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Coronavirus (COVID-19) is a serious concern to our community.

To our patients:

We recognize that Coronavirus (COVID-19) is a serious concern to our community. As a private doctor’s office committed to providing the highest level of patient care, we want to assure you that we are doing everything we can to keep our office safe for everyone.

First and foremost, if you are experiencing symptoms ( of COVID-19, we are asking that you stay home and call the office to reschedule any routine appointments:

* High fever

* Dry cough

* Shortness of breath or difficulty breathing

* Have traveled to an area affected by COVID-19 or have had exposure to someone with COVID-19

Please be advised that we are taking the following steps to keep our office safe, as recommended by the Centers for Disease Control (CDC):

* Increased sanitization of common areas

* Equipment is disinfected between each patient

* Hand sanitizer available throughout office space

* Doctors and staff are encouraged to stay home if they are displaying symptoms, or if anyone in their household has been exposed to COVID-19

For additional information and resources, please review the Montgomery County Health and Human Services Novel Coronavirus (COVID-19) Information Page (

We will continue to keep you updated as any additional precautions become necessary. Thank you for trusting us with your eye care during this ever-evolving situation.


If you wear bifocals and have astigmatism a new lens is now available that provides excellent vision at all distances. Please call our office to schedule a time to see if this lens is right for you.

The Ultra Multifocal for Astigmatism, a new monthly replacement silicone hydrogel lens from Bausch + Lomb, can correct near or distance vision, astigmatism and presbyopia all in one. The manufacturer says it is “the first multifocal toric lens to be available as a standard offering in the eye care professional’s fit set.”

The lens will use the company’s three-zone progressive design found on its other multifocal products, as well as its MoistureSeal two-phase manufacturing process that retains moisture and delivers a highly wettable surface.

New WHO guidance: Very limited daily screen time recommended for children under 5

The World Health Organization (WHO) is recommending children under age 5 spend one hour or less on digital devices and those under age 1 spend no time at all on a daily basis.

“The goal is not to take away screens but to help parents manage time on screens and frequency of breaks.”

WHO released its recommendations, “WHO Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 Years of Age,” on April 24. Among its other recommendations: children should spend more time engaged in physical activity and getting enough sleep. The WHO study refers to sedentary screen time, which includes watching television or videos, or playing computer games.

Here are WHO’s screen time recommendations by age:

  • Infant (less than 1 year of age): Screen time is not recommended.
  • 1-2 years of age: No screen time for a 1-year-old. No more than an hour for 2-year-olds, with less time preferred.
  • 3 to 4 years old: No more than one hour.

Sedentary behavior by youngsters has been identified as a risk factor in global mortality and has contributed to the rise in obesity, the guidelines say.”Achieving health for all means doing what is best for health right from the beginning of people’s lives,” WHO Director-General Tedros Adhanom Ghebreyesus said upon the guidelines’ release. “Early childhood is a period of rapid development and a time when family lifestyle patterns can be adapted to boost health gains.”Said Fiona Bull, WHO programme manager for surveillance and population-based prevention of noncommunicable diseases: “Improving physical activity, reducing sedentary time and ensuring quality sleep in young children will improve their physical, mental health and wellbeing, and help prevent childhood obesity and associated diseases later in life.”

Link between vision and inactivity

Developing the ability to “use” vision starts at birth, says Glen Steele, O.D., professor of pediatric optometry at Southern College of Optometry in Memphis, Tennessee. When a baby watches a parent form words or point to objects, their actions lead to development of a baby’s “looking” process, which fosters their internal curiosity, he says. That curiosity leads to the baby wanting to get to an object out of reach and a desire to move toward it.”When an infant sees a parent looking at an object and follows their gaze to that object by 12 months of age, they will be able to identify 335 words by 18 months of age,” Dr. Steele says. “When they do not follow the parent’s gaze, they will only be able to identify 197 words by 18 months of age. Huge difference. This work was done by Andrew Meltzoff, Ph.D., at the University of Washington. Vision triggers curiosity, which triggers movement and exploration.”Hands-on exploration is one of the ways children learn.

Consequences of too much screen time, being sedentary

Studies also have shown that being sedentary can have significant developmental consequences, Dr. Steele says. Among them:

  • Children are less likely to have the fine motor skills necessary for writing when entering kindergarten.
  • Vocabulary, communication skills and eye contact are reduced.
  • Developmental delays are documented with increased device use. Screen time, for instance, has been linked to ADHD symptoms (self-regulation).
  • Attention, decision-making and cognitive control are reduced.
  • Creativity also suffers. Screen time interferes with problem solving.
  • Psychiatric disorders reported.
  • A premature thinning of the cortex based on brain scans.

Canadian researchers found in a study published online Jan. 28 in JAMA Pediatrics that 2- and 3-year-old children watched television for respectively 2.4 and 3.6 hours a day. Further, the authors linked excessive TV watching to “poorer performance on developmental screening tests,” which may partially explain why children are not developmentally ready for starting school.

Although excessive screen time is not solely an “eye problem,” its effects are readily apparent during a comprehensive eye examination through observation of pupil size and assessment of accommodative function, Dr. Steele says. When noted, optometrists should be prepared to have discussions with parents, he adds. He used the term “technoference,” which refers to how technology can interfere in relationships (parent and child).

According to the AOA’s 2018 American Eye-Q® survey, three-quarters of parents are concerned their children may damage their eyes due to prolonged use of electronic devices. In the survey, 4 in 5 parents reported their child spends at least an hour a day using a computer or mobile device.

Conversations with parents

Dr. Steele has developed a brief guide doctors of optometry can provide parents at the conclusion of the examination.”It includes the WHO information and also a recommendation for taking breaks,” says Dr. Steele, who will be presenting more detailed information on screen time at the AAO annual conference in October. “The 20-20-20 rule (take a 20-second break every 20 minutes and view something 20 feet away) was developed in the 1990s and, at the time, it was sufficient because we were using CRT (cathode ray tube) screens that were larger and farther away. Now, the kids are using phones very close to their faces, which is a completely different mode of operation.”The goal is not to take away screens but to help parents manage time on screens and frequency of breaks,” he says. “More frequent breaks are step No. 1 in aiding in this process.”Click here to access the AOA resource for patient education, “Healthy Vision Using Digital Devices.”


New for contact lens wearers: Oasys with Transitions!

Acuvue has developed a new bi-weekly disposable lens that reacts to light and darkens to protect your eyes from UV and brightness. We have just received the lens trials so contact us if you would like to try them!

Smartphones, Summer Birth Could Raise Kids’ Odds for Nearsightedness

By Steven Reinberg

HealthDay Reporter

TUESDAY, Nov. 6, 2018 (HealthDay News) — Kids with summer birthdays, especially those who spend long hours playing on smartphones and tablets, might be at greater risk for vision problems, a new study suggests.

Nearsightedness, also called myopia, is on the rise worldwide. It’s what eye doctors call a refractive error, meaning the eyes can’t focus light properly. The result: Close objects look clear; distant ones, fuzzy.

It’s most often caused by continuously focusing on close objects while the eyes are still developing — as in reading, for example. But the growing use of electronic devices seems to be making the problem worse, researchers report.

“As ever, everything should be done in moderation,” said lead researcher Dr. Christopher Hammond, chairman of ophthalmology at King’s College London in England. He urged parents to limit kids’ use of electronic devices.

That appears to be especially important for kids born in the summer, the study suggests. That’s because they start formal schooling at a younger age than kids born in winter so they are exposed to more reading sooner. And that increases myopia risk, the researchers said.

The researchers added that, while their study doesn’t prove smartphones, tablets and computer games cause nearsightedness, those devices may lead kids to spend less time outdoors. And less time outdoors also appears to increase myopia risk.

“We know that time outdoors is protective, and so kids should spend probably up to two hours a day outside,” Hammond said.

Myopia can be corrected with glasses, laser surgery or contact lenses. Later in life, however, sufferers are more likely to develop sight-robbing conditions such as cataracts or glaucoma, the researchers said.

Experts predict that by 2050, nearly 5 billion people worldwide will have myopia. That compares to about 2 billion in 2010.

Genes have been linked to a person’s risk for the condition, but even if it has a genetic component, that doesn’t account for the dramatic increase, Hammond said.

For the study, his team collected data on nearly 2,000 twins born in the United Kingdom between 1994 and 1996.

The researchers reviewed results of eye tests, as well as social, economic, educational and behavioral data on the twins between the ages of 2 and 16. They also had questionnaires completed by parents and teachers.

On average, children started wearing glasses for myopia at age 11. About 5 percent had amblyopia (“lazy eye”), and about 4.5 percent had a squint. Overall, 26 percent of the twins were nearsighted, the study found.

Kids who had college-educated mothers, those who were born in summer months and those who spent more time using electronic devices had a higher likelihood of nearsightedness, the study found.

The findings were published online Nov. 6 in the British Journal of Ophthalmology.

Dr. Tien Wong, medical director of the Singapore National Eye Center, is co-author of an editorial that accompanied the study.

“Evidence supports a link between device screen time and myopia, which includes time on phones and tablets,” he said.

This is concerning in view of how many young kids have access to these devices, Wong said. Evidence shows 2-year-olds spend up to two hours a day using digital devices.

“Managing your child’s device screen time and increasing their outdoor play can help reduce the risk of developing myopia,” Wong said. “We must better monitor our children’s device activities, even during their preschool years.”

Surprisingly, the researchers said children born as a result of fertility treatment had a 25 percent to 30 percent lower risk for myopia. They said that may be because many are born premature and have developmental delays, which could account for shorter eye length and less myopia.

More information

To learn more about myopia, visit the U.S. National Eye Institute.

SOURCES: Christopher Hammond, M.D., chair, ophthalmology, King’s College London, England; Tien Wong, M.D., medical director, Singapore National Eye Centre, Singapore; Nov. 6, 2018, British Journal of Ophthalmology, online


Transitions® Signature® lenses in new colors!

Transitions® Signature® lenses style colors feature four new vibrant fashion colors – sapphire, amethyst, amber and emerald – and complement the existing iconic colors – gray, brown and graphite green – for seven total Transitions Signature lens colors. In addition, Transition XtraActive now has the option of 6 custom mirror finishes for the lenses for added style and function. To read more click here

TBI, Concussion and Vision

Traumatic brain injury, or TBI, is a disruption of the normal functioning of the brain caused by a bump, blow or jolt to the head. TBI can range in severity from “mild” (a brief change in consciousness or mental status after the injury — including confusion, disorientation or loss of memory) to “severe” (an extended period of unconsciousness or memory loss after the injury).

Concussion is a term commonly used to describe mild TBI.

According to CDC, TBI or concussion accounted for more than 2.5 million emergency department (ED) visits and 282,000 hospitalizations in 2013. (These statistics include diagnoses of TBI alone or TBI in combination with other injuries.) TBI also contributed to the deaths of nearly 50,000 people that year.

Other researchers have found that, in 2012, an estimated 329,290 children age 19 or younger were treated in U.S. emergency departments for sports and recreation-related injuries that included a diagnosis of TBI or concussion.

Falls typically are the leading cause of TBI and concussion in the U.S., accounting for 47 percent of all TBI-related ED visits, hospitalizations and deaths in 2013, says CDC. The percentage fall-related TBI was highest among adults age 65 and older (79 percent) and children under age 14 (54 percent).

Being struck by or against an object (including sports and recreation-related injuries) was the second leading cause of TBI and concussion, accounting for about 15 percent of all TBI-related ED visits, hospitalizations and deaths in the U.S. in 2013.

Among all age groups, motor vehicle crashes were the third overall leading cause of TBI-related ED visits, hospitalizations and deaths (14 percent of total), according to CDC.

Other researchers have found that sports and recreational activities account for for about 21 percent of all traumatic brain injuries among American children and adolescents.

TBI and Concussion Symptoms

TBI and concussion symptoms may include cognitive problems such as headache, difficulty thinking, memory problems, attention deficits, mood swings and frustration.

An eye doctor moving her finger in front of a soccer player's eyes.The leading causes of concussion are falls, motor vehicle accidents and contact sports like American football. But other sports like soccer also pose a risk.

Also, following a traumatic brain injury, there often is an interruption in communication between the eyes and the brain. According to the Neuro-Optometric Rehabilitation Association (NORA), studies show that 90 percent of TBI patients suffer from vision problems following the injury, including:

Vision problems also are common symptoms of concussion among teenagers. In one study, out of 100 adolescents diagnosed with a concussion, 69 percent also were diagnosed with a functional vision problem.

Unfortunately, concussion-related vision problems may be overlooked during initial treatment of a traumatic brain injury. Also, in some cases, visual symptoms of concussion may not be present until sometime following the injury.

Left untreated, TBI and concussion-related vision problems can have serious consequences, such as loss of ability to organize and make sense of visual information, reduced depth perception, balance and posture problems, chronic headaches and reduced concentration and reading comprehension.

Treatment of TBI and Concussion Vision Problems

If you experience a concussion or other traumatic brain injury, you should see an eye care professional with special expertise in TBI-related vision problems. This is especially true if you notice any changes in your vision following a concussion or other head trauma.

Two types of eye doctors specialize in the detection and treatment of TBI and concussion-related vision problems: neuro-optometrists and neuro-ophthalmologists.


A neuro-optometrist is a Doctor of Optometry (OD) who has special training and clinical experience in the diagnosis and treatment of neurological conditions that affect the visual system.

Treatment of TBI and concussion-related vision problems provided by a neuro-optometrist typically is called Neuro-Optometric Rehabilitation (or Vision Rehabilitation).

A number of associations offer optometrists advanced training in Neuro-Optometric Rehabilitation, including a residency program offered by SUNY College of Optometry in New York.

It’s important to know that Neuro-Optometric Rehabilitation is not the same as optometric vision therapy, though the latter sometimes also is prescribed to treat post-concussion visual symptoms. Not all doctors who offer vision therapy are trained in Neuro-Optometric Rehabilitation.


A neuro-ophthalmologist is a medically trained eye doctor and surgeon (eye MD) who specializes in vision problems that relate to the nervous system — including loss of sight due to injury to the brain or the optic nerve that transmits visual signals from the eye to the brain. Such injuries can be caused by trauma, inflammation, strokes, tumors, toxicities and infections.

Neuro-ophthalmologists also see patients who have strabismus (misaligned eyes) or problems controlling eye movements, which sometimes are treated with surgical procedures.

Neuro-optometrists and neuro-ophthalmologists both are skilled at identifying TBI and concussion-related vision problems. Depending on the type and severity of vision problems detected, they might offer similar or dissimilar treatment plans.

In addition to tests performed during a routine eye exam — such as visual acuity, refraction, glaucomatesting, etc. — a neuro-optometrist or neuro-ophthalmologist typically will assess other visual functions, including how the eyes work together as a team, the connection between vision and other systems such as balance and movement, and accuracy of eye movements.

Following the exam, the neuro-optometrist or neuro-ophthalmologist may develop and prescribe a treatment plan specially designed to eliminate post-concussion vision symptoms and difficulties. Treatment may include specialized glasses to help with visual processing and/or a program of in-office and at-home procedures to help reduce symptoms and promote visual recovery.

In brain injury, often one type of vision rehabilitation treatment is not enough to address all an individual’s needs. An interdisciplinary, integrated team approach can play a vital role in the rehabilitation of patients with concussions, stroke or other neurological deficits.

In addition to a neuro-optometrist or neuro-ophthalmologist, rehabilitation team members may include nurses, physical and occupational therapists, speech-language pathologists, physical medicine and rehab physicians, neurologists, neuropsychologists and others.

Often, the best way to locate a neuro-optometrist or neuro-ophthalmologist is by professional referral from your eye doctor. Visit our Doctor Locator to find an eye doctor near you who can refer you to a post-concussion or TBI vision specialist.

Read Full Article Here.

Toys to avoid this holiday season due to safety concerns!

Here’s a list of six types of toys you might want to cross off your list when buying gifts for young children. Each has a high potential risk for eye injuries — especially if used by young children without adult supervision and guidance:

1. Guns that shoot ANY type of projectile. This includes toy guns that shoot lightweight, cushy darts. You might think these soft projectiles would pose little or no risk, but toy guns of this type can shoot up to distances of 75 feet, and the darts move at speeds fast enough to cause a serious eye injury — especially when used at close range indoors.

2. Water balloon launchers and water guns.Water balloons can cause serious blunt trauma to the eye that can cause a retinal detachment and permanent vision loss. Even toy guns that shoot a stream of water can cause serious eye damage, especially when used at close range.

3. Games that include toy fishing poles. The end of a toy fishing pole or objects secured to the end of the fishing line can easily end up in a playmate’s eye.

4. Toy wands, swords, sabers or guns with bayonets. There’s really no need to explain why these are a bad idea, right?

5. Aerosol string. The chemicals in these products can cause eye irritation and a type of pink eye called chemical conjunctivitis. When used at close range, aerosol string also can cause a corneal abrasion that could lead to serious eye infections ( .

6. Laser pointers and bright flashlights. Though technically not toys, many children love to play “laser tag” or “flashlight tag.” Portable laser pointers, like those used for business presentations, should never be used by children, as the light intensity of these devices is sufficient to cause permanent vision loss. Even high-powered LED flashlights can be dangerous, because they can cause temporary blindness, putting children at risk of a fall or other accident.

Celebrate New Year’s Safely! Safety Tips for Champagne Corks

Watch this video on how to open a champagne bottle without causing eye injury. (Source: eyeSmart)

According to the American Academy of Ophthalmology, this happens more often with champagne and sparkling wine bottles that haven’t been fully chilled, because the bubbles contain gas that expands when warm. This causes the corks to come out much more forcefully, at speeds of up to 50 mph. It is recommended that you chill the beverages to 45 degrees Fahrenheit or colder before you open them.

To prevent eye injury, follow these instructions provided by the Academy (or watch this how-to video ( ):

* Don’t shake the bottle before opening it, because this just increases the pressure inside and therefore the speed at which the cork leaves the bottle.

* Point the cork away from yourself and others while opening the bottle.

* After removing the foil, hold down the cork with your palm as you remove the wire. Do not use a corkscrew for bubbly beverages!

* Don’t push under the cork. Instead, place a towel over it, and keep your palm on the cork as you twist the base of the bottle. Don’t worry, it will still make that delightful “pop,” and you and your friends will be much safer!