I just got a telephone call from a patient complaining of eye pain.  Triaging the complaint is probably the most important thing a doctor or staff can do.  There are certain questions that must be asked when trying to ascertain the reason for the pain.

How and when did the pain start?

Is it one eye or both?

Is the patient a contact lens wearer and was he/she wearing the lens when the pain started or after removal?

Is the eye red, tearing, or oozing?

Are the eyelids stuck together?

Was there any trauma to the eye?

Once the questions are asked and the eye doctor has an idea about the case, the patient’s eyes need to be checked thoroughly with a microscope called a slit lamp. This instrument magnifies the doctor’s view from 6 to 30 times aiding with the diagnosis.  In some cases, dilation and an internal eye evaluation must be done.

What causes pain?

Severe pain may be due to a corneal abrasion.

Moderate to severe pain may be due to a corneal ulcer, which is a bacterial infection usually caused by injury, underlying disease or over-wearing a contact lens.

Deep pain may be due to blunt trauma indicating a medical eye emergency.

Mild pain can be caused by a simple red eye or allergy.

Whatever the reason, it is always a good idea to seek eyecare from a qualified eye doctor if your eyes are not seeing well, looking good in a mirror, or feeling good.

Have your eyes examined regularly.

Dr. Joel Kestenbaum
www.optixeyecare.com

What do all these activities have in common?

• Walking on the beach or sunbathing on the beach
• Playing baseball
• Golfing
• Fishing
• Tennis
• Swimming
• Biking
• Long hikes with your spouse, family or friends
• Driving the convertible with the top down

Answer:

They are all outdoor activities exposing our body to harmful ultraviolet rays.  Unless you live in a bubble, we have all heard that UV rays are harmful to our skin.  As a preventative measure against sunburn, most people I know apply sunscreen.

But what I do not see is a majority of people wearing sunglasses to protect their eyes from sun damage.  Statistics show that 80% of a person’s lifetime exposure to ultraviolet light comes before the age of 18. Ultraviolet light exposure has been shown to cause cataracts, corneal burns, dry and red eyes and even problems with the macula (the part of the retina responsible for sharp clear vision and color vision perception).

I was in Europe recently and noticed that almost everyone was wearing sunglasses, including infants.  Then I returned to the good old USA and noticed that only a small percentage of people here were wearing them.

It made me question “why?”  So I did an informal study in my practice.  I questioned about 100 random adult patients ages 18 and over.  I asked:

Did you know that ultraviolet light can damage the eye?

Do you routinely wear sunglasses?  If not, why not?

The answers astounded me. 40% of the people surveyed said they did not believe that UV rays can harm the eyes.  About 40% of the non believers routinely wore sunglasses.  Of the 60% that believed that UV rays harmed the eyes, only 30% of those people wore sunglasses.  First of all, these numbers don’t make sense to me.  When those that didn’t wear sunglasses were asked why they didn’t, the answers ranged from “just lazy” to “I lose them” to “they are expensive.”
Now I practice in an upper middle class neighborhood so I have trouble with “they are expensive.”  Most of my patients drive expensive foreign cars and they probably eat out three or more times a week.  Is it priorities or lack of concern for their well-being?  Are Europeans that much more concerned about their health or are they just more educated than we are with their priorities in the right place?  I don’t know the answer to that but perhaps someone out there can shed some light……..without UV of course.

Enjoy your summer and stay UV protected.

Joel Kestenbaum, OD
www.optixeyecare.com

There are many early signs of diabetes, many of which are common eye complaints.   Styes, double vision, light sensitivity, fluctuating vision, glare and frequent changes in eyeglass prescriptions are just a few early signs.  These and other signs can also affect people who have had diabetes for a long time.  Getting a periodic eye examination by a qualified specialist can detect problems that may be vision threatening.  Early detection can lead to early sight saving treatment.

(picture shows an example of diabetic retinopathy)

Having diabetes does not mean that your sight will be affected, but there is a greater risk.

Controlling blood sugar via diet, medication or both is extremely important in minimizing the affects of diabetes.  Exercise, weight loss, lowering cholesterol and not smoking are all ways to help control all the effects of diabetes.

Recently I had a patient who did not control her diabetes.  She was a smoker, stopped seeing her doctor three years ago, did not eat well or exercise, stopped taking her insulin two years prior, and for the last 6 months, has been experiencing some of the eye signs mentioned earlier.  A comprehensive eye examination revealed retinal bleeding and leakage of fluid.  This is typical of diabetic retinopathy, requiring treatment by a retinal specialist in an attempt to save her precious eyesight.

Do yourself and your family a favor.  Take your children, your spouse and your elderly parents for an eye examination.  Early detection can lead to early treatment.  Be smart even if you do not have diabetes.  Have annual eye examinations.

Dr. Joel Kestenbaum

www.optixeyecare.com

Every year, I stock up on over-the-counter allergy eye drops and pre-write prescriptions for allergy medications in anticipation of the droves of patients reporting to me with eye allergy symptoms.  These symptoms include itchy, red and watery eyes, a gritty feeling and reduced contact lens tolerance.  These symptoms are caused by airborne allergens including pollen, mold, dust and pet dander.

The best way to treat allergies is to avoid the allergens that cause them.  But, given the reality that life brings, we all know that this is nearly impossible.  So we have to find alternative methods to treat the symptoms that allergies bring.

Sunglasses help to prevent pollen from blowing into your eyes especially on windy days.  Staying indoors on bad allergy days is a choice for some.  For others, contact lenses usually become difficult to wear during allergy season.  But certain types of contact lenses approved by the FDA for people with allergies can also help to reduce symptoms.  If possible, one way to reduce allergy related eye symptoms is to wear disposable contact lenses that are replaced daily.  Since 1990, I have been recommending daily disposables and truly believe that this is the healthiest contact lenses type to wear.  Think about it.  You always have a fresh lens, you never put a less than perfectly clean lens in your eyes, you don’t have to clean them, you cannot be sensitive to cleaning solutions, and they are very convenient.

Here in New York, around mid to late March, I start prescribing allergy eye medications in an attempt to reduce patient symptoms of seasonal allergic conjunctivitis.  These prescription medications include Pataday, Patanol, Elestat, and Optivar.  These are usually used daily but some doctors recommend them for as-needed symptomatic relief.  Consult your doctor for the proper way to use these medications.

In addition to prescription medications that are stronger, I sometimes recommend over-the-counter allergy eye drops to provide temporary relief of allergic conjunctivitis symptoms.  Use for extended periods of time may make redness in the eye worse; therefore these drops should be used with caution and with your doctors recommendation.

Fortunately for most people, seasonal allergies usually last only about 6 weeks. Whether you use sunglasses, OTC eye drops, prescription medications, One-Day Contact Lenses or move to the North Pole, preventing symptoms is the true goal.

ENJOY SPRING.

Dr. Joel Kestenbaum

www.optixeyecare.com

A visual defect in which distant objects appear blurred because their images are focused in front of the retina rather than on it; nearsightedness. Also called short sightedness.

My Definition:

A perceptual defect in which an individual thinks he or she is seeing well and refuses to admit to themselves that they need glasses.  These people are either nearsighted, farsighted and or have and astigmatism.  But in every case, they are short sighted.

When William Shakespeare’s character said “To be or not to be,” he really meant “To see or not to see.” That was the question.   And apparently many of today’s adult population who were rebellious back when they read Shakespeare as a child are still rebellious today.

It amazes me how when I demonstrate to a seemingly intelligent person that they are not seeing as well as they could possibly see, that the choice is often made not to see.

I, for one, when given the chance to see at my best always choose to do so.  In this way, I can always be at my best.

Try not to be myopic.

Dr. Joel Kestenbaum

www.optixeyecare.com

Note- although this picture shows that myopia is due to a LONGER eye, myopia is often the result of an eye that is TOO powerful. This additional power is generated by the cornea, the principle refracting surface of the eye. In both situations, this causes light to be focused in front of the retina, causing a blur circle on the retina and hence blurry vision.

This photo was recently taken at our annual holiday dinner.  Thanks to a great staff and very loyal patients, Optix recently celebrated our 25^th year serving our community.

Now that I have a new photo of our staff, I just had to rave about what a good job they do.  Along with my associates Dr. Michelle Zalaznick and Dr. Todd Lustig, each member of my staff is an integral part of the great Optix eyecare experience.

Our Opticians:
Judy, Jan, Cathy and Jack

Our Technicians:
Gilma and Eileen

Our Support Staff:
Sharon and Jeanette

Our man in charge operations:
Evan

Our optometry student intern missing from this photo but just as important to us:
Matt Geller

Thank you to my staff.

Thank you to my patients.

We are all looking forward to treating your eyecare needs for the next 25 years, one day at a time.

Dr. Joel Kestenbaum

www.optixeyecare.com

What’s Your 2010 New Years Resolution?

New Years 2010 is upon us.  It’s not only the end of a tumultuous decade; it’s the beginning of a new one.  I for one have a lot to look forward to in this next decade.  It is my feeling that my visions will only be achieved if I set goals for myself.

As a baby boomer, good health is at the top of my list.  So I resolve to eat better, exercise more, and attempt to reduce as much stress in my life as possible.

As a husband married almost 30 years, special time with my wife is up near the top too.  So I resolve to take more time off to spend more quality time with my wife Judy.

As a father of two grown sons, more quality time is needed there too.

As an optometrist in practice 30 years, I resolve to continue to provide the quality of care that I have provided in the first 30 years of practice…….and better.

As a business owner and person in charge of a terrific staff, I resolve to be a role model, educator and compassionate leader while promoting a rewarding work environment.

As a person, I resolve to be a good friend and neighbor, increase my charitable contributions, to smile and to be HAPPY.

So what is your New Year’s Resolution for 2010?

HAPPY NEW YEAR!!!

Dr. Joel Kestenbaum

www.optixeyecare.com

We wish all of our patients, friends and family a Happy and Healthy Holiday Season. Our vision is to help you with your vision in the future. We hope all your wishes come true in 2010.

Sincerely,

Dr. Joel Kestenbaum and Staff

Optix Family Eyecare Center

www.optixeyecare.com

Everywhere we shop we are exposed to over-the-counter readers. They are in all the drug stores, supermarkets, department stores, big-box retailers and even in eye doctor’s offices. They come in so many sizes and colors that it is hard to resist the temptation of buying one or a box full of these “cheap readers.” And yes, there are differences in the quality of these eyeglasses and the vision a person gets from them.

The biggest danger in over-the-counter readers is that a person will not get their eyes examined. When a person thinks he or she can see, there is a false sense of security that the eyes are healthy. But there are eye diseases, like glaucoma, that are what we call silent diseases that can rob your sight without any symptoms.

Eyestrain, headaches, glare, prescription changes, and fatigue are just a few of the symptoms that can be caused by over-the-counter readers. Why does this happen? Over-the-counter readers make the assumption that a person has the same prescription in each eye. The truth is that most people have different prescriptions in each eye.

What else? Cheap readers assume that all people are built alike. Again, not true. One of the most important measurements that an eyecare professional takes before fabricating eyeglasses is the distance between your eyes. Do you know if the lens magnification in over-the-counter glasses is centered in front of your eyes?

OTC readers are not all bad. They can be used to read a map, a menu or even take out a splinter. But I personally would never use them to read a book or work at a computer. Short term use only or for emergencies……..that’s it.

Have your eyes examined regularly. Let your eye doctor recommend the proper correction for your eyes.

Dr. Joel Kestenbaum

www.optixeyecare.com

Have you ever thought about how to improve your quality of life with the proper eye wear? Think about all the things you do every day and how you can make your visual life easier.

• Everyday Living - Contact Lenses, Eyeglasses, Sunglasses
• Work Environment – Computer eyeglasses (Gunnar Eyewear), Safety Eyewear, Reading glasses
• Tennis- Sports protective eyeglasses, Sunglasses, Contact lenses
• Golf- Golf Glasses, Contact Lenses, Sunglasses
• Reading- Reading Glasses, Bifocals, Progressives
• Biking- Sun glass wraps for protection with interchangeable lenses, Contact Lenses
• Skiing- Ski Goggles with prescription eyeglass insert, Contact Lenses
• Fishing- Polarized Sunglasses
• Misc Sports- Contact Lenses, Sports safety eyewear
• TV- Single Vision TV Glasses, (in addition to progressives for everyday living)
• Computer- Computer Glasses, Progressives
• Driving- Clear non-glare eyeglasses for night driving, Polarized Sunglasses for daytime. (One for each car)

This is just a thought. What do you think? What special needs do you have that need vision correction. How have you helped your vision today?

Dr. Joel Kestenbaum

www.optixeyecare.com