Mellis Eyecare: 2015

Monday 7 December 2015

Blepharitis

What is blepharitis?

Blepharitis is the medical term for inflamed eyelids.

You may notice tired, or gritty eyes, which may be uncomfortable in sunlight or a smoky atmosphere. They may be slightly red, and feel as though there is something in them.

What is the cause of blepharitis?

The eyelids have tiny glands in them, especially the lower lids. These glands make lipids that provide a protective oil coating over the tear film and helps stop the tears from breaking up.

As you get older, and particularly if you have dry skin, these glands can block. Without the substance that makes the tears spread, the tears break up, and dry patches develop. These patches make the eyes feel sore or gritty.

Aims of blepharitis treatment:

to unblock the glands in the eyelid, which may be infected and inflamed, like acne on the face or a tiny boil.
to replace tears if the eyes are dry.

The treatment will your eyes more comfortable, but there is no magic cure and it may return once treatment is ceased. Even with treatment your eyes may remain a little sore, but no harm will come to them and there is nothing to worry about. It's not a serious condition, and there is rarely any damage to your eyes.

1 Lid Cleaning

Soak some cotton wool in warm water. Rub the cotton wool over the closed eyelids for 2-3 minutes, and repeat. Then clean the edge of the lower eyelid with a cotton bud to remove scales and debris on the edge of the eyelid. Move the cotton bud along the eyelid, using a mirror, and pulling the lid away from the eyeball with the fingers of the other hand. Rub the edge of the lid gently. The warm bathing helps to soften up the scales first. It is preferable to boil the water first to sterilise it, and allow it to cool. It may be two weeks for any improvement. Bathe 2-3 times a day, gradually reducing the frequency of bathing as the eyes become more comfortable (although bathing does not help everyone). It is safe to stop cleaning, but you may need to start again if the condition returns. There is a number of dedicated lid hygiene wipes and cleaners such as “Supranettes”, “Lidcare” and “Ocusoft Lid Cleaning Foam.” These are embedded with special cleaning agents which specifically target the secretions produced by blepharitis. Ask at the reception desk for details.

2 Lubricants

Lubricants can helpful to both assist the spread of your own tears and lubricate the eye, and replace tears if you have ‘dry eyes’. We recommend sodium hyaluronate based products as they help restore healthy conjunctiva helping treat dry eye. Drops such as ‘Systane’ or 'Blink Intensive Eye Drops' may help. Gels such as ‘Celluvisc’ or ‘Viscotears’ are usually helpful. Lipid replacement sprays, such as actimist, in some cases can help.

3 Warm Compresses

The lipids produced by the glands in the lids tend to be liquid at body temperature (36 degrees C). As the lids are exposed they tend to be a bit cooler and the lipids solidify. This leads to the lipids not spreading so well blocking the glands and allowing bacteria to inhabit the lash margins and glands. The bacteria can then release endotoxins into the the tears which can make the eyes feel uncomfortable, itchy and burning. Warm compresses will increase the temperature of the lipids to flow more like a liquid which will help unblock the glands.

4 Antibiotic ointment/Antibiotic tablets

If the cleaning is not helpful, an antibiotic ointment may be required from your GP. Try it for 3 months (chloramphenicol or fucithalmic). As the condition can return once treatments are stopped, you may need a repeat prescription from your GP. In severe blepharitis, antibiotic tablets may be an option, especially if associated with skin condition, such as acne rosacea, or very dry skin, or if the edge of your eyelid stays red with many scales. Antibiotic tablets are NOT suitable for everyone, particularly if you use several other tablets or have stomach problems. You will need to discuss this treatment with your GP first. Oxytetracycline 250mg twice daily (or doxcycline 50mg once daily [or erythromycin]) is usually used for 3 months. The benefit lasts several months after this treatment, but you may need to use further lid hygiene to stop recurrence.

Other causes of sore eyes

If you continue to have symptoms we recommend that you have your eyes assessed. You may have dry eyes (or at least poorly spreading tears) and replacement tears may help, as described. You may have an allergy, particularly if the eyes are itchy: Optichrom or another anti-allergy drop could help with these symptoms. You can see your GP on the NHS or alternatively, you can book in for a private Dry Eye Assessment with your Optometrist. Your eyes should be checked routinely by an optometrist for other conditions such as glaucoma; occasionally new spectacles may make the eyes more comfortable. If your eyes remain red and very irritable we can now offer DRY EYE ASSESSMENTS for £35.00 which can investigate the causes. Alternatively you can see your GP for NHS treatment.

Lid Wipes

Cleans lid crusting

INTRODUCING BLEPHEX

Until recently Blepharitis was very hard to manage. Now there is the BlephEx. The First and Only Clinician Treatment for Blepharitis, is now available at Mellis Eyecare

BlephEx™ is a revolutionary new patented hand piece, used to very precisely and carefully, spin a medical grade micro-sponge along the edge of your eyelids and lashes, removing scurf and debris and exfoliating your eyelids.

Initial assessment and treatment is £40.00

Wednesday 18 November 2015

A Guide to Modern Varifocals

A guide to varifocals

What are varifocals and who needs them?

Whereas a normal single vision lens has one prescription in the lens which generally corrects for either poor distance vision or poor near vision, a varifocal lens (also called a progressive powered lens, or PPL) has more than one focus of clear vision in the same lens. In this regard, the varifocal is similar to a bifocal lens, but the varifocal has the cosmetic advantage of looking no different to a standard single vision lens.

Like the bifocal lens, the varifocal lens is useful to almost everyone over a certain age (typically between 40 and 45) because at around this age, everyone looses accommodation, which is the eye's ability to focus clearly close up. Someone who has lost the ability to accommodate is a called presbyopic.

As well as looking better than a bifocal lens, which typically has an annoying line visible in the lens where the two prescriptions meet, the varifocal is more useful too. Instead of the line between the distance vision part of the lens and the near vision part of the lens that a bifocal has, where the eye jumps straight from one prescription to the other, a varifocal has an additional area of clear vision between the distance and near prescription called the intermediary part.

This allows the wearer to see well at intermediate distances, such as are useful for working on computers, as well as seeing clearly in the distance and close up.

What about the downside?

Although the varifocal has three prescriptions in one lens and can do the job of three different pairs of glasses, the vision in each part of the lens will not be quite as good as it would be in a single vision lens dedicated to the distance, or intermediate, or near prescription. However, wearing one set of varifocals is much more convenient than carrying up to three different sets of spectacles around! One other potential disadvantage is that some people have difficulty getting used to varifocals because they find it uncomfortable to move their eyes quickly between the different powers of the lens leading to a swimming effect.

Traditionally, around one in ten people found it uncomfortable to use varifocals, which was often due to excessive amounts of blurred vision and distortion in the periphery of the lens because of the poor quality of the design used but today with the most advanced modern lenses adaptation is quick due to a minimum amount of swim.

Pupillary Distance

Fitting Heights

Another cause of intolerance to varifocals can be the poor fitting of the lenses. To fit a standard varifocal lens some basic measurements are required. In rushed practices where they don't take time to measure this can lead to inaccuracies. If these are only slightly off by half a millimeter it can complicate adapting to varifocals.

Even when precautions are taken to stop intolerances to varifocals some people still can't get away with them. Because a small amount of people still do struggle to adapt to varifocals, Mellis Eyecare offers a three month period of grace, during which varifocals can be exchanged for a pair of bifocals or two pairs of single vision glasses at no extra cost meaning you aren't left with a pair of spectacles you can't use.

Are all varifocals the same?

No, there are many, many different types of varifocals on the market, all of which offer the wearer different levels of improved vision and comfort. Here at Mellis Eyecare, we offer a wide range of lenses to suit every budget, and chosen by our highly qualified Eye Care specialist, specifically for their high quality and up-to-date designs.

And, just like when buying a suit, there are varifocals that can be bought off the shelf, varifocals that are made to measure, and bespoke varifocals that are altered to the precise requirements of the individual. The main difference being that the lens form moves from a one size fits all style, for the more basic lenses, to a more and more precisely tailored fit for the more expensive lenses.

Our off the shelf varifocals come in three different styles, starting with the Hoya Amplitude, a good quality all round basic lens. The Hoya Summit Pro is a good mid-range lens, with improved lens usage. The Hoya Lifestyle lens offers the best off the shelf solution to the requirements of the presbyopia and comes in two different standard versions: the Lifestyle Harmony, which is designed to maximize all round vision, with an equal bias between distance and near vision, and the Lifestyle Clarity, which is designed to favour distance vision and is perfect for people who drive a lot, or play a sport that requires the highest level of hand eye co-ordination.

Back Vertex Distance

The Lifestyle Exact is a made to measure lens that is tailored to the individual spectacle frame and takes into account the back vertex distance, pantoscopic tilt and dihedral angle of the fitted lens.

The back vertex distance is how far the lens sits from the eye ball.

The pantoscopic tilt is the angle that the lens sits in front of the eye.

The dihedral angle is the curve of the frame on your face.

Measuring these extra values allows Hoya to maximise the varifocal design for the frame optimising the vision through the distance, intermediate and near.

Pantoscopic Angle

Dihedral Angle

For those that refuse to compromise, the Hoya Mystyle is the last word in individually tailored lenses, and offers the best all round solution to the needs of the presbyope.

This top of the range bespoke lens, is designed precisely for the spectacle choice and vision requirements of the individual, having eleven different customizable design parameters.

Our Hoya varifocal lenses also come with a wide range of water, oil and dirt repellent protective and anti-reflective coatings. The Lifestyle and Mystyle lenses come with the High Vision Long Life anti reflective hard coat - the hardest coat available on the market.

MELLIS eyecare

Thornaby 01642 751048 North Ormesby 01642 225671

BOOK ONLINE TODAY
www.melliseyecare.co.uk

Monday 9 November 2015

Children Sight Tests

Testing Young Children

Because young children can't always answer the optician's questions in the test room, the first eye examination for a baby or toddler has several unique components that are designed to overcome such difficulties. Also, because young children are growing rapidly, there are lots of common conditions that first appear at this age, and which it is important to treat quickly as they become harder to correct the older the child is.

One such condition is called strabismus, which most people call a squint or a turn. In this condition the eyes do not align properly, and if left untreated it can lead the patient to develop amblyopia, or a 'lazy eye', a condition that makes normal binocular vision (stereopsis) impossible. If the strabismus is treated early enough, however, it can often be corrected, which is why it is so important to test young children. Up until the age of five, a period known as the 'critical period' normal binocular vision can often be preserved with the correct treatment and sometimes it can even be returned once it has been lost. It is also important not to assume that a child without strabismus does not need testing because one in four children without any sign of a squint will nevertheless have some underlying condition that will progressively worsen without treatment.

To overcome the difficulties in testing children who are too young to answer the optician's questions, there are several tests that the optician carries out that do not rely on verbal answers. Here at Mellis Eyecare, we use the most up-to-date computer based tests to ensure that children engage fully with the eye examination, and the best healthcare outcomes are achieved.

So if you have any concerns about your child's eyesight, no matter how old they are, why don't you book them in for a sight test today?