Published: 24 June 2020

Fireworks Eye Injuries Have More Than Doubled in Recent Years Fireworks sales will be blazing across the country from now through the Fourth of July. As retailers begin their promotions, the American Academy of Ophthalmology is shining a light on this explosive fact: The number of eye injuries caused by fireworks has more than doubled in recent years. Fireworks injuries cause approximately 10,000 emergency room visits each year, according to data from the U.S. Consumer Product Safety Commission. The injuries largely occurred in the weeks before and after the Fourth of July. The CPSC’s most recent fireworks report showed that about 1,300 eye injuries related to fireworks were treated in U.S. emergency rooms in 2014, up from 600 reported in 2011. To help prevent these injuries, the Academy is addressing four important things about consumer fireworks risks: Small doesn’t equal safe. A common culprit of injuries are the fireworks often handed to small children – the classic sparkler. Many people mistakenly believe sparklers are harmless due to their size and the fact they don’t explode. However, they can reach temperatures of up to 2,000 degrees – hot enough to melt certain metals. Even though it looks like a dud, it may not act like one. At age 16, Jameson Lamb was hit square in the eye with a Roman candle that he thought had been extinguished. Now 20, Lamb has gone through multiple surgeries, including a corneal transplant and a stem cell transplant. Just because you’re not lighting or throwing it doesn’t mean you’re out of the firing line. An international study of fireworks-related eye injuries showed that half of those hurt were bystanders. The researchers also found that one in six of these injuries caused severe vision loss. The Fourth can be complete without using consumer fireworks. The Academy advises that the safest way to view fireworks is to watch a professional show where experts are controlling the displays. If you experience a fireworks eye injury: Seek medical attention immediately. Avoid rubbing or rinsing the eyes or applying pressure. Do not remove any object from the eye, apply ointments, or take any pain medications before seeking medical help. Watch the AAO’s animated public service announcement titled “Fireworks: The Blinding Truth.” Article contributed by Dr. Brian Wnorowski, M.D.

Published: 18 June 2020

Help! Growing Older and Can No Longer Read with My Contacts! More middle-aged and older adults are wearing soft contacts than ever. And one of the biggest reasons they decrease or stop wearing contacts is the difficulty they face reading with their contacts after presbyopia begins to set in around the early 40’s. Presbyopia is the diminished ability of the natural lens in our eyes to focus up close on near objects. It begins with the occasional medicine bottle being a struggle to read and then over time more and more gets blurry. It can be very frustrating to stare at something up close and have it be blurry regardless of what you do. So there are three basic choices a contact lens wearer can do to aid their reading while still wearing contact lenses. Reading Glasses Initially, the use of an over-the-counter reader or prescription reading glass for occasional use works well for people in the early stages of presbyopia. They are worn over distance contact lenses so there is little adjustment and vision is clear near and far. However, they need to be with you, not left in the car or at work, and oftentimes people end up just wearing readers all day since it is just that much clearer. Monovision This fitting technique can be used with any type of contact lens. The brand of lenses you are currently wearing can often be used to fit you with monovision. Your dominant eye is determined. Then the non-dominant eye prescription is adjusted to compensate to make it a reading contact lens. So once fitted you have one eye for distance and the other for reading. Yes, it sounds really crazy, but it actually works quite well. Your brain initially has to adjust to using each eye individually to obtain the sharpest vision, but once this is achieved, year-to-year adjustments can be made to the reading eye to allow comfortable distance and reading vision for many years. Monovision fits are not always successful. Some people just cannot adjust to it regardless of motivation or desire. It seems to work best when someone has had some difficulty with reading and they are noticing more and more that they need their readers. At that point, they can appreciate the ability to read and their brain seems to adapt more readily. When I wear my contacts this is the option I have used for myself. Multifocal Contacts Another option is multifocal contact lenses. Most every major manufacturer of soft contact lenses has some type of disposable multifocal lens available. They do not work like multifocal glasses. They use a technique called simultaneous viewing where you are actually looking through all the powers at once. To visualize this, imagine a vinyl record with the label in the center and the various tracks extending outward. Most of the lenses are made with the strongest reading power located in the center where the label would be, then each ring further out gradually becomes weaker until you reach your full distance power. So essentially you are looking “around” the reading part for distance then through the center for reading. It works, sort of. Multifocal lenses work better on younger patients, say 40-50 years old, for help with reading. There is no adaptation period to these lenses like monovision. What you see is what you get. But if you have any significant amount of astigmatism or if you wear a toric contact that corrects for astigmatism, multifocal lenses are not for you. And because the reading is central in the lens, if you make it too strong for reading then you blur the distance vision too much, so oftentimes a multifocal lens wearer after age 50 faces a dilemma to either wear reading glasses to boost their reading needs or change to monovision. Conclusion In conclusion, while none of the options are perfect they all may present some level of relief in your quest to continue to wear contacts into middle age, retirement, and beyond. But some options may better serve you at a certain point in your life or career than others. Talk to your eye doctor to see what choices are best for you Article contributed by Eugene Schoener O.D.