degeneration.

2010-04-27T11:08:00.000-07:00

I was hearing that the increase in texting has led to individuals developing carpal tunnel syndrome. In fact there are young individuals who text 100 times, per day. Viewing a screen that close for that duration could very well affect one's vision. This is especially true in that many of the prolific texters are young. For information regarding extreme close up work over a period of time, go to our website at www.wehelpuc.com.

2010-04-18T17:48:00.000-07:00

I had the pleasure of attending the International Congress of Behavioral Optometry last week. Even though I was only able to attend one day of the Congress, the information I learned was wonderful. A lot of the information dealt with how we process information, visually. There were speakers from all around the world. I learned about a new lens that specifically for the over 40 set who work on a computer. I am anxious to try it on myself. Also I saw professors who
I had 30 years ago. I really enjoyed everything.

2010-04-08T09:55:00.000-07:00

An issue often overlooked with children is eye safety. Particularly if the child doesn't need a prescription to see clearly. I have seen kids (and for that matter adults) who play various sports including soccer, tennis baseball, football and other sports who have suffered eye injuries from being hit by a ball, person or racket. These injuries sometimes are sight threatening. We recommend that anyone participating in sports should wear a sports goggle with impact resistant lenses for protection. If the individual wears glasses normally, they should be a special frame that will withstand substantial impact. It could make all the difference in the world.

2010-04-03T21:06:00.000-07:00

I had a new patient come into the office with a very red eye. He was a contact lens wearer who had just used a different solution than what he was using previously. I am currently treating him. I am not sure whether he had an allergic reaction or the bottle he used was contaminated. Either way, when using contact lens solutions, try to stay with the same brand in order to avoid possible problems.

2010-03-28T21:22:00.000-07:00

My office staff and I visited the Vision Expo in NYC last week. We plan on making a few additions to the office. The advances in contact lenses, lenses for spectacles and diagnostic imagery is fantastic. It is very important to realize also that there is a person behind the eyeballs.

2010-03-26T11:24:00.000-07:00

We have now celebrated our 21st year in my practice here in Rancho Cucamonga, CA. I so enjoy being in private practice. Optometry for me has been a most rewarding career. I have seen many of my patients grow from childhood to adulthood. It is most gratifying when patients have confidence in the practice to refer their family and friends. I am quite involved with the happenings in the surrounding area. I'm involved with three different chambers of commerce. Interesting enough, I am one of the only health care professionals that is active in the functions of the chambers. I thoroughly enjoy both the direct networking and social networking (electronic) aspects of my business.

If I had to do it all over again, I would certainly pick the same profession.

2010-03-05T11:58:00.000-08:00

Sometimes when you prescribe an individual over forty years of age glasses for distance and they don't want a bifocal, there can be discomfort. I had a patient who was in her fifties whom we prescribed distance glasses for ( she normally takes her glasses off for reading). She stated the distance was great but she got dizzy looking at her dashboard while driving as well as looking at the ground. I had to weaken the prescription slightly so she could view up close more easily while not disturbing the distance vision significantly. the outcome was good.

2010-02-20T20:28:00.000-08:00

A patient was in the office today discussing with me about an optometrist who worked in her facility. The facility deals with injured and neurologically compromised individuals. The optometrist worked with patients who had either brain injuries or strokes. He dealt with rehabilitative care of these individuals which could involve prisms or actual vision training. The results of this could be quite profound.

2010-02-10T12:15:00.000-08:00

I had an interesting patient that I have been working with over the last couple of months. The patient was a male in his 20s. He noticed a sudden blurring of his right eye. I was unable to correct it with glasses or contacts. I looked in the eye and I could see the central part of the back of the eye was abnormal (maculopathy). I immediately had him referred to a retinal specialist. There is an eye condition which does affect young males who are under stress this way.

Fortunately, I just saw the patient yesterday. His best corrected vision with glasses was 20/20 in the affected eye. The condition as followed by the retinal specialist resolved on its own. In other words no surgery or medication was administered. I did note that there was residual scarring of the macula. This did not seem to affect the patient's vision significantly.

2010-01-30T16:28:00.000-08:00

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.

2010-01-28T09:40:00.000-08:00

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.

2010-01-24T19:38:00.000-08:00

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.

2010-01-18T21:32:00.000-08:00

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.

2010-01-10T20:29:00.000-08:00

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.

2010-01-04T13:18:00.000-08:00

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.

2009-12-31T09:37:00.000-08:00

I had a patient yesterday who was in the eighth grade. The mom's complaint was that his studies were faltering. The patient was 20/20 at both reading and distance. The eyes also appeared healthy. I did note that there was a problem with the patient coordinating his eyes together. I prescribed a weak power reading prescription which seemed to make a significant difference in his reading comfort.

There are a couple of things I look for during the examination when evaluating kids for learning problems which are visually related. One questions I ask if the patient gets motion sickness, particularly in the back seat of the car as compared to the front seat. Also, I note if the patient has to bring the reading material either very close or far away to read. These findings usually indicate a visual problem that could cause a learning problem.

2009-12-27T14:29:00.001-08:00

I had a college age student in my office yesterday. She had two complaints. Her vision was blurred at night. Also, her eyes were bothering her on the computer. Her distant vision was a little less than 20/20. Even though her vision was pretty good, her complaints were significant for her.

In her case, I had to prescribe for both the distance blur as well as for her complaints concerning working with the computer. This required two different small prescriptions. I have seen this type of case quite often. If I were to prescribed for her just the distance prescription, this could actually make the up close vision worse.

Every patient is different. Sometimes the prescription for distance and near is the same and sometimes it's not. The findings are determined during the examination and demonstrating its results to the patient.

2009-12-16T10:32:00.000-08:00

Contact lens wearers. should always have a pair of back-up glasses. Most do. I have seen contact lens patients who have extremely poor vision, uncorrected, who don't have any glasses. I had a patient come into the office yesterday with an irritated eye. There was a small bleb on the front surface of the eye which meant she could not wear her contact lenses. She had no glasses. She did wind up getting glasses immediately. Contact lens wearers should always make sure they carry their back-up glasses with them in case their eyes are irritated and they have to remove them at once. Sometimes wearing a contact lens that irritates the eye for a period of time could cause significant infection.

2009-12-09T10:04:00.000-08:00

We are now coming to a close of another year. I have now been practicing optometry for 28 years. I've been established here in my own practice in Rancho Cucamonga for over 20 years. I completely enjoy it. There are so many reasons why. For one, it's a people profession. Through my patient base as well as my networking through the community and the chambers of commerce, I have met many interesting people as well as making good friendships. Also, optometry is exciting for me. The patient could almost immediately realize the benefit of what you've done for them. I could also say that there are those who we have definitely changed their lives for the better as a result of out service. Also, there are a few who we could say we possibly have saved their sight or possibly their lives as a result of our services. Finally, looking back over the last 28 years, I am proud to be part of a profession that has advanced so dramatically over the years.

2009-11-28T09:52:00.000-08:00

One of the more challenging patients we work with in the office is the long time contact lens wearer who has turned 40 or older and is losing their ability to focus up close with their contact lenses. There are three ways to deal with it. The first way is by far the easiest but sometimes least convenient, that is wearing reading glasses over the contact lenses for near. The second way and successful for some is wearing one eye for reading and one eye for distance. This causes a blur in one of the eyes for reading and blur in the other eye for distance. The issue that is very important here is driving, particularly at night. There are ways to deal with this situation. The third method of fitting this type of patient is with multifocal contact lenses. The technology of these lenses has improved greatly over the last several years. These lenses do not work on everybody but when they work, they work.

2009-11-19T08:49:00.000-08:00

Individuals who use computers, particularly desktops, have particular visual needs. I had a patient who was prescribed a progressive lens for distance and near. He noticed that when he viewed the desktop, he wasn't able to view the screen comfortably. Since his computer was at about 22"-24" and he also had to view text at about 16", we prescribed him a bifocal with the top portion set for his computer distance and the bottom portion situated for 16". This worked out for him a lot better. What's important here is that the prescription is set for these distances. You would not be able to see clearly at far away with them. For further information regarding vision and computers, please visit my website at www.wehelpuc.com.

2009-11-08T16:07:00.000-08:00

There have been many advances in contact lenses over the years. One of these advances involves the contact lens' ability to transmit oxygen. The more oxygen a contact lens can transmit, the healthier it is for the eye. These lenses are generally a silicone based lens. Basically, it is always safer to take a contact lens out than to sleep in it. Many infections that occur due to contact lens wear involve sleeping in the lenses. Even though I don't condone sleeping in the lenses, if you're going to do this, it is better to do this with a contact lens that transmits a significantly higher amount of oxygen.

2009-11-05T12:25:00.000-08:00

I had a 10 year old patient yesterday. His mom's complaint was that his eyes watered. I noted that his lids drooped significantly. The patient was referred from the school for blurred distant vision. I found the patient to have a significant astigmatism as well as a focusing problem up close. I could tell by the responses of the patient that he was a bright kid. The mom said however that he had problems reading. When I put the prescription in front of the patient, his reading was very fluid (normal). The mom stated she never heard him read aloud like this before.

Also, I feel the lid droop could have possibly caused the astigmatism. I referred the patient to a specialist to determine whether it was necessary to have the lid condition treated with possible surgery. He was also prescribed drops for eye allergy.

2009-11-01T17:42:00.000-08:00

I visited NYC last week. I took 18 hours of continuing education at the optometry school on 42nd street. The advances in my field are breathtaking, especially with all the technology. My love and passion for the profession has only grown since I graduated in 1981. Optometry is one of the few professions where the patient can realize the improvements almost immediately. It is most gratifying. It is exciting for me. I love to share my knowledge with anyone whom I meet.

2009-10-18T16:24:00.000-07:00

Networking is important in any business. I'm fortunate in that I enjoy it. Many of my patients have come to me through networking events with the various chambers of commerce that I belong to. I have worked with some patients whom I met at Twenty-Four Hour Fitness. Over the last several months I've started working with the electronic social medial such as Facebook and Linkedin. As you can also see I enjoy blogging. My other blog is www.newyorkcityhighlights.blogspot.com regarding places of interest in NYC.

I also enjoy talking to different groups from secretarial groups to diabetic support groups to seniors discussing areas of vision as it pertains to them. I am very enthusiastic about the profession I so enjoy practicing.

2009-10-15T12:04:00.000-07:00

My first patient this morning came in for her annual vision exam. No complaints. she was wondering why she was coming in since it was just a little over a year since she was last seen. As it turned out, it was a good thing we examined her. Her pressure in her eyes went up significantly. She will be monitored and probably treated for glaucoma. If she would have waited another year, she could have developed a serious loss in her vision.

2009-10-14T14:45:00.000-07:00

There have been recent advances in fitting the "over forty crowd" with contact lenses. Many people over forty were fit with one eye for reading and one eye for distance (monovision). This for some individuals works quite well. The other other method used was just fitting reading glasses over contact lenses.

Recently, there has been the development of multifocal contact lenses. They don't work on everybody. However, when they do work, the vision feels very natural. There are a few manufacturers of these particular contact lenses. Sometimes the patient has to return to the office a few times to get the correct lens fitted. I work quite diligently with my patients in trying to get them fit.

2009-10-13T14:56:00.000-07:00

I conduct seminars on vision to local groups, teachers, PTA's, business groups and various service organizations. The seminars include such topics as visi0n and computers, vision's affect on learning and sports performance or even the effect of systemic disease (diabetes and hypertension, for example) on the eye. If you are interested, please contact us at (909) 980-3535.

2009-10-06T15:01:00.000-07:00

If you're interested in visiting New York City., visit our blog at www.newyorkcityhighlights.blogspot.com. It's quite unique in design and information.

2009-10-06T09:55:00.000-07:00

The computer over the last two decades has created a significant demand for optometric services. People starring at screens for hours on end can cause changes in the visual system. Also bifocal wearers have unique problems with the video displays in the sense that their working distance is usually further away than normal reading and the height in which they view the computer (especially a desktop set-up) varies from their normal reading. A lot of times, the prescription for normal reading is different than the one for the computer. This must be taken into consideration in prescribing for the patient. Also contact lens wearers appear to have more problems when viewing the screen due to the constant close-up content as well as the wearer not blinking enough. This could lead to a dry eye situation.

Over the last few years another form of extreme viewing has occurred. Texting. Here the viewing distance is even closer than normal reading and this over time can have an impact on vision.

2009-10-01T10:25:00.000-07:00

One of my most interesting cases occurred several years ago. A patient was referred to my office after brain surgery. Her complaint was that she would continuously walk into walls. Her eyesight was clear as she was 20/20 in each eye. Her problem was with her peripheral vision. She was missing the right side of her vision, probably as a result of the surgery. Even though I cannot restore a lost visual field, I was able to shift the lost vision over to the side with prisms. This made the patient more balanced in her visual world. She was able to perform a lot better. To start with, she wasn't walking into walls anymore. Secondly, her outlook toward life improved immeasurably as a result. Also, she was able to read a lot better. The result was immediate.

2009-09-30T15:00:00.000-07:00

We got a couple of referrals this week based on the glasses our patients were wearing. The patients coming in commented how much they liked the frames our previous patients were wearing. They asked where they got them and they referred them to our office.

We have a great selection of frames in all price ranges. What's important is that I have a very knowledgeable and professional staff who can choose the appropriate frame and fit it.

2009-09-30T09:07:00.000-07:00

I just attended a seminar at the Southern California College of Optometry on aviation and vision. Many issues facing pilots were gone over. Such areas such as contact lenses, color vision, spatial orientation and refractive surgery were gone over. Such issues as when 20/20 vision is not good enough were covered. Information regarding the disappearance of lighted straight ahead objects disappearing when being viewed at night was shared. The course lasted from five to six hours.