Category Archives: Refractive issues

NIH Study Commissioned to Examine Prevention of Nearsightedness with Soft Bifocal Contact Lenses

The National Institutes of Health awarded the University of Houston College of Optometry and the Ohio State University College of Optometry $7.5 million to study the use of soft bifocal contact lenses in the prevention of nearsightedness (myopia) in children. The Bifocal Lenses in Nearsighted Kids (BLINK) Study will follow 300 children, ages 7 to 11 years of age over a period of 3 years. The Ohio State University College of Optometry previously published the Corneal Reshaping and Myopia Study in a 2009 issue of the British Journal of Ophthalmology where it found that orthokeratology lenses were effective in preventing the lengthening of the eyeball in children which in turn slowed the progression of nearsightedness.

Do you have a family history of nearsightedness? Are your kids nearsighted? Would you like to prevent the progression of myopia in your kids? Summer is a great time start Myopia Regulation Treatment. If you would like more details you can set up a free consult with Dr. Driscoll.

More information about orthokeratology can be found at the OrthoKDoctor.com website.

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Florida State Heisman Candidate QB Jameis Winston Gets OrthoKeratology!

Jamies-Winston-OrthoKThe sports pages were all atwitter this weekend talking about how, the FSU quarterback, Jameis Winston doesn’t like to wear his contacts while playing football. He is afraid they will pop out. Problem solved, squinting Jameis Winston  decided to get  OrthoKeratology. The commentators of the FSU-Miami game even commented on how the Heisman candidate QB was squinting to see which play the coach was calling from the sideline. Yahoo News also shows him squinting to find a receiver downfield.

No matter how good you are you will play, and perform at a higher level with better vision. A fact not lost on Winston’s coach, Jimbo Fisher. At the post game press conference Fisher stated “imagine how good he would be if he could see.” I concur, now he will be able to see the eyes of the defender, and his receiver’s, a huge benefit for players at any level. Look out Wake Forest and Syracuse.

Orthokeratology allows nearsighted patients of all ages to achieve clear vision without glasses or contact lenses. OrthoKeratology has also been shown to be effective in slowing, and in some cases stopping the progression of nearsightedness in children. More information on Orthokeratology at Total Eye Care is also available on the OrthoKDoctor.com website.

Summer – A Great Time for Orthokeratology

I was asked what is the 60 second brief on OrthoK so here are my high points along with a video. 

Orthokeratology – or·tho·kera·tol·o·gy – a treatment for improving vision by altering the shape of the cornea through the application of corneal molds that are worn while you sleep.

Adult patients, kids, and parents alike express amazement at how we can alter or mold the shape of the cornea with a contact lens, resulting in clear vision during the day without the need for glasses. It’s not magic, the science is very well established and FDA approved.  We remold the cornea like what is done in LASIK. The difference is that Ortho-K achieves this without the use of a laser, it is reversible, and it is easily modifiable.

Check out the video below and see what patients are saying about Orthokeratology. If you want to know more about Orthokeratology call our office for a free consultation 817.416.0333 or visit www.OrthoKDoctor.com

Study Shows Orthokeratology Effective in Reducing the Progression of Nearsightedness in Children

The study of myopia control (nearsightedness) is a hot field of study, particularly in China where the High Myopia – Partial Reduction Orthokeratology (HM-PRO) study was conducted. This study is the latest in an effort to find an effective means to slow or even stop the progression of nearsightedness in children. The HM-PRO study is unique in that it treated 18 highly myopic children (Rx over -5.75 D) between the ages of 8 and 11 with a combination of OrthoK lenses and glasses, and followed them for two years. The study participants were matched with a control group of 18 children, the same age and also with prescriptions over -5.75D.

In the HM-PRO study 18 participants and 18 control patients were followed for 2 years. 15 of the treatment patients and 13 control patients completed the study.  After two years the treated patient’s nearsightedness increased by – 0.13D and the untreated (control) patients increased their nearsightedness by -1.00D.

Myopic progression is also measured by how much the eye grows in length (called the axial length). In this case the treated patients showed a significant reduction in progression with their axial length increasing by 0.19 mm whereas the control group’s axial length increased by 0.51 mm.

The study authors concluded that orthokeratology lenses slowed axial length elongation by 63% and reduced the prescription change by 87%. It has yet to be shown that orthokeratology lenses stop the myopic progression clearly this study, like numerous other before it, show that orthokeratology is effective in markedly slowing the progression of nearsightedness in children. At Total Eye Care we have been using reverse curve orthokeratology lenses to control myopia since 1999 and have fit hundreds of kids and adults.

Scleral Lenses – An Old Dog With New Tricks

Eye with keratoconusScleral lenses have been around for over 100 years. Until the new gas permeable lens materials were developed patients could only wear scleral lenses for a few hours a day. With the highly oxygen permeable lens materials now in use, patients can comfortably wear these lenses all day. Scleral lenses are most commonly used to treat eyes with irregular corneas such as keratoconus and post surgical eyes (usually following corneal transplant surgery or related to complications from refractive surgery). Another common use for scleral lenses is in the special effects industry where they are used to protect the cornea and/or to give the eye an exotic appearance.

What Is A Scleral Lens?

Scleral lenses are large contact lenses that rest on the sclera (white part of the eye) with the remainder of the lens vaulting over the cornea. Tears are trapped between the lens and the cornea allowing sclerals to treat irregular corneas. The average soft contact lens has a diameter of about 14 mm whereas scleral lenses typically have a diameter exceeding 14.5 mm. 

How Are Scleral Lenses used?

At Total Eye Care Dr. Driscoll has  used scleral lenses to treat many conditions such as irregular astigmatism, keratoconus, high myopia, dry eye syndrome, and complications related to LASIK and PRK. Because of their size, sclerals are quite comfortable. Patients often report the comfort being similar to that of a soft contact lens. Most patients with irregular corneas will see better with a scleral lens than with glasses. 

Below is a good video that shows how scleral lenses are cared for and how to insert and remove them.

Dr. Driscoll Attends International Orthokeratology Academy Meeting

April 28-May 1, 2011: Orlando, FL —Richard A Driscoll, O.D. attended the Orthokeratology Academy of America Educational Conference. In keeping with Total Eye Care’s philosophy of providing a complete solution to their patients visual needs Dr. Driscoll has furthered his knowledge in the area of Orthokeratology a procedure where patients wear a vision retainer at night, remove the lens during the day and experience good vision all day long. Says Dr. Driscoll, “some patients simply are not surgical candidates for LASIK or PRK and want a safer alternative to refractive surgery, Orthokeratology provides that safe, effective surgical alternative.”

Current research also shows that the same vision retainers used in Ortho-K can slow myopic progression in children. Said Dr. Driscoll “parents often ask if there is anything they can do to prevent their child from becoming more nearsighted. We can now tell them that studies show Orthokeratology vision retainers significantly slow the progression of nearsightedness in children. New lens designs were also discussed at the meeting and we expect they will be shown to be even more effective. Early reports on these new lens designs will likely be presented next year.”

The keynote address, Myopia as a Public Health Concern, was given by Melbourne Hovell, Ph.D., M.P.H. The international faculty of presenters covered topics including myopia control (including soft lens technology), corneal reshaping research, safety of corneal reshaping, progressive/hyperopic Ortho-K lens designs, new corneal reshaping technologies, post LASIK lenses, Keratoconus / Ortho-K lenses, lens designs for corneal rehabilitation, corneal cross-linking and Ortho-K in China. “This is by far the most widely attended meeting on Orthokeratology and myopia control in the world. There were doctors in attendance from every continent except Antarctica” said Dr. Richard Driscoll, “controlling the progression of myopia was a central theme to the meeting.”

President Dr. Cary Herzberg had the pleasure of announcing the inception of the new International Academy of Orthokeratology(IAO). The IAO brings together Ortho-K organizations from the United States (OAA) as well as Europe and Asia. This international organization will support, promote and advance corneal reshaping worldwide through quality education and research presentations at meetings held around the world.

About Dr. Driscoll and Total Eye Care

Total Eye Care - Colleyvile Contact Info QR Code - SmallDr. Richard Driscoll is a Therapeutic Optometrist and Optometric Glaucoma Specialist. Dr. Driscoll has been taking care of patients in Colleyville and Keller, Texas since 1995. Dr. Driscoll sees a wide variety of patients however his clinical interests include myopia control / orthokeratology, connective tissue disease, keratoconus, post refractive surgery and anterior segment disease.

More information on Ortho-K and Total Eye Care is available at
www.OrthoKDoctor.com
www.TotalEyeCare.com
OrthoKeratology posts on The Eye Doc Blog

All About Pinhole Glasses

A few times during the life of The Eye Doc Blog I’ve been approached by numerous merchandisers to review or place banner ads promoting pinhole glasses.  This begs the question do pinhole glasses work?  The simple answer is it will make the image a little clearer and much darker.  Comparing the vision from pinhole glasses to that attained by prescription lenses is like comparing your vision at midday versus 20 minutes after the sun sets.  OK, maybe pinhole glasses aren’t that good.  Pinhole glasses however do have a valuable purpose.

How Do Pinhole Glasses Work

First let’s discuss how prescription lenses focus light on the eye.  Prescription lenses focus light on the fovea (the most sensitive part of the retina where we have our best visual acuity) by taking all of light that is entering the eye and focusing it at one point, on the fovea.  The further the light is from the center of the pupil the more it most be focused to allow us to see clearly.  Image Copyright 2010 R. Dirscoll, O.D. Light that enters the pupil at the center does not have to be focused at all. This is how pinhole glasses work.  Pinhole glasses block out all of the light in the periphery that must be focused in order to hit the fovea and allows in only the light that enters directly into the center of the pupil and thus does not need to be focused.

Do Pinhole Glasses Serve Any Purpose

Pinhole glasses are used in a doctor’s office to see if a patient, presenting with a red eye, for instance, can see better if she was wearing her glasses. As an example, a new patient presents to an eye doctor’s office with a red eye. After we have asked them the typical questions to provide some history about her red eye we want to see how well she is seeing.  Often, a patient with a red eye was driven to the office by someone else and didn’t bring their glasses. After we check their vision we see that they have 20/80 vision in their red eye. Now the question becomes is their poor vision due to not wearing their glasses or is there another cause?  Enter pinhole glasses, or more likely a pinhole occluder (a paddle with lots of little holes in it). We recheck our patient’s vision while she is looking through all of those little holes and lo and behold her vision through the pinhole glasses is 20/30.  It’s still not 20/20, however we now have an additional degree of comfort that if she was wearing her glasses her vision would be normal. A pinhole is used to see if the vision is likely to improve with glasses.

So there you have it. Pinhole glasses, while certainly not a substitute for prescription eyewear, do serve a purpose as a screening tool for refractive conditions.