Every few years the technology for imaging eye health transforms to provide another level of eyecare.  It’s exciting that even after 30 years as optometrists, we are so excited at the new wide field retinal imaging that has just arrived at CapitalEyes in Karori. It’s arrival preceded the installer, so it was sitting boxed up and waiting outside the consulting room, looking like a very large present!

Our new Eidon machine uses confocal scanning laser ophthalmoscopy to create high resolution images of the retina at the back of your eye.  It uses a laser beam with a series of mirrors and lenses to create an image of the retinal surface, detailed and in true colour, a wide field image of the eye.  

The wide field is a standard 90 degree view, as shown in the picture with Kevin. Then we also have the option to combine multiple images of the periphery giving a view of 200 degrees – astonishing.  It also copes with images taken through small pupils, so already we are finding less need for drops at a regular eye check, and better quality view even for those with hazy cataracts forming.

What this means for you is an easy painless check, giving a high quality image for the optometrist to check your eye health, and save for future monitoring over time.

We then also show you the image on our large screen and it is astonishing!  The clarity and detail – and of course it’s always more interesting your are looking back at yourown eye!

Designed in Finland, made in Italy, and now in Karori – the new Eidon machine looks space age and the cover hides the very clever tech inside.  Alongside the Eidon we also have the OCT imaging which scans the layers beneath, providing excellent eye care.

We are excited with this transformative update to our well equipped consulting room, and it does feel like a new era – and wide field imaging is now routinely available as part of our regular eye care in Karori.  This retinal image isn’t just a picture, it’s a window to your eye’s health, and a glimpse into the future of eye care. 
In case you haven’t guessed – the optometrists are very excited!

The World Congress of Optometry was held in Melbourne last weekend, and CapitalEyes optometrists, Kevin & Leith were excited to attend a conference with world leading speakers.  There were multiple simultaneous lectures, so plenty of choice.  The presentations about myopia (short sightedness) management and dry eyes were very relevant to our Karori clients.   

The key speakers were world leaders in their field, including researchers and also some authors from the International Myopia Institute of the World Health Organisation, who have written the white papers of clinical guidelines and managements for people with myopia.  There is a lot of evidence regarding treatments to slow myopia progression in children and teenagers with the goal to reduce the likelihood of high myopia. 

Fantastic to hear Professor Mark Bullimore (USA) with his clear thinking and leading conversations about why myopia matters – we must do more in the short term to provide benefit for the longer term for our young patients.  Rather like sunscreen which is a short term intervention that not only prevents sun burn but reduces the risk of skin cancer.  Myopia management gives better uncorrected vision in the short term, but the long term benefit reduces the risk of eye disease and visual impairment as an adult. 

Our key takeaways are continuing the development of our myopia management eyecare, and also regarding dry eyes and how effective some simple treatments that help improve the tear film quality and a person’s quality of vision. 

Alongside the Congress was the largest optical trade fair in Australasia – wow!  There are so many exciting choices for new equipment, and to be able to compare different brands at the same time sure helps the decision making.  In the next few months we’re looking forward to having new exciting retinal imaging tech at Karori.

And such a wide range of eyewear – we have selected an exciting new Australian designed kids frame brand called Augie.  Classic shapes, good sizes and some fun colours - we’re looking forward to seeing what the kids think! 

The other “back to some-normal” was having a conference in person – wonderful to meet new people and catch up with old friends.  Like many industries, many people have been in optics for a very long time – like Leith and Kevin. To see how much innovation is happening and hear more of the exciting developments in optometry is refreshing.  From inside the consulting room, the research that comes before new eyecare and equipment, as well as the fun fashion side.  No wonder you can be an optometrist for 30+ years!

This is officially Myopia Awareness Week – a global problem for children’s vision – including NZ.  The treatment options for myopia, and to slow the vision changes, are improving every year, making regular eye examinations an important part of children’s health checks. 

The children particularly at risk are those with myopic parents, or children and teens who spend a lot of time either reading, or on screens.  For most young people, if they aren’t bookworms, they are pretty keen on their screen time.

The conversations about how to improve the vision and future myopia risks of eye health damage, for our young people are a regular part of our optometrists day –with both parents, and the young people who we see for eye examinations.

“In the last few years, there has been an incredibly concerted effort from leading researchers and producers of eye health technology to develop robust treatment methods for slowing myopia progression. We are now at a critical stage in the effort to curb myopia, where we have the tools to create meaningful change. It is now time to engage ... putting to use the incredible bodies of research and advancements in technology that are pushing the case for a world where half the population doesn’t need to be impacted by this debilitating eye disease,” said Yvette Waddell, CEO, Brian Holden Vision Institute (BHVI).

The BHVI is based in Australia, is a world class organisation working to reduce the progression of myopia . Here in NZ, we pay attention to the research and recommendations, and we are fortunate to have access to several evidence based treatments to help slow the progression of myopia.  Please book your child or teen in for a regular eye examination if they haven’t had comprehensive check in the past year.

From the start of April, we are reluctantly moving our City practice to Karori, which has been our “home” practice for many years.  Our move will take place from 1 April 2023, until then we continue as usual at the City location in Manners Street.

The Karori store, at 260 Karori Road, is big and bright, earthquake strengthened and where we can continue to provide the highest standard of care and services for our clients.  Our longer opening hours from 8am to 6pm during the week and 9am – 2pm on Saturdays will provide more options for eye appointments than what we can offer in the City.

At Karori the spacious area is welcoming for all, with easy access and parking, and a play area for children.  From April, Karori will have an expanded range of eyewear, increased staffing, increased opening hours and is both on the bus route and has free suburban parking.

All our client’s City clinical records will be transferred to Karori, and we’ll continue to remind them about having regular eye examinations with us.  Many of our City clients already use our courier services for repeat contact lens orders, and this will continue to be an easy option.

We’ve loved having a practice in the CBD and we recognise it is a convenient option for our clients who work nearby.  The building we are currently located in must undertake earthquake strengthening from early 2023.  With the other issues of Wellington’s declining CBD, parking difficulties and the new investment to fit out a new space, the option to care for all our clients from our established suburban site is the best one to take.

We are very appreciative of the support from our City clients, and we hope they will come to our Karori location after 1 April 2023 - until then all will run as usual at the City branch.

Glasses wearers have a few choices when it comes to reducing glare and UV protection, and one of these is a photochromic lens.  The technology continually improves, giving us a lens that is virtually clear indoors and at night, but darkens to become sunglass like when outdoors.

They are commonly called Transitions, which is a brand name of the most well known photochromic lens. We have a few choices of colours – the standard is grey, but there are many other options, popularly brown or a G15 /green tint which some people prefer, or they just match the frame choice! 

The lenses are activated by light and UV, and tint darkest in cooler temperatures – amazing if you are up the mountain. When you understand the tint change, then it explains why the lens isn’t our first choice for driving sunglasses, as the tint doesn’t fully activate behind the windscreen. The R&D have come up with a Transitions for driving too, although it doesn’t go as clear in low light as the regular Transitions, it can be a great choice.  Another option is a nifty sun-clip to use in the car when you need the extra tint over the regular photochromic option.

Also interesting to know, is that the clearest and fastest version of photochromic lenses is with an anti-reflective coating on the lens surface – we definitely recommend this for photochromic lenses.  And the other bonus is the lens also reduces the blue light that transmits through the lens – perfect if you use screens – and most of us do!

If you rely on your glasses, we all need a second pair, and often having a clear pair and a photochromic set of eyewear, gives you even more versatility! 

As health care has evolved, specialist eye doctors (ophthalmologists) have become even more specialised. If your eyes need specialist medical care, you also still need your optometrist eye care.

What we do is different to the specific medical treatment say for glaucoma. We ensure that you continue to have the best focus vision, and milder conditions like dry eyes are well managed.
We frequently find that our appointments with these people include more discussion about their eye condition, and regularly will provide an update about their vision to their ophthalmologist.  These people appreciate that they don't need to see us as often as their specialist, usually just every 2 years and we help keep them seeing and looking their best.

Often we see people who used to wear contacts, but have ended up back in their glasses.
Life is busy, kids, work and just one thing less in their busy lives. When we ask them if sometimes it would be good to be able to wear contacts, they are often still unsure if they might.  Recently we have had quite a few people excited to leave their appointment with some free trial daily disposable contact lenses.

And now with the added complication of masks and glasses fogging, it’s re-igniting some previous lens wearers motivation.

The "dailies" are a great choice, just open a new packet on the days that it's easier not to wear your glasses.  Same reasons that teenagers often start out with contacts - for sports and going out.  No reason that the over 30s don't feel the same - getting out on a bike or swimming in the sea, and of course, all glammed up, it's great to have the choice of contacts again.

We often surprise people at their appointment with our recommendations for eye health or future vision changes.  Now that school has started again, we see more students than other times of the year, and a key message now for younger eyes, is that time outdoors, is protective for developing myopia/short sightedness. 
The evidence shows that 2 hours a day outside is the time for young eyes to be less likely to become short-sighted.  At primary school, we find that when we ask about time outside, the kids work out for themselves that with lunch, playtimes, and a bit of sport, they are mostly having the 2hours.  And often parents add comments like "we were going to start scootering to school, instead of driving".

The teenagers are much less likely to have the outdoors time, and more likely to be hibernating inside - both during their school day and outside school time.  I know some of our teenagers think we harp on about time outside for their best vision, but it's such an "easy" treatment! 

NZ is now at Orange Level of the new framework for Covid19 protection, aka traffic lights.  This brings different requirements for many businesses.   As optometrists we are a mix of both healthcare and retail, we have a range of clients, including vulnerable people, and staff to care for.
The guidelines we receive come from our Registration Board (Ministry of Health), NZ Association of Optometrists and the Government Covid-19 Protection Framework.

All of our team are fully vaccinated, and wear masks.  For healthcare we do not have a Vaccine Pass requirement for entry.  Prior to a consultation we will ask a few healthcare questions to ascertain Covid19 risks, to ensure the protection of both other clients and our staff.  It may be appropriate for a person to have an alternative tele-health consultation for urgent care or reschedule for a more appropriate time.

The questions we ask before a consultation are:
-  Are you currently experiencing any Covid-19 symptoms?
-  Are you awaiting a result from a Coivd-19 test?
-  Are you self isolating, or anyone you are in contact with isolating?
-  Are you vaccinated against Covid-19?

Mask wearing is mandated for our team, and thus if you have a mask exemption, please advise us when booking your appointment. 
Covid-19 is a respiratory disease, and as the Ministry of Health advises “wearing masks and face coverings is one way of keeping yourself safe and protecting others from COVID-19, especially when physical distancing is not possible”.
Without the mask protection additional precautions may be indicated for the safety of both our staff and other possibly vulnerable clients in-store.

We continue with previous measures such as QR code scanning for contact tracing, physical distancing, disinfecting and eyewear is sanitised after touching, so our staff provide assistance.

It has been a long year with lockdown and more uncertainty, so we appreciate the support from our clients who have often asked how we are – thank you for also caring.  We look forward to 2022 and while we may have to be in Red level to come, we hope also to look forward to Green!

Sometime after 40, we all start to notice changes with our vision focussing for close work.  Reading up close isn’t as easy, phone fonts start to be enlarged and the dim light of an atmospheric restaurant is not so appealing when you can’t read the menu.

As your optometrist, we then make adjustments to your glasses prescription to include an extra part called the “near add”.  The near add part of the glasses is great for reading but then makes the view across the room blurry – remember those people who look over the top of their glasses at you?

We are fortunate to have many choices of lens designs for our glasses providing both near and further away vision clarity.  When we talk about lens options with people, some still look horrified that we are suggesting the bifocal lens with a line that they remember “old” people wearing!  With much relief they start to understand that modern technology lets us have a lens with a progressive power change shifting down the lens.  Hence the name of these as “progressives”, technically referred to as PALs – progressive addition lenses.
Often people variably call these multifocals, transitionals or invisible bifocals – as long as we’re all talking about the same idea, we run with you!

The technology for progressives has continued to improve since the first versions 30+ years ago.  The gains have been made by computer design of the lens optics to be surfaced by the lab, customising the lens for not only the lens power but also compensating for what the other eye’s lens is power is, and then the lens angle and position in the chosen frame.  It’s getting very high tech, and with this comes the tech on our side.  Once a frame is selected our optical dispensers will take the accurate measurement to 1/10th of a millimetre using imaging via an ipad to obtain the specifications we need for the lens design and manufacture.

This technology isn’t cheap, and while most people understand the “you get what you pay for”, we are often told that “I can get progressives much cheaper with my free eye exam”.  Yes, there are cheaper options, but they are not the same.  Value is a mix of the dollars spent and the quality of the product – just because something is cheap, it’s not necessarily good value.

Over the past few months, we’ve had several people tell us that they now realise that there is a big difference to the vision they have with their customised progressives, compared to other cheap glasses from elsewhere.  It’s great to hear unprompted comments like this, we recommend what our optometrists choose to wear – why would we want less for our clients!

For some people, the only thing that matters with their sunglasses is that they look cool – that’ll do just fine.  Whatever your reason, we all should have sunglasses, or some version of. 
Your sunnies are to protect your eyes from both harmful UV radiation and provide comfortable vision by reducing the intense glare.  The other benefits include stopping things going in your eyes like pollens at allergy times, and bugs when riding your bike. 

So when our glasses wearers ask “what about sunglasses?” we can help with the options of

1.      Prescription sunglasses – a separate pair, but does give you the best solution

2.      Photochromic tint changing lenses in your everyday or second alternate pair of glasses

3.      Very clever, light-weight polarised sun-clips that are magnetised onto your usual glasses lenses.

The UV burns concept is well known for skin, and our eyes are vulnerable too.  Skin cancers around the eyelids (a common place) and also damage on the eye pterygium/”surfers eye”, along with inside the eyes developing cataracts younger and UV associated with retinal damage and macula degeneration. 
We talk about UV-A (320-380nm) which ages the eyes with cataracts, and UV-B (290-320nm) the particularly damaging range that will “sun burn” your cornea and give you snow blindness, a very painful experience.  The ancient Tibetans knew about this and wove fine horsehair into a type of sunvisor to protect them in the bright sun and snow.

The UV protection comes from the lens material blocking the UV and often other filters added to the lens surface.  Some of the high index lens materials are 100% UV protection without any additional UV treatments.  Another option from fixed tint sunglasses, is a photochromic lens, commonly referred to as Transitions (a brand name) and this is 100% UV protecting.

Sunglasses as we know them are credited to the US Army Air Corps in the 1920s for high altitude glare protection for their pilots.  The first lenses were a green tint and then in the later 1940s the neutral grey tint was developed and became popular from the 1950s.

The darker the tint doesn’t mean more UV protection, there is just less visible light to your eyes reducing the discomfort of glare, with an 85% tint allowing just 15% of the light through the lens.  Most people will have 65-85% tints and we have samples to choose from your prescription sunglasses.
As well as tint, we can reduce the reflected light through the lens with a polarised filter in the lens.  So your sunglasses will either be just tinted, or tinted and polarised.  The colour of your tint is personal preference, however most people find the grey tint gives them less colour distortion.  In Europe the brown tints are popular, a mix of fashion and the different skies?

If you choose prescription sunglasses, we’ll work though the options with you:

1.      Do you want on-trend Moscot or stylish Kate Syvlester frames?
If you are working with more of a budget our Bill Bass sunglasses are a great option

2.      We carry sunglass ranges that are “prescriptable” making them suitable for optical prescription lenses

3.      We’ll recommend the best lens materials and lens design for your prescription

4.      We’ll ask do you want tinted or polarised lenses?  Which colour and how dark? – let’s show you samples

5.      Water based weekends? – we recommend the Maui Jim polarised tint, you’ll not regret the best polarised lens we’ve seen, and you can have this in your prescription with same tint quality!

6.      And once we’ve worked all of this out, our staff will take the accurate measurements needed for your lenses to these frames.

So, what do you do for sunglasses?  Let us know if we can help – we love hearing the comment “I love my prescription sunnies, don’t know why I didn’t get them sooner!”

Spring in Wellington is not our best season – you think winter is over, but then those annoying winds start up, and we just want to look forward to proper summer.  If you are unlucky, spring is also the return of your hayfever and other allergies. 

Our optometrists hints for avoiding those allergy eyes!

1.      Don’t touch or rub your eye – it only makes it worse.  Try a cold damp flannel instead.

2.      Wash your hands often and especially after touching pets or out in the garden

3.      Wear sunglasses, even a face mask if out in the grass

4.      Get someone else to mow the lawn – if you have to, wear sunglasses and change your clothes afterwards

5.      Keep a box of single use eye drops at home, and if you often need anti-allergy eye drops, make sure you keep an unopened bottle at home.  Then you can start treating before the allergy problem gets out of hand. 

6.      Keep pets off the pillows – and the bed, & out of your bedroom.  No –one wants to ban their cat, but try not to make the problems worse!

7.      Avoid eye makeup.

8.      Wash your hair at night – especially if you have a lot of hair as the pollen and hair static go well together, dropping off onto your pillow after a few hours, causing more eye allergies.

9.      Pillows with dust covers, washed frequently and regularly replaced can make a big difference.

10.   Contact lens wearers if not already in daily disposable lenses, have some boxes to just swap to these in allergy times.

If you suffer from allergies, it’s just your immune system responding to an “allergen” that causes a chain of events that give you the itchy, red, watery eyes. 

The chain of events is the conjunctiva becoming inflamed with histamine released and the blood vessels expanding.  So the treatment approach is to settle the histamine release and constrict the blood vessels.

If your eye allergies are not managed, then please book an appointment with our optometrist, we can help you.

One thing we know about lockdowns, is that we all spend more time on screens, and that includes kids and teens, for both schooling and their down time.  It’s all very understandable, but also the question arises - is this bad for their eyes?  The answer is “yes” and “but we can....”.

So the yes part is several reasons.  Firstly the more near time kids and teens have, the more likely their eyes are to develop myopia.  Then the screen time is visually more demanding than books and pen and paper, so even minor focusing errors can cause discomfort.  And we all blink less when looking at screens so even young eyes can start to have dry eye problems.  Lastly the extra screen time usually means there is less outside time, which is associated with myopia development.

Lets explain more ....
Myopia or short sightedness is when the eye develops structural changes making the distance vision blurry, and the near vision is clearer.  There are several factors that make this more likely for kids and teens – if you have parents who are myopic, if you do a lot of near focusing time and if you have less outdoor time.  Sure, we can correct myopia with glasses, but the bigger concern is that if you have higher levels of myopia, your eye health is of increased risk as you get older from conditions like retinal detachment, maculopathy and glaucoma.  If we can reduce the risk of our kids having these potentially blinding conditions in their later life, we must do this.  And every extra dioptre of myopia is extra risk. 

What is exciting, is that we know the factors that increase the risk, and as well as reducing these, optometrists have treatments that are shown to work to slow the progression of myopia in kids and teens.  This is exciting, as we can work with families to improve the future of their kids vision.  Not only using these treatments for the young eyes who are already myopic, but often starting these options at the earliest signs of vision changes, and not waiting for the blurry myopia to progress.

The other concern with screen time is that if your eyes are working harder than normal, to focus clearly or work your eyes together, or you have uncorrected astigmatism this is visually tiring.  Adults often refer to their computer glasses, and this is the type of correction that some kids also need.

If your eye surface is getting dry, then signs of this can be the person blinking more or rubbing their eyes.  The eyes may also be red.  Dry eyes are uncomfortable and tiring – whether you are a child or an adult.  Sometimes the reduced blinking is worse with uncorrected vision that child is trying to work with, thus their eyes get dry.

So what can we do??  Kids rely on their parents, so parents, we’re writing this for you

1.      Screen time in moderation – mix up screen time with book-time and other activities.
2.      More green time, less screen time.  It’s recommended that kids and teens have 2 hours a day outside to reduce the development of myopia. 
3.      Use the 20-20-20 rule for screen time.  Every 20 minutes look 20 feet away for 20 seconds
4.      Talk to kids about why this is important – we’re not saying no screens, but we do want them to have great eyes and vision for the rest of their life
5.      Book your kids in for an eye exam, if even one parent is myopic, the chances are already higher that our kids will develop myopia.  Just because they say they can see, or the letter chart at the school check was ok, it’s not enough to look after our kids the best we can.  Don’t wait to see them squinting, or a teacher to notice that they are having difficulties

Our optometrists are parents and also myopic.  We see the difficulties of adults with higher myopia, and it’s not just that glasses can be a bother.  Talking with these adults, the common comment is that they wish there had been treatments to slow their myopia progression.   Please parents, this is important stuff!

We love school holidays at CapitalEyes, because it’s a time when we see more than our usual number of kids and teens for their eyecare.  There are those we’ve seen before, but also we’re really enjoying meeting a number of new kids.  From the 3 year olds in their favourite gumboots and sparkling dress ups to the older teens, who are now driving and looking forward to finishing school and the exciting adventures beyond.

A topic that gets us excited is myopia management.  How can we help slow the progression of myopia for kids and teens, who are either just starting to become myopic or are already moderately myopic (short sighted).  There is so much research and now options that their already myopic parents never had.  From advanced optics in spectacle lenses that alter the peripheral retina focus, thus slowing progression, to using eye drops or contact lenses with optics to slow myopic progression.

Parents are often surprised by the fact that if one parent is myopic their children have double the risk of developing myopia but having both parents myopic, the risk increases by five times.  But equally they are excited that there are options to slow progression, that they never had, and so we spend a lot of time explaining options and recommending for their child’s best visual future.

The other surprise for parents is often how well kids , even 8 year olds manage to handle their own contact lenses.  And we love seeing the confidence that comes from having clear vision, both for sports and socially at school.

We hope everyone enjoys the school holidays as much as we do!

Since Queens Birthday weekend, we've relocated our Karori branch 2 doors along from our previous space, to a brighter new site on the corner of Karori and Parkvale Road.  The site was previously ANZ bank, and became available from 1 April 2021, so April and May was a busy time with designer, architect, builders, painters, floor sander, carpet layer, plumber, electricians and sign writers all coming together to make our space ready for our move. The ATM is staying, the service side of it is a room within our store, although you hardly notice it from the inside.

We love our new space, there's more room in our frame area for both an expanded range of eyewear and for people to move around - especially when we have families with children choosing their glasses. Our previous space had solid walls and no room to expand our testing equipment, but now we have a much larger consulting room and have been able to fit in advanced technology imaging and testing equipment.

The geek parts of us are really excited to have the OCT (Optical Coherence Tomography) imaging and computerised visual field testing equipment.  The OCT enables imaging of the layers of the retina and optic nerve head, to micron levels, so provides an excellent clinical indication for ongoing eye health monitoring and then ophthalmological referral as indicated.  For those of us with family history of macula degeneration and glaucoma, the baseline measuring is excellent and will provide better management and signs of change will be detected earlier.

So "why have we moved"?? we knew we were going to have to be out of our old site for months with further earthquake strengthening - living in Wellington yellow stickers on buildings isn't uncommon, but it had to be part of our planning.  The new corner site has been extensively strengthened and evidence of this with some K framing and steel pillars.  We now have the space to provide a level of service for both eyecare and a wide range of eyewear locally, that equals the CBD and look forward to meeting more locals.

Thanks to our amazing team from Lintott Construction, Kieran Kelly Painters, a.k.a architecture, Native Grain Flooring ,Good Nick Flooring, Wellington City Plumbing, Newson Electrical and Wellington Signs creating the vision from Lynne Parker our designer.  You all worked fast to make our short timeline come together - thank you!

The old saying of life begins at 40, is also the age when people start to notice their near vision changing. It gets harder to focus on small details, things up close are harder so you start holding the page out a bit further. In low light it gets harder to see and you’ll start to find work-arounds – like enlarging the font on your phone, turning on more lights or just going over by the window to see more easily.  Those arms are just getting too short and your eyes need more light to see!

The average age for needing reading glasses is 43.  Some people need them sooner and others hang in there a bit longer.  But for many people, this is the first time they find an optometrist. At your eye examination there is not just finding out about focusing your vision but also the reality of the important eye health checks.  Chances of developing eye conditions, such as glaucoma, increase when you’re over 40, so as an optometrist, we’re really pleased to meet you and take care not only of helping you see more clearly but also ensuring your eyes stay healthy.  This is the annoying reality of actually being grown up.

The problem for all of us into our 40s is called “presbyopia”.. The Greek translation is from presbus “old man” and new Latin opia “vision problem”.  Really not very cheery, but our life expectancy is definitely longer than in ancient times.  Turning 40 is really only on the half way mark for the NZ average life of around 82 years!

So once we’ve worked out what lens power or prescription we need for your glasses, then it turns more technical options with different lens designs.  Depending on how much time you spend reading vs on your laptop or desktop, how many screens on your desk and what’s the mix of time looking up close and then further away eg meetings or shopping.  There are many different lens options to consider and recommend, as well as lens surface coatings that reduce reflections and give you the clearest vision.  There’s also the option to have coatings that reduce the blue light that transmits through the lens if you are doing a lot of time looking at screens.

For some people their glasses are entirely functional, and others are high fashion.  You only live once and so let’s make your glasses great.  If you are the functional person, you’ll be interested in the lightest weight glasses that fit your face for comfortable wearing.  And if you are into fashion there are so many choices, how good can you look in your new glasses!

Great glasses make you feel good, by looking great and seeing clearly again.  Don’t worry about the old Greeks, just think life begins at 40 - and if you’ve not needed an optometrist before, it’s time to add us to your team.

Many young people we see are myopic (short-sighted) ,and we spend a lot of time working with them and their families on treatments to slow the progression/worsening of their myopia.  The kids and teens with the blurry vision totally understand when their eyes are changing and vision getting worse – sometimes even more than some parents.

Myopia occurs when the axial length of the eye increases, stretching the eye and is associated with increased risk to longer term eye health.  The higher the myopia, the higher the risks.  So these health risks along with the person being more dependent on glasses with higher prescriptions that have thicker and more costly lens options mean that managing myopic progression is a priority for our young people.

Our treatment choices so far have been contact lenses with special optics or nightly eye drops that both have good evidence of slowing the rate of myopic progression.  Until now there hasn’t been a spectacle lens option that will significantly slow the progression of the myopia

Standard single vision spectacle lenses have a centre optical power to focus the vision, onto the centre of the retina.  But this single power results in the periphery of the retina having a detrimental focus effect, thought to increase the rate of myopic progression.

The optical effects from new types of contact lenses are used to slow myopia progression by altering the focus on the peripheral retina. But how to create a spectacle lens that the eyes move behind, focusing to the vision, but not triggering the peripheral retina changes that are likely causing the myopia to further increase?

Defocus Incoporated Multiple Segments (DIMS) technology gives us a spectacle lens to correct the myopia with hundreds of tiny lenslets that alter the focus on the periphery of the retina. 
A central optical zone with the required distance power is surrounded by a ring of the 400 tiny (1mm) +3.50 lenslets spaced over main lens power. So the general vision clarity is maintained, but the periphery of the retina receives a defocus effect.

The optics of the lens have shown to have minimal effect on the viewer’s quality of vision, although it is critical that the lenses are fitted accurately to an appropriate frame that is stable and sized so that the eyes are in the centre of the lenses.  The lens looks quite normal.

A study published in the British Journal of Ophthalmology showed over 2 years a 60% reduction in the rate of myopia progression, with DIMS lens, and for 21% of children there was no progression of their myopia.

We are recommending this as a first choice lens for their glasses worn for myopia.  At CapitalEyes we recommend review consultations 6 monthly for children and teenagers with developing myopia.  If the progression continues, then additional treatments may be recommended.

What a year!  and now we are adjusting to face masks being part of our new routine.  Whether it's a washable and personalised mask, or the standard disposable blue keeping us all a bit safer, they do affect our eyes. 

The increasing reports of more problems for people with dry eyes when wearing masks has started to catch the attention of the dry eye researchers.  Findings that not only people who already have dry eyes are worse, but there are also new dry eye sufferers.  The problem is the tear film that lubricates the front of our eyes, drying out faster.  The symptoms of dry eyes are sore, irritated, stinging, burning and sometimes watery and red eyes.

Wearing a mask keeps your breath close to you, but it still has to go somewhere - that fogging up of your glasses shows where the breath is going - upwards, and over the surface of your eyes, like a gentle breeze. Along with air conditioning, or screen time on your phone or computer when we blink less, the faster rate of evaporation of the tear film on the front surface of our eye makes them dry.

Those of us who wear glasses have worked out that a tighter fitting mask over our nose is a big help in reducing the fogging, and also helps dry eyes.  But we may also need to use lubricating eye drops to replenish our tear film. There are a range of lubricating eye drops that we can advise on, depending on how mild or severe the drying is.

So along with fixing the fogging up glasses problem, a tightly fitted mask over the top of your nose, will also help your dry eyes.

We know that our kids inherit all sorts of interesting genetic traits from us.  As a parent you gradually realise that not only will your kids likely follow with your height, or colouring, but also your eyes.  Chances are high that if you are myopic (short-sighted), that your kids will also likely develop this trait too.  Having one parent who is myopic doubles the chance your child will also develop myopia, but having both parents myopic, the risk increases 5 times!

But parents can’t take all the blame for their kids myopia, there are other factors too.  The environment of the child will affect their eyes, and likelihood of developing myopia.  Remember the bookworm (maybe you are/were one), spending long periods of time on close work is associated with myopia.  While there is varied evidence on time spent on screens, we are watching a generation spend more time viewing close up – books or screens than ever before.

You might have heard that time spent outside is protective for young eyes developing myopia.  The exact “why” is still being researched, however it is an easy recommendation for Kiwi kids.  More time outdoors seems to result in less myopia, with 2 hours a day being the recommendation.  We think in Wellington with our weather, sometimes it might have to be 14 hours over a week!
At primary school, our children seem to get this outside time, between lunch breaks, sport and walking to school.  Once at college this seems to drop off, with inside lunch breaks and time huddled over screens.  Some sports choices also mean that active kids might not actually be outdoors – think swimming, dance, karate – vs football, cricket, netball and hockey.

Previously the standard approach to myopia was to provide glasses, and see if things changed – and if they do, just make the glasses stronger.  The big change in thinking now is to consider the risks for each child/teenager with myopia, and so a consultation at age 6 is the first starting point for assessing likely future risks. 

Why wait?  As there is new and developing research on treatments to slow myopia progression, this is becoming the new standard of care for our young clients.  The options include different lens types in their glasses, soft contact lenses with different peripheral optics or a nightly eye drop of very weak atropine.
Myopia management requires a very individualised approach, and there are options, which we customise to each person.  The earlier this approach is started, the better – why wait until their myopia is bad? The sooner the progression to higher myopia is slowed or stalled, the better!

Lastly, we occasionally have a parent pointing out that “it’s ok” their child can just have laser surgery when they’re older, and it will all be fixed.  While the surgery will likely “fix” the need for glasses or contact lenses, the eye has not changed on the inside.  The myopic eye has stretched longer, and the eye is now at much higher lifetime risk for conditions such as cataracts, glaucoma, retinal detachment and myopic maculopathy.  The higher the myopia, the higher the likelihood of these conditions.  For those of us adults who are already myopic, we can’t change this, but how exciting to be able to help the next generation have better vision and lifelong eye health.

Almost all of us have some “screen” time every day – and the past 2 months it’s upped and for some of us it feels like “all day”.  Getting through the COVID lockdown would have been so very different without the screen time and technology that let so many people continue with work, school, uni and keeping in touch with family and friends. 

Since we’ve been back to Level 2 and re-opened to seeing people again, the high level of screen time has been a frequent cause of symptoms such as sore and tired eyes.  When you think about our days of laptops and phones, these are closer to our eyes than the traditional desktop back in the office.  Added in is that instead of walking to meet someone for a meeting, or to see your teacher, it’s all just a click away and then more screen time.  And once work or school is over, there are movies, computer games and even dance lessons on the screen still.

So what is different for our eyes with all this screen time?  In short, we just weren’t built to sit inside and stare at screens, we are meant to be outside hunting and gathering our food, and this means looking far away and being outside.  Our eyes focus by adjusting the ciliary muscle to keep the lens focus set at a close distance for long periods of time.  For many of us this is tiring, and even harder with even a low level of long sightedness (hyperopia) or astigmatism, or we are approaching 40, when our focusing reserves naturally decrease.  Added to this our eyes need to team together and align accurately for comfortable vision, so if your eye “posture” is naturally over or under converging, this is also tiring.

Then our blink rate slows when we look at screen, so the front surface of our eye is more likely to dry.  A dry eye feeling includes not just sore, stinging, red or watery eyes but also we often hear “just tired eyes”.  We are more likely to have a dry eye problem as we get older, for women (thanks hormones!) and if you take certain medications, including anti-histamines during allergy times.

On top of our visual system is the screen and ergonomics of our set up.  Ideally our eyes should be looking slightly down (10-20 degrees), not straight ahead.  Increasingly people are using multiple screens! When you pick up your phone, then naturally we hold this closer.

The screen itself emits blue light, which can affect our melatonin.  Melatonin is key in our sleep wake cycle, and it’s hard enough to have that routine working well at the best of times!

So it’s hardly surprising that we start to have some problems, ranging from eye strain with tired sore eyes, headaches, neck or shoulder pain, dry gritty or even red eyes, blurred or double vision at close range or far vision to just general fatigue.

And all this screen time isn’t going away, in this next-normal of COVID-19 changes there will continue to be more screen time for most of us, and so what should we do?

• Make sure you’ve had thorough assessment of your vision – this takes time and is part of a comprehensive eye examination.  You may or may not need glasses for screen work.

• The 20-20-20 rule after 20 minutes of screen time, look into the distance 20 feet away for 20 seconds.  A bit American not being metric, but it is easy to remember.

• Deliberate blinks – during a mini break, take 10 deliberate blinks.

• Think posture – starting with feet flat on the floor, knees at right angles, and desk height so that your forearms make a right angle with your elbow.

• Screen set so you have downward gaze of 10-20 degrees.

• Reducing blue light by a combination of screen settings, and glasses with coatings that protect your eyes.

• Get our kids outside – more time reading or on screens is associated with more myopia (short sightedness), while time outdoors is protective for younger eyes to slow myopia developing.

Writing this blog was also my screen time, and it was a good reminder to adjust my posture, and have regular breaks.  Time for all of us to look after ourselves.