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Ophthalmic Migraines Explained

Hello, Dr. Ed Huggett here. Wanted to talk to you today about migraines. Yup. Migraines and how they’re associated with the eyes. There are some people that would come in and say, you know, Dr. Huggett, I get these migraine headaches when I use my eyes or I’m reading. Yes, migraines can be triggered by reading and eye stain. But there’s a certain kind of migraine really that I want to talk about today. I want to talk about an ophthalmic migraine. Ophthalmic migraines are migraines that occur and actually affect a person’s vision. But unlike most migraines that have pain, this type of migraine has no pain or rarely has pain. And that’s a kind of migraine that it will actually sometimes block a person’s vision out. They’ll say, you know, I, all of a sudden had this gray area of my vision and I couldn’t see around it or see through it or looks like zigzag patterns. It’s like Chevron or zigzag pattern that a person will see. Sometimes it looks like a kaleidoscope. I’ve had patients say, it looks like my vision, it’s almost like a, stained glass window, just all crinkled in the pieces. Typically in most cases that is what’s called an ophthalmic migraine. Typically sudden onset usually lasts maybe 15, 20 minutes and then slowly, gradually goes away. If you’re not sure about it and obviously you are worried about stroke or worry about other things. Ophthalmic migraine is typically very benign, doesn’t cause any problem. If you have questions about it, give your eye doctor a call, obviously. What causes them? Well, stress number one, who has stress? Of course you don’t have stress, but stress can do it.

Another common trigger is a food. Certain foods can do it. Like nuts broad beans , navy beans, lima beans, hard cheeses can do it. Process meats, salami, bologna, that kind of thing. Hard liquor, whiskey scotch, things like that can cause or trigger ophthalmic migraines. What I tell people to do is if you have an ophthalmic migraine, obviously run by your doctor. Make sure everything’s fine. Each time you have what write down the foods that you ate the previous 24 hours. And about the second or third time you do that, you’re going to start to see correlations of foods that are common. If it’s, triggered from foods. A commonality, maybe it might be Swiss cheese, one time and cheddar cheese the next time, or it might be navy beans one time or lima beans the next time. So, but you’ll start seeing these commonalities. And once you do that, now, you know what to start to eliminate. So if you see maybe two or three common kind of common foods that may trigger, eliminate one of them. Let it go for awhile. See if the migraine goes away and it never comes back. If it doesn’t come back, you know, you’ve eliminated the source of the problem. The typically migraines occur as maybe middle-aged so around 25 on up into the 50s and 60s. But if you have any questions about them, any comments, please leave them here. I’d love to hear from you.

Struggling with a visual impairment? Let us help!

Hello, Dr. Ed Huggett here today.

I’m going to talk about some additional things I do and have available to me to help you with a vision impairment.

So let’s take off from where we left off in the past.

So a person comes in to see me. They have a vision impairment due to some issue, macular degeneration, diabetes, whatever may be.

Referred to me by the retina specialist, maybe heard about us or looking at what vision a person has then.

And if I find out what you want to see with it, whether it’s faces TV, you want to be able to see across the room.

You want to be able to read. You want to be able to crochet. See your computer.

If I know what vision you have and what you want to do with it, I know then what I need to do to make it better.

So how do I do that?

Well, we talked about optical devices in the past, but most people don’t realize there’s one other really valuable tool, critically valuable tool that I have.

If you’ve ever had physical therapy, you know, that physical therapy is rehab and rehab is done to regain some lost body function, usually after an injury or surgery or something to that effect.

Most people don’t realize that most major medical insurances will actually pay for rehab vision rehab, lost vision. So if you’ve lost a vision, we can actually do some rehab to help with that loss vision.

And that’s done by some orders.

I would write to an occupational therapist. Occupational therapist, specially trained in vision rehabilitation. And they actually, under my orders, would actually go to a person’s residence where they live and do the things that I asked them to do to help a person with their vision.

So it deals with whatever device I would prescribe, helps them use it better. It makes it work better for them.

And not only that, occupational therapy will be my eyes and ears in that person’s residence, their home to be able to see what other things that can be done possibly to help that person.

So they actually will go out into the person’s home and report back to me say, Dr. Huggett yeah, this person needs this, or needs that, this will help him. And then we can prescribe some additional devices.

So it all boils down to keeping a person with a vision impairment, as independent, as possible, safe and operating in a much higher level. And occupational therapy, like I said, most major medical insurances cover the cost.

And most people, most eye doctors don’t even know that that’s available.

We’ve been using occupational therapy for a good 30 years or plus. So that’s one of the other tools I use. And then with the occupational therapy, they’ll look at fall prevention, things that can be done to help a person that’d be likely to fall, can adapt their environment to the person with the vision impairment.

They keep them safe and independent and happy. So that’s it in a nutshell.

If you have any questions or comments, leave them here for us. Like our YouTube channel. If you’re a subscriber and we look forward to talking to you in the near future.

What causes low vision?

Hello, Dr. Ed Huggett here.

I wanted to talk to you today about causes of low vision.

What can cause low vision? Well, let’s talk about low vision first, real quickly.

Low vision is where you have an impairment of your vision caused you to have difficulty doing something that you want to do on a daily basis.

Vision impairment doesn’t mean that everything you do on a daily basis is impaired or your vision is impaired.

It means that something that you’re doing on a daily basis is impaired because you can’t see it like you need to see it. So that’s a vision impairment.

It could be something from something very mild to something very profound, where you have such an impairment that you basically are seeing just shadows, maybe just a light and that’s it.

But if you have vision in most cases, if you have vision, it can be improved.

In fact, we have a standing order in our office that if I can’t help you, there’s no charge because I’d love seeing patients with vision impairments, I love to take my 30 years of experience to help a person see better.

But, causes of low vision? Most commonly age-related macular degeneration could be cataracts. Those are two very common causes of a vision impairment.

Two, it could be a, glaucoma. Glaucoma is a condition where you have peripheral vision loss, where it kind of constricts sand to the point where you actually can have like, a tunnel vision.

Diabetic retinopathy, diabetes leading cause of vision impairment.

In fact, if you have diabetes for any number of years, eventually most people will have some type of vision impairment, some type of vision loss, and a person with a vision impairment due to diabetic retinopathy can easily be helped.

So those are just some of the main causes.

You can either be born even with some issues, that cause of vision impairment.

It can be born with amblyopia. It can be born with an optic nerve problem.

So there’s, any number of things can cause that, but basically if you have vision with a proper vision rehab and low vision exam, it could be made better.

And typically within one hour, it’s all it takes about one hour of a low vision exam.

And what we do is we determine what vision you have and then what we could do to make it better.

And we can actually, in most cases, just put together in the office, right at that exam time, we would recommend to help you see that you can see better. So that’s it for today.

What is a low vision assessment?

Hi, Dr. Ed Huggett here. (I) wanted to answer some questions today about how do we test for low vision?

What actually is done to see if a person is visually impaired, and how can we test for that?

Well, three of the things we look at – one is we look at what’s called visual acuity.

How small letter, how small word can we actually make out?

One of the many cards I use is a… we call it the game card and you can obviously see why it’s called the game card.

And we’ve got words that go all the way down into very, very small words.

Top word, there is 2,400, and this typically is tested right at about 16 inches.

So right at the 16 inch distance, we’re testing to see how small a word a person could actually make out because you know, it actually, can be a different measure of whether you’re testing the letters versus actually words.

And I like to test word acuity. I call this word acuity because that’s more to like, more to actual vision.

Other thing that we test for is what’s called your field division.

How far can you see to the side, your peripheral vision?

Do you have a problem with your, your central vision? Maybe with macular degeneration, your central vision is impaired and you’ll only have peripheral vision.

Or you have a visual field cut like a what’s called a Hemianopsia where you may have lost vision due to head trauma.

You could have lost vision to a stroke. And sometimes after surgery that occurs, if you have some type of brain surgery.

So, acuity, your field of vision and one of the things that’s rarely ever tested that I test for on a routine basis, and that’s called contrast sensitivity.

Contrast sensitivity is how much contrast do you need to be able to see what you want to see.

And you can see on this test here, each letter is slightly less contrast than the previous.

Fades out that looks like almost nothing at the bottom, but then believe it or not, there are letters across, down here.

So contrast sensitivity is very, very critical, and we’ll be talking about that in the next video. If you have questions, any comments, please leave them here. Like our video and YouTube channel. And we’ll talk to you soon.

Hope in Sight for Low Vision

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Low vision is a condition in which an individual suffers significant vision loss that can’t be fully corrected with glasses, contact lenses, medication or surgery. Low vision can affect both children and adults, but is more common in the elderly, and requires significant adjustments to daily life. Here are some facts about the condition and tips for coping with it on a daily basis.

What are causes of low vision?

  • Eye diseases such as: glaucoma, macular degeneration, cataracts, diabetic retinopathy, and retinitis pigmentosa
  • Eye injury
  • Heredity

How does low vision affect eyesight?

Low vision causes partial vision loss leaving the person with some ability to see. Typically the impairment includes a significant reduction in visual acuity to worse than 20/70, hazy, blurred vision, blind spots or significant visual field loss and tunnel vision. Sometimes the extent of vision loss is considered to be legal blindness (20/200 or less visual acuity in the better eye) or almost total blindness.

How does low vision affect daily life?

With the loss of significant vision, it can become challenging to complete common daily tasks including reading, writing, cooking and housework, watching television, driving or even recognizing people.

When low vision is diagnosed it can come as a shock. Initially, it is an adjustment to learn how to function with impaired vision but the good news is there are numerous resources and products available to assist. It can be associated with depression, as there may be a loss of independence that is brought about by low vision.

Visual Rehabilitation and Visual Aids

Low vision means that a minimal amount of sight remains intact. There are millions of people who suffer from the condition and manage to function with the remaining vision available to them through the use of visual rehabilitation or visual aids.

What are visual aids?

These are devices that help people with low vision function by maximizing remaining eyesight. This often involves the use of magnifiers and other tools to enlarge the images of objects to make them more visible. Some visual aids reduce glare and enhance contrast which makes it easier to see. Other low vision aids act as guides to help the person focus on non-visual cues, such as sound or feel. Finding the right visual aid is a matter of consulting with a professional and experimenting with what works for you and your daily needs.

How to make life with low vision easier

  1. Ensure that you have adequate lighting in your home. This may require some trial and error with different lights and voltages to determine what works best for you.
  2. Use a magnifier. There is a vast selection of magnifiers available, ranging from hand-held to stand magnifiers. Binoculars and spectacle mounted magnifiers are also an option.
  3. Your optometrist or low vision specialist can recommend specialized lens tints for certain conditions such as retinitis pigmentosa or cataracts, which enhance vision or reduce light sensitivity.
  4. Use large print books for reading. Alternatively, try digital recordings or mp3s.
  5. Make use of high contrast for writing. Try writing in large letters with a broad black pen on a white piece of paper or board.
  6. Adding a high-contrast stripe on steps (bright color on dark staircase, or black stripe on light stairs) can prevent falls in people with low vision, and may enable them to remain independent in their home.
  7. Find out what other technology is available to help make your life simpler.

If you or a loved one has low vision, don’t despair. Be sure to consult with your eye doctor about the best course of action to take to simplify life with low vision.

Further Resources:

http://lowvision.preventblindness.org/

http://www.preventblindness.org/sites/default/files/national/documents/fact_sheets/MK34_LowVision.pdf

http://www.applevis.com/apps/ios-apps-for-blind-and-vision-impaired

8 Tips to Relieve Winter Dry Eyes

Whether you live in a climate with cold winter weather or you are planning a ski trip up north, winter can be a challenge if you suffer from dry eyes. Dry, cool air, cold winds and even drier indoor heating can cause eye irritation, burning, itchiness and redness, and sometimes even excessively watery eyes as more tears are produced to compensate for the dryness. Many people have a chronic feeling that they have something in their eye and some even experience blurred vision. These symptoms can be debilitating!

Dry eyes is one of the most common complaints eye doctors get from patients during the winter season, especially in the cooler climates. That’s why we’d like to share some tips on how to relieve dry eye discomfort, and how to know when your condition is serious enough to come in for an evaluation.

Tips to Relieve Winter Dry Eyes:

  1. Keep eyes moist using artificial tears or eye drops. You can apply these a few times each day when the eyes are feeling dry or irritated. If over-the-counter drops don’t help or if you have chronic dry eyes, speak to your eye doctor about finding the best drops for you. Since not all artificial tears are the same, knowing the cause of your dry eye will help your eye doctor determine which brand is best suited for your eyes.
  2. Use a humidifier to counteract the drying effects of indoor heaters or generally dry air.
  3. Point car vents or indoor heaters away from your face when the heat is on. Try to keep your distance from direct sources of heating, especially if they blow out the heat.
  4. Drink a lot! Hydrating your body will also hydrate your eyes.
  5. Protect your eyes outdoors with sunglasses or goggles – the bigger the better! Larger, even wrap-around glasses as well as a hat with a wide brim will keep the wind and other elements out of your eyes. If you wear goggles for winter sports, make sure they fit well and cover a large surface area.
  6. Soothe dry eyes using a warm compress and never rub them! Rubbing your eyes will increase irritation and may lead to infection if the hands are not clean.
  7. Give your eyes a digital break. People blink less during screen time which is why extensive computer use can lead to dry eyes. Follow the 20/20/20 rule by taking a break every 20 minutes to look 20 feet away for 20 seconds and make sure you blink!
  8. For contact lens wearers: If you wear contact lenses, dry eyes can be particularly debilitating as the contact lenses can cause even further dryness and irritation. Contact lens rewetting drops can help your eyes feel better and may also allow you to see more clearly. Not all eyedrops are appropriate for use with contact lenses, so ask your optometrist which eyedrop is compatible with your contacts and cleaning solution. If rewetting drops don’t help, consider opting for glasses when your dry eyes are bad, and speak to your optometrist about which brands of contact lenses are better for dry eyes. Many people find dry eye improvement when they switch to daily single use contact lenses.

Chronic Dry Eyes or Dry Eye Syndrome

Dry eye syndrome is a chronic condition in which the eyes do not produce enough tear film, or do not produce the quality of tear film needed to properly keep the eyes moist. While winter weather can make this condition worse, it is often present all year round. If you find that the tips above do not alleviate your discomfort or symptoms, it may be time to see a optometrist to see if your condition requires more effective medical treatment.

Diabetes and Your Eyes

Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million.

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring.

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes.

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy.

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness.

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

  • Blurred or fluctuating vision or vision loss
  • Floaters (dark spots or strings that appear to float in your visual field)
  • Blind spots
  • Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages.

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy.

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision.

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss.

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids.

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes.

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