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Online Eye Consults

Online Eye Consults

Online Eye Consults: What You Need to Know

With the changing social landscape, Dr. Sciberras now provides consultation services online through video technology. The concept of getting an eye health consultation online is rather new, so we have prepared this article to explain how Dr. Sciberras provides online eye consults and the process involved. It’s simple and right for the times.

Registration and Consent  

An online eye exam consultation begins with some of the same procedures that you would expect when visiting the clinic. First, we begin by completing a short registration form and submitting it electronically through our website. It is important that you list any medications, allergies, and any other information related to your eye and general health. You will then submit a signed consent form regarding the provision of tele-optometry services. Again, you submit it electronically. 

Visual Acuity Test  

Before beginning your live consult with Dr. Sciberras, you will have your vision measured using a modified vision chart.  The chart will be displayed on your computer screen, and should be viewed from a distance of 4 feet. If you wear contacts or glasses for distance sight, they should be worn while taking the vision test. Just like at the optometrist’s office, you will attempt to read letters as they get successfully smaller. These measures get recorded and emailed to the eye care professional for review. Avoid leaning forward or squinting while trying to read the letters and it is important to guess at letters you are unsure of as far down the chart as possible.

Secure Platform and Payment

Another important point: when you are in front of your screen camera, lighting should be bright so that the doctor can easily see you and the whites of your eyes. Dr. Sciberras uses the doxy.me platform, which is a secure platform, and will not be recorded, but the doctor will keep physical notes of the encounter for proper record keeping. At this time, OHIP does not cover fees associated with the provision of this service.  Fees are tiered based on new or existing patient status and are processed directly through the doxy.me platform.

Case History 

After submitting the short registration form, consent form, and the vision test results, you will then proceed to begin your live online consultation with the optometrist. You should be prepared to answer some of the following questions:       

  • Is your eye(s) in pain?
  • When did your symptoms begin?
  • Have you noticed a change in your vision?
  • Are the symptoms getting better or worse?
  • Is this your first occurrence, or is this a recurring problem?
  • Are you treating the condition in any way? How? Is it helping?

Treatment Plan

During the consultation, a treatment plan will be devised and explained, any required prescriptions drafted and emailed to you. If further monitoring is required, it will be arranged at this time. In my professional opinion, online consultations can help reduce unnecessary visits to the ER and will be valuable in monitoring certain eye conditions and contact lens trials. There is a place for tele-optometry, especially now, but video consultations should not be considered a replacement for an in-person comprehensive oculo-visual assessment with your eye care professional.

Online consult registration is quick and simple, and we are flexible in our scheduling to fit your needs. Check out our online video consults page to learn more.  Don’t hesitate to reach out to us if you have any questions. 

Mi-Sight Dailies Myopia Control Contact Lenses

Mi-Sight Dailies Myopia Control Contact Lenses

What is myopia?

Myopia is caused by elongation of the axial length of the eye. This causes light rays to focus at a point in front of the retina for objects that are far, rather than directly on the retinal surface. This means distant objects are blurred.  The greater the myopia, the nearer objects are before they become blurred.  To explain, someone that has a prescription of -1.00 has a focal point of 1 meter, which means objects further than 1 meter become blurred the further away they are.  For someone with a prescription of -3.00, their focal point is now only 33cm, meaning objects become blurred if they are further than 33cm away.

Below are some examples of relative sight to demonstrate the effects on vision of different levels of myopia compared to someone with no prescription, known as emmetropia.

The development of myopia in early childhood is particularly disturbing as it provides a longer time to become progressively worse, as myopia tends to increase on average by 0.50D per year until about 16. As myopia progresses, it typically means the eye continues to elongate, increasing a child’s risk of more serious vision problems in adulthood. For every 0.1mm increase in eye (axial) length, an increase of about 0.25D of myopia occurs.

FACT: The earlier the onset of myopia, the higher the rate of progression and the higher the final degree of myopia.

  • The retina pulls away from the eye’s supportive tissue
  • Can cause permanent vision loss

Cataracts

  • Typically associated with aging, but tend to develop sooner in nearsighted eyes
  • specifically the posterior subcapsular variety of cataract, which happens on the back surface fo the lens, can progress rapidly, and is often very detrimental to vision
  • cataract surgery can remove the lens opacity, but again, myopes face increased risk of post-operative retinal detachments

Glaucoma

  • Due to higher pressure in the eye, which often has no presenting symptoms or pain, leading to insidious vision loss
  • Damages the optic nerve with resultant peripheral vision loss in the early stages, and later on to central vision loss (irreversible and often referred to as tunnel vision)
  • Myopes have a 2 to 3 times greater risk of developing Open-Angle Glaucoma

Myopic Maculopathy or Degeneration

  • The most common complication of high myopia
  • A slowly progressive and sight-threatening condition in which visual loss develops from atrophy of the retinal pigment epithelium and/or sub-retinal neovascularization

What causes myopia development and progression?

Genetics (a family history of myopia), individual characteristics (e.g. dopamine levels), and environment (e.g. lack of outdoor activity).

Why is early-onset myopia particularly concerning?

The earlier the onset, the higher the rate of progression, and the greater the degree of myopia in adulthood.

How is myopia diagnosed?

An optometrist or ophthalmologist can diagnose myopia in the course of a routine eye exam which includes visual acuity, retinoscopy, and subjective refraction.

What are the risks associated with myopia?

Myopia is associated with an increased risk of retinal detachment, cataracts, glaucoma, and myopic maculopathy. All these conditions can lead to irreversible vision loss. In fact, in 2010, myopia was estimated to be the main cause of distance visual impairment worldwide – and it is ranked as the second most common cause of blindness globally. By 2050 it is estimated that 50% of the world’s population will be nearsighted or myopic, that means 5 billion people globally will be affected.

How is myopia treated?

Current treatment consists of glasses, atropine, rigid contact lenses (Ortho-K), D.I.M.S. spectacle lens technology, bifocal/multifocal spectacles in some cases of binocular or accommodative dysfunction and peripheral defocus modifying contact lenses (soft contact lenses). It is the latter type of correction that we will be discussing here due to its convenience, safety, and high rate of success at retarding the progression of myopia.

MiSight by Coopervision: 1st Daily Disposable Lens to Treat Myopia

Daily disposables offer ease of care (no cleaning/disinfecting solutions required) and reduced risk of infection (younger children are found to actually have a lower rate of infection than teens, and the overall rate of eye infection in children waring daily disposable soft lenses is 1 case in 12,000 years of wear.

 

Important Facts:

  • MiSight 1 day – the first soft contact lens treatment proven to slow the progression of myopia in children by 59%.
  • Glasses can help the child see clearly but has little or no effect on slowing down the progression of Myopia.
  • Treatment lenses such as MiSight 1 day is proven to significantly reduce the rate of myopia progression in children as young as 8 years, or younger as per the discretion of the eye care professional
  • 85% of children say MiSight 1 – day lenses are easy to insert
  • 100% of children found MiSight 1 – day lenses are easy to remove
  • 90% of children said they preferred wearing their MiSight 1-day contact lenses over wearing their spectacles
  • 98% reported seeing well while playing outdoors
  • 41% of children had no clinically meaningful change

To determine your child’s risk of developing myopia and more advice on how to help further slow the progression, click here and take the short survey.

MiSight lenses, as mentioned earlier, are one of several options for treating childhood myopia.  To learn the status of your child’s eye health and vision, and the potential best options for treatment, please call Dr. Sciberras office to book your child’s first or annual eye exam. Regular eye examinations for young children are important to identify and treat myopia early. This may help to reduce the final prescription and the potential risk for future eye health issues. Every dioptre helps, and the younger we start, the better.

The Benefits Of Omega 3

The Benefits Of Omega 3

You already eat a healthy, balanced diet containing fish, and you buy omega-3 enriched eggs at the supermarket. So why is your doctor recommending you take an omega-3 supplement to treat your dry eyes?  Let’s break it down.

Omega-3 in the form of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are the most effective. Omega-3 is an essential nutrient, meaning the human body can’t synthesize it; we have to get it from food sources like oily fish (salmon, trout, tuna, mackerel), nuts and seeds (chia, flax, walnuts), vegetables (broccoli, spinach, cauliflower), free-range eggs, and grass-fed meat sources. Omega-3s are incredibly important to our health, because they possess powerful anti-inflammatory properties, and decrease the risk of:

  • Eye disease – macular degeneration, dry eye and ocular surface disease
  • Cardiovascular disease (blood pressure, heart attack, and stroke)
  • Cancers (colon, prostate, and breast)
  • Mood disorders and mental health concerns (depression and anxiety)
  • Autoimmune disease (Type 1 diabetes, rheumatoid arthritis, ulcerative colitis, Crohn’s disease and psoriasis)
  • Age-Related mental decline, including Alzheimer’s disease

So why can’t you simply add more salmon and tuna to your weekly menu?  Well, you can, and you should, try consuming more omega-3 in your diet. However, it’s a little like trying the fill a swimming pool with a squirt gun. Although humans evolved consuming a diet with roughly equal amounts of omega-3 and omega-6 essential fatty acids, today’s western diet means we eat almost 20 to 30 times more omega-6 due to the prevalence of processed food intake.

 

MiSight by Coopervision: 1st Daily Disposable Lens to Treat Myopia

Daily disposables offer ease of care (no cleaning/disinfecting solutions required) and reduced risk of infection (younger children are found to actually have a lower rate of infection than teens, and the overall rate of eye infection in children waring daily disposable soft lenses is 1 case in 12,000 years of wear.

 

Important Facts:

  • MiSight 1 day – the first soft contact lens treatment proven to slow the progression of myopia in children by 59%.
  • Glasses can help the child see clearly but has little or no effect on slowing down the progression of Myopia.
  • Treatment lenses such as MiSight 1 day is proven to significantly reduce the rate of myopia progression in children as young as 8 years, or younger as per the discretion of the eye care professional
  • 85% of children say MiSight 1 – day lenses are easy to insert
  • 100% of children found MiSight 1 – day lenses are easy to remove
  • 90% of children said they preferred wearing their MiSight 1-day contact lenses over wearing their spectacles
  • 98% reported seeing well while playing outdoors
  • 41% of children had no clinically meaningful change

To determine your child’s risk of developing myopia and more advice on how to help further slow the progression, click here and take the short survey.

MiSight lenses, as mentioned earlier, are one of several options for treating childhood myopia.  To learn the status of your child’s eye health and vision, and the potential best options for treatment, please call Dr. Sciberras office to book your child’s first or annual eye exam. Regular eye examinations for young children are important to identify and treat myopia early. This may help to reduce the final prescription and the potential risk for future eye health issues. Every dioptre helps, and the younger we start, the better.

How is Omega-6 different than Omega-3?  They too are an essential fatty acid, but in this case, they are counterproductive. In large amounts, omega-6s become pro-inflammatory. Even worse, they compete with omega-3s for the same enzymes in our natural physiology, meaning any anti-inflammatory benefit that you were going to get from that delicious sushi you ordered last night will be nullified by the presence of Omega-6.

To counteract the large presence of Omega-6 in our Western diets, you need a large amount of omega-3. To ingest the amount of Omega-3 known to have a measurable, positive effect (i.e. 2000mg), you would need to eat 37 cans of tuna per week!  Yes, 37 cans! This is why your doctor has recommended a supplement.  But there are so many out there, so how do you choose from all the options on store shelves? 

Unpurified native oil is pressed directly from fish, so it is in a triglyceride form that is recognized and well-absorbed by your body. Unfortunately, unpurified means it likely contains toxins (such as PCBs, mercury, and dioxins) that become more concentrated the higher up you go in the food chain and therefore can be present in dangerous amounts in larger fish. It also has an unpleasant fishy aftertaste.

To remove the toxins from native fish oil, manufacturers chemically convert the omega-3s to the ethyl ester form, which although free of toxins, is poorly absorbed and may require as many as 40 capsules to provide the equivalent benefit of just one tablespoon of fish oil. The ethanol in the final product is also an irritant to the lining of the stomach and should not be taken by patients who are at risk of ulcers. This is the form present in the majority of omega-3s sold in pharmacies and grocery stores.

PRN is a brand of omega-3 that goes one significant step further. The omega-3s found in PRN are reassembled as a re-esterified triglyceride, making them readily absorbed by the human digestive system. Just four soft gel capsules, or one teaspoon of liquid PRN, supplies the recommended therapeutic dosage of 2000 mg in the clinically-proven ratio of 3:1 EPA:DHA, without the fishy odor or aftertaste observed in other forms.

PRN is also the only omega-3 brand clinically tested in dry eye disease.  In a study, it was shown after 12 weeks of supplement intake, patients showed a significant decrease in several measures of dry eye disease, including inflammation and a 50% reduction in symptoms like itching, burning, and redness. The effect was so pronounced that several patients reported that they were able to reduce the frequency of use of their artificial tear supplements.

The right formulation of omega-3 can go a long way to help you manage your dry eye symptoms effectively, and offer you the myriad of health benefits mentioned earlier here.  Remember, look for at least 2000 mg of a re-esterified triglyceride (it should say right on the bottle) in a 3:1 EPA:DHA ratio. PRN has it and is available through your Eye Care Professional.