Night driving and your Vision

Dark winter months make night driving a challenge. It is a physiological fact that our vision is best in daylight- so our eyes need all the help we can give them while driving at night. Furthermore our eyes require a full 5 minutes to adapt to the dark. While driving at night, light conditions are variable and can change rapidly. This ability to adapt to differing light levels will slow as we get older and some eye conditions impede this process.

How to maximise your night driving experience;

Get your eyes tested- regular eye exams ensure your vision is at its best. Even small focussing errors can have great effect on night vision- so even if you meet the minimum vision requirement to drive without glasses, you may still experience difficulty with night driving. Conditions such as cataract can increase glare sensitivity while driving at night, but also decrease your contrast of vision.

Check your glasses- Visit Eyes of Howick for a free glasses WOF including fit adjustment and ultrasonic cleaning. We can inspect the lenses for any lens defects which may impact  your vision. Clean your lenses daily with cool to luke-warm water and a soft, clean cloth to keep them smudge free. Or better yet, use recommended products such as our lens spray cleaner, wipes of peeps- the carbon lens cleaner. See our online store for our lens cleaning options.

Choose the right lens-Ensure your lenses have an antireflective coating- this improves light transmissibility through the lens and reduces disabling glare while night driving. Crizal Sapphire HR lenses are the most transparent anti-reflective lenses. Furthermore, Crizal Prevencia blue blocking lenses are reported to reduce glare discomfort for night drivers.

Clean your windscreen- on the inside and out! That greasy film can be a real distraction, particularly with oncoming headlights and sun strike through the day. Replace your wiper blades as required and keep the washer bottle topped up.

Clean your headlights- any dirt will reduce their effectiveness at night. Also check for yellowing of any polycarbonate headlamp covers- this can be cleaned off with the appropriate product.

Use your headlights effectively – from 30 minutes before sundown and 30 minutes after sunrise. Don't be hesitant to use high beam while travelling at night except for when approaching and following other vehicles and this can cause disabling glare for other drivers.

Avoid the glare -If you find glare of oncoming traffic a problem- avert your eyes to the left side of the road to avoid this direct glare source while at the same time remain aware of oncoming vehicles. Also don't travel at night with the internal vehicle light on as this will cause extra visual fatigue.

Slow down-Drive at a speed so you can see the road at least 2 seconds ahead.

Remember if you have any queries about your vision difficulties or your eyewear, we are always happy to help at Eyes of Howick. Here's to happy and safe driving!

An Eye on Melanoma

What is melanoma?

Melanoma occurs when Melanocytes- the pigment-producing cells that give colour to the skin become cancerous. Melanomas can occur anywhere on the body, with the eye being the second most common site after the skin.

Signs may include a new, unusual growth or a change in an existing mole or naevus. Treatment may involve surgery, radiation, medication or in some cases, chemotherapy.

Ocular melanoma

As an optometrist, I frequently note pigmented spots and lesions in eyes of my patient’s. These can range from benign iris freckles (small pigmented spots on the surface of the coloured part of the eye), through to large choroidal naevi (large moles situated beneath the retina at the back of the eye).

Posterior uveal melanoma- choroid and ciliary body

Being the most common site for ocular melanoma and occuring inside the eye, they are only detected during an eye examination. Symptoms may include blurred vision or blind spots, new floaters or flashes- however, these usually occur when the melanoma is well advanced.

Conjunctival melanoma

The conjunctiva is the delicate, vascularised tissue that overlays the sclera (white of the eye). Accounting for 10 percent of eye melanomas, treatment outcomes are favourable. However, recurrence is high so regular reviews are important.

Iris melanoma

Generally found during routine eye examinations and often occurring from pre-existing iris naevi- New Zealand has the highest known incidence in the world. If caught early, treatment options are favourable.

Risk factors

·        Fair skin- although 4% of Uveal Melanoma in an Auckland Clinic occurred in Maori patients

·        Light coloured eyes

·        Having a pre-existing mole within the eye

·        Ultraviolet light exposure

·        Older age

Recommendations

Wear sunglasses, ensuring they provide 100 percent UV protection. A hat is also beneficial to further shield ambient light exposure around the eye.

My strongest recommendation would be to those who have never had an eye examination to book one! This enables the Optometrist to screen you for any risk factors of eye cancers and advise a time frame for any further reviews. As mentioned, as many of these lesions are not visible to the naked eye, it is only during a routine eye exam that they may be detected.  

When should my child have an eye test?

Most of a child’s learning is done through their eyes so there is a clear link with how well a child can see and how well they may develop either academically, socially or athletically. 

Vision doesn’t just happen. In fact, when a child is born, they don’t know how to see. A child’s brain learns how to use eyes to see, just like it learns how to use legs to walk or a mouth to form words.  

Vision develops from birth, right through until the age of eight. This is known as the ‘critical period’ because if a vision deficit is corrected during this time, the eye to brain pathway is still able to adapt and allow quality vision. It is crucial during this time that the two eyes see equally in order for them to learn to work together. This allows the child to develop good binocular or 3D vision. 

Unfortunately, the longer a vision problem goes untreated, the more a child’s brain learns to accommodate that problem. For example, if one eye has blurred vision, this eye will become amblyopic or lazy- this means it will never see as well as the other eye regardless of glasses, contact lenses or surgery in their later years. 

The good news is that the majority of vision impairment in school age children is due to them simply needing a pair of glasses to correct a defocus of one or both eyes. 

Preschool kiwi kids receive a free vision screening as part of their 4 year old B4 School Check (B4SC). This entails checking distance vision and comparing the results to an expected normal level. This can be particularly useful in detecting myopia or short-sight. However, it has been postulated for some time, that kids with hyperopia or long-sight may well go undetected. Long-sighted children can often compensate for their refractive error by focusing hard to achieve clear vision, however, this can result in reduced comfort and performance with near tasks. 

The recent Welcome to School (WTS) was employed in Auckland to test the efficacy of the B4SC to detect refractive error and visual impairment by following a group of 6-7 year old children. 

Results showed the B4SC was effective at detecting all children with amblyopic risk factors, ( for example, one eye having reduced vision), however, the vision screening was shown to be ineffective at detecting significant refractive error with nearly 60% of kids in this category passing the screening! Furthermore, having passed the test, none of these children had visited an optometrist for an eye exam and therefore, they were not wearing glasses to correct their focusing error. 

As an optometrist, I understand that children with uncorrected vision conditions or eye health problems face many barriers in life. High quality eye care can break down these barriers and help enable our children to reach their highest potential. For this reason it is never too early to have their vision and eyes assessed. In fact, the New Zealand Association of Optometrists recommends that children have their eyes examined: 

• At 6 to 12 months old

• At 2 to 3 years of age

• Before starting school

• Through their school years as indicated by vision screening, school performance or as recommended by your GP or optometrist. 

It is particularly important for children to be tested at a young age if either of his/her parents required glasses as a child or teenager. 

 An eye exam is tailored to your child and their age and most kids really enjoy it – parents often comment they are surprised at how well their child has managed all the different vision checks. 

If you have any queries regarding your child’s vision don’t hesitate to contact me through our website or Facebook page. Or simply contact us to arrange an appointment.

Migraine

What is migraine?

It is a neurovascular headache, meaning it manifests as a result of complex events and interactions between both the central and peripheral nervous system and blood supply to the brain.

Migraine is often inherited and is considered the 3rd most common disabling event for those under the age of 50 years.

Symptoms of migraine

Warning stage – You may experience subtle clues that you will develop a migraine which may include neck stiffness, mood changes, constipation, fatigue, thirst or craving of sweet foods

Aura- Visual disturbance which may include light flashes, zig-zags, spots or tunnel vision. But may also cause numbness or tingling on one side of the face or body, hearing or speech disturbance, memory loss, confusion, dizziness or even fainting. The Aura usually occurs before the headache and most commonly persists for 5-20 minutes. Some people will experience the aura only; without the headache developing.

The Headache- throbbing pain, usually on one side of the head. This may be accompanied by nausea, vomiting, and sensitivity to light, sound or head movement.

Resolution & Hangover- Symptoms usually gradually fade but a ‘hangover ‘effect can persist for hours to several days. Symptoms may be similar to the early warning stage or can be the opposite, ie. If appetite was initially lost you may be incredibly hungry.

What causes migraine?

Genetics- sufferers often have a first degree relative with migraine

Sensory overload- sensitivity to light, patterns, sound and even smells

Foods and food additives- certain foods may trigger a migraine such as cheese and chocolate. MSG and some artificial sweeteners may also be implicated.

Sleep disturbance- either too much or not enough

Hormonal fluctuations

Stress or Anxiety

Physical Exertion

What you should do

First of all, if you experience regular headaches, or any significant headache event it is paramount you visit your family doctor for a thorough general health assessment and diagnosis.

A headache diary can be useful to help pinpoint any trigger to your headache.

What can help?

Medication can be prescribed to reduce the pain and even prevent events from occurring. Some patients require referral to a neurologist to help manage their symptoms.

Lifestyle changes including regular sleep, exercise and a healthy diet. Limit alcohol.

Consider an eye examination. In my experience, those with migraine, benefit from correction of even small vision imperfections. We often recommend lenses to reduce light intensity, blue-light exposure, reflection and glare indoors. Prescription sunglasses are helpful in brighter light conditions. I have also recently experienced success with a migraine patient who has found relief from light sensitivity with the new Acuvue Transition Contact Lenses. These lenses, incredibly incorporate the adaptive tint technology of traditional Transitions spectacle lenses but within a contact lens. They can even be helpful to reduce glare when night driving.

Feel free to contact us if you have any queries about your vision or light sensitivity.

Presbyopia- vision after 40

Change- to vision after 40

Ch- ch- changes turn and face the strain.

Pretty soon you’re gonna get a little older

Time may change me

But I can’t trace time

If you know the rest of the words to this David Bowie song, chances are you are over 40! Speaking of change, an inevitable one to occur around this age is the reduced ability to see near print and objects clearly. 

If you have never required glasses or contacts to correct distance vision, this loss of near vision can be concerning and frustrating. You may feel like you have abruptly lost the ability to read that restaurant menu, your mobile phone or even the DVD screen on that last plane trip. 

In reality, your vision has been undergoing gradual change since childhood but it is only now that your eyes don’t have enough focusing power to see clearly for closer work- this is known as presbyopia. A result of the lens inside the eye losing its flexibility which allows the eye to change focus from objects that are far away to objects that are near. 

Another inevitability is that we all approach change differently. Some of us resist it, while others embrace it, or likely just gradually resign ourselves to things being different. When your vision starts to change, the unknown is scary. However, presbyopia is normal and there are several solutions to enhance your vision. 

While some people resort to cheap over the counter glasses; they are just getting by. Furthermore as we get older, we also need to look after our health. Medically speaking, from the age of 40, is when our risk increases for eye conditions like glaucoma – conditions that with early detection and treatment mean that you can maintain good vision for your lifetime. So the change in near vision focus after 40 could be said to be telling you that it’s time to see your optometrist, and start having regular eye examinations.  

People with presbyopia have several options to regain clear near vision. They include;

 Glasses; with a personalised prescription and quality lenses your vision can be as sharp as ever and depending on your lifestyle, occupation, hobbies and daily visual demands there are several lens options to ensure glasses work well for you. 

Furthermore, don’t underestimate the importance of a perfectly fitting spectacle frame. Frames are not unlike shoes: they not only have to look good but they must fit well for the glasses to work their best. Quality does feel better and will last the distance meaning you can often reuse your frame even if your prescription lenses require updating. 

Contact lenses; including multifocal to provide both clear distance and near vision simultaneously. 

Surgery; such as LASIK or other refractive surgeries

 Initially, presbyopia becomes more advanced. You may notice that you need to change your glasses or contact lens prescription more frequently than you used to. Around age 60, these changes in near vision reduce, and prescription changes should occur less often.

Presbyopia can't be prevented or cured, but most people should be able to regain clear, comfortable near vision for all of their lifestyle needs. So if it is you or someone in your family, experiencing changing vision, help them to embrace the change and book in for a comprehensive eye examination at your local optometrist. And just in case you are wondering, David Bowie’s song Changes, was released on the Hunky Dory album in 1971.