Seeing Eye To Eye

Computer Vision Syndrome (CVS)
Written By: | April 23, 2012

More than 50% of Americans spend 2 hours or more on a computer.  Computer Vision Syndrome (CVS) describes a group of eye and vision-related problems that arise from extended periods of computer use.

Many of us who spend a great deal of time on the computer recognize and experience many of these symptoms:

  • Difficulty focusing and blurred vision
  • Headaches
  • Dry, itchy, watery eyes
  • Pain or muscle spasms in the neck and shoulders

Minor vision problems such as uncorrected nearsightedness, farsightedness or presbyopia can contribute to the development of CVS.  Poor eye coordination and focusing skills can contribute as well.

Steps to manage CVS:
  • Adjust text size so that it is three times the smallest text you can read from your normal working distance.
  • Experiment with color choice.  Black text on a white background works well for most but a light text on a dark background or other color combinations may work better.
  • Adjust the brightness to match the room brightness.  Then, increase the contrast to the highest comfortable level.
  • Reduce  glare:
    • Position your monitor so that windows are to the side of the monitor.
    • Do not shine a desk lamp on the screen.
    • Consider using a glare filter over the monitor or a monitor hood.
  • Use lubricating eye drops.   And, remember to blink.
  • Make sure to use proper “computer ergonomics”
    • Position your monitor 20 to 26 inches away.
    • Make sure your monitor is 4-9 inches below straight ahead gaze.
    • Position your chair and monitor so that your arms are parallel to the floor while typing and your feet are flat on the floor.
    • Use a document holder close to the screen.
    • Finally, take a break.  Either look away from the computer and even stand up or stretch.
  • Take time to make your computer use as comfortable as possible.
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Eye Can Hear
Written By: | April 16, 2012

The next time you are seen at Pepose Vision Institute, you may be surprised when the technician offers to perform a hearing screening test using a 5 tone screening device held up to each ear. If hearing loss is detected, the doctor will offer you an opportunity to have a free audiology evaluation with a licensed audiologist in our office. If needed, the audiologist will dispense hearing aids. If the evaluation suggests the possibility of more serious disease, then you will be referred to an ENT specialist.

Why would an ophthalmology practice find it important to offer hearing testing services? For a number of very important reasons, outlined below.




Hearing Loss is a Risk Factor for Macular Degeneration

Numerous studies have shown a higher prevalence of hearing loss in patients with macular degeneration. A recent study suggested that hearing loss was significantly greater (in decibels) in the dry kind than the wet. Surprisingly, hearing loss in patients 55 years of age or younger was associated with an even higher (4.3X) increase in odds ratio of developing macular degeneration compared to those older, so we screen both younger and older patients.

When a group of patients living in Beaver Dam, Wisconsin between age 48 and 92 were examined, 45.9% had hearing loss. It was more common in men and the risk increased with every 5 years of life. Of note, of those that needed it, only 14.7% of patients wore hearing aids. Patients visit an ophthalmologist with far greater frequency than an ENT specialist, which provides us a unique opportunity to help.

A study published last year in the Archives of Ophthalmology showed that the overall increased risk of developing macular degeneration in a patient with hearing loss was 2.28 times those without. Put into perspective, that is a 36% larger increase in the odds of developing macular degeneration compared to the impact of smoking more than 11 years. Patients with hearing loss may need to be monitored more closely by us for the development of macular disease, so it is important for us to know your hearing status.


We are in the Business of Enhancing Quality of Life

I think you can now appreciate why screening for hearing loss is good medicine for those of us in eye care. Patients who have both sensory hearing loss and vision loss more often become isolated, dependent and have problems communicating. They are more prone to depression, falls, and accidents. We want to take advantage of the unique opportunity we have to make a positive impact in your quality of life. Please contact us at 636-728-0111 or by clicking here  to schedule free hearing testing at Pepose Vision Institute, which can often be provided the same day as your next eye examination.

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Why Cataract Surgery in the 58 year old?
Written By: | April 2, 2012

Most of us think that one has to be older to develop a cataract.  This makes sense as cataract formation is generally age-related.  A cataract is a cloudy natural lens inside the eye that distorts light entering the eye.  However, a number of factors may accelerate cataract formation.  Cataracts can develop at an earlier age due to trauma to the eyes, from medical conditions such as diabetes, or from spending more time outdoors without wearing sunglasses to block UV light.  Earlier cataracts are also seen in patients who use steroids chronically, such as with Prednisone pills, asthma inhalers, allergy nasal sprays, or steroid eye drops.

During the early phase of cataract formation, patients will note subtle changes in their vision.  They will report that their vision with their present glasses or contacts is not as sharp as when they first received the glasses.  They will need more light to read.  Street signs at night will be more difficult to see until they are very close to the signs.  There may be more glare from oncoming car headlights.

These symptoms are initially treated by updating the glasses or contact lens prescriptions.  As the cataract clouds, a different glasses prescription is needed to bend the light around the new cloudy areas that have developed since the previous glasses prescription,  In a sense, this means that patients with early cataracts face the challenge of trying to catch up the progressing clouding.  Hence, patients wonder if a more permanent solution to their vision problems makes more sense than updating their glasses every 6 – 12 months while struggling in between.

An alternative treatment for symptoms related to early cataract formation is consideration of cataract surgery.  The advantages of cataract surgery in these patients are that surgery: (1) permanently removes the clouded natural lens; (2) is generally a 1 time procedure; (3) replaces the cataract with an artificial, clear lens or implant that further improves the vision because glasses prescriptions can be built into the implant (as if the glasses were permanently placed inside the eye); and (4) provides long-term stable vision as the artificial implant does not change over time, as long as the health of the remainder of the eye remains the same.  For these reasons, patient even in their 50s and 60s are considering cataract surgery as a safe, effective, long-term treatment to improve their ability to drive and read without “filmy,” “hazy,” “ghosting,” or “glary” vision.


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