Frequently Asked Questions

General

Routine eye examinations are an effective aspect of preventive, primary health care. You or a member of your family can have a vision or eye health condition without being aware of it. Uncorrected, poor vision affects your ability to function and, therefore, your general health and well being. Eye disorders and disease often have no readily recognizable symptoms. Waiting for symptoms in order to initiate an eye examination can place you at unnecessary risk. Routine eye examinations are important in diagnosing and treating vision anomalies. At the same time, they can detect more serious eye disorders and diseases as well as symptoms of other potential medical problems. Early detection and diagnosis of these health concerns at the primary care level lessen the likelihood of long term, chronic disability.

Many factors will influence how often you should have your eyes examined, and only your optometrist, after analysis of your particular vision and health needs, can determine when your next visit should be. However, as a general guideline, Manitoba Optometrists support the following recommendations of the Canadian Association of Optometrists:

Infants and Toddlers (birth - 24 months) Exam around 6 months of age
Preschoolers (2-5 years) Exam at age 3 and prior to school entry
School Age (6-19 years) Exam annually
Adults (20 - 64 years) Exam every one to two years
Senior Adults (64 years and older) Exam annually

Your optometrist is a highly educated, caring and trustworthy individual concerned with your general health and, especially, the health of your eyes. A Doctor of Optometry (O.D.) is a provincially licensed health care professional, specifically educated and clinically trained to examine the eyes and the visual system and to detect, diagnose and treat vision problems.

The optometrist's training and experience also enables him or her to diagnose eye pathologies and detect symptoms of medical conditions which manifest in the eye, such as diabetes or hypertension. Optometrists work in cooperation with family practitioners and ophthalmologists (medical/surgical eye specialists) to ensure that patients receive a level of care responsive to their particular health needs, including referrals to other professionals as required.

Common Vision Problems

Astigmatism means "without a single focal point". Ideally, the curve of the front of the eye (the cornea) is round or spherical. If the shape is more like an egg or football, where the curvature is flatter is one direction than the other, no sharp focus occurs. Uncorrected, astigmatism can cause blurred vision, squinting, headaches, head tilt, red eyelids and light sensitivity.

Strabismus (crossed eyes) occurs when the eye muscles point one or both eyes in the wrong direction. It often first appears between birth and 21 months. Because the brain has difficulty in blending the two images, problems with depth perception and double vision may occur. Untreated, the condition may get worse and result in a lazy eye. Treatment for crossed-eyes has excellent results if detected within the critical period of ages 6 months to 5 years, and may include glasses, prisms, vision therapy and in some cases, surgery.

You may sometimes see small specks or clouds moving in your field of vision. They are called floaters. You can often see them when looking at a plain background, like a blank wall or blue sky. Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of your eye.

Floaters can get in the way of clear vision, which may be quite annoying, especially if you are trying to read. You can try moving you eyes, looking up and then down to move the floaters out of the way. While some floaters may remain in your vision, many of them will fade over time and become less bothersome. Even if you have had some floaters for years, you should have an eye examination immediately if you notice new ones.

Right now there is no scientific evidence that computer monitors are harmful to the eyes. However, more people are suffering the effects of prolonged computer use and advances in technology are addressing these concerns.

Eyestrain, however, is linked with staring at computer screens for long periods of time. While on the computer, you may experience eye irritation, fatigue, or difficulty focusing. Though eyestrain is annoying, it does not mean that computers damage the eye. To find relief, you should first have a complete eye examination to rule out eye disease and provide proper glasses, if you need them.

Since a computer screen is usually placed farther away and higher than one's usual reading distance, different glasses may be necessary. This is especially true for people who wear bifocals, trifocals, progressives or reading glasses. We can prescribe the correct glasses for you and will be pleased to give you a free brochure about eliminating or reducing computer eyestrain.

Eye Health Problems

A cataract is a clouding or fogging of the normally clear and transparent lens of the eye. When a cataract develops, the lens becomes as cloudy as a frosted window and light cannot be properly focused on the retina resulting in an unclear image. Often, only a small part of the lens is affected and if sight is not greatly impaired, there is no need to remove the cataract. If a large portion of the lens becomes cloudy, sight maybe partially or completely lost until the cataract is removed.

There are many types of cataracts. Most are caused by a change in the chemical composition of the lens. Theses changes may be caused by aging, heredity or birth defects, injury to the eye, or certain diseases or conditions of the eye or body.

The normal process of aging can cause the lens to harden and turn cloudy resulting in senile cataracts. These are the most common type and may occur as early as age 40.

Cataracts may develop in children. When they appear in children they may be hereditary or may have been caused by infection or inflammation affecting the pregnant woman and unborn baby. These are congenital cataracts and are present at birth.

Eye injuries can cause cataracts in people of any age. A hard blow, puncture, intense heat or chemical burn can damage the lens, resulting in a traumatic cataract.

Certain infections or diseases, such as diabetes mellitus, may also cause the lens to cloud resulting in secondary cataracts.

Depending on the size and location of the cloudy areas in the lens, a person may or may not be aware that a cataract is developing. If the cataract is located on the outer edge of the lens, no change in vision may be noticed. However, if it is located near the center of the lens, it usually interferes with clear sight.

As cataracts develop there may be hazy, fuzzy and blurred vision. Double vision may also occur. The eyes may be more sensitive to light and glare, making night driving difficult. Remember, cataracts like most eye-diseases, cause no eye pain. There may be a need to change the eyeglass prescription frequently.

As the cataract worsens, stronger glasses no longer improve sight. It may help to hold objects closer to the eye to read and do close-up work. The pupil, which is normally black, may undergo noticeable changes in colour and appear to be yellowish to white.

Cataracts cannot usually be seen from the outside of the eye without proper instruments. If you have noticed blurred vision or other symptoms, you should visit your optometrist. Provide him/her with a thorough personal and family health history, and follow your optometrists recommended appointment schedule.

When a cataract causes loss of sight that interferes with your work or lifestyle, it probably is time to have it removed. Surgery is the only effective way to remove the cloudy lens. Cataract surgery is highly successful, and over 90% of patients who undergo the surgery regain useful vision.

During this procedure the cloudy lens is removed and a replacement lens is implanted inside the eye. This lens is called an intra ocular lens (IOL). This replacement restores one's sight to pre-cataract conditions. (It is important to note that, as with all surgeries, results cannot be guaranteed.)

Reduce your exposure to ultraviolet radiation (UV) over your lifetime. It is very important to wear sunglasses to protect your eyes that have 99-100% UV protection. In addition to sunglasses, a wide brimmed hat will help protect your eyes.

Stop Smoking. Cigarette smoke in known to contain substances that interfere with the eye's antioxidant defense mechanisms, increasing smoker's risk.

Lower your alcohol consumption. Studies have shown that more than 1 drink per day increases the risk of cataracts. Scientists believe that alcohol in the body is converted into a harmful substance called acetaldehyde that may damage the eye's lens.

Maintain a healthy lifestyle. New research has also found that obesity also may be a risk factor.

Watch for new research. Investigators are seeking ways to boost the eye's natural ability to fight UV. Nutrients called antioxidants (such as Vitamins A, C, and E, beta-carotene and lutein) found in fruits and vegetables may help the lens to protect itself against UV radiation. Research is not yet clear on whether supplementing your regular diet with these nutrients can lower your risk of cataract, but studies continue.

Crystalline lens (lens) - helps focus light on the retina.

Pupil - the black opening or aperture of the eye.

Retina - is the innermost layer of the back of the eye, formed of light sensitive nerve endings that carry visual impulses to the optic nerve.

Glaucoma is the second leading cause of blindness in Canada. Glaucoma is a group of disorders where eye tissue damage is at least partially related to pressure. This pressure is known as intra ocular pressure (IOP). If glaucoma goes undetected or untreated it can cause damage to the optic nerve resulting in a loss of vision and even blindness.

A clear fluid called the aqueous humor nourishes the lens, cornea and iris. This fluid is continually produced and it circulates through the front of the eye to the Sachems canal where it is absorbed back into the bloodstream. If a block in drainage occurs, or excess fluid is produced, eye pressure may be increased. Normal pressure is 10 to 21 mmHg.

Unfortunately like many eye diseases, glaucoma often develops gradually and painlessly, so your vision may be affected without any symptoms.

Although glaucoma can occur at any age, it is more common in adults over 35. Other risk factors include persons with diabetes, and any vascular disorders; it has also been found to be hereditary. As with any disease early detection is important.

Glaucoma cannot be prevented, but it can be treated. Dr's. Friesen, Lautenschlager & Magarrell start monitoring pressure at age 13. For healthy eyes the Canadian Association of Optometrists recommend routine eye exams.

With the use of prescription eye drops and in some cases surgery, glaucoma can be treated. Frequent review of visual field sensitivity, intra ocular pressure and optic nerve condition are important to ensure glaucoma is well controlled. Early detection and treatment can prevent loss of vision by lowering the pressure in the eye. Any vision loss that occurs before detection is permanent and cannot be restored.

Macular degeneration (ARMD) is an eye disease that affects central vision. This is the area responsible for fine details such as sewing, reading and face recognition. Even in its most severe form, a person with ARMD will still have good peripheral vision, however, the ability to see details maybe lost.

There are two forms of macular degeneration:

Dry is a slow breakdown or death of light sensing cells in the retina. This results in a gradual loss of central vision. As bad as this may seem, it is a gradual process and is compatible with reasonable functioning for many years. The majority of macular degeneration cases involve this form of deterioration.

Wet is a rare form of macular degeneration. In cases of wet ARMD abnormal, new blood vessels grow from their normal location in the choroid into an abnormal location beneath the retina. The abnormal blood vessels leak and bleed resulting in sudden and severe loss of central vision. Wet ARMD patients can have rapid progression in as little as days to months.

The leading cause of macular degeneration is age. People over 50 are at risk for ARMD and that risk increases as we age. Other risk factors include:

  • Smoking - there is an increased risk of smokers and even former smokers developing ARMD.
  • Genes - some studies have found a hereditary link in ARMD.
  • Health risks - people who have high blood pressure, artriosclerotic vascular disease and diabetes are at a higher risk of developing ARMD.
  • Ultra violet rays & over exposure to harmful UVA and UVB rays from the sun over a lifetime can contribute to ARMD.

As with many other diseases of the eye, macular degeneration in both forms causes no pain. Generally, the earliest sign of ARMD is blurred vision. As more light sensitive cells in the macula are damaged, vision will become more and more impaired. The damage that occurs is irreversible and any vision loss is permanent.

With frequent eye health examinations changes in the eye can be detected before damage occurs. With the use of drops, Optometrists can dilate the pupil and view the back of the eye. Fundus photography (a picture of the inside of your eye) is also an important tool in monitoring possible changes in the eye. These photos are available with every examination for a nominal fee.

Macular degeneration is an incurable eye disease, but if diagnosed early enough treatments can be prescribed to slow its progression. These treatments include:

  • Laser used in the fight against Wet ARMD. 15% of cases are eligible for laser treatment. This eligibility is determined by the location of the abnormal blood vessels.
  • Photodynamic therapy using Visudyne, a light sensitive drug injected intravenously into a patients arm and then absorbed by the abnormal blood vessels in the eye. A "cold" laser is used to activate the drug. This treatment is used only for Wet ARMD.

There is no treatment for the dry form of AMD. It has been suggested that vitamin supplements such as Lutein, an antioxidant, Vitamin A, Vitamin E and Zinc may help slow progression of Dry ARMD. However, it is important to remember that any vitamin supplements should be taken on the advice of your doctors. Protective eyewear and sun wear filtering out harmful UV light while outdoors is another suggested precautionary measure.

Retina is the innermost coat of the back of the eye, formed of light sensitive nerve endings that carry visual impulses to the optic nerve. The retina maybe compared to the film of a camera.

Macula is a small area in the retina that provides our most central, acute vision.(Example: Driving, reading, etc.)

s consists of blood vessels and is the inner coat between the sclera and retina.

Patients who have diabetes are at risk for vision loss or impairment due to diabetic retinopathy. As diabetes damages blood vessels in various parts of the body, including feet and kidneys, blood vessels in the retina may also be affected.

As vessel linings weaken and bulge into the retina, the light-sensing membrane in the back of the eye, they begin to leak fluid into the retina, causing swelling. This condition called background retinopathy may not affect sight; however, the center of the retina may swell making reading difficult. At this stage, the retinopathy is not sight threatening.

Still, background retinopathy can lead to a more serious disease such as proliferate retinopathy. Characterized by new blood vessel growth, scarring and hemorrhaging, this condition can cause severe vision loss. Because the retina has no pain receptors, diabetic retinopathy is not painful and gives patients little, if any symptomatic warning.

If you suffer from diabetes and have not had your eyes examined in the past year, it is vitally important to your eyesight that you schedule an appointment soon. Yearly eye examinations are essential for any diabetic, whether diet controlled, on oral medications or insulin.

Eye Care Products and Services

If your optometrist recommends that you fill a prescription for corrective lenses, you probably will consider the purchase of glasses. This involves frame and lens selection, as well as prescription verification and fitting the glasses to your face for comfort.

More than fashion must be considered when selecting glasses. Your specific vision needs may not be suited to a particular type of lens or frame. The prescription itself, as well as, the intended use for the glasses (e.g. work, recreation or other lifestyle factors) are considerations to take into account. Other important choices involve the right lens type, such as bifocal or progressive, glass or plastic, and whether high index (thinner) lenses should be considered. This is critical in achieving satisfaction in the performance of your glasses.

Even with these particular considerations in mind, the choice today in both frames and lenses is vast. Our certified optometric assistants can help you select a frame that is well made, the right size, comfortable, attractive, and within your budget.

Increasing numbers of people are electing to wear contact lenses instead of or in combination with glasses when corrective lenses are prescribed. A variety of contact lenses are available to suit varying prescription needs and lifestyle choices.

Contact lenses are advantageous over glasses in that they allow a natural field of view since there are no frames to obstruct side vision, and the wearer usually looks through the center of the lens where the vision is the best. However, they are medical devices, in that they rest on the eye, and regular eye health monitoring is essential for safe, long term use of contact lenses.

In order to determine a prescription for contact lenses, supplemental ocular health assessments must be made by the prescribing doctor to ascertain whether your eyes can safely accept contact lenses and, if so, the appropriate parameters for those lenses. These additional tests, evaluation and diagnosis are not considered part of a routine eye examination.

Contact lens technology has come a long way in the last few years. New materials, designs, and manufacturing techniques have resulted in contact lenses that provide visual correction for almost any eye condition. These include farsightedness, nearsightedness, astigmatism and presbyopia. So, if you were ever told you couldn't wear contact lenses, it's time to ask again.

The cost of contact lenses varies according to an individual's prescription. Our contact lens fees are part of a comprehensive fitting program to provide you with convenient, carefree and safe contact lens wear. Our licensed contact lens technician will be happy to explain the program most suitable to your visual needs.

Yes. We have a free "try-on" contact lens visit available for any individual who is interested in contact lenses. This free trial also includes trying on tinted contact lenses.