Friday, May 20, 2011

Don't let "Anchors Aweigh" cause "Vision Away"

From Dr. Levy:

I had a patient recently who was complaining that he couldn't read any of the menus on a recent cruise he had been on, nor could he read his books on deck or on the beaches they stopped at on the cruise, despite the fact that he could normally read. His left eye was completely blurred up close, and his right eye somewhat less so. He also noticed that everything was brighter than normal, but he attributed that to being in the Caribbean. When he got back on land, the inability to read continued for several days, although by the time he made it in for his exam, it had returned.

"What happened?", he asked."Let me ask you a question," I responded; "Do you suffer from seasickness when you go on a cruise?" "Yes, why?" "Did your doctor prescribe you a patch?" "Yes." "Did you put it behind your left ear?" "Yes..."

One of the more popular seasickness patches contains scopolamine, a medicine that helps with motion sickness, but is also used in an eyedrop we use to dilate people's pupils.

By putting the scopolamine patch behind the patient's ear, enough scopolamine was absorbed through the skin, that it dilated the patient's pupils, relaxing the patient's focusing system, leaving him unable to focus up close. Because the patch was put behind the left ear, more of the medicine was absorbed on the patient's left side, and affected the patient's left eye more severely.

Although the patient was reassured that the condition was completely subsided by this point, he was still somewhat annoyed that he was inconvenienced on his cruise by something that was supposed to help him.

"Good thing the waiter recited the specials each night..." he quipped.

So any time you are given a new medicine by a doctor, it's always a good idea to read up on, or just ask, what the potential side effects might be!

Sunday, May 1, 2011

Lesson Learned - money and time wasted on online glasses ordering

Last week I had one patient who learned about online glasses the hard way. He came in wondering why he couldn't see anything out of his new glasses that he had purchased online with his brand-new prescription. I had him put his glasses on, and I marked where his pupils were in the glasses. They were almost 1 centimeter LOWER than where the prescription was located. Poor guy, he was seeing through a place in the glasses that was 50% less prescription than what it should have been. No wonder he wasn't very happy! He learned that in certain prescriptions, it makes a difference whether you look through the top of the glasses, the bottom of the glasses, and in some cases, even the sides of the glasses. He said that the online order form just filled in an 'average' for the distance between his pupils, and that it put an 'average' for how high the bifocal line should be. Well, in order to see clearly out of your prescription, your pupils must line up correctly behind the lenses. In this case, we confirmed that the prescription was actually correct in the glasses, however, it was located in an area that didn't match his face and his eyes. This means that you must try on the frames to your face and make accurate measurements about where your pupils are in the frames. Sometimes, you get what you pay for! I have always been pleased by the customer service offered by LensCrafters, and I know they do an excellent job at making sure everyone's glasses are fitting them properly. Next time you get a glasses prescription, make sure it is accurately fit in the glasses frames as well!

Picture: A Progressive lens design shows that the prescription for distance vision is at the top, while it progressively changes to a near prescription at the bottom. Depending on your prescription, it may be different at the top than what it is at the bottom!