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Have you ever seen a temporary black spot in your vision? How about jagged white lines? Something that looks like heat waves shimmering in your peripheral vision?

If you have, you may have been experiencing what is known as an ocular migraine. Ocular migraines occur when blood vessels spasm in the visual center of the brain (the occipital lobe) or the retina.

They can take on several different symptoms but typically last from a few minutes to an hour. They can take on either positive or negative visual symptoms, meaning they can produce what looks like a black blocked-out area in your vision (negative symptom), or they can produce visual symptoms that you see but know aren’t really there, like heat waves or jagged white lines that look almost like lightning streaks (positive symptoms).

Some people do get a headache after the visual symptoms but most do not. They get the visual symptoms, which resolve on their own in under an hour, and then generally just feel slightly out of sorts after the episode but don’t get a significant headache. The majority of episodes last about 20 minutes but can go on for an hour. The hallmark of this problem is that once the visual phenomenon resolves the vision returns completely back to normal with no residual change or defect.

If you have this happen for the first time it can be scary and it is a good idea to have a thorough eye exam by your ophthalmologist or optometrist soon after the episode to be sure there is nothing else causing the problem.

Many people who get ocular migraines tend to have them occur in clusters. They will have three or four episodes within a week and then may not have another one for several months or even years.

There are some characteristics that raise your risk for ocular migraines. The biggest one is a personal history of having migraine headaches. Having a family history of migraines also raises your risk, as does a history of motion sickness.

Although the symptoms can cause a great deal of anxiety, especially on the first occurrence, ocular migraines rarely cause any long-term problems and almost never require treatment as long as they are not accompanied by significant headaches.

So if symptoms like this suddenly occur in your vision, try to remain calm, pull over if you are driving, and wait for them to go away. If they persist for longer than an hour, you should seek immediate medical attention.


Article contributed by Dr. Brian Wnorowski, M.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

The spots, strings, or cobwebs that drift in and out of your vision are called “floaters,” and they are more prominent if you’re looking against a white background.

These floaters are tiny clumps of material floating inside the vitreous (jelly-like substance) that fills the inside of your eye. Floaters cast a shadow on the retina, which is the inner lining of the back of the eye that relays images to the brain.

As you get older, the vitreous gel pulls away from the retina and the traction on the retina causes flashing lights. These flashes can then occur for months. Once the vitreous gel completely separates from the back wall of the eye, you then have a posterior vitreous detachment (PVD), which is a common cause of new onset of floaters.

This condition is more common in people who:

  • Are nearsighted.
  • Are aphakic (absence of the lens of the eye).
  • Have past trauma to the eye.
  • Have had inflammation in the eye.

When a posterior vitreous detachment occurs, there is a concern that it can cause a retinal tear.

Symptoms of a retinal tear include:

  • Sudden increase in number of floaters that are persistent and don't resolve.
  • Increase in flashes.
  • A shadow covering your side vision, or a decrease in vision.

In general, posterior vitreous detachment is unlikely to progress to a retinal detachment. Only about 15 percent of people with PVD develop a retinal tear.

If left untreated, approximately 40 percent of people with a symptomatic retinal tear will progress into a retinal detachment – and a retinal detachment needs prompt treatment to prevent vision loss.

Generally, most people become accustomed to the floaters in their eyes.

Surgery can be performed to remove the vitreous gel but there is no guarantee that all the floaters will be removed. And for most people, the risk of surgery is greater than the nuisance that the floaters present.

Similarly, there is a laser procedure that breaks the floaters up into smaller pieces in hopes of making them less noticeable. However, this is not a recognized standard treatment and it is not widely practiced.

In general, the usual recommendation for floaters and PVD is observation by an eye care specialist.


Article contributed by Jane Pan M.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ. This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician.

A wrinkle on the retina - which is also known as an epiretinal membrane (ERM) or a macular pucker - is a thin, translucent tissue that develops on the surface of the retina.

The retina is the inner layer that lines the inside of the back of the eye and is responsible for converting the light image into an electrical impulse that is then transmitted to the brain. An epiretinal membrane that forms on the retina goes unnoticed by the patient many times, and is only noticed during a dilated eye exam by an eye doctor.

Epiretinal membranes can become problematic if they are overlying the macula, which is the part of the retina that is used for sharp central vision. When they become problematic they can cause distortion of your vision, causing objects that are normally straight to look wavy or crooked.

Causes of a wrinkle on the retina

The most common cause is age-related due to a posterior vitreous detachment, which is the separation of the vitreous gel from the retina. The vitreous gel is what gives the eye its shape, and it occupies the space between the lens and the retina. When the vitreous gel separates from the retina, this can release cells onto the retina surface, which can grow and form a membrane on the macula, leading to an epiretinal membrane.

ERMs can also be associated with prior retinal tears or detachments, prior eye trauma or eye inflammation. These processes can also release cells onto the retina, causing a membrane to form.

Risk factors

Risk for ERMs increases with age, and males and females are equally affected.

Both eyes have ERMs in 10-20% of cases.

Diagnostic testing

Most ERMs can be detected on a routine dilated eye exam.

An optical coherence tomography (OCT) is a noninvasive test that takes a picture of the back of the eye. It can detect and monitor the progression of the ERM over time.

Treatment and prognosis

Since most ERMs are asymptomatic, no treatment is necessary. However, if there is significant visual distortion from the ERM or significant progression of the membrane over time, then surgical intervention is recommended. There are no eye drops, medications, or nutritional supplements to treat or reverse an ERM.

The surgery is called a vitrectomy with membrane peeling. The vitrectomy removes the vitreous gel and replaces it with a saline solution. The epiretinal membrane is then peeled off the surface of the retina with forceps.

Surgery has a good success rate and patients in general have less distortion after surgery.


Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

It could be a retinal vein occlusion, an ocular disorder that can occur in older people where the blood vessels to the retina are blocked.

The retina is the back part of the eye where light focuses and transmits images to the brain. Blockage of the veins in the retina can cause sudden vision loss. The severity of vision loss depends on where the blockage is located.

Blockage at smaller branches in the retinal vein is referred to as branch retinal vein occlusion (BRVO).  Vision loss in BRVO is usually less severe, and sometimes just parts of the vision is blurry.  Blockage at the main retinal vein of the eye is referred to as central retinal vein occlusion (CRVO) and results in more serious vision loss. 

Sometimes blockage of the retinal veins can lead to abnormal new blood vessels developing on the surface of the iris (the colored part of your eye) or the retina. This is a late complication of retinal vein blockage and can occur months after blockage has occurred. These new vessels are harmful and can result in high eye pressure (glaucoma), and bleeding inside the eye.

What are the symptoms of a retinal vein occlusion?

Symptoms can range from painless sudden visual loss to no visual complaints. Sudden visual loss usually occurs in CRVO. In BRVO, vision loss is usually mild or the person can be asymptomatic. If new blood vessels develop on the iris, then the eye can become red and painful. If these new vessels grow on the retina, it can result in bleeding inside the eye, causing decreased vision and floaters – spots in your vision that appear to be floating.

Causes of retinal vein occlusion

Hardening of the blood vessels as you age is what predisposes people to retinal vein occlusion.  So retinal vein occlusion is more common in people over the age of 65. People with diabetes, high blood pressure, blood-clotting disorders, and glaucoma are also at higher risk for a retinal vein occlusion.

How is retinal vein occlusion diagnosed?

A dilated eye exam will reveal blood in the retina. A fluorescein angiogram is a diagnostic photographic test in which a colored dye is injected into your arm and a series of photographs are taken of the eye to determine if there is fluid leakage or abnormal blood vessel growth associated with the vein occlusion. An ultrasound or optical coherence tomography (OCT) is a photo taken of the retina to detect any fluid in the retina. 

Treatment for retinal vein occlusion

Not all cases of retinal vein occlusion need to be treated. Mild cases can be observed. If there is blurry vision due to fluid in the retina, then your ophthalmologist may treat your eye with a laser or eye injections. If new abnormal blood vessels develop, laser treatment is performed to cause regression of these vessels and prevent bleeding inside the eye. If there is already a significant amount of blood inside the eye, then surgery may be needed to remove the blood.

Outlook after retinal vein occlusion

Prognosis depends on the severity of the vein occlusion. Usually BRVO has less vision loss compared to CRVO. The initial presenting vision is usually a good indicator of future vision. Once diagnosed with a retinal vein occlusion, it is important to keep follow-up appointments to ensure that prompt treatment can be administered to best optimize your visual potential.


 Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Age-related Macular Degeneration or AMD is a disease that causes a slow and painless loss of central vision. Central vision is what you use when you look straight at an object; it allows you to see fine detail needed when reading or driving.

On the inside of the eye is the retina, which contains over 120 million light sensitive cells or photoreceptors. The largest concentration of photoreceptors is in the macula, located in the center of the retina .

Directly behind the photoreceptors is the pigment layer, and behind that is the choroid, containing the blood supply to the retina.

Macular Degeneration occurs in two forms: dry and wet.

In the dry form, cellular debris called drusen accumulates between the retina and the choroid; and the retina can separate. The risk is considerably higher when the drusen are large and numerous, which can disturb the pigmented cell layer under the macula.

At the onset, most patients with the dry form have good vision. But over time, as the disease progresses, colors appear less bright and print may appear blurry or distorted. A dark area or empty area can appear in the center of vision. In about 10% of patients with the dry form, the disease progresses to the more serious wet form.

In the neovascular, or wet form, damage to the macula can occur rapidly. Proteins in the eye cause abnormal blood vessels to spring up from the choroid behind the retina. As the blood vessels grow, they can leak blood and fluids that kill the photoreceptors, causing permanent blind spots. Eventually the retina can also become detached.

Patients may see a dark spot in the center of their vision field. Straight line objects, like doorways may appear wavy, as the retinal structure is distorted.

Macular degeneration is the most common cause of vision loss and blindness in individuals over the age of fifty. About 1.8 million US residents currently have advanced age-related macular degeneration, so it's important to have your eyes examined regularly by your eye care professional.


EYEiQThe content of this video and blog cannot be reproduced or duplicated without the express written consent of EYEiQ.

Here are some treatment options for Dry and Wet Age Related Macular Degeneration.

Nutritional supplements and Dry Age Related Macular Degeneration (AMD)

The Age-Related Eye Disease Study 2 (AREDS2) showed that people at high risk of developing advanced stages of AMD benefited from taking dietary supplements. Supplements lowered the risk of macular degeneration progression by 25 percent. These supplements did not benefit people with early AMD or people without AMD.

Following is the supplementation:

  • Vitamin C - 500 mg
  • Vitamin E - 400 IU
  • Lutein – 10 mg
  • Zeaxanthin – 2 mg
  • Zinc Oxide – 80 mg
  • Copper – 2 mg (to prevent copper deficiency that may be associated with taking high amount of zinc)

Another study showed a benefit in eating dark leafy greens and yellow, orange and other fruits and vegetables. These vitamins and minerals listed above are recommended in addition to a healthy, balanced diet.

It is important to remember that vitamin supplements are not a cure for AMD, nor will they restore vision. However, these supplements may help some people maintain their vision or slow the progression of the disease.

Wet AMD treatments

The most common treatment for wet AMD is an eye injection of anti-vascular endothelial growth factor (anti-VEGF). This treatment blocks the growth of abnormal blood vessels, slows their leakage of fluid, may help slow vision loss, and in some cases can improve vision. There are currently three anti-VEGF drugs available: Avastin, Lucentis, and Eylea.

You may need monthly injections for a prolonged period of time for treatment of wet AMD.

Laser Treatment for Wet AMD

Some cases of wet AMD may benefit from thermal laser. This laser destroys the abnormal blood vessels in the eye to prevent leakage and bleeding in the retina. A scar forms where the laser is applied and may cause a blind spot that might be noticeable in your field of vision.

Photodynamic Therapy or PDT

Some patients with wet AMD might benefit from photodynamic therapy (PDT). A medication called Visudyne is injected into your arm and the drug is activated as it passes through the retina by shining a low-energy laser beam into your eye. Once the drug is activated by the light it produces a chemical reaction that destroys abnormal blood vessels in the retina. Sometimes a combination of laser treatments and injections of anti-VEGF mediations are employed to treat wet AMD.


Article contributed by Jane Pan M.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

The jury is still out on that question. There is some supportive experimental data in animal models but no well-done human studies that show any significant benefit.

What you shouldn’t do is pass up taking the AREDS 2 nutritional supplement formula, which is clinically proven to reduce the risk of severe visual loss in. Almost all the data supporting the POSSIBLE benefits of bilberry in visual conditions is related to NON-HUMANS. Stick with the AREDS 2 formula that has excellent clinical evidence.

So, what is bilberry and why do some people use it?

Bilberry (Vaccinium myrtillus), a low-growing shrub that produces a blue-colored berry, is native to Northern Europe and grows in North America and Asia. It is naturally rich in anthocyanins, which have anti-oxidant properties.

During World War II, British pilots in the Royal Air Force ate bilberry jam, hoping to improve their night vision. No one is exactly sure where the impetus to do this came from, but it is believed that this event is what lead to some widespread claims that bilberry was good for your eyes.

A study by JH Kramer,  Anthocyanosides of Vaccinium myrtillus (Bilberry) for Night Vision - A Systematic Review of Placebo-Controlled Trials, reviewed most of the literature pertaining to the claim that bilberry improves night vision. He found that the four most recent trials, which were all rigorous randomized controlled trials (RCTs), showed no correlation with bilberry extract and improved night vision. A fifth RCT and seven non-randomized controlled trials reported positive effects on outcome measures relevant to night vision, but these studies had less-rigorous methodology.

Healthy subjects with normal or above-average eyesight were tested in 11 of the 12 trials. The hypothesis that V. myrtillus improves normal night vision is not supported by evidence from rigorous clinical studies. There is a complete absence of rigorous research into the effects of the extract on subjects suffering impaired night vision due to pathological eye conditions.

Even though there is no solid evidence in human studies that bilberry produces any positive visual effects on night vision there is some experimental evidence that implies it might be useful in some ocular conditions whose mode of action is oxidative stress. There are recent epidemiologic, molecular and genetic studies that show a major role of oxidative stress in age-related macular degeneration.

There have been some studies showing oxidative protective effects of bilberry in non-human models. 

In Protective effects of bilberry and lingonberry extracts against blue-light emitting diode light-induced retinal photoreceptor cell damage in vitro, Ogawa et al showed in cultured mouse cells that adding bilberry extract to cells before subjecting them to high-energy short-wavelength light that the cells survived better mostly by reducing the amount of reactive oxidative molecules. 

In Retinoprotective Effects of Bilberry Anthocyanins via Antioxidant, Anti-Inflammatory, and Anti-Apoptotic Mechanisms in a Visible Light-Induced Retinal Degeneration Model in Pigmented Rabbits, Wang et al found similarly improved survival of pigmented rabbit retinal cells when exposed to bilberry abstract prior to high-intensity light.

But bilberry is not without potential side effects.

Bilberry possesses anti-platelet activity; it may interact with NSAIDs, particularly aspirin. And excessive drinking of bilberry juice may cause diarrhea. One study of 2,295 people given bilberry extract found a 4% incidence of side effects or adverse events. Further, bilberry side effects may include mild digestive distress, skin rashes and drowsiness. Chronic uses of the bilberry leaf may lead to serious side effects. High doses of bilberry leaf can be poisonous.

Bilberry has not been evaluated by the Food and Drug Administration for safety, effectiveness, or purity.


Article contributed by Dr. Brian Wnorowski, M.D.

The retina is the nerve tissue that lines the inside back wall of your eye. Light travels through the pupil and lens and is focused on the retina, where it is converted into a neural impulse and transmitted to the brain. If there is a break in the retina, fluid can track underneath the retina and separate it from the eye wall. Depending on the location and degree of retinal detachment, there can be very serious vision loss.


The three 3 F’s are the most common symptoms of a retinal detachment:

  • Flashes: Flashing lights that are usually seen in peripheral (side) vision.

  • Floaters: Hundreds of dark spots that persist in the center of vision.

  • Field cut: Curtain or shadow that usually starts in peripheral vision that may move to involve the center of vision.


Retinal detachments can be broadly divided into three categories depending on the cause of the detachment:

Rhegmatogenous retinal detachments: Rhegmatogenous means “arising from a rupture,” so these detachments are due to a break in the retina that allows fluid to collect underneath the retina. A retinal tear can develop when the vitreous (the gel-like substance that fills the back cavity of the eye) separates from the retina as part of the normal aging process.

The risk factors associated with this type of retinal detachment:

  • Lattice degeneration – thinning of the retina.

  • High myopia (nearsighted) - can result in thinning of the retina.

  • History of a previous retinal break or detachment in the other eye.

  • Trauma.

  • Family history of retinal detachment.

Tractional retinal detachments: These are caused by scar tissue that grows on the surface of the retina and contraction of the scar tissue pulls the retina off the back of the eye. The most common cause of scar tissue formation is due to uncontrolled diabetes.

Exudative retinal detachments: These types of detachments form when fluid accumulates underneath the retina. This is due to inflammation inside the eye that results in leaking blood vessels. The visual changes can vary depending on your head position because the fluid will shift as you move your head. There is no associated retinal hole or break in this type detachment. Of the three types of retinal detachments, exudative is the least common.

Diagnostic tests

  • A dilated eye exam is needed to examine the retina and the periphery. This may entail a scleral depression exam where gentle pressure is applied to the eye to examine the peripheral retina.

  • A scan of the retina (optical coherence tomography) may be performed to detect any subtle fluid that may accumulate under the retina.

  • If there is significant blood or a clear view of the retina is not possible then an ultrasound of the eye may be performed.


The goal of treatment is to re-attach the retina to the eye wall and treat the retinal tears or holes.

In general, there are four treatment options:

  • Laser: A small retinal detachment can be walled off with a barrier laser to prevent further spread of the fluid and the retinal detachment.

  • Pneumatic Retinopexy: This is an office-based procedure that requires injecting a gas bubble inside the eye. After this procedure, you need to position your head in a certain direction for the gas bubble to reposition the retina back along the inside wall of the eye. A freezing or laser procedure is performed around the retinal break. This procedure has about 70% to 80% success rate but not everyone is a good candidate for a pneumatic retinopexy.

  • Scleral buckle: This is a surgery that needs to be performed in the operating room. This procedure involves placing a silicone band around the outside of the eye to bring the eye wall closer to the retina. The retinal tear is then treated with a freezing procedure. Vitrectomy: In this surgery, the vitreous inside the eye is removed and the fluid underneath the retina is drained. The retinal tear is then treated with either a laser or freezing procedure. At the completion of the surgery, a gas bubble fills the eye to hold the retina in place. The gas bubble will slowly dissipate over several weeks. Sometimes a scleral buckle is combined with a vitrectomy surgery.


Final vision after retinal detachment repair is usually dependent on whether the macula (central part of the retina that you use for fine vision) is involved. If the macula is detached, then there is usually some decrease in final vision after reattachment. Therefore, a good predictor is initial presenting vision. We recommend that patients with symptoms of retinal detachments (flashes, floaters, or field cuts) have a dilated eye exam. The sooner the diagnosis is made, the better the treatment outcome.


Article contributed by Dr. Jane Pan

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

No this is not a late-night personal injury lawyer infomercial.

This is a recommendation that you have your records available, for your own good, later in life.

There are 2 million cataract surgeries done yearly in the U.S. and the odds are, if you live long enough, you will eventually need cataract surgery too.

What does this have to do with LASIK surgery? 

When doctors perform cataract surgery we remove the cataract, which is the lens of your eye that has become cloudy.  And we replace that lens with an artificial lens called an Intraocular Lens implant (IOL).

The IOL needs to have a strength to it to match your eye so that things are in focus without the need for strong prescription eyeglasses.

Currently, we determine what the strength the IOL needs to be by using formulas that mostly depend on the measurements of the curvature of the cornea and the length of the eye.

Those formulas work best when the cornea is its natural shape - i.e., not previously altered in shape after LASIK.

If you plug the “new” post-LASIK corneal shape into the formulas, the IOL strength that comes out is often significantly off the strength you really need to see well.

This is where having your records becomes important.

Knowing what your eyeglass prescription and corneal shape was BEFORE you had LASIK greatly improves our formula’s ability to predict the correct implant strength.

In most states there is a limit to how long a doctor needs to keep your records after your last visit, so everyone who has had LASIK surgery should get a copy of your pre- and post-LASIK records NOW before they no longer exist.


Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

The 2017 National Coffee Drinking Trends report showed that 62 percent of more than 3,000 people who participated in the online survey said they had drunk coffee the previous day, which is interpreted as daily consumption. This was up from 57 percent in 2016, said the report, which was released at the coffee association's conference in Austin, Texas.

Even though the U.S. population is drinking more coffee than ever it still only ranks 22nd overall in per capita consumption. The people of Finland average 3 times as much coffee consumption as in the U.S.

So what does all this caffeine intake do to our eyes?

The research is rather sparse and the results are mixed.

Here are the major eye topics that have been investigated:


One study, published in the journal Investigative Ophthalmology and Visual Science, showed that coffee consumption of more than 3 cups per day compared to abstinence from coffee drinking led to an increased risk for a specific type of Glaucoma called Pseudoexfoliation Glaucoma.

Another analysis of several existing studies by Li,M et al demonstrated a tendency to have an increase in eye pressure with caffeine ingestion only for people who were already diagnosed with Glaucoma or Ocular Hypertension, but no effect on people without the disease. A separate study, published by Dove Press, done with the administration of eye drops containing caffeine to 5 volunteers with either Glaucoma or Ocular Hypertension showed that there was no change in the eye pressure with the drops administered 3 times a day over the course of a week.

Summing up the available studies in terms of Glaucoma, the evidence points to maybe a slight increase in Glaucoma risk for people who consume more than 3 cups of coffee a day.

Retinal Disease

A study done at Cornell University showed that an ingredient in coffee called chlorogenic acid (CLA), which is 8 times more concentrated in coffee than caffeine, is a strong antioxidant that may be helpful in warding off degenerative retinal disease like Age Related Macular Degeneration.

The study was done in mice and showed that their retinas did not show oxidative damage when treated with nitric oxide, which creates oxidative stress and free radicals, if they were pretreated with CLA.

Dry Eyes

A study published in the journal Ophthalmology looked at the effect caffeine intake had on the volume of tears on the surface of the eye. In the study, subjects were given capsules with either placebo or caffeine and then had their tear meniscus height measured. The results showed that there was increased tear meniscus height in the participants who were given the caffeine capsules compared to placebo. Increased tear production, which occurred with caffeine, may indicate that coffee consumption may have a beneficial effect on Dry Eye symptoms.

Eyelid Twitching

For years eye doctors have been taught that one of the primary triggers for a feeling of twitching in your eyelid has been too much caffeine ingestion (along with stress, lack of sleep and dry eyes). I have been unable to find anything substantial in the literature to support this teaching. Therefore, I’m going to have to leave this one as maybe, maybe not.

The End Result

Overall, the evidence for the pros and cons of coffee consumption and its effects on your eyes appear to be rather neutral. There are one or two issues that may increase your risk for glaucoma but it also may decrease your risk of Macular Degeneration or Dry Eyes.

Since there is no overwhelming positive or negative, our recommendation is, and this holds for most things, enjoy your coffee in moderation.


Related links



Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided on this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

There are several different variations of Glaucoma, but in this article we will mainly focus on Primary Open Angle Glaucoma. This means that there is no specific underlying cause for the Glaucoma like inflammation, trauma or a severe cataract. It also means that the drainage angle where fluid is drained from the inside of the eye into the bloodstream is not narrow or closed.

Closed or Narrow Angle Glaucoma, which will be discussed in another article, is treated differently from Open Angle Glaucoma

In the U.S., Primary Open Angle Glaucoma (POAG) is by far the most common type of Glaucoma we treat.

Glaucoma is a disease where the Optic Nerve in the back of the eye deteriorates over time, and that deterioration has a relationship to the Intraocular Pressure (IOP).  Most - but not all - people diagnosed with Glaucoma have an elevated IOP.  Some people have fairly normal IOP’s but show the characteristic deterioration in the Optic Nerve. Regardless of whether or not the pressure was high initially, our primary treatment is to lower the IOP. We usually are looking to try to get the IOP down by about 25% from the pre-treatment levels.

The two mainstays of initial treatment for POAG in the U.S. are medications or laser treatments. There are other places in the world where Glaucoma is initially treated with surgery. However, while surgery can often lower the pressure to a greater degree than either medications or laser treatments, it comes with a higher rate of complications. Most U.S. eye doctors elect to go with the more conservative approach and utilize either medications - most often in the form of eye drops - or a laser treatment.


There are several different classes of medications used to treat Glaucoma.

The most common class used are the Prostaglandin Analogues or PGA’s.  The PGA’s available in the U.S. are Xalatan (latanaprost), Travatan (travapost), Lumigan (bimatoprost) and Zioptan (tafluprost).

PGA’s are most doctors’ first line of treatment because they generally lower the IOP better than the other classes; they are reasonably well tolerated by most people; and they are dosed just once a day, while most of the other drugs available have to be used multiple times a day.

The other classes of drugs include beta-blockers that are used once or twice a day; carbonic anhydrase inhibitors (CAI’s ), which come in either a drop or pill form and are used either twice or three times a day; alpha agonists that are used either twice or three times a day; and miotics, which are used three or four times a day. All of these other medications are typically used as either second-line or adjunctive treatment when the PGA’s are not successful in keeping the pressure down as single agents.

There are also several combination drops available in the U.S. that combine two of the second-line agents (Cosopt, Combigan, and Symbrinza).


The second option as initial treatment is a laser procedure.

The two most common laser treatments for Open Angle Glaucoma are Argon Laser Trabeculoplasty (ALT) or Selective Laser Trabeculoplasty (SLT).  These treatments try and get an area inside the eye called the Trabecular Meshwork - where fluid is drained from the inside of the eye into the venous system - to drain more efficiently.

These treatments tend to lower the pressure to about the same degree as the PGA’s do with over 80% of patients achieving a significant decrease in their eye pressure that lasts at least a year.  Both laser treatments can be repeated if the pressure begins to rise again in the future but the SLT works slightly better as a repeat procedure compared to the ALT.

Article contributed by Dr. Brian Wnorowski, M.D.

EyeMotion Animations

There are two basic types of astigmatism; myopia and hyperopia. These two types affect up to one third of the population and can be treated in a variety of ways from corrective lenses to surgery.

Myopia, or nearsightedness occurs when the eyeball is slightly longer than usual from front to back or the shape of the cornea is too steep. This causes the light entering the eye to come to a focus in front of the retina which results in a blurred distance vision.

Hyperopia, or farsightedness is the opposite of myopia. It occurs when the eyeball is slightly shorter than normal, or the shape of the cornea is too flat. This cause the light entering the eye to come to a focus behind the retina, which results in blurred near vision. Distance vision may also be blurred depending on the severity of hyperopia.

Presbyopia is an age related condition that effects your ability to focus clearly on near objects like printed text, computer screens and photographs. It primarily affects people over the age of 40 and is not a disease.

When light from a close object enters the eye it naturally comes to focus behind the retina. To focus the light properly the cilliary muscle around your lens contracts, which changes the shape of the lens, allowing the light to focus properly. With Presbyopia, your lens begins to gradually harden as you get older. This hardening of the lens does not allow it to change shape properly resulting in blurred vision.

There are a variety of ways to correct presbyopia including glasses, bifocals, trifocals or contact lenses. LASIK surgery or conductive keratoplasty, known as CK, are also options. Because Presbyopia is a gradual process you will need to consult your eyecare provider regularly to monitor the condition

Dry Eye Syndrome is characterized by itching, burning, gritty, red eyes. There are many causes for Dry Eye and, consequently there are many treatments.

Your tears serve many important functions. They wash out debris, keep your eyes moist and have special enzymes that neutralize microorganisms that colonize your eyes. Tears are made up of three layers, the lipid, aqueous and mucus layers. The lipid layer is the outer oily section, the aqueous layer is the watery middle part, and the mucus layer is the inner section closest to your cornea. The layers are produced by different glands in your eyelid and a problem with any of them can cause dry eye syndrome. If left untreated, dry eye can cause tissue damage and scarring of the cornea, leading to major vision problems.

There are many factors that can cause dry eyes. Age, certain medications, insufficient blinking, chemical composition of tears and environmental factors like sunlight, wind, dust and smoke. Dry Eye is also the number one complaint of people who wear contact lenses. With all of these potential causes there are also a variety of ways to treat dry eyes.

Artificial tears drops can help simulate tears in your eyes, reducing redness and clearing vision. Wearing sunglasses, cleaning furnace and air conditioning filters, avoiding smoke and using a humidifier can also help you reduce dryness. If you are having problems with a medication or if you wear contact lenses and are experiencing dry eyes, consult with your eye care provider to explore other options.

Because of the wide array of causes and solutions for dry eye, make sure to visit with your eye care provider to determine the best solution for you.

Fall brings a lot of fun, with Halloween bringing loads of it.

But did you know that some Halloween practices could harm your vision? Take Halloween contacts for instance. They are wildly fun with everything to monster eyes, goblin eyes, cat eyes, sci-fi or a glamour look. If properly fit by an eye care professional, they can be just the added touch you need for that perfect costume. However, some people do not realize that the FDA classifies contact lenses as a medical device that can alter cells of the eye and that damage can occur if they are not fit properly.

Infection, redness, corneal ulcers, hypoxia (lack of oxygen to the eye) and permanent blindness can occur if the proper fit is not ensured. Another concern that ICE, FTC, and FDA have are the illegal black market contacts that come into the country unchecked. Proper safety regulations are strictly adhered to by conventional contact lens companies to insure that the contact lenses are sterile and packaged properly and accurately.

Health concerns arise whenever black market, unregulated contacts come into the US market and are sold at flea markets, thrift shops, beauty shops, malls, convenient stores and the likes. These are sold without a prescribers prescription, and are illegal in the US. Buyer beware because these are the contacts that cause concern, after all, you don’t want to bargain shop on parachutes OR your eyes! There have also been reports of damage to eyes because Halloween Spook houses ask employees to share between shifts the same pair of Halloween contact lenses as they dress up for their costume.

So the take home message is, have a great time at Halloween, and enjoy the flare that decorative contacts can bring to your costume, but get them from a reputable venue and be fit by a eye care professional with a proper legal prescription. 


The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

Now that you have picked up your new pair of prescription eyeglasses, your focus becomes taking care of them. A task many disregard, it is absolutely imperative that you make sure you are following a couple simple steps to keep the quality of your vision where it is with your new spectacles.

We are all guilty of using a garment of clothing when in a rush to wipe away a pesky smudge on our glasses. This act is unfortunately the worst thing you can do for your lenses.

No matter how clean your clothes are, dust particles and even small bits of sand and debris cling to them. Since eyeglass lenses are not made of diamonds, these tiny little particles can do tremendous amounts of damage to your new lenses. The smallest little crumb can grind an inconspicuous scratch directly in your line of vision, which in turn can render your glasses almost useless.

Most of us know what it feels like trying to concentrate on the world in front of you when there is a little scratch distorting and distracting your vision. A majority of the time, these little scratches can be avoided by following a few simple steps.

You may have noticed when shopping in your favorite store that they sell a variety of eyeglass cleaners. You need to be careful because the sprays and wipes that you can purchase in retail stores are not necessarily approved for all types of eyeglass lens materials.

This factor makes them fall under that category of products that many eye care professions cannot recommend. Most of these liquids contain a form of acetone or other cleaning agent that is too harsh for plastic lenses. Many years ago, when all eyeglasses were actually made out of crown glass, these products would have worked just fine. Now, during a time where they have developed thinner, lighter materials like cr-39 plastic and polycarbonate, these products have proven to be too hard on the lenses.

Over time, the lenses will start to break down if exposed to the chemicals used in these sprays, causing a fogging effect. Once again, you are left with a pair of glasses that are now unable to be worn.

Now that we have gone over the two main culprits in the destruction of eyeglass lenses other than accidents, let’s focus on some tips to extend the lifetime of your glasses.

Most importantly, you should use an eyeglass case. For the large portion of patients who wear their glasses all day, it’s understandable how awkward it can be to carry a case around. But it’s nowhere near as frustrating as realizing the new pair of eyeglasses you just purchased are becoming scratched and ruined.

Also, you do not need to carry the case with you everywhere you go. Strategically leaving a case on a bedside table, in your car, or in a purse is the difference between “life or death” for your glasses.

This is also a simple way to clean your glasses that does not require you to purchase anything you probably don’t already have at home. Using lukewarm water at the sink, place a small, pea-sized dab of dish soap on your fingers. Gently rub the soap on both lenses from side to side, and then rinse with warm water. A disposable paper towel is recommended to dry the glasses.

Disposable towels work because they are just that, disposable - which guarantees they are not carrying dirt or sand from a prior use.

Taking care of your glasses today means you have them for clear vision tomorrow and into the future.


Article contributed by Richard Striffolino Jr.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

It is safe to say that many people prefer shopping online to shopping in stores for many of their needs.

With technology constantly improving and evolving, people tend to take advantage of the convenience of shopping online. Whether it’s clothing, electronics, or even food, you can easily find almost everything you need on the Internet.

Eyeglasses, unfortunately, are no different. Many online shops have been popping up in recent years, offering people that same convenience. But what they don’t tell you is that it comes at a price, and this article’s purpose is to shine a light on the negatives of shopping online for eyeglasses.

Here are some important reasons to avoid the temptation of ordering glasses online.

  1. Accuracy- Instead of saving the most important point for last, we will focus on the main reason that ordering eyeglass online is a bad idea first. Product accuracy is a huge reason that the online market has not completely taken off. Every person who needs eyeglasses needs to understand the process for how their prescription is obtained in order to truly understand why shopping online is a bad idea. It is called an eyeglass prescription for a reason. Your ophthalmologist or optometrist is prescribing your lenses as if they were prescribing any form of medication. To take that prescription and hand it over to a website that does not require licensed workers to interpret the prescription is not the wisest choice. Equally as important as the prescription itself are the pupillary distance (PD) measurement, and the optical centers. These measurements are not given at the time of the examination by the ophthalmologist or optometrist, but instead are administered by the optician at the point of sale. Not having these measurements done accurately will negatively affect the quality of vision as much as an error in the prescription.
  2. Quality- Similar to the accuracy of the lens, the quality of the product you are purchasing is affected when making the decision to purchase online. The saying “too good to be true” is the case more times than not, and this purchase is no exception. When you see enticing advertisements for pricing that seems to be too good, there is a reason. This product is often not inspected or handled by a state-licensed optician. These websites rely on mass production in order to operate. Factory workers operating machines pale in comparison to the experience you will receive in a professional office. Skilled opticians licensed to interpret and manufacture your eyeglass prescriptions and are held to a much higher standard than factory workers.
  3. Warranty- Due to their low prices, most of these websites do not include any form of product warranty or guarantee. Opticians, however, stand behind your purchase. If there are issues with adjustment or a patient not being comfortable in a specific lens or product, professional opticians are willing to work with you. This personal experience is not attainable on the web.
  4. Coordination with your doctor- With the complexity of eyeglass lenses, the ease of working in house is always a benefit worth keeping in mind. Eyeglass lenses can be very complex products. Having the benefit of being able to work directly with the doctor gives the optician the best chance to put you in the exact lenses you need. There is a substantial difference in the percentage of error between shopping online and the care you get in a private practice.
  5. Personal Experience- Probably the most important factor for many people, the personal experience you get when shopping in person is something you cannot obtain by using the Internet. Dealing with the same opticians year in and out is something patients emphasize and appreciate. Just like people tend to keep the same doctors over the years, patients like knowing that the same people will be in charge of making their glasses. Shopping online will not offer that experience.

All of these factors should be carefully weighed when making the decision to shop online. While the initial price difference could entice you at first, know that it does come at a price. Whether it be a warranty, quality, or convenience all of these are very important factors when buying glasses. People sometimes tend to discount how intricate eyeglasses are.

Purchasing eyeglasses is handled best in person by professionals who can provide you with the utmost care and quality.


Article contributed by Richard Striffolino Jr.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

Choosing a new pair of eyeglasses can be a daunting task.

Making a decision on what style glasses you will be wearing for the next year until your vision is checked again can be stressful. This is one of the many reasons opticians are here for you. In many ways, this may be the most important task for the optician, because keeping you happy motivates you to wear your glasses daily.

Most people’s reaction is to play it safe with new glasses and stick with something relatively similar to what they are currently wearing.

While not necessarily a bad decision, this isn’t something opticians try to promote. Opticians often spend time meeting with frame representatives and browsing the Internet to keep up with the ever-changing trends in the world of eyeglass frames. And it’s a great feeling to successfully “update” your image with a new set of frames. Many patients are amazed at the difference a well-fit and -styled pair of glasses makes on their overall look.

There are many simple tips and tricks to consider when starting to browse for your next pair of frames.

The goal of this article is to improve your starting point when beginning to choose frames. That way, once the optician gets involved, the process is already well under way. Keep in mind that these are guidelines and “outside the box” thinking can be good as long as it fits within the required parameters of your prescription.

The first step is successfully identifying what face shape category you seem to fit into.

This image shows the most common face-shape categories. These are a great guidelines to help decide which frames will most likely appear to fit the best.

Oval - Oval faces are considered to be the “most versatile” because most frame styles and sizes fit well on this face type. As a general rule, and especially for oval faces, avoid choosing frames that extend past the widest part of your face. Stick with moderate-sized frames.

Upside Down Triangle - To even out the proportions of this face shape, choosing semi-rimless frames is always a positive. Less attention to the bottom half of the frame helps enhance the natural curves of this face shape. Frames that stay wide at the bottom and do not taper inward will also help even out this face.

Oblong - Being longer than it is wide, this face shape enjoys having larger frames on it. A lower bridge will help shorten the nose, and solid dark colors are a positive as well.

Square - A strong jaw line is the focus of this face shape, so to work with that, choosing smaller, narrow frames is a positive. Ovals and rounds work better than squares.

Diamond - Broad cheekbones are the focal point of this face shape. Being quite rare, the best style of frames to put on these faces are in the cat eye family. Following the face’s contours, flare-top frames, semi-rimless frames, and fun colors tend to work well with this shape.

Round - Rectangular frames work best on round faces. Wide bridges help separate the eyes and bring symmetry to the face. Make sure the frames are wider than they are deep.

Triangle - Cat eye frames work exceptionally well with this face shape also. Frames that have a lot of style and accents to the upper part of the frames and temples are a plus as this brings attention to the naturally narrow forehead.

Along with shapes and styles, some believe that certain colors work best with certain faces.

All people are considered to have either cool (blue) or warm (yellow) skin tones. Some people feel customers should stick within their family of coloring. Again this is only a recommendation since you should wear what you like. This is just strictly a guideline for those struggling to choose a frame for themselves. Based on experience, eye color can make a difference as well. People with lighter eyes tend to prefer lighter frame colors, and vice versa for people with darker eyes. Also, hair color can be considered. Patients with lighter or grey hair tend to shy away from darker frames unless looking to make a statement.

At the end of the day you have to choose what is most comfortable for you. Opticians’ suggestions and educated opinions can help steer you in the right direction. There is much to consider, but always keep in mind that comfort and functionality are the priorities.

Some people believe plastic or zyl frames are more comfortable than metal or semi-rimless. Having nose pads, metal frames feel “heavy” to some. Others cannot wear plastic due to oily skin. Plastic frames may slide as the day progresses so metal may be better suited.

Don’t be overwhelmed. Follow some simple guidelines, and remember to enjoy the process. There are infinite styles and options to get you seeing well and looking great. And while you’re considering lenses for your regular lenses, don’t forget to look for sunglasses frames!


Article contributed by Richard Striffolino Jr.

This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.

Oftentimes, contact lens wearers will skimp on their lens care because some of the solutions are costly and it seems like a good way to save some hard-earned cash. This is not a good idea.

Cutting corners can result in infections or irritations, and after one or two copays to your ophthalmologist or optometrist office you will probably spend more than what you saved in a year by cutting corners, plus your discomfort and inability to wear your contact lenses while you are being treated.

The reasons you clean your contacts is to give increased lens comfort, prolong lens oxygen permeability, and to protect your eyes from infection. The reason you have to disinfect your contact lenses is - as nasty as it may sound - your eyeball and eyelids are covered in essential bacteria that are kept in check by your body’s immune system. When you remove your contact lens at night it is covered in these essential bacteria. If you don't kill them overnight this will allow the bacteria to grow unchecked and then, instead of inserting a freshly cleaned lens, you are inserting a lens covered in more bacteria than your eye is used to and you end up getting an infection.

Let’s talk about the most widely used type of solution - the multipurpose solution. While this is often the most incorrectly used solution, multipurpose solutions are a very safe and effective disinfection method when used properly.

Many multipurpose solutions advertise themselves as “No Rub.” Just put it in the case and you are done. This is OK to do, but a quick rub with the no-rub solution in the palm of your hand and the opposite hand’s middle or ring finger provide and even better cleaning option. Just the slight roughness of your fingerprint adds a light scrubbing effect that helps improve the removal of surface debris, protein and mucous better than just letting the lens soak overnight. This rubbing of the lens is especially important for women to remove any cosmetics that are rarely removed by just soaking alone. This few seconds of extra cleaning will make your lenses stay more comfortable longer during their wearing cycle, and help to keep the pores of the lenses open, allowing more oxygen to contact your cornea to keep them healthier for your eyes.

Many name brands and store/warehouse brands of multipurpose solutions exist. All are FDA approved to do the same thing: clean/disinfect/rinse/store your contact lenses. You can't really mess them up unless you try. Remove the lenses, lightly rub them with the multipurpose solution, place your lens into a CLEAN and DRY lens case, and cover the lens with solution to disinfect it. Then let it sit for the amount of hours recommended by the manufacturer, generally between 4 to 8 hours, or overnight. Remove the lenses in the morning, rinse with the same multipurpose solution and rinse the lens case out and leave it open to air dry in an area away from your sink and toilet to prevent airborne contaminants from getting into your case as it dries.

The biggest misuse of the multipurpose solution is not changing your case’s solution nightly and just adding more solution to the case each night. We call this “topping off the case.” This is NOT safe because it will lose disinfection power since the old/used solution was busy killing the bacteria and organisms from the night before. Just adding a little fresh solution will eventually allow for the bacteria to take over and you may be adding more bacteria into your eyes than if you never disinfected the lenses to begin with.

Multipurpose solution companies oftentimes will give you a new case when you buy bigger bottles of solution. This is meant for you to START with the NEW CASE with the NEW BOTTLE of solution. Not to stash the case away and have a drawer full of new cases. There are fungi and other organisms that have been demonstrated to grow from very old lens cases so USE the new case and don't keep it for when you break the old one.

There are many different multipurpose solutions on the market. They aren't cheap and it is tempting to purchase “what is on sale” to save a few dollars. If it does the same thing as the expensive one, then why bother spending the extra? But remember, your contacts are like little sponges that soak up your lens solution. The lens companies don't care if brand A’s solution is compatible with brand B’s or C’s. So over time you can develop a sensitivity to one particular brand of solution, or mixing solutions with the same lens can cause a chemical reaction that occurs because the solutions are not compatible. If you are using the same brand regularly and start having issues your doctor may recommend a solution change to another company that you haven't tried and this may potentially solve your problem. But if you have used several different ones in a few weeks prior to your visit it makes it much harder to determine the cause of your irritation.

The generic/store brands are fine products but a grocery store or discount chain doesn’t have a factory that makes their solution for them; they purchase it from a larger supplier. These third-party suppliers can alter their recipe for their multipurpose lens solution and you as the consumer never know. You could just start finding your contacts are not as comfortable as they used to be and it is actually the unknown generic solution change that is bothering you. Brand name companies like Bausch and Lomb, AMO, and Alcon will rarely make product changes without making consumers aware that they've reformulated the product so if something changes with the reformulated product you have a better chance of knowing it than with a generic solution manufacturer.

Finally, there is a product called saline solution. Saline is extremely inexpensive, generally half to a third the price of multipurpose solutions. This is a product made by many different companies and was the first lens solution ever used. Saline solution was initially used in a heat disinfection system where the lenses were boiled nightly. The boiling of the lens provided the disinfection, not the saline solution. The solution was to just to prevent the lens from drying out while you cooked it. You should NEVER use saline solution as a replacement for multipurpose solution. Saline solution is NOT a disinfectant for your lenses. It doesn’t contain an agent that will prevent bacteria and organisms from growing in the case overnight and potentially can set you up for infections. However, it’s totally acceptable if you want to rinse your lenses in the morning with saline prior to inserting them after they were disinfected with your multipurpose.

Oftentimes, a practitioner will recommend a certain type of solution to help with things like dryness, environmental allergy-sensitive patients, or patients who are allergic to multipurpose solutions. I always recommend to check with your practitioner before making any changes to your lens care solution or lens care routine. The best advice for saving money on your preferred solution is buy extra when it is on sale, buy in bulk, and buy what is most comfortable in a multipurpose solution for you. Then stick with it and use it correctly for many years of happy lens wear.

More middle-aged and older adults are wearing soft contacts than ever.

And one of the biggest reasons they decrease or stop wearing contacts is the difficulty they face reading with their contacts after presbyopia begins to set in around the early 40’s.

Presbyopia is the diminished ability of the natural lens in our eyes to focus up close on near objects. It begins with the occasional medicine bottle being a struggle to read to eventually even having a meal is blurred. As I am going through this problem myself, it is very frustrating to stare at something up close and have it be blurry regardless of what I do.

So there are three basic choices a contact lens wearer can do to aid their reading while still wearing contact lenses.

Reading Glasses

Initially, the use of an over-the-counter reader or prescription reading glass for occasional use works well for people in the early stages of presbyopia. They are worn over distance contact lenses so there is little adjustment and vision is clear near and far. However, they need to be with you, not left in the car or at work, and oftentimes people end up just wearing readers all day since it is just that much clearer.


This fitting technique can be used with any type of contact lens. The brand of lenses you are currently wearing can often be used to fit you with monovision. Your dominant eye is determined. Then the non-dominant eye prescription is adjusted to compensate to make it a reading contact lens. So once fitted you have one eye for distance and the other for reading. Yes, it sounds really crazy, but it actually works quite well. Your brain initially has to adjust to using each eye individually to obtain the sharpest vision, but once this is achieved, year-to-year adjustments can be made to the reading eye to allow comfortable distance and reading vision for many years.

Monovision fits are not always successful. Some people just cannot adjust to it regardless of motivation or desire. It seems to work best when someone has had some difficulty with reading and they are noticing more and more that they need their readers. At that point, they can appreciate the ability to read and their brain seems to adapt more readily. When I wear my contacts this is the option I have used for myself.

Multifocal Contacts

Another option is multifocal contact lenses. Most every major manufacturer of soft contact lenses has some type of disposable multifocal lens available. They do not work like multifocal glasses. They use a technique called simultaneous viewing where you are actually looking through all the powers at once.

To visualize this, imagine a vinyl record with the label in the center and the various tracks extending outward. Most of the lenses are made with the strongest reading power located in the center where the label would be, then each ring further out gradually becomes weaker until you reach your full distance power. So essentially you are looking “around” the reading part for distance then through the center for reading. It works, sort of.

Multifocal lenses work better on younger patients, say 40-50 years old, for help with reading. There is no adaptation period to these lenses like monovision. What you see is what you get. But if you have any significant amount of astigmatism or if you wear a toric contact that corrects for astigmatism, multifocal lenses are not for you. And because the reading is central in the lens, if you make it too strong for reading then you blur the distance vision too much, so oftentimes a multifocal lens wearer after age 50 faces a dilemma to either wear reading glasses to boost their reading needs or change to monovision.


In conclusion, while none of the options are perfect they all may present some level of relief in your quest to continue to wear contacts into middle age, retirement and beyond. But some options may better serve you at a certain point in your life or career than others. So while you happily wore contacts from your teens into your 40’s, just because you’re another year older is no reason to give them up. Talk to your ophthalmologist or optometrist to see what choices are best for you.


Article contributed by Eugene Schoener O.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

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