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Kahala Eye Clinic Articles

Corneal Refractive Therapy

Corneal refractive therapy, also known as CRT, is a simple, painless treatment for refractive eye errors like myopia and has two core benefits. First, it can be used to help patients see clearly during the day without using glasses or contact lenses, giving them the freedom and flexibility that they need to live life to the fullest. Second, CRT has been shown to help slow the progression of myopia, keeping prescriptions under control and potentially reducing the likelihood of patients developing serious eye health problems associated with high myopia in the future. 

Here’s everything that you need to know about corneal refractive therapy and what it means for you. 


Understanding refractive eye problems

Refractive eye problems like nearsightedness, farsightedness and astigmatism are extremely common, with nearsightedness – also known as myopia – being the most common of all. Patients with myopia can see nearby objects clearly, but those further away become progressively more blurred. Refractive eye errors occur when the shape of the clear dome covering the front part of the eye, called the cornea, impair the light-bending and focusing process in your eyes. This leads to the light ending up in the wrong place inside the eye, and the message that is sent to our brain from our eyes is muddled, causing blurred vision. 
 

What is corneal refractive therapy?

Corneal refractive therapy was initially developed as a treatment to correct and slow the progression of nearsightedness. However, it has also been found to be effective at controlling other refractive errors, including farsightedness, astigmatism and an age-related refractive condition called presbyopia.

CRT is a non-invasive, painless and straightforward method of correcting patient vision so that they don’t need to wear contacts or glasses, and they don’t need laser vision correction surgery to see clearly. CRT uses special contact lenses that are worn overnight and apply light pressure to the cornea in order to reshape it so that light is refracted correctly, and the image sent from the eyes to the brain is clear. The cornea is able to retain this new shape even after the contact lenses are removed the next morning, meaning that you can continue to see clearly for several hours. The more consistently you wear your CRT lenses overnight, the longer your eyes will learn to retain their new shape and eventually, patients can enjoy up to 48 hours of clear vision without using prescription lenses. However, the effects aren’t permanent so if you stop wearing the lenses, your vision will gradually return back to normal over the course of a few days. 


Slowing the progression of myopia with corneal refractive therapy

Another key benefit of CRT is that it can actually help to slow the progression of myopia. Most people who are nearsighted find that their eyesight gets progressively worse as they get older. This deterioration may not be rapid, but it can end in patients requiring high prescriptions. Studies have found that patients who have high myopia are more likely to develop serious eye problems in the future, including glaucoma, macular degeneration, cataracts and a detached retina. Regular use of your corneal refractive therapy lenses could help keep your prescription stable and lower your risk of developing these problems. 


Am I a candidate for corneal refractive therapy?

You may be a candidate for corneal refractive therapy if you:

  • Have a myopia prescription within specific parameters

  • Have a prescription for hyperopia, presbyopia or astigmatism within specific parameters

  • Have stable vision, which means that your prescription hasn’t changed during the last two years

  • Are not a suitable candidate for laser vision correction

  • Have a job that makes it impractical or unsafe to wear glasses or contact lenses

  • Enjoy hobbies that make it impractical or unsafe to wear glasses or contact lenses

  • Have healthy eyes and are generally in good health



For more information, please contact our friendly and knowledgeable team today.  


Tonometer

A tonometer refers to the equipment that is used in tonometry – a test that measures the pressure inside your eyes, also known as intraocular pressure or IOP for short. Tonometry is rarely performed at your average comprehensive eye exam unless you are at high risk of or have been already diagnosed with glaucoma. Fortunately, tonometry can be used to detect changes in eye pressure before they cause any symptoms, enabling prompt action to be taken before your vision is affected.


About Glaucoma

Glaucoma is a common eye condition that occurs when the optic nerve, which connects the eye to the brain, becomes damaged. It’s normally caused by fluid building up in the front part of the eye, which causes the pressure inside the eyes to build. As the pressure increases, the optic nerve becomes increasingly damaged, and this prevents messages from being transmitted between your eyes and brain effectively. As a result, the patient’s vision becomes compromised. Without treatment, the level of vision loss will continue to increase. Unfortunately, any vision that has been lost as a result of glaucoma cannot be restored.
 

Most of the time, glaucoma develops very slowly which means that many people don’t realize that they are affected until some damage to their vision has already occurred. However, occasionally glaucoma can develop quickly, and symptoms do occur.

These can include:

  • Red eyes

  • Intense headaches

  • Tenderness around the eyes

  • Eye pain

  • Seeing rings/halos around lights

  • Blurred vision

  • Nausea and vomiting


If you notice any of these symptoms, it’s important that you make an appointment with your eye doctor right away so that you can be assessed. You are likely to have a tonometry test as part of this assessment.
 

What to expect from tonometry testing

There are various methods of tonometry testing, but many eye doctors use either Goldmann tonometry, which is the conventional technique to measure eye pressure, or electronic tonometry.
 

Goldmann tonometry testing is carried out using the Goldmann applanation tonometer, which is attached to a slit lamp microscope. This requires anesthetic eye drops to be used which numb your eyes, before a small probe is pressed gently against the eye, indenting the cornea. The pressure that the cornea pushes back onto the tonometer is what is measured to give your IOP reading. Electronic tonometry is where a handheld, mobile device is gently and quickly applied to the cornea to check the pressure, providing an accurate reading. Some eye doctors also offer non-contact tonometry which is where a puff of air is used to flatten the cornea, although this is reported to be less accurate than the Goldmann technique.
 

If you would like to find out more about Tonometry testing, please call our office to speak with our dedicated eyecare professionals.


Specialty Contact Lenses

Every patient is different and so are their eyes. This means that there need to be different types of contact lenses to suit each individual. Some patients have corneal abnormalities which mean that conventional lenses won’t sit comfortably on the surface of their eyes, while others suffer from eye conditions that mean normal contact lenses won’t be comfortable or could irritate their eyes. 

As you may have guessed from the name, specialty contact lenses are unconventional contacts that are designed for patients that regular contacts might not be suitable. Here are some of the main types of speciality contact lenses and who they are recommended for. 
 

Who might be a good patient for specialty contact lenses?

 

Some of the patients that might benefit from specialty contact lenses include those who:

  • have been diagnosed with dry eye syndrome

  • have corneal scarring

  • have been diagnosed with keratoconus, a condition characterized by the bulging of the cornea

  • suffer from strabismus, a condition where the patient has an eye that turns in or out relative to the other

  • have suffered an injury to the eye

  • suffer from a peripheral corneal thinning disorder

  • are intolerant to other types of lenses


Your eye doctor or contact lens provider will be able to tell you if you need specialty contact lenses and if so, which lenses would be best based on your individual requirements. 
 


TearCare: Understanding Dry Eye and Its Causes

Dry eye is a common condition that affects millions of individuals worldwide. It occurs when the eyes do not produce enough tears or the tears evaporate too quickly. This can lead to discomfort, irritation, and even vision problems. TearCare offers a breakthrough treatment option for long-lasting relief from dry eye.
 

What is TearCare?

 

TearCare is a revolutionary treatment option that offers long-lasting relief for dry eye sufferers. This innovative technology utilizes wearable eyelid warming devices to precisely deliver heat to the meibomian glands, effectively unclogging them and promoting healthier oil production. The treatment is performed in-office by a trained eye care professional and typically takes less than 15 minutes.
 

TearCare targets the root cause of the problem - meibomian gland dysfunction. By restoring the proper function of these glands, TearCare helps to stabilize the tear film, improve tear production, and alleviate the symptoms of dry eye. This breakthrough solution offers a safe and effective alternative to medications and artificial tear drops, providing long-lasting relief for those suffering from dry eye.
 

How TearCare Works to Treat Dry Eye

 

TearCare works by gently applying heat to the eyelids, stimulating the meibomian glands and promoting the release of healthy oils. The wearable eyelid warming devices are designed to maintain a consistent temperature, ensuring optimal results. The heat helps to liquefy any hardened oils or debris clogging the glands, allowing them to function properly again. This treatment can also help reduce inflammation and improve overall eyelid hygiene.


Tyrvaya for Dry Eye Relief

Dry eye is a common condition that occurs when your eyes do not produce enough tears or when the tears evaporate too quickly. This can result in discomfort, irritation, and a gritty sensation in the eyes. Understanding the causes and symptoms of dry eye is crucial for finding effective treatment options. Tyrvaya offers a breakthrough solution for dry eye relief.
 

What Causes Dry Eye?

 

There are several factors that can contribute to the development of dry eye. The meibomian glands are responsible for producing the oily component of the tear film, which helps prevent evaporation of tears and maintains a smooth ocular surface. Meibomian gland dysfunction occurs when these glands become blocked, leading to a decrease in the quantity and quality of the meibum. This can result in evaporative dry eye, discomfort, and inflammation of the eyelid margins.
 

Another common causes is age. As we get older, our tear production tends to decrease, making us more prone to dryness. Hormonal changes, such as those that occur during menopause, can also affect tear production and lead to dry eye.
 

Environmental factors can play a role as well. Dry or windy climates, air conditioning, and excessive screen time can all contribute to dry eye. Additionally, certain medications, such as antihistamines and antidepressants, can cause dryness as a side effect.
 

Other underlying health conditions, such as autoimmune diseases like Sjogren's syndrome or rheumatoid arthritis, can also contribute to dry eye. In these cases, the body's immune system mistakenly attacks the tear glands, leading to reduced tear production.


Types of Daily Contact Lenses

Wearing contact lenses gives patients the flexibility and freedom to live life to the fullest, without some of the difficulties presented by wearing glasses. Many people who choose contact lenses do so because they don’t like the way that glasses look or feel, or because wearing glasses compromises their ability to perform certain tasks or activities, such as sports or jobs that require the use of safety goggles. 

There are lots of different contact lenses to choose from, with two of the most popular being daily disposables and toric lenses. 
 

Disposable Lenses

As their name suggests, these daily contact lenses are disposable. This means that they can and should be discarded at the end of each day rather than re-worn. Disposable lenses do tend to be a little more expensive than some repeat-wear varieties, but the benefits usually outweigh the cost. 

Some of the advantages of choosing daily disposable contact lenses include:

  • You don’t have to clean them, which saves patients a great deal of time and hassle. It also helps save money in terms of the ongoing cost of cleaning solution. 

  • Disposable lenses are also great for people with eye allergies. This is because with ordinary lenses, there’s an opportunity for deposits and microorganisms to build up. With daily disposables, allergens have less chance to attach themselves to the lenses and cause irritation and other allergy symptoms. 

  • You don’t need to schedule regular replacements either, which makes wearing contact lenses easier on your schedule. 

  • Disposable contact lenses are particularly good for people who have busy lives and are likely to cut corners when it comes to caring for their eyes or contacts since there is no cleaning or maintenance required.


Daily disposable contact lenses are available in a wide range of prescriptions, including those for patients with nearsightedness and farsightedness. Your eye doctor will be able to advise you if you are a candidate for disposable contact lenses. 
 

Toric Lenses

Toric contact lenses are recommended for patients who have a refractive eye problem called astigmatism. Patients with astigmatism have corneal abnormalities that cause the refraction of the eye to be different between the vertical and horizontal planes, causing blurred vision and difficulty seeing fine details. Toric contact lenses are shaped in a particular way that creates the different focusing powers needed in each part of the lens to correct your vision. For this reason, it’s essential that Toric lenses are placed into the eyes in the correct position.

Fortunately, manufacturers design Toric lenses with features that help them to stay in place, including:

  • Thin/thick zones

  • Creating areas of the lens that are thicker or heavier which helps secure it in position 

  • An area where the bottom of the lens is slightly cut off 


To keep them stable, Toric lenses are a little firmer than conventional soft lenses. This means that some patients can find them a little less comfortable, but the superior vision they obtain outweighs this. Your eye doctor will be able to advise you if you are a good candidate for Toric contact lenses and which variety would best suit you. 

To find out more about daily contact lenses, speak to our friendly and knowledgeable team. 


Urgent Eye Care

 

Urgent eye care encompasses prompt evaluation and treatment of sudden or severe eye-related issues, including foreign object removal, chemical exposure, corneal abrasions, sudden vision loss, eye trauma, acute glaucoma, chemical burns, and eye infections. Seeking immediate professional attention from an optometrist is vital to prevent further damage and preserve vision.
 

Common Eye Emergencies or Urgent Eye Care Appointments

 

Eye emergencies can manifest in various forms, and it is essential to be able to identify them quickly. Some common eye emergencies include:
 

  • Foreign Object in the Eye: Particles, debris, or small objects can become lodged in the eye, causing pain, redness, tearing, and potential damage to the eye's surface.

  • Corneal Abrasions or Scratches: Injuries to the cornea, such as abrasions or scratches, can cause severe eye pain, light sensitivity, and a feeling of something in the eye.

  • Sudden Loss of Vision: Any sudden and unexplained loss of vision requires immediate attention to determine the underlying cause and initiate appropriate treatment.

  • Eye Trauma or Blunt Force Injury: Injuries to the eye from impact, trauma, or accidents can lead to serious complications, including retinal detachment, hemorrhage, or intraocular foreign bodies.

  • Chemical Burns: Exposure to caustic substances or chemicals can cause serious damage to the eyes, resulting in pain, redness, and potential vision loss.

  • Eye Infections: Infections such as conjunctivitis (pink eye) can cause redness, discharge, and discomfort in the eyes.
     

Recognizing these symptoms and seeking urgent care can prevent further complications.
 

The Importance of Basic Red Eye Exams in Urgent Care

 

Red eye exams are a fundamental part of urgent eye care. They help identify the cause of redness and determine the appropriate treatment. Basic red eye exams involve a comprehensive evaluation of the eye, including examining the eyelids, conjunctiva, cornea, and iris. These exams aid in the diagnosis and treatment of various conditions, such as conjunctivitis, uveitis, dry eyes, and corneal abrasions.


Cataract Surgery Co-Management

Cataracts are a common eye condition that can significantly affect your vision. They occur when the lens of your eye becomes cloudy, causing blurred or distorted vision. This clouding is typically a result of aging, but other factors such as genetics, diabetes, or prolonged exposure to sunlight can also contribute to the development of cataracts.
 

As cataracts progress, you may experience symptoms such as difficulty seeing at night, increased sensitivity to glare, or a decrease in color perception. These changes can make daily activities like reading, driving, or recognizing faces more challenging.
 

Why Cataract Surgery May be Necessary

 

Cataract surgery is often recommended when cataracts start to interfere with your vision and affect your ability to perform daily tasks. The primary goal of cataract surgery is to remove the cloudy lens and replace it with an artificial intraocular lens (IOL).
 

The decision to undergo cataract surgery is a personal one and should be made after consulting with your optometrist. Factors such as the severity of your cataracts, your overall eye health, and your lifestyle requirements will be taken into consideration when determining if surgery is necessary.
 

What is Cataract Surgery Co-Management?

 

Cataract surgery co-management refers to the collaborative approach between an ophthalmologist, who performs the surgery, and an optometrist, who provides pre-operative and post-operative care. This partnership ensures that you receive comprehensive eye care throughout the entire process, from the initial consultation to the final follow-up appointments.
 

Your optometrist plays a crucial role in cataract surgery co-management by conducting a thorough pre-operative evaluation to assess your overall eye health and determine the most suitable IOL for your specific needs. They will also provide guidance and education on the surgical procedure, address any concerns you may have, and help you make informed decisions about your eye care.


Atropine Drops

Myopia is a common vision problem affecting a large number of individuals worldwide. It occurs when the eye is unable to focus properly on distant objects, resulting in blurred vision. Myopia can develop during childhood and progress into adulthood if left unmanaged.
 

What Causes Myopia to Develop?

 

Myopia can be caused by a combination of genetic and environmental factors. If one or both parents have myopia, there is a higher chance that their children will develop the condition. Additionally, excessive screen time, lack of outdoor activities, and prolonged near-work activities such as reading or using electronic devices can contribute to the development of myopia. These lifestyle factors can lead to the elongation of the eyeball, resulting in the inability to focus on distant objects.
 

The Importance of Myopia Management

 

Managing myopia is crucial to prevent its progression and associated complications. High levels of myopia can increase the risk of developing eye conditions such as glaucoma, cataracts, and retinal detachment.
 

Additionally, severe myopia can lead to vision loss and significantly impact the quality of life. Early intervention and proper management of myopia can help slow down its progression and reduce the risk of these complications.


Surgical Co-Management

In the realm of eye care, surgical co-management has emerged as a collaborative approach that aims to provide patients with comprehensive and seamless treatment. This concept involves the joint efforts of optometrists and ophthalmologists, each bringing their unique expertise to the table. By working together, these eye care professionals strive to enhance patient outcomes and deliver exceptional care.
 

The Role of Optometrist and Ophthalmologist in Surgical Co-Management

 

Surgical co-management is built upon the unique skill sets and areas of expertise of optometrists and ophthalmologists. By understanding their respective roles, you can appreciate the synergy that this collaborative approach fosters.


Optometrists are primary eye care professionals who specialize in the examination, diagnosis, and non-surgical treatment of vision disorders. Their responsibilities in surgical co-management include:

  • Performing comprehensive eye examinations and evaluations

  • Monitoring and managing pre-existing eye conditions

  • Providing pre-operative and post-operative care

  • Educating patients on surgical procedures and aftercare

  • Collaborating with ophthalmologists to ensure continuity of care
     

Ophthalmologists are medical doctors who specialize in the diagnosis, treatment, and surgical management of eye diseases and disorders. Their role in surgical co-management encompasses:

  • Evaluating patients' candidacy for surgical interventions

  • Performing complex surgical procedures

  • Providing specialized medical and surgical care

  • Collaborating with optometrists to ensure seamless patient care

  • Monitoring and managing post-operative complications

  • By combining the expertise of optometrists and ophthalmologists, surgical co-management ensures that patients receive comprehensive and coordinated care throughout their treatment journey.

How Surgical Co-Management Works

 

Surgical co-management is a well-orchestrated process that involves several key steps. Understanding how it works can help you navigate this collaborative approach with confidence.

  • Initial Evaluation: The process typically begins with an optometrist conducting a comprehensive eye examination. During this evaluation, the optometrist assesses the patient's visual needs, identifies any potential issues, and determines if a surgical intervention is necessary.

  • Referral and Consultation: If surgery is recommended, the optometrist refers the patient to an ophthalmologist for further evaluation and consultation. This step ensures that the patient receives specialized medical advice and a thorough assessment of their suitability for the proposed surgical procedure.

  • Pre-operative Care: The optometrist plays a crucial role in providing pre-operative care, which may include managing any existing eye conditions, ensuring the patient understands the surgical process, and addressing any concerns or questions they may have.

  • Surgical Procedure: The ophthalmologist performs the necessary surgical intervention, leveraging their specialized training and expertise in surgical techniques.

  • Post-operative Care: After the surgery, the patient's care transitions back to the optometrist, who closely monitors the recovery process and provides post-operative care and management. This may involve follow-up appointments, monitoring for any complications, and ensuring the patient adheres to the prescribed treatment plan.

  • Ongoing Collaboration: Throughout the entire process, the optometrist and ophthalmologist maintain open communication and collaborate closely. This ensures that the patient's care is seamless, and any concerns or issues are promptly addressed by the appropriate healthcare professional.


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