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COVID-19 Office Updates

Our new protocols require:

– Wear a face mask/covering.

– Have your temperature taken, over 100 deg F will be sent home.

– Only one patient or one parent/guradian with a minor in exam room.

– No one can be seen if they have signs of illness, been exposed to a COVID positive person or traveled outside country within last 4 weeks of visiting our office.

We will have hand sanitizers available, implemeting UV disinfection for our eyeglass frames and cleaning our surfaces with Vitula Biocide which is a hospital grade cleaning agent that is completely contact and food safe!

Please call before you come to the office so that we may maintain our disinfection protocols.

978-658-2020

Is 20/20 Vision “Perfect” Vision?

If you have an eye exam and are told you have 20/20 vision, does this mean you have perfect eyesight? Is it possible to achieve even better than 20/20 vision? And what is “perfect vision” anyway?

To answer these questions, let’s take a closer look at vision-related terminology to fully understand how eye doctors measure the quality of your vision.

Visual Acuity, Eyesight and Vision: What’s the Difference?

Visual acuity. This, literally, is the sharpness of your vision. Visual acuity is measured by your ability to identify letters or numbers on a standardized eye chart from a specific viewing distance.

Eye chart, with young girl covering one eye.

Visual acuity is tested one eye at a time, with the help of a standardized Snellen eye chart.

Visual acuity is a static measurement, meaning you are sitting still during the testing and the letters or numbers you are viewing also are stationary.

Visual acuity also is tested under high contrast conditions — typically, the letters or numbers on the eye chart are black, and the background of the chart is white.

Although visual acuity testing is very useful to determine the relative clarity of your eyesight in standardized conditions, it isn’t predictive of the quality of your vision in all situations. For example, it can’t predict how well you would see:

  • Objects that are similar in brightness to their background
  • Colored objects
  • Moving objects

Three major physical and neurological factors determine visual acuity:

  1. How accurately the cornea and lens of the eye focus light onto the retina
  2. The sensitivity of the nerves in the retina and vision centers in the brain
  3. The ability of the brain to interpret information received from the eyes

Only light that is focused on a very small and highly sensitive portion of the central retina (called the macula) influences visual acuity measurements obtained during an eye exam.

Visual acuity typically is quantified with Snellen fractions

Eyesight. The exact definition of “eyesight” is difficult to pin down. Depending on which dictionary or other resource you check, it can mean “ability to see,” “the sense of seeing,” “vision,” “range of sight” or “view.” Often, the terms “eyesight” and “visual acuity” are used interchangeably.

Vision. This is a broader term than visual acuity or eyesight. In addition to sharpness of sight or simply a description of the ability to see, the term “vision” usually includes a wider range of visual abilities and skills. These include contrast sensitivity, the ability to track moving objects with smooth and accurate eye movements, color vision, depth perception, focusing speed and accuracy, and more.

If this more inclusive (and accurate) definition of “vision” is used, what most people call “20/20 vision” should really be called “20/20 visual acuity.” Realistically, that probably won’t happen. For better or worse, the term “20/20 vision” is likely here to stay.

What Is 20/20 Vision?

The term “20/20” and similar fractions (such as 20/40, 20/60, etc.) are visual acuity measurements. They also are called Snellen fractions, named after Herman Snellen, the Dutch ophthalmologist who developed this measurement system in 1862.

Eye doctor tests the eyes of an older man.

Your eye doctor or an assistant will use an instrument to show you choices of lenses to sharpen your eyesight.

In the Snellen visual acuity system, the top number of the Snellen fraction is the viewing distance between the patient and the eye chart. In the United States, this distance typically is 20 feet; in other countries, it is 6 meters.

At this testing distance, the size of the letters on one of the smaller lines near the bottom of the eye chart has been standardized to correspond to “normal” visual acuity — this is the “20/20” line. If you can identify the letters on this line but none smaller, you have normal (20/20) visual acuity.

The increasingly larger letter sizes on the lines on the Snellen chart above the 20/20 line correspond to worse visual acuity measurements (20/40, 20/60, etc.); the lines with smaller letters below the 20/20 line on the chart correspond to visual acuity measurements that are even better than 20/20 vision (e.g., 20/15, 20/12, 20/10).

The single big “E” at the top of most Snellen eye charts corresponds to 20/200 visual acuity. If this is the smallest letter size you can discern with your best corrective lenses in front of your eyes, you are legally blind.

On most Snellen charts, the smallest letters correspond to 20/10 visual acuity. If you have 20/10 visual acuity, your eyesight is twice as sharp as that of a person with normal (20/20) vision.

Is It Possible to See Better Than 20/20?

Yes, it’s indeed possible to have sharper than 20/20 vision. In fact, most people with young, healthy eyes are capable of identifying at least some of the letters on the 20/15 line or even smaller letters on the Snellen chart.

This may be due in part to better printing methods available today vs. those in the 19th century when Snellen was determining the smallest letters a person with normal vision should be able to discern. So a case could be made that “normal” visual acuity today is an ability to identify letters that are a bit smaller than those on the 20/20 line of a traditional Snellen eye chart.

Even if you see 20/20, you may feel your vision isn’t as sharp as you’d like. There are remedies for this.

On the other hand, people are living longer today than they did in Snellen’s era. Normal aging changes in the eye, such as early cataracts, could justify considering somewhat larger letters than those on the 20/20 line as being indicative of “normal” vision among adults in their 60s or older.

Regardless of these considerations, let’s say your eye doctor says you have 20/20 vision (or, more accurately, 20/20 visual acuity), and you want sharper eyesight. What can you do?

 

Glasses with special high definition lenses might give you sharper vision than regular eyeglass lenses.

What Is “Perfect” Vision?

It’s nearly impossible to quantify what “perfect” vision is. Besides, a more interesting question would be, “Perfect for what?”

For example, if you are driving on a sunny day, excellent Snellen visual acuity might be the main factor in your satisfaction with your vision. But your girlfriend, who has worse visual acuity than yours, might be happier with her vision in the same circumstances because she is wearing polarized sunglasses with anti-reflective coating that enhance contrast and block glare.

Or an athlete who has better than 20/20 vision might struggle with his performance because he doesn’t have certain dynamic visual skills that allow him to react to moving objects as quickly as a teammate whose static visual acuity isn’t as sharp as his.

Where to Get Expert Advice

The first step to maximizing the clarity and comfort of your eyesight in all situations is to see a qualified optometrist for a comprehensive eye exam and vision evaluation.

If you are interested in finding out if laser vision correction could sharpen your vision better than glasses or contacts, ask to be referred to an experienced LASIK surgeon for a consultation.

Finally, if your child has 20/20 vision but is struggling with eye strain and other vision problems in school, seek the advice of our pediatric optometrist who specializes in children’s vision to have your child evaluated for possible learning-related vision problems.

The most well-known part of a comprehensive eye exam is the basic visionblog_photo_12_31_15 test. When you have a general vision test, one of the main conditions the eye care practitioner is checking for is a refractive error. A refractive error means there is an abnormality in the shape of the eye, changing the eye’s ability to focus light directly onto the retina.This causes blurred vision and can usually be corrected by wearing prescription eyeglasses, contact lenses and possibly, alternate treatments such as vision therapy, ortho-k, LASIK or refractive surgery such as LASIK.

The term, “refractive error” refers to a problem with the process of refraction that is responsible for sight. Normally, light rays that enter your eye are refracted or bent through the cornea and the lens, and ultimately converge or are focused onto a single point on the retina. From the retina, messages are sent through the optic nerve to the brain which then interprets these signals into the image that we are seeing.

In order for this process to work effectively, the anatomy of the eye including the length of the eye and the curvature of the cornea and the lens must be just right to be able to focus the light onto the retina. When this is not the case, a refractive error will occur.

There are several different types of refractive errors, depending on which part of the eye is affected, and it is possible to have multiple refractive errors at the same time:

Myopia or nearsightedness:
In myopia the length of the eyeball is too long which results in light coming to a focus in front of the retina, rather than on the retina. This allows the individual to see well when objects are close but not clearly when looking at objects at a distance.

Hyperopia or farsightedness:
Hyperopia is when the eyeball is shorter than normal and can result in near objects being blurry. However, people experience hyperopia differently. Sometimes distant objects are clear while other times people may experience overall blurred vision near and far or no problems at all. In children particularly, the lens may accommodate for the error allowing for clear vision but may cause fatigue and sometimes crossed eyes or strabismus. Hyperopia causes eyestrain or fatigue especially when looking at near objects for a period of time. Often people with 20/20 vision may still need glasses at their desk to relax their eyes and improve concentration.

Astigmatism:
Astigmatism is usually the result of an irregularly shaped cornea (although it can sometimes also be due to a misshapen lens). The cornea, which is normally round, is more football-shaped in an eye with astigmatism, resulting in multiple focus points either in front of the retina or behind it (or both). People with astigmatism usually have blurred or distorted vision to some degree at all distances, near and far.

Presbyopia:
Presbyopia is an age-related condition which usually begins to appear sometime after 40. As the eye begins to age, the lens stiffens and can no longer focus clearly on objects that are close.

It’s important to note that presbyopia is often confused with hyperopia, as both cause problems focusing at near distances. However, high hyperopia can also cause blur at far distances as well, especially in dim lighting, and depth perception problems can result in motor vehicle accidents. In these instances people with hyperopia could use glasses at any distance.
If you are having trouble seeing, it is important to have an eye exam to determine the cause of the problem and to effectively correct your vision. Even if your vision is fine, you should schedule a routine eye exam on a regular basis to ensure that your eyes are healthy and that any potential problems are caught early.

How to Prevent Diabetic Vision Loss

senior 20couple 20in 20orange 20and 20whiteEye Complications of Diabetes

It’s true. Diabetics have a higher risk of blindness than those without the disease. That fact coupled with the superior prognosis of early intervention, makes it easy to understand why optometrists and doctors say routine eye care is absolutely essential. Below, we’ll discuss what your eye doctor is looking for during a diabetic eye exam.

As the incidence of diabetes increases, it is important to spread awareness about the risks and proper preventative care for diabetes patients. November is Diabetes Awareness month, so read on!

Diabetics are at greater risk of for a number of eye problems.

Diabetic Retinopathy:

Diabetic retinopathy is the term used for the disorders associated with diabetes that cause progressive damage to the retina. The longer a patient has had diabetes, the more likely it is that he will develop these conditions which can be very serious, vision-threatening complications.

There are two types of retinopathy: nonproliferative and proliferative.

Nonproliferative retinopathy, which is the most common form, is when capillaries at the back of the eye become weakened and may start to leak blood and fluids. Nonproliferative retinopathy, which often has no symptoms, can be characterized as mild, moderate or severe, depending on how many blood vessels are affected and becoming blocked. This type of retinopathy usually doesn’t require treatment and doesn’t cause vision loss, unless the leaking fluid ends up in the macula where the eye focuses – a condition called macular edema. If this happens, vision can be blurred and even lost so preventative treatment is essential.

Proliferative retinopathy is much more severe. This is when so much damage is done to the blood vessels that they begin to close off. New blood vessels begin to grow in the retina as a response to this deterioration. The new and weak vessels can leak blood, impairing vision, or can form scar tissue which can distort the retina or cause a retinal detachment.

Proliferative retinopathy requires urgent referral to an ophthalmologist for treatment. While it usually takes years to develop, some instances of proliferative retinopathy can occur within weeks or months if blood sugars are not well-controlled. Pregnancy can also accelerate proliferative retinopathy in known diabetics. Yet if detected early, treatment can be done successfully.

Like high blood pressure, there are often no warning symptoms until advanced stages of diabetes. It is best to get checked each year by an optometrist. If you experience any changes in your vision such as spots in vision, flashes of light, blurred or double vision (rarely pain), make an appointment with your eye doctor immediately. Treatments do exists for retinopathy and many of them are successful in repairing damage and sometimes even restoring vision.

Cataracts:

Cataracts are a clouding of the lens of the eye which blocks light from entering and impairs vision. While cataracts are a fairly common and treatable condition, people with diabetes are 60% more likely to develop the condition and often get them at a younger age. Those with the condition also may experience vision fluctuation which occurs from sugar levels affecting the lens of the eye. Cataracts often progress faster in diabetics as well. In serious cases of cataracts, a surgical procedure is done to remove the natural lens of the eye which can sometimes cause complications in diabetic patients that may already have symptoms of other conditions such as diabetic retinopathy.

Glaucoma:

Glaucoma is a serious condition where pressure builds up in the eye causing damage to the retina and optic nerve and eventually if left untreated, blindness. Diabetics are 40% more likely to develop glaucoma and the risk increases with age and the amount of time the individual has had diabetes. There are treatments for glaucoma including medications and surgery but early detection and treatment are essential to prevent permanent vision loss. Glaucoma is often called the “silent thief of sight” because vision loss often doesn’t occur until significant damage is done. Therefore, yearly eye exams are essential.

Cornea Alterations:

Diabetics may experience reduced sensitivity in their cornea. This means that contact lens wearers that are diabetics should be more cautious, as they develop higher tolerance if the lens irritates the eyes and may be at greater risk of infection.

Eye Muscle Disturbance:

More advanced diabetes cases can show restriction of eye muscle movement due to nerve palsy.

 

For diabetics, the key to early detection and treatment – and therefore preserving your vision – is to have your eye health monitored on a regular basis. Get your eyes examined every year by an optometrist and if you experience any changes in your vision such as spots, floaters, blurred vision or pain, make an appointment with your eye doctor immediately.

6 Things You Need To Know About Cataracts

father 20and 20son 20shaking 20handsCataracts are a leading cause of vision loss in the United States and Canada. Here are 6 things you need to know.

1. Chances are you will develop a cataract!

Cataracts are considered part of the natural aging process so if you live long enough, you will likely eventually develop one.

2. A cataract is a clouding of the usually transparent lens in your eye.

The lens in your eye focuses light onto the retina at the back of your eye, allowing you to see. When your lens starts to clouds up, the images projected onto your retina become blurry and unfocused. You can compare this to looking through a dirty or cloudy window. If the window is not clear, you can’t see!

3. Age is not the only risk factor for cataract development.

While the risk of developing a cataract does increase as you age, it is not the only factor. Other risk factors include eye injury, certain medications (eg: steroids), diseases such as diabetes and macular degeneration, lifestyle choices such as alcohol consumption, smoking and prolonged exposure to the sun.

4. Your treatment options are not limited to surgery.

If cataracts are detected in the early stages of development, non-surgical options including stronger glasses or even better lighting go a long way to help alleviate the condition’s detrimental impact on your vision at first. However, most people do need cataract surgery eventually. Fortunately, the procedure is very low risk and has an excellent success rate. It is relatively non-invasive, often requiring no more than a tiny laser-assisted incision, performed in an outpatient clinic.

5. Cataracts have warning signs

Cataracts don’t suddenly develop overnight. If you notice you have cloudy vision or see halos around lights, have trouble with night vision or see double in one eye, make a visit to your eye doctor a priority so you can get it checked out.

6. What you eat can reduce your risks.

While making healthy food choices plays a vital role in your overall health, it can also play a very specific role in reducing your risk of cataract development. A study published in American Journal of Clinical Nutrition found that increased intake of vitamin C or the combined intake of multiple antioxidants significantly reduced the risk of cataracts in older adults.

For more details see: http://www.allaboutvision.com/nutrition/cataracts.htm

Don’t let cataracts interfere with your quality of life. Be sure to schedule regular eye exams so that you stay on top of your overall eye health.

The Importance of Eye Exams For Children

girl 20with 20pink 20bow 20in 20the 20grassProper eye care is an extremely important part of a child’s development. Developments during this period will effect a child for the rest of his/her life. It is extremely important that children receive attention regarding their eyesight from a very early age to be sure that everything is developing correctly and to diagnose and treat any problems before they worsen or lead to more serious complications. Because many conditions may show symptoms even while your child is still an infant and become much harder to correct the longer they go untreated, it is very important to have regular eye exams for your child. Dr. Suraj Afhsar of Heller Eyecare in Wilmington, MA says, “Beginning from the age of 6 months, children should have comprehensive eye exams at least every year to assess any conditions that may hinder a child’s development.”

 

Many eye conditions that can cause difficulties later in life can be easily detected and treated in childhood if parents are cautious to have eye exams early and often for their children. Two such conditions are Strabismus and Amblyopia.

 

In Strabismus the eyes are not aligned together, with one eye looking straight while the other may look inward, outward, up or down. This happens when muscles that control eye movements are misaligned or underdeveloped. Children who have other conditions affecting development, such as cerebral palsy, downs syndrome, prematurity or brain tumors are especially susceptible. In eyes which are healthy and properly aligned, each eye sees essentially the same image of an object being viewed, with only slight variation and the brain combines these two slightly varied perspectives into a single interpreted image. This is called Binocular Fusion. In a child with Strabismus, the misalignment of the eyes sends completely different images, causing Binocular Fusion to be unusually difficult or impossible. The child’s brain eventually reacts to the differing images sent by the misaligned eyes by eliminating images coming from one of the eyes. This can cause a condition called amblyopia, or “lazy eye.” Amblyopia, sometimes known as lazy eye is a condition in which a person has very poor sight in one eye because that eye did not develop healthy sight during the person’s development. Several problems can develop that can seriously effect vision from childhood into adulthood if amblyopia is not diagnosed and treated in a timely manner. The weaker eye may develop a serious and permanent visual defect and depth perception may be lost.

 

You should also be cautious to have regular eye exams for your child because your child’s success in school relies heavily upon enjoying proper vision. In these eye exams the doctor will check for less serious conditions such as nearsightedness, farsightedness, and astigmatism. “Your child’s eyesight is his or her front line in the struggle for knowledge. If your child doesn’t receive proper eye care, the classroom may just be one big blind spot, and you may be sentencing your child to failure before the battle has even begun.” cautions Dr. Afshar. “Your eye doctor also needs to check early for basic skills related to good eyesight for learning. These include eye movement skills, Peripheral awareness and Hand-eye coordination.”

 

Contact Dr. Afshar today for more information, and to schedule your child’s comprehensive eye exam.

 

A Vision of Back-To-School  

mom with daughters2The new school year is coming up fast, and parents and students are getting ready to embark on new adventures and experiences. But this is also a reminder to parents that good eyesight is possibly the most important school supply your child may not have. A good education for children doesn’t just mean good schools, good teachers and good friends. Good vision is just as important. Dr. Suraj Afshar of Heller Eyecare in Wilmington, MA explains, “Your child’s eyes are his/her gateway into the world of learning. When your child’s vision is not functioning properly, learning and participation in recreational activities will suffer. Children are not likely to recognize vision problems or report them, and it is therefore the responsibility of parents and teachers to recognize signs of visual problems in their children.”
There is a basic set of vision skills that are needed for school. The first is near vision. This is the ability to see clearly at a distance of about 10-13 inches. This is obviously important for reading, writing and close work at your child’s desk. Distance vision, the ability to see clearly and comfortably beyond arm’s reach, is also important in order to see the board in the classroom, and Binocular coordination, or the ability to use both eyes together, is important for extra-curricular activities. Both are vision skills needed to be successful in school. Additionally, focusing skills, peripheral awareness and eye-hand coordination are also important. As a parent, it is your job to be alert for symptoms that may indicate your child has a vision or visual processing problem. A few examples of common conditions that may effect your child’s ability to learn are below:
If your child gets headaches while trying to read or do other close work, exhibits a short attention span during visual tasks, and/or has to use a finger to guide reading, it is possible your child may have a condition called convergence insufficiency. This is a condition in which the eyes have a hard time converging on a certain point close up. This may also cause the words to “jump” or “blur” when your child attempts to read.
You may also find that your child’s eyes do not seem to move together, that the eyes do not face the same direction, and/or that your child tilts his/her head or squints in order to see better. This could indicate a condition called Strabismus. This results from muscles in one or both eyes being misaligned or underdeveloped. This can cause severe difficulty for your child, and may cause more significant problems, including loss of depth perception, if not treated promptly. Dr. Afshar adds, “Other symptoms to look out for that may signal vision related problems are difficulty remembering or identifying shapes, difficulty remembering what was read, excessive blinking or rubbing of his/her eyes, or placing his/her head very close to the book or desk when reading or writing”.
Because changes in your child’s vision can occur without you or your child noticing them, your child should visit the eye doctor every year or more frequently if specific problems or risk factors exist. Remember, school vision or pediatrician’s screenings are good, but they are not a substitute for a thorough eye exam.
To learn more, contact Dr. Afshar today.

Pink, Stinging Eyes?

Conjunctivitis, also called pink eye, is one of the most frequently seen eye diseases, especially in kids. It can be caused by viruses, bacteria or even allergies to pollen, chlorine in swimming pools, and ingredients in cosmetics, or other irritants, which touch the eyes. Some forms of conjunctivitis might be quite transmittable and quickly spread in school and at the office.

Conjunctivitis is seen when the conjunctiva, or thin transparent layer of tissue covering the white part of the eye, becomes inflamed. You can identify conjunctivitis if you notice eye redness, discharge, itching or swollen eyelids and a crusty discharge surrounding the eyes early in the day. Pink eye infections can be divided into three main types: viral, allergic and bacterial conjunctivitis.

The viral type is usually a result of a similar virus to that which produces the recognizable red, watery eyes, sore throat and runny nose of the common cold. The red, itchy, watery eyes caused by viral pink eye are likely to last from a week to two and then will clear up on their own. You may however, be able to reduce some of the discomfort by using soothing drops or compresses. Viral pink eye is transmittable until it is completely cleared up, so in the meantime maintain excellent hygiene, remove eye discharge and try to avoid using communal pillowcases or towels. If your son or daughter has viral conjunctivitis, he or she will have to be kept home from school for three days to a week until symptoms disappear.

A bacterial infection such as Staphylococcus or Streptococcus is usually treated with antibiotic eye drops or cream. One should notice an improvement within just a few days of antibiotic drops, but be sure to adhere to the full prescription dosage to prevent pink eye from recurring.

Allergic pink eye is not contagious. It is usually a result of a known allergy such as hay fever or pet allergies that sets off an allergic reaction in their eyes. First of all, to treat allergic pink eye, you should eliminate the irritant. Use cool compresses and artificial tears to relieve discomfort in mild cases. When the infection is more severe, your eye doctor might prescribe a medication such as an anti-inflammatory or antihistamine. In cases of chronic allergic pink eye, topical steroid eye drops could be used.

Pink eye should always be diagnosed by a qualified eye doctor in order to identify the type and best course of treatment. Never treat yourself! Keep in mind the sooner you begin treatment, the lower chance you have of giving pink eye to loved ones or prolonging your discomfort.

 

Welcome to our New Website

We invite you to take a look around our new site to get to know our practice and learn about eye and vision health. You will find a wealth of information about our optometrists, our staff and our services, as well as facts and advice about how to take care of your eyes and protect your vision.

Learn about our Practice specialties including comprehensive eye exams, contact lens fittings and the treatment of eye diseases. Our website also offers you a convenient way to find our hours, address and map, schedule an appointment online, order contact lenses or contact us to ask us any questions you have about eye care and our Practice.

Have a look around our online office and schedule a visit to meet us in person. We are here to partner with you and your family for a lifetime of healthy eyes and vision. We look forward to seeing you!

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