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Frequently Asked Questions
THE EYE EXAM
I think I see fine, why do I need a regular eye exam?
Your vision is only one aspect of eye care. Many patients have 20/20 vision without realizing that they have conditions such as glaucoma, high blood pressure, diabetes, thyroid conditions, etc. All of these can be detected in a routine eye exam, sometimes before they are detected at a general physical examination. Plus, even if you feel your vision is fine, you may be surprised to learn that you could see even better! Changes in vision are usually slow, taking months or years; it's very easy to "get used to" your vision, even if it isn't 20/20.
My child just passed her school's vision screening, that means her eyes are fine, right?
A screening is just that, it screens for the grossest abnormalities in vision and eye movement, but it is not intended to be a substitute for a regular eye examination. Even if your school gave a full body health screening, you'd still want to have your child examined annually by their pediatrician. The mere fact that your child has 20/20 vision does not mean that they are not having difficulty seeing at certain distances or particularly with reading. Children have an amazing ability to compensate for visual deficits daily (and at screenings), but many eye and visual problems can be detected by a regular eye exam, such as why your child has trouble reading or comprehending their paperwork, or why they maintain that they dont "like" to read, it may be because a visual condition makes reading difficult.
Do we have to do the "air-puff" test?
No! The air puff test (called the NCT) is more of a screening instrument and is typically run by an assistant. Dr. Miller himself utilizes an instrument called the Goldmann Tonometer which is the most accurate way of taking your eye pressure readings (one of the tests for glaucoma). It does not startle the patient like the NCT. 98% of Dr. Miller's patients say they prefer the Goldmann Tonometer.
I hate seeing fuzzy after an eye exam, does Dr. Miller have to dilate?
Dr. Miller uses non-blurring dilating drops whenever it's applicable (in about 80% of dilations). A dilation is a critical part of total eye care. It doesn't have to be done at every single exam, but usually at the very first exam and roughly every other year from then on. It is the only way to see the vast majority of the eye's interior to ensure that any problems aren't being missed. Retinal photographs and imaging are nice, but they don't give a doctor the true 3-D view of the eye's interior like a dilation. Not having a dilation when one is needed would be like going to your dentist and asking him or her to check your teeth and gums for problems without opening your mouth wide! The eyes, besides being the "windows to the soul" are also, literally, the "windows to the body"; they are the only part of your body where skin does not cover your nerves and blood vessels. This allows Dr. Miller to see your nerves and blood vessels in your eye which often appear the same as the nerves and blood vessels in the rest of your body; they are an excellent indicator of overall health. Based on these findings, it is possible to see the earliest signs of such conditions as hypertension, diabetes, high cholesterol, thyroid conditions, and many others, sometimes even before you or your general physician (GP) can detect them, simply because your GP can't see blood vessels and nerves through your skin. A yearly eye exam fills in the holes missed by your yearly physical!
Which is better, One or Two?
Patients are often nervous wondering if they're going to answer this question wrong. Truth is, there is no wrong answer. You and your eye doctor work together to come up with the prescription that helps you to see the best, and by giving the doctor the answer to this question, you are steering him in the right direction.
My eyes are red and Visine seems to help that, is that all that I need to do?
Drops like Visine, Murine and Clear Eyes do exactly what they are marketed to do: they "get the red out". The redness is your eyes surface blood vessels becoming engorged with blood which makes them more visible. These drops shrink these blood vessels so that you notice them less. That gives a good cosmetic result, but the fact is that your eyes become red for a reason: dryness, fatigue, allergies, infections, injury, irregular tissue growth, etc. These drops just cover up the problem without treating the underlying cause. Worse, if you use these drops chronically, your eyes can become dependent on the drops to stay white. If your eyes become red, you need to see your eye doctor to make sure of the cause and get proper treatment for it. Eye redness is often an early signal that a medical condition needs to be treated as soon as possible. Permanent loss of vision can result from an eye problem left untreated.
I think I have a stye on my eyelid, can I use the ointment that I found at the drug store to get rid of it?
There are many "lumps and bumps" that can appear on the eyelids: chalazia, hordeolae, meibomianitis, and both benign and malignant growths. Most are harmless, though irritating, others are more serious. You should have your eye doctor look at any unusual bump to rule out the more serious ones. Left untreated, certain of these bumps can cause permanent damage to your eyelids, become septic and in extreme cases, fatal.
I think I'm getting another eye infection and I have some drops that my doctor gave me before, should I see if they drops will help?
No. There are hundreds of things that can irritate your eyes and cause infections and there are just as many drops for each of them. Putting the wrong drop on the wrong problem could be like trying to douse a fire by throwing gasoline on it instead of water (they're both clear liquids, but they have a slightly different effect on a fire!). Call your prescribing doctor about the problem, they will probably want you to come in to identify the problem and prescribe the appropriate medication.
After using the computer for a while, I really want to rub my eyes, which makes them feel better, is this OK?
As a general rule, NO. Obviously, it feels good, but you may potentially scratch your corneas with "sleep" that is floating in your tears or with concretions that are imbedded in your eye lids; this may lead to infections. If your eyes are dry or tired from computer work, use artificial tears that are available over the counter (e.g. Optive, Systane, Refresh). You may refrigerate them to make them even more cooling and refreshing when inserted.
I think I need bifocals, what can I do to avoid looking like my grandad?
We are fortunate to live in times when modern optics and technology has freed us from bifocals and trifocals: we have progressive lenses! This is short for progressive addition lenses (PALs), sometimes incorrectly referred to as "no-line bifocals". Incorrect because bifocals give you just that, only two focuses, one at distance (e.g. for driving) and one at near (reading distance). But PALs give you a dozen or more focus powers smoothly blended from one power to the next so that there is no line on the lens, and more importantly, many more powers to choose from for varying focusing distances (e.g. computer distance, music distance, needlework, etc.). The smooth progression in powers also means that there is no bifocal "image jump" when you move your eyes from focusing at near to far, or vice versa. And best yet, since there are no lines, no one can tell you're wearing multifocals!
But my friend got progressives and hated them, so what good would they do me?
Everyone is different and so are their prescriptions and visual needs. Patients may have problems with a given pair of PALs for many reasons: most often, the PAL design (there are many out there) wasn't suited for their needs, the PALs weren't adjusted properly on their face, or the spectacle prescription may have just been wrong in some way (doctors aren't infallible). If they're fitted correctly, the vast majority of patients love the PALs right from day one; a smaller percentage have a very fast "learning curve" of 3-5 days to learn to use them. To draw an analogy between bifocals and PALs: when you made the transition from riding a bicycle to driving a car, learning all of the features of the car (dials, levers, shifter, buttons, pedals, mirrors, etc.) was overwhelming; both a bicycle and a car will get you where you want to go, but once you've learned to use the features of the car, would you want to go back to a bicycle?
What brands of frames do you carry?
We proudly carry Ann Klein, Guess, Converse, Lucky Brand, Candies, Calvin Klein/CK, Joseph Aboud, William Rast, Maui Jim, Bebe, Flexon and many other fashion lines. Eyeglasses are functional jewelry and our staff takes great pride and pleasure in helping our patients look their best in their eyewear.
What is the difference between regular sunglasses and polarized sunglasses?
Regular sunglasses cut down light at all wavelengths, basically making your perceived vision darker. While this relieves eye stress on sunny days, it has the potential to reduce detail in shaded areas. Polarized filters selectively block the glare from sunlight, sky haze, reflections off snow, etc. while allowing in plenty of light in shaded areas. Fishermen particularly like polarized filters because they reduce the reflections off of the surface of lakes, rivers and oceans that they can see their quarry under the water better. Both kinds of sunglasses are desirable to wear with contact lenses, but you may have either made with your prescription in them.
How are my glasses like my bed?
We often hear comments like, "I have glasses but I don't like wearing them because a) they're unattractive, b) they're too heavy on my nose, and c) I get too much glare with them. Conventional wisdom states that because we spend 1/3 of our lives sleeping, you shouldn't cut corners, but rather should invest in a higher quality bed. Now consider that you spend the remaining 2/3 of your life awake, using your eyes--- why would you skimp on your glasses to save a few dollars? Yes, you can get less expensive glasses at a chain store, but you can invest in higher quality glasses that you actually enjoy wearing. Long after you've forgotten the cost of extras like anti-reflective filters, hi-index lenses (to reduce lens thickness and weight) and quality frames, your glasses will be improving your quality of life all of your waking hours! And they'll last a lot longer than those from a chain store.
How come my contact lens and spectacle prescriptions are different?
This can be for several reasons; one is a mathematical formula called effectivity: for spectacle prescriptions more than +4.00 DS or -4.00 DS, when you move the lens from the spectacle plane (where the glasses lens is about 13mm in front of the eye) to the surface of the eye (as in a contact lens), in order to maintain the same relative lens strength, the contact lens prescription must be either raised or lowered to compensate. There are other factors as well dealing with astigmatism, binocularity and simply patient preference that dictate modifying the contact lens prescription from the spectacle prescription.
What age is appropriate for my child to start wearing contacts?
It mostly depends on how responsible and dexterous the child is. The average age is around 12 or 13, but even younger children can master contact lenses--it all depends on if they are self-motivated enough to change them when prescribed and wear them as prescribed. It is not a good idea for a parent or caregiver to be responsible for inserting and removing the child's contact lenses or reminding them when to change to a new pair.
My doctor prescribed my disposable contacts for 2 weeks of wear before throwing them out and opening a new pair, but I found that the contacts work and feel just as good if I wear the same pair for 3 to 4 weeks before disposing of them, so I'm saving money, right?
You could potentially save so much money that way that you lose vision permanently. After the prescribed length of time, you contact lenses begin to lose much of their design shape and surface (on a microscopic scale) and they begin to rub your corneal surface in a very unhealthy manner. The longer you do this, the sicker your cornea becomes and this throws your contact lens prescription and your spectacle prescription into chaos. Once this happens, you will spend much more money trying to heal your eyes than any minor amount that you've saved, and it's possible that you'll have permanent corneal damage that can't be corrected by any contact lenses, spectacles or refractive surgery. Your contact lens wearing time prescription is not a suggestion, it is what your eye doctor has prescribed for you to keep your eyes healthy. Patients often say, "I know when to change my contacts, they begin to bother my eyes..." Now consider this: If your physician prescribed you a medication, would they say, "Just use it until it starts bothering you..."? No! It's a prescription, not a suggestion!
But what about Purevision and Nite/Day lenses that are advertised to be worn 30 days continuously?
If you read the ad closely, it says "up to 30 days". All eyes are different, some patients are able to wear them that long, some will only get 2-3 weeks of wear before it becomes too uncomfortable. This discomfort is caused by one undeniable fact: the cornea needs oxygen, and the best way to get that oxygen is to take the lenses off before bedtime to let them catch up on any oxygen they've missed during the day. Despite marketing to the contrary, the only lens that is "like wearing nothing at all" is one that is not worn at all.
I have to wear reading glasses over my contacts to read, are there contacts that would make the reading glasses unnecessary?
Absolutely, we can fit you in multifocal contacts or monovision contacts that enable you to do you entire daily routine without reading glasses.
My last eye doctor said that I have astigmatism, can I get contacts even if I have astigmatism?
Absolutely, we fit patients with astigmatism every day and they feel like they have a new lease on life by not having to wear spectacles anymore. Even if you've been fit unsuccessfully before, Dr. Miller has a very high success rate with astigmatic patients and will work with you for however long it takes to get you happy.
Do you carry colored contact lenses?
Yes, we can fit you in colored contacts and we take pride in our staff who can steer your to the color(s) that best complement your features.
Why can't I get refills on my contact lenses when my prescription is expired, my vision hasn't changed and my contacts feel fine?
Because contact lenses are medical devices that can potentially cause damage to the eyes if not properly monitored, therefore, eye doctors are required by law to check them on the patient's eyes on a regular basis. Minimally, this is every year, but in certain cases, the doctor may require to see the patient even more often to ensure stability and safety of the contact lens fit. Many patient's contact lens prescriptions stay the same for years but then suddenly change. You are trusting the continued health of your eyes and clarity of your vision to your eye doctor, the only way that they can do that is to see you regularly.
How come my contact lens and spectacle prescriptions are different? This can be for several reasons; one is a mathematical formula called effectivity: for spectacle prescriptions more than +4.00 DS or -4.00 DS, when you move the lens from the spectacle plane (where the glasses lens is about 13mm in front of the eye) to the surface of the eye (as in a contact lens), in order to maintain the same relative lens strength, the contact lens prescription must be either raised or lowered to compensate. There are other factors as well dealing with astigmatism, binocularity and simply patient preference that dictate modifying the contact lens prescription from the spectacle prescription.
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