New Way to Reach EyePlace

Our new phone system is tele-medicine ready. You can still talk to a person by dialing the our main number( 248-332-0200) but you can send text messages to the same number with images and files. If you have simple questions try our new phone system by sending your questions with images. Depends on the urgency, you might get the answers even after ours.

Are There Comfortable Keratoconus Lenses ??

“ I can’t wait to take the lenses out of my eyes as soon as I get home” or “ My eye hurts when I take the lenses out. ” are the common complaints we hear from the current keratoconus patients. Good fitting keratoconus lenses can be reasonably comfortable while providing vision we needed.

I am sure you heard of ” we are trading in comfort for the vision.” That is still somewhat true but not as much as before thanks to newer types of lenses. For example, Kerasoft lenses are as comfortable as common weekly disposable soft contact lenses but as clear as small hard lenses ( RGP). We are big fan of using Kerasoft lenses for mild to moderate conditions. Even many advanced keratoconus can be fitted successfully with large diameter RGP scleral lenses to improve comfort and vision. The hybrid lenses ( RGP centered soft lenses) such as Synergeyes Lenses can be very comfortable long term solution when fitted correctly with proper movement of lenses with each blinking of eyes. Even small diameter RGP lenses can be reasonably comfortable if it rests on broader area of cornea with good centration.

We have been diligently expanding our portfolio of keratoconus contact lens offerings. We fit our patients with brand names like, Kerasoft, Normal eyes Scleral lenses, Synergeyes, Rose -K and custom RGP lenses and soft/ hard (RGP) piggy back lenses.

RGP Recommended Solution, Unique PH, Progent, Lacripure, Web Store Link

Menicon America Web Store Link for Recommended RGP, CRT Lenses, Scleral Lenses, Rose K lenses

We recommend all of our patients to use Unique PH because of ease of rubbing and rinsing. Unique PH is much less viscus before it goes into eyes. Reduced viscosity helps to clean lenses and rinse with ease. We also recommend most of our patient to use Progent RGP cleaners to give a lenses turbo clean to dissolve all nonsenses on them. Lacripure is recommend to rinse and fill up the large diameter lenses ( Scleral lenses) be fore insertion to reduce chemically induced lens intolerance.

Here is MeniconAmerica.com web site. Starter code  for the web site is  [  004 682 C  ].

Unisol 4 Replacements, Preservative Free Saline Alternatives for Kearatoconus Patients.

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Great Replacement Salines for Unisol 4 Users!

The preservative free Unisol 4 was great saline solution for dry eyes and keratoconus patients. The preservatives that keeps most bottled solution from contamination are known irritants for people with dry eyes and keratoconus. Ever since Unisol  4  stopped production, we have been looking for replacement that performs as good as  Unisol 4.

Unisol 4 replacement
LacriPure, Preservative free contact lens solution

Menicon America, one of major player in rigid gas permeable (RGP) contact lens manufacturer and maker of Unique Ph RGP solutions introduced Lacripure preservative free single dose packs.

FDA Approved Unisol 4 replacements

Unisol 4 was great non preserved saline solution to rinse and fill the contact lenses before insertion into eyes. Purilens solution was first product to fill the void but it was hard to get more information on product and manufacturer. Lacripure saline solution was introduced by Menicon America soon after. Because we are big fan of Unique PH RGP solution and Progent protein deposit remover, we are biased toward to Lacripure Salines.

How Lacripure and Purilens are Packaged?

Purilens comes in 4 pack 4 oz bottles ( 16 oz) and Lacripure comes in 98 pack of 0.17oz unit-dose(16.6oz).  Once it is opened, Purilens bottle expires in 15 days. Any multi dose bottles have contamination risk and need special care to keep the tips of bottles from touching any objects.  Lacripure is 0.17oz unit dose  vile ( use once and discard) and has close to no contamination risk.   Most of large diameter keratoconus lens  and Prosthesis user are strongly recommend unit dose package to reduce risk of infection.

Where Can You Buy Lacripure or Purilens?

Menicon sells their product directly from their web site. Before you knocking on Menicon website you need a code < 004 682 C > to access their consumer site. Purilens are sold on their web site as well.

Comfortable Keratoconus Contact Lenses -Is it Possible?

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Can I Get Fitted for Comfortable Keratoconus Contact Lenses??

Keratoconus requires some form of hard(rigid) contact lenses to improve vision beyond what a pair of eyeglasses can provide.  The most frequent  complaints of keratoconus patients are ”  lenses are uncomfortable and hard to wear long enough hours to cover a typical day”.  All the keratoconic contact lenses – custom soft, RGP ( Rose K etc.), hybrid , scleral- have inherent comfort level characteristics but all can be reasonably comfortable if it is matched correctly.

What kind of Contact Lens Options are available?

Except eyeglasses and general soft contact lenses, there are more than few options are available for keratoconus. Custom made keratoconus soft lenses, Rigid Gas Permeable(RGP, ie Rose-K..)  lenses, Hybrid ( Synergeyes.. etc.) lenses, custom soft contact lenses ( Kerasoft..etc)  and Scleral ( Normal Eyes..  etc) are major groups of lenses that are commonly used for keratoconus fitting.

What are the differences of the lenses?

Here are my takes on the lenses;
1) Soft Lenses for Keratoconus :- very comfortable, fairly clear vision, great for early to moderate cases.
2) RGP lenses for Keratoconus( Rose K etc..): Very clear vision, not too comfortable, easy to use, great for most cases.
3) Hybrid lenses( Synergeye..etc) : Good clear Vision, Comfortable, somewhat difficult to use.
4) Scleral lenses( Normal Eyes, Rose K XL..etc): Good clear vision, great for advanced cases, relatively comfortable, somewhat difficult to use.

Which lens is the best for me?

There are no one lens that is the best for the every cases. The type of lenses should be  determined by condition of cornea and desired comfort level and easy of use. You should have a discussion with a contact lens specialist about your condition and pros and cons of your options. In our practice, we have many happy patients with different lens types. Some lenses may require more work than others to achieve desired comfort level and vision.

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Reading Problem Can be Eye Problem!

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20/20 Vision….No Eye Problem…Right??

My kid has no eye problem. He has 20/20 vision but he does not like to read just like his dad. Are you sure he has NO EYE problem? 20/20 only means that an eye can focus small letter at 20 feet away. A kid with even moderate farsightedness can get 20/20 easily depends on age. But surely he will have some reading issues if he has farsightedness.

Anything Else Affects Reading??

Misalignments of the eyes can create reading problems even with perfect 20/20 vision. Reading needs good focus and good tracking skills. Focusing and tracking (following the sentences) should be automatic like walking so we can look around while strolling neighbors. If you have misalignment, it can be difficult to follow the sentences when you read. Your mind can be preoccupied with following the line as a result little attention is left for meaning of sentences. You went through paragraph but you are not sure of what the paragraph is saying. So you re-read.

I was tolled my kids need glasses but has healthy eyes…

Routine eye exam is focused on finding vision corrections and health of eyes. It may not provide enough information to rule out such as misalignment related issues. Misalignment related issues can be determined by binocular vision exam. A through binocular vision exam can pinpoint out source and extent of problems including misalignments. A detailed binocular vision exam can take more than an hour in some instances.

Can it be fixed??

Depends on type of binocular vision problems, we use different type of treatments. The fix can be as simple as a pair of glasses. Some cases might need vision therapy ( eye muscle exercise). Few cases even need a surgery to lessen the misalignment.

After 13 Years, Our Approach to Myopia Control

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Myopia Tsunami That Started in 2000….

I practiced optometry for 10 years in Port Huron, Michigan since my graduation from the Michigan College of Optometry in 1993. In this small town, I examined  few kids and lot more adults in any typical given day.  When I opened up my practice in here, Metro Detroit,  in 2003, that picture changed. I saw proportionality of kids with myopia jumped some what.  In early 2000, the surveys from Asian countries showing their myopic kids population were increasing substantially.

Who is to blame???

Even if every one saw increasing number of myopic kids, no one was pointing finger at electronics and books but the “genes” . If gene was only thing to blame then it must be mutating because , as you know, population as whole is becoming more myopic in every country. Still, even today some doctors think that gene is only cause for the myopia!

What Happens when eye worsens??

If you are looking for scientific explanation, here is the link.  Simply put, when eyes get tired from too much near work,  focus of retina goes back of retina and that makes eyes grow longer. As an eye ball gets longer, myopia worsens.

What Should We Do??

Back in old days, my parent let me roam with my friends out side all day until dark. Incidentally, I am much less nearsighted than my studious younger relatives!  Big study from UK concluded ” Kids who spent more outdoor activity had later onset of myopia and had less progression”.  Ya~, it ‘s no brainer when you are out playing soccer it is hard to play iPhone games. It is easy to say to limit the near work. But in this hyper competitive world, it is impossible to limit the near work.

What other Options are there?

The primary goal of myopia control is putting the image of eye in front of retina. There are many ways to achieve that goal but hard to sustain every day. After 13 years of providing myopia control, we became more practical.

Here are my list ( least to most effective in order):
1)#4: Bifocal glasses– all  lined or no line bifocal eyeglasses- Not much effective, Blurry Dizzy, hard to get used( ask 50yr old uncle Jack about his)
2)#3: Bifocal/multifocal Soft Contacts-daytime wear ( good luck putting that thing in the busy school morning)- Better result than glasses.
3)#2: Bifocal/multifocal Hard(RGP) contacts– more flexible on astigmatism. Easy on & off, clear vision but least comfortable.
4)#1: CRT(ortho keratology)– Wear at night only, best preventive effect, good daytime vision, easy to put in & out on even uncooperative young kids.
I do not recommend Atropine related eye drops because unknown long term side effect on young kids.

Conclusion…

Myopia control is not one dimensional process. Kids need to spend less time on books and electronic screens. Parents,  try to get the CRT(Ortho-K (night contact lenses)) for your kids  if it’s possible. The less effective soft bifocal (multifocal) contact lenses can be a substitute  if CRT is not possible. The least effective bifocal eyeglasses can be the last option if every thing else fails.

And, Moms !  Don’t sign up too many lessons. Here is what my patients are saying.

Premium Eyeglass Lenses- Are they worth the Money?

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Premium Lenses- What are they?

Back in 80’s, lenses were simple. They were single vision or bifocals without much of “premium” distinctions.  Then competition and technology brought many  premium brands and generic eyeglass lenses to the market.

Most of today’s lenses are much better quality then 20 years ago. But quality of lenses are not all the same as you might suspected. As a Canon pro series camera lens is much  more expensive than a generic  lens from a supermarket, same kind parallelism exist in eyeglass lenses. The brands such as Varilux, Zeiss and Hoya  are the top tier brands in eyeglass field. Especially Varilux brand now owned by Essilor  was the original brand that invented “No line bifocals”  lens category in 80’s. The Varilux S 4D lenses are top dog in the field at this moment. Zeiss and Hoya are right behind in this horse race of lenses.

Why Premium Lens?

People who are in lens business knows there are no such thing as perfect lenses. Because of this limitation, there are better lenses and worse lenses. The diminishing return on investment curve exist in any lenses in the market. As a novice accidental photographer, I took equally bad pictures with my Canon or iPhone. But I know that with my Canon with expensive lenses, I will have better chance of taking higher quality pictures. With my top Varilux lenses , I will have better chances of seeing as nature intended.

But it Cost a lot..

Today’s top lenses are made based on each individuals prescription, facial and dynamic measurements. Generalization (Bell Curve-rization)  in manufacturing process reduces cost of manufacturing and inventory. Top quality lenses are not premanufactured as lesser quality ones. Some lenses are completely made from a raw block of lens material.  While some are half way premanufactured to just add prescription on unfinished bottom half.  And some are completely premaufactured to trim into patients’ frames.  As you can imagine, price of lenses are directly correlated with how much custom manufacturing has to be done to the lenses.

What Should I choose?

As old saying goes” you get what you pay for” and it applies to eyeglasses too. We recommend to all my patients the best lenses that industry can offer. We start with top Varilux S 4D lenses then new Varilux family of lenses for our patients.  Most of people take our advice or closer to our top recommendations. As a result, we have very few complaint about lenses compare to the industry standard.

New to EyePlace State Optical and Kawasaki Eyewear

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We just added State Optical and Kawasaki eyewear to our collections. State Optical frames are hand made in Chicago USA . If you are looking for a eyeglasses that is original yet add sophistication to your look , please try State Optical collections.

Kazuo Kawasaki eyewears are designed for the minimalists in mind. It is simple but elegant and clean but resilient. Kazuo Kawasaki frames are must tries for the Rimless enthusiast.