Bob Costas’ eyes – An eye doc’s perspective

Screen shot of Bob Costas on air

Screen shot of Bob Costas on air

I’ve been seeing quite a bit of pink eyes these last couple of days. The first one started with Bob Costas’ left eye on TV Friday night while watching the Olympics coverage. The next day, I received two calls on my on-call line from patients worried that they might have a contagious pink eye. I returned to work Monday and have seen more pink eyes in three days than I can remember.

I believe I have Bob Costas to thank for that. Sure, Sage Kotsenburg scored the first gold medal in snowboarding slopestyle, but that wasn’t what my Facebook friends were talking about these last two days. They wanted to know what’s going on with Bob Costas’ eye.

Sadly, I noticed that his infection has spread to the other eye, although the Twitter account @BobCostasEyes probably let slip the 4-1-1 first.

I wish I could definitively diagnose his eye condition. But being that all I have to go on are pixelated images of Bob Costas frozen in mid-speech without the use of microscopes and surface dyes to judge for irregularities, I can only surmise.

If it was a bacterial infection from a contact lens, antibiotics should have cleared it up by now, and it wouldn’t have spread to the other eye.  Now that it’s spread to the right eye, it’s most likely a viral infection.  It looks much worse than it feels. The eyes are usually watery, glassy and bright red. A microscope would show bumps on the inner eyelids as well as any cloudy areas on the surface. This can be treated with medications to limit the length of the infection, although it can last up to three weeks. Cool compresses and artificial tears can provide some relief of symptoms also.

But if you look at Costas’ outer eyelids, they’re also very red and irritated. It’s quite possible that he was given medications that he discovered he was allergic too. In either case, it was smart to finally take a sick day and go off the air to give him time to recuperate. Let’s hope for a speedy recovery before Matt Lauer’s beard has its own Twitter account.

So, to all of you with healthy, white and clear eyes, keep your hands clean and away from your face, don’t shake hands with someone with a pink eye, and see your optometrist if you think you have an irritated pink eye. To read more about pink eye, see our previous blog article on this topic.

~Cindy P. Wang, OD, FAAO

California Optometric Association
http://www.coavision.org

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Health care reform & vision coverage for your children

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Children’s vision now covered by most plans
If your child is covered by an individual or group health insurance plan in California, their annual eye exam and eye glasses are covered with no out-of-pocket cost until the child reaches age 19. This is required for health plans purchased through or outside Covered California.

Legal residents of California will be able to get health coverage through a new marketplace established by Covered California. Starting in 2014, there will be several new and expanded government programs, including Medi-Cal, that offer financial assistance to reduce the cost of health insurance.

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  1. Premium assistance — Federal help will be available to reduce the cost of an individual’s or family’s monthly health insurance payments.
  2. Cost-sharing assistance — Cost-sharing subsidies reduce the amount of health care expenses an individual or family has to pay at the time of medical care.
  3. Medi-Cal assistance — Starting in 2014, Medi-Cal will cover more people under age 65, including people with disabilities and those with incomes $15,856 or less a year for a single individual and $32,499 or less for a family of four. Medi-Cal is free for those who meet the requirements and is part of the changes included in the Patient Protection and Affordable Care Act (Affordable Care Act).

An online calculator at the Covered California website helps estimate how much it will cost to purchase health insurance in 2014 and the amount of financial assistance available to qualified individuals. In addition, by completing a Covered California application, an individual will learn whether he or she qualifies for financial assistance.

~Kristine Shultz, Government and External Affairs Director
California Optometric Association

Common myths about eyeglasses debunked!

Photo courtesy of Ben Andreas Harding on Flickr.

Photo courtesy of Ben Andreas Harding on Flickr.

As an optometrist, I often hear a variety of misconceptions about eyeglasses from my patients. Most concerns fall into a few broad categories with a few bizarre ones sprinkled in. I would like to take a brief moment to address some of the most common ones I hear:

  1. “Wearing glasses will make your eyes weaker.” This is probably the one myth I hear the most often and it is absolutely false. The biggest thing people forget to account for when they notice they are more reliant on their prescription glasses is that they are a bit older. As a person gets older, their ability to continue to see clearly without prescription glasses deteriorates. While this applies to everyone, it is most pronounced in my far-sighted patients in particular.
  2. “Not wearing your prescription glasses will make your eyes get worse.” This also is not true. Not wearing your glasses will not damage your eyes, but it can cause a significant amount of eyestrain. Extended viewing of computer monitors, smart phones, tablets or televisions without a proper prescription can lead to significant eyestrain and may cause you to discontinue viewing sooner than you planned.

    Photo Courtesy of TempusVolat on Flickr

    Photo Courtesy of TempusVolat on Flickr

  3. You can’t play sports with glasses on.” Not true! Glasses for sports can be made to protect your eyes and clear your vision at the same time. Protective lenses such as polycarbonate plastic can be put into sports goggles to allow a person to wear glasses when participating in sporting activities. Many patients prefer to wear contacts when they play sports, but it is a personal preference. Be sure to talk to your optometrist if you need specialty lenses for any of the activities you participate in.
  4. “Over the counter readers are just as good as prescription glasses.” This myth is not necessarily untrue. For a small group of patients, over the counter readers do work just as well as prescription reading glasses. The bad news is it’s an extremely small group of patients and those glasses work only when they are reading. Proper prescription glasses can correct each eye individually for the distance so both eyes are in focus and balanced. Once the eyes are balanced and working together, your optometrist can determine the proper power you need for your computer monitor or for reading materials. For the overwhelming majority of patients, there is a difference between the prescriptions between their eyes or some astigmatism in their correction that you cannot find in over the counter glasses.

I hope these answers help open your eyes to how prescription glasses can help you see clearly.

~Ranjeet S. Bajwa, OD, FAAO
California Optometric Association
http://www.coavision.org

Night blindness 101

The term night blindness sounds alarming, as though some people are actually blind at night.  There is a small percentage of the population that does in fact experience true night blindness, but it is rare and often the result of late stage eye disease.  In optometry, it is not common to use the term night blindness although we do encounter a significant number of patients who complain of poor night vision.  The symptoms are usually blur and dimming of vision at night, glare and haloes around lights and poor adaptation from light to dark environments.  How do you know if what you are experiencing is normal or a result of something more serious?

There are a handful of eye conditions that can create symptoms of poor night vision.

Photo Courtesy of kenleewrites on Flickr

Photo Courtesy of kenleewrites on Flickr

  1.  Patients who have had surgery to the corneas such as LASIK or corneal transplants may notice glare and haloes around light.  They may also experience diminished contrast sensitivity which can cause images in the evening to appear more dim.  Unfortunately, surgical results usually cannot be reversed.
  2. Cataracts are the number one cause of decreased night vision.  Patients over the age of 40 will begin developing mild cataracts.  This is when the natural lens inside the eye becomes more yellow and opaque as a result of age and ultraviolet exposure.  Cataracts can cause haloes and dimming of vision in the dark and decreased contrast sensitivity.  Fortunately, cataracts are easily removed thereby restoring problems with night vision.
  3. Corneal diseases such as keratoconus and severe dry eyes may also affect one’s vision in the evenings causing double vision or haloes.  For some of these patients, specialty contact lenses or eyedrops will alleviate these symptoms.
  4. Newer technology has also allowed optometrists to detect higher order aberrations in some patients.  For these patients, standard spectacle lenses may not improve night vision problems.  An instrument to detect higher order aberrations will determine whether a patient requires a specialty custom-made spectacle lens to improve night vision.

Some patients do in fact have true night blindness caused by an eye disease in its late stage.  Usually, symptoms begin slowly over time and progress to an inability to see in the dark.  These patients usually suffer from one of two eye conditions.

  1.  Retinitis pigmentosa is an inherited eye disease of the retina, the tissue that lines the back wall of the eye and captures visual images.  Retinitis pigmentosa affects the rods of the retina and causes slow deterioration of these structures.  The rods (unlike the cones) are responsible for night vision and for peripheral vision.  As the disease progresses, patients will notice a decrease in their ability to see in the dark and in the periphery.  Unfortunately, there is no current cure for retinitis pigmentosa.
  2. Glaucoma is an eye disease where the optic nerve slowly degenerates.  Patients with glaucoma usually have no symptoms in the early stages of the disease.  As the disease progresses, nerve fibers in the retina begin to deteriorate resulting in a decrease in peripheral vision as well as night vision.  Usually, patients do not experience symptoms of poor night vision and poor peripheral vision until the late stages of the disease.

Now that you know the causes, what are some ways to alleviate or improve poor night vision?  The simplest solution is to wear an updated pair of prescription glasses (if you have a prescription) with higher index lenses and an anti-glare coat.  Your optometrist can also inform you if you require customized lenses to correct for higher-order aberrations.  If your night vision problems are not a result of surgery or any eye diseases that you are aware of, then it is important that you visit your optometrist for a comprehensive eye examination.

– Cindy P. Wang, O.D., F.A.A.O.
California Optometric Association
www.coavision.org