Acuvue Releases New Daily Disposable Contact Lens That Is A Perfect Match For Teenagers

Acuvue has released a new soft contact lens referred to as Acuvue TruEyes. This lens is a perfect match for kids and teens who are just starting contact lens wear, and teenagers who have problems keeping up with contact lens cleaning and disinfecting regimens.

The Acuvue TruEyes Contact Lens Combines The Healthy Eye Properties Of Daily Disposable Contact Lenses With The High Oxygen Permeability of Silicone Hydrogel Soft Contact Lens Materials Ideal For Low Humidity Climate Like Northern Colorado

Daily disposable contact lenses have long been a favored choice for children and teenagers first starting to wear contact lenses. By starting with a fresh new contact lens every day, there is no concern about improper disinfection of the lenses. Daily disposable contact lenses do not suffer from buildup of deposits on the lens surface that can cause eye infections, allergic reactions, and other vision problems. Unfortunately , some teenagers actually leave these contact lenses in for extended periods of time and often end up sleeping with their contact lenses on -they have been known to leave in the same pair of lenses as long as wearing the same clothes! The Acuvue TruEye contact lens is made of a material called Narafilcon A.  Narafilcon A is a silicone hydrogel contact lens material, or falls in the category commonly referred to as SiHy contact lenses. SiHy lenses currently account for over half of the new contact lenses being fit today. Hydrogel is the soft contact lens that has been widely used for years, he addition of silicone greatly increases the permeability of the contact lens to oxygen.  The permeability measures 100 which is almost 400% higher than the Acuvue 2 lens which measures at 28. At a level of 28, when the lens is left in overnight the clear corneal tissue underneath the contact lens almost doubles in the amount of swelling that would normally occur at night. The Acuvue TruEye transmits enough oxygen through the contact lens that corneal selling is negligible in a clean lens. (As lenses age they develop coatings from deposits that reduce the permeability).

Increased Contact Lens Permeability Solves A Serious Dilemma in Teenager Contact Lens Wear

The dilemma has always been between lowering the risk of infection by eliminating improper contact lens care and disinfection versus having a higher margin of safety for non prescribed overnight wear of lenses. We have had daily disposable contact lenses for a number of years and silicone hydrogel contact lenses in 2 to 4 week disposable contact lenses for several years but not both on one lens. The TruEyes contact lens now offers that option, and is a welcome addition for young contact lens wearers. It also is a nice option for adults who wear contact lenses occasionally and don’t want the hassle of maintenance and cleaning and may prefer to leave them in after a long day or extended flight.

Other Properties of the Acuvue TruEyes Contact Lens

The TruEyes contact lens is 46% water and has a benzotriazol ultraviolet absorbing agent in the lens to help protect the eye. The FDA does not consider this adequate UV eye protection but it does help, and should be considered as a preventative measure for children in terms of lifetime UV exposure  for cataracts and macular degeneration risk. The TruEye contact lens blocks over 99% of the  UVB radiation (280-315 nanometers) and over 90% of the UVA radiation (316-380 nanometers). It has a lite blue handling tint to make the lens easier to see from the addition of Reactive Blue Dye #4.

Increased wetting and contact lens comfort is achieved by adding Polyvinylpyrrolidone (PVP) to the lens material. The Acuvue Advance and Acuvue Oasys contact lenses have utilized PVP to improve the comfort of the lenses.  PPV absorbs up to 40% of its weight in water and helps retain it in the lens. Not only does this contribute to a lens that stays wetter, it also presents a smoother surface to the eyelids when they slide across the lens surface with blinking.  This is presumably related to the lowest reported lubricity value among the silicone hydrogel materials. Lubricity is the measure of the reduction in friction between two different materials and a wetting agent in between (in this case the tears). Presumably the PPV alters the surface of the contact lens and allows less friction to be transmitted from the eyelids to lens surface, and from the posterior lens surface to the cornea tissue underneath the contact lens. This reduction in friction translates to an increase in comfort. The PPV in conjunction with the silicone hydrogel material is referred to as Hydraclear Plus. The Plus part is an increase in the amount of PPV incorporated into the contact lens material. The Acuvue TruEyes contact lens also has a lower modulus of elasticity at  0.66 compared to other silicone hydrogel lenses that run 1.0 and above. The modulus of elasticity is the lenses tendency to be deformed elastically or not permanently when force is applied. A lower modulus means the contact lens is less stiff or rigid, and tends to drape more assuming the shape of the eye instead of retuning to its original shape. Usually a lower modulus is more comfortable. However, there is some evidence that a higher modulus may slow prescription changes in children.

This is a welcome addition to our contact lens armamentarium, especially for the pre-teen and teenager contact lens market. Fortunately, this lens  already has a track record in Europe where it has been available for several years. For the dry eye contact lens patient in Fort Collins it is another option to help by combining a fresh wetting clean lens surface every day with an optimized wetting contact lens material.

A swollen, yellowish raised area on the white of the eye located towards the outside can be very alarming when first noted on a child’s eye. Demolipoma is a congenital condition present at birth. It is a benign growth of normal tissue in a place they are not usually found. The area is not tender or red, and typically grows very slowly or is stable. It may show a growth spurt in adolescence. After diagnosis, it is normally managed conservatively by observation. Vision may be mildly effected in some cases by the development of astigmatism. To prevent amblyopia (lazy eye), vision should be checked on an annual basis. While a dermolipoma can be surgically removed, multiple complications can occur. Dry eyes from damage to the lacrimal gland, double vision from damage to the lateral rectus eye muscle, droopy eyelids from eye nerve damage, are a few of the possible complications. Since surgery is for cosmetic concerns and not for visual problems, it is normally not performed. If the eye appearance very disturbing to the child, surgery may be considered. It is important to find a well qualified oculoplastic surgeon. This is an  ophthalmologist who is also a facial surgeon and ideally a fellow of the American Society of Ophthalmic Plastic and Reconstructive Surgery. If surgery is chosen as an option, it requires an eye physician that is very careful and does minimal removal of tissue to prevent complications.

Occasionally, dermolipoma can occur in conjunction Goldenhar syndrome where one side of the face may have incomplete development of the ear, nose. lips, and jaw. Other organs in the body may be effected. This is apparent from facial appearance at an early age so there is not a concern about it developing after dermolipoma is diagnosed. Since serious conditions can appear similiar, the most important part of managing a dermolipoma is an accurate initial diagnosis.

The eyes have been referred to the gateway to the soul. Sometimes they are reflective of psychological problems such as physical and sexual abuse or post traumatic stress syndrome.

Your eyes have two different mechanisms of tracking moving objects. The first type are referred to as pursuit eye movements and are used to track an object moving at slower speeds. These are steady movements that keep up with the moving objects speed. When watching a baseball game you would probably be using pursuit movements most of the time. When the speed becomes to fast the pursuits can’t keep up and saccadic eye movements occur. These are some of the fastest movements our bodies are capable of and resemble a jump of the eyes from one object to another, or in the case of a fast moving object may be used to catch the eyes up when the pursuit eye movements fall behind. Both eye movements are extremely complex, with latency periods before starting and in the case of saccadic eye movements there is some suppression of vision to prevent a visual blurring effect.

In Schizophrenia, it has been thought for a number of years that abnormal pursuit eye movements may be genetically related. Some studies have shown pursuit eye movements may be abnormal in children who have been victims of physical or sexual abuse. (HJ, Green MJ, Marsh PJ). This may indicate environmental causes instead of genetic.

Pupil dilation is generally interpreted as a sign of interest, arousal, fear, pain or anything that results in an increase in vigilance to the environment, due to stimulation from the sympathetic part of our nervous system. The response of the pupil to constrict is inhibited during these situations, further making the dilation response more marked. This is the system that is activated when the so called fight or flight response is elicited by something in the environment. In the past that was considered the appropriate response to a saber tooth tiger about to have you for dinner. Today, many researchers are adding a third category of freeze, where an animal or person freezes in place as if to remain hidden and unnoticed from any threat. The amygdala, a small area of the brain that responds to primitive emotions, has been shown to result in pupil dilation when stimulated. A study by Demos, K E (KE); Kelley, W M (WM); Ryan, S L (SL); Davis, F C (FC); Whalen, P J (PJ); also provided evidence that if you view dilated pupils it stimulates your amygdala.

Children who have been abused have over stimulation of the amygdala that often becomes a permanent state and often live in a state of hypervigilence. As a result of living in an unpredictable environment that is often harmful they need to be constantly alert for signs of danger. Some characteristic vision behaviors are often seen.

Eye movements frequently appear darting and saccadic movements are more common. Presumably this is constant scanning of the environment for danger in preparation for fight or flight from the danger. This could be the cause of poor perceived pursuits eye movements or result in a lack of their proper development. Sometimes the freeze response, or being completely still with few eye movements, results in a frozen eye posture. This occurs in an attempt to remain hidden similar to the behavior a deer or rabbit can exhibit when approached. Pupillary dilation is also seen as fear and arousal are at a high level. Dilation of the pupils allows greater activation of peripheral vision and detection of motion. This is a function of the magnocellular visual pathway. Although only about ten percent of the nerve fibers of the eye are in this pathway, it passes information very rapidly and allows a rapid response to approaching threat changes in the environment. Detailed visual information is passed though a slower pathway. Sometimes victims of abuse will use a direct staring behavior as an aggressive challenge to try and ward of an attack. This is the opposite of the freeze behavior when there is an avoidance of eye contact. Often this avoidance of eye contact becomes a habitual behavior seen most of the time. It can be misinterpreted as deceitful or lying when in fact it as an learned behavior from the past to avoid harm. Pupil constriction increases depth of field and may clear central focus at the cost of peripheral awareness. It is often interpreted as a sign of disinterest, but could also be utilized to search for distant threats. Some people have reported pupil constriction preceding anxiety attacks. Since anxiety and fear are not necessarily the same emotion this could occur in select individuals.

Children who have been abused may show signs of severe post traumatic stress disorder. There can present at times as a glazed, dilated appearance of the eyes, with minimal movement and not focused in the present, often gazing at of into the distance. They do not exhibit normal behaviors such as turning towards you when spoken to or reflexive moments to sound or motion. Frequently this is a sign of a

Other manifestation of abuse may include reduced visual acuity, tunnel vision, reductions in depth perception, and reduced color vision. These have different characteristics than the same problems caused by eye diseases. They can also be the result of stress, not abuse.

No specific visual behavior indicates abuse. Pupil size varies between individuals. Many people avoid eye contact that are shy. Children are often spacey and gaze off into space with a tremendous capacity to tune adults out.

Adding to the mystery, Eye Movement Desensitization and Reprocessing also referred to as EMDR is a method of therapy utilizing eye movements to treat post traumatic stress syndrome.

Some day there may be a viable eye test for psychological disorders. Unless that happen, it is important to consult a therapist experienced in victims of abuse if you notice some of these types of changes in eye behavior accompanying alterations in mood and other social changes. Especially important are clear changes around specific people or situations as triggers.

Headaches come from many different sources and people often bring their child to see the eye doctor first to rule out vision problems as a cause. Headaches are the second most common reason parent bring their children in to our Fort Collins Optometrist,  Practice Usually it is not a vision related problem, but there are cases that have a direct correlation with the eyes. If headaches are related to eye problems, most of the time your optometrist will uncover a specific visual task the headaches seem to center around. It could be reading, computer use, video games or time in the sun.

Eyeglass frames can cause pressure behind the ears and on the side of the head if not properly adjusted. Frames that are tilted can alter the effective lens prescription and result in eye strain. Nickel is a common component in many metal frames (and in parts of plastic frames). Nickel allergies are fairly common and can cause discomfort, itching and possible mild headaches.

Your child’s eyeglasses prescription may cause headaches under certain conditions. Large uncorrected amounts of farsightedness are probably the most common cause in children. With farsightedness, they may have the focusing capacity to pass the eye doctors chart test with flying colors while not wearing prescription lenses. In doing so, they may be close to using all of their focusing reserve capacity. This would be like spending all day walking around carrying close to the maximum amount of weight you can hold. Because the focusing muscle is considered smooth muscle and does not fatigue like the striated muscles you use for your arms or legs, there is some disagreement on this point. It is really an academic point since the headaches do commonly occur, possibly due to variations in focusing and resultant clarity, constriction of the colored iris tissue, or other unknown factors. How much uncorrected farsightedness is required to cause headaches? We know higher amounts are more significant as age increases but with lower amounts it is not as clear what levels create eyestrain and headaches. Sometimes the only way to know is to fill an eyeglasses prescription and see if the headaches resolve.

Focusing problems in general are very hard to diagnose with precision. Eyes may over focus, under focus, have variable focusing, and on rare occasions have focusing spasms. Some prescription medications can cause focusing problems, dry eyes and sensitivity to light increasing the likelihood of headaches.

Uncorrected nearsightedness can cause a child to squint to see the blackboard and result in headaches. Usually they will be complaining about blurry vision, unlike with farsightedness. Nearsightedness has normally been corrected by an eye doctor due to blurry vision before there are complaints about headaches.

Astigmatism is a condition where the eye has two different curvatures, shaped more like half of a tennis ball squeezed on top and bottom. While astigmatism does blur vision, children frequently notice more eyestrain than blurriness. The eye is focusing for one curve then the other trying to find the clearest focus point. Moderate to high levels of astigmatism can cause headaches but usually the child has complaints that sound more like eyestrain and may be squinting to try and clear things up.

Convergence insufficiency is one of the leading causes of headaches related to vision in children. In our optometry practice in Fort Collins, we find it is one of the most common undiagnosed eye conditions. When your child reads or works up close the eyes have to perform two functions. First they have to adjust the focus for the correct distance. Secondly they must turn in both eyes (converge) to point in the exact direction of what they are looking at. Most reading is done at about 14 to 16 inches away from the face in children. Kids should be able to keep their eyes pointing at an object at least until it is within 4 to 6 inches from their nose. If they can’t, they lack enough reserve capacity to keep their eyes pointed at the object and they will have eyestrain and headaches. The severity of the problem is related to how well their brain functions in partially shutting down the image from one eye. If they lack this capacity the headaches can be severe with near work, resulting in headaches, eyestrain, blurred vision, and failing grades in school.

Muscle imbalances are similar to convergence insufficiency. Due to eye muscles or tendons that are slightly misshaped or inserted slightly abnormally, their eyes may have a tendency to turn in, out, up, or down. Constantly struggling to keep images from doubling can cause frequent headaches if the brain is not good at shutting off one of the images. Fixation disparities are very tiny eye alignment errors that can have a similar result but can only be diagnosed with appropriate testing.

Migraines are a very common cause of headaches and take many different forms. Usually there is a family history of migraines already known. Children that develop migraines at an older age often are carsick at younger ages. These headaches tend to be on one side of the head and may be associated with nausea and light sensitivity. Migraines need to be thoroughly tested and diagnosed in conjunction with your child’s pediatrician and possibly a neurologist. The only association migraines have with eyes are some people have migraines triggered by small changes in their eye glass prescription, and some migraines can cause very minor damage to the eyes over time.

Some children and adults are naturally very sensitive to small changes in their eyeglass or contact lens prescription. Every time there is a minor change they start having headaches, and learn quickly it is time for an appointment with the optometrist. Autistic children may have somewhat of an opposite type of  problem, and clearing up vision too much may contribute to sensory overload and headaches.

Rare causes of headaches around the eyes are tumors around the optic nerve or eye. Inflammation inside the eye that sometimes accompanies childhood arthritis and other autoimmune diseases can cause eye pain, headaches, and light sensitivity. Unusual light sensitivity, red eyes, headaches, abnormally small or large pupils, changes in behavior and school grades can be indicators of illicit drug usage, now common even in elementary schools. School counselors usually have a pretty good idea who is involved and it is a quick call.

A sinus infection can result in headaches around the eyes and in rare cases even sight loss.

Never forget lack of sleep. Fatigue, poor diet, caffeine crashes, dehydration, and stress probably cause most headaches. Preventative eye exams for children always helps rule out some easily fixed causes so don’t neglect an eye check up if your child is being afflicted with headaches.

Last, but not least is the friend who just got new glasses syndrome. All of a sudden your child develops blurry vision and headaches. Fortunately, an optometrist can diagnose this case pretty easy. Sometimes you may want to consider discussing in advance with your child’s eye doctor a placebo pair of glasses  with little or no prescription. Occasionally with a strong willed child it is easier to just let them wear a pair for six months  and spend your energy on the bigger battles.

Ten Reasons To Be More Concerned About Your Child’s Headaches

1. Headaches that are continuing to get worse or becoming more frequent

2. Headaches that occur in the same area of the eye or head

3. Headaches that wake children up at night or are present at the beginning of the day

4. Headaches accompanied by double vision, blurred vision, or abnormal eye movements

5. Headaches that cause a child to cease their normal activities

6. Any headache that occurs after a fall, possible bump to the head, or after loss of consciousness or

memory, however brief

7. Any headache that is accompanied by changes in responsiveness, sluggish thinking, slurred

speech, changes in balance, different pupil sizes, severe vomiting, droopy half open eyes, altered or

unusual behavior

8. Headaches that only occur when a specific person is around (possible abuse)

9. Headaches occurring in other people present (possible carbon monoxide poisoning)

10. Severe Headaches with very rapid onset, high fever, stiff neck

If you have concerns about your child having mild or moderate headaches, starting with appointments with your optometrist and family doctor makes sense, proceeding to a neurological evaluation if needed.

Do your child a favor when they visit their optometrist for back to school eye exam this year. Discuss sunwear protection with the eye doctor. Lifetime doses of UV radiation from the sun are associated with nuclear sclerosis. This is a type of cataract where the lens yellows then turns brown similar to plastic left outdoors for a few years. UV exposure has also been implicated as a risk factor for macular degeneration, and recent studies suggest even visible blue light may be damaging.

If you live in an area like Fort Collins at high altitude and snow,  closer to the equator, or spend time around lakes or the ocean, your child’s exposure rate is much higher.

Think of sun protection for the eyes just like sun protection for the skin. No reputable childcare center allows children on outdoor excursions without sunscreen. It should be the same for your child’s eyes. UV (Ultraviolet) protection with sunwear that is tinted or transitions lenses that are clear indoors and darken outdoors are both good options. If you child spends a large amount of time in outdoor activities consider sunglasses that wrap around on the side.  If you Normal eye glasses  may allow 35% of the light in from the side. Gray is the tint that alters color perception the least but brown is popular also.

For non prescription sun wear avoid the cheap $5.00 variety. Look for something with an 100% UV protection. Expect to pay $30 to $40 at minimum for the quality your child deserves. Poor quality sunwear may actually damage your child’s eyes by dilating them and allowing more UV exposure with inadequate protection.

By starting early you are providing preventative care for two of the leading causes of blindness.

Your Child’s First Eye Exam- Ten Steps to Prepare for the Eye Doctor

Is your preschooler or kindergartner ready for their first eye exam? There are critical times to have eye check ups, and this is when you as a parent typically start to have concerns that your child can see his or her best. The onset of the school year brings in many young children to the eye doctors office for the first time. Some of them are very anxious because their experience with doctors has normally been associated with sickness and pain.

You can help alleviate your child’s anxiety about going to see the optometrist with ten easy steps.

1. Explain this is not like the regular doctors office and they will have fun and a new experience. Mostly they need to answer questions as best as they can and they probably won’t need eye glasses. If they do, tell them their are all types of cool glasses today and they will get to help pick out colors and shapes they like. If they need vision correction give them some ownership of the process. If it is determined they need glasses, make positive statements of how much they will enjoy seeing the leafs on the trees and everything else they have been missing like scenes from their favorite movie.

2. Assure your child they will not be receiving any shots or painful procedures.

3. Prepare them for eye drops. You can refer to them as tickle drops; they tend to tickle for a few seconds. Yes they do sting briefly but when I tell children they will probably tickle a few seconds that is what usually happens.

4. Right after drops are put in the eye I start asking children questions to distract them for the first minute or so. If they are thinking about something and answering questions they don’t feel the drops. You can do the same thing by barraging them with questions that have happy answers.

5. Explain there might be several drops and after the first drop the others won’t tickle. The eye is normally numbed first so subsequent drops can’t be felt. Talk to them about how their eyes will be blurry up close for a few hours and they will need to wear some funny looking sunglasses when they are outside for a few hours also.

6. Go to the store and purchase a small bottle of artificial tears. Artificial tears usually feel good and it lets them know the procedure. Giving them a drop will give them a positive experience. If they are too resistant to this or you don’t feel comfortable doing it don’t continue to try as it could make it harder for the eye doctor.

7. Explain they will need to read very small letters on a wall. Have them cover one eye and practice with a magazine page with some print size you can read easily taped to the refrigerator from across the room. Or make your own eye chart. If they don’t know their letters yet pick three objects they know and do the same thing as above. Explain the eye doctor may ask them to compare how they see with different lenses and sometimes it is very hard to tell the difference. They only need to try their best and it is not like a test with wrong answers.

8. Tell your child the optometrist will shine some bright lights in their eye for a short period of time. You can briefly shine a flashlight at their nose to give them the idea.

9. Explain they may need to sit very still for a few minutes while an eye computer checks their eyes. Play a game of sitting still for 1 minute with reward when they do.

10. Promise a reward after the eye exam if they do good. Doing something they enjoy right after a vision exam will give a positive association with going to see the eye doctor.

Making your child’s first visit to the optometrist a fun, positive experience can help them maintain a lifetime of healthy eyesight. Make sure the eye doctor enjoys seeing children. I find they are my easiest patients, are normally cheerful, and they never complain. Last but not least schedule their eye exam at a time when they are at their best, not at the end of the day or around nap time. Help make it be a fun new adventure.