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Many patients come to us every day struggling to get through their daily lives with their current choice of vision correction. Some have eyeglasses that do not sit properly on their face or feel that their peripheral vision is hindered by the frames. While contact users may find the lenses uncomfortable or have them fall out at inconvenient times. For these patients, we are pleased to offer orthokeratology, or Ortho-K, a revolutionary way to help you see clearly throughout the day without having to wear glasses or contacts and without having to get laser eye surgery.

What is Ortho-K?

Generations ago, eye doctors knew that the tissue in the eye was soft and somewhat malleable. This knowledge caused them to wonder if they could push the eye back into the proper shape, would an individual be able to see clearly even if they were not wearing their prescription lenses. With the development of gas permeable contact lenses, a few eye doctors began to notice that their patient’s prescriptions did not change as rapidly as previously noted and that they appeared to be able to see correctly even when they were not wearing their contacts.

From these early discoveries, the world of Ortho-K was born. Ortho-K is a special treatment to help patients see clearly even when they are not wearing a prescription lens. Instead, a special gas permeable contact lens is placed into the eye each night before bed and the lens gently pushes the eye into the proper shape while you sleep. In the morning, you can remove the lenses and still see clearly throughout the day. Some patients can even see clearly for up to three days after wearing them for just one night!

Who Should Consider Ortho-K?

• There are a number of issues that our patients can have with prescription lenses. If you have one of the following conditions or concerns, call our office today to schedule an appointment.

• Allergies to the materials in contact lenses

• Dry eye that is made worse by wearing prescription lenses

• Dirt or other debris that gets under contact lenses

• You play sports and do not want to worry about glasses or contacts

• The ability to wake up at night and see clearly

• A general dislike of glasses or contacts

What the Doctor Does During a Contact Lens Exam

…and why you still need it even if you already had an Eye Exam

A contact lens fitting is a separate medical evaluation that ensures contacts are safe, comfortable, and appropriate for your eyes. It goes far beyond checking your vision — it evaluates how a medical device (the contact lens) interacts with your eye.    Depending on your medical history, the doctor may do some or all of the following:

 1. Evaluates Your Eye Health

Before any lens goes on your eye, the doctor checks for conditions that affect contact lens wear, such as:

• Dry eye
• Allergies
• Corneal health
• Eyelid issues (like blepharitis)
• Tear film quality

2. Takes Specialized Measurements (Not Included in an Eyeglass Exam)

Contacts must match the anatomy and physiology of your eye. These measurements ensure the lens fits properly and won’t cause irritation or long-term damage.
 

Corneal Curvature (Keratometry)

Measures how steep or flat the front of your eye is.

• Too steep → lens can “suction cup” and reduce oxygen flow
• Too flat → lens moves excessively and causes irritation. This determines the base curve of your lens.

Corneal Topography (if needed)

Creates a detailed map of your cornea’s surface.

• Important for astigmatism, post-surgery eyes, or irregular corneas
• Helps select the right lens design and stability

Horizontal Visible Iris Diameter (HVID) (if needed)

Evaluates the width of the colored part of your eye.

• Determines the diameter of the lens
• Ensures the lens fully covers the cornea properly.

Pupil Size

Measured in bright and dim light.

• Affects night vision, glare, and halos
• Important for multifocal and specialty lenses

Tear Film Evaluation

Contacts rely on your natural tears for comfort and clarity. The doctor assesses:

• Tear quantity
• Tear quality
• Tear breakup time (TBUT)

What Tear Breakup Time (TBUT) Is

TBUT measures how long your tears stay smooth and stable on the surface of your eye before they start to evaporate or “break up.”

• A dye (usually fluorescein) is placed in your tears.
• You blink once, then hold your eyes open.
• The doctor times how long it takes for the first dry spot to appear.

A short TBUT means your tears evaporate quickly, which can cause:

• Dryness
• Blurry vision
• Contact lens discomfort
• Reduced wearing time

This measurement helps determine whether you need:

• A specific lens material
• A different replacement schedule
• Dry eye treatment before wearing contacts

Lid Position and Blink Pattern

Your eyelids influence how the lens moves and stays centered.

• Affects stability
• Especially important for toric and multifocal lenses

Baseline Corneal and Conjunctival Health

The doctor documents the condition of the cornea and surrounding tissues to monitor for future contact-related changes.
 

3. Selects the Correct Lens Type

Based on your measurements, eye health, and lifestyle, the doctor chooses:

• Soft or rigid gas-permeable lenses
• Daily, biweekly, or monthly disposables
• Toric lenses for astigmatism
• Multifocal lenses
• Specialty lenses

Even if you’ve worn the same brand for years, the doctor must confirm it’s still appropriate.
 

4. Test the Lens on Your Eye

You try on trial lenses so the doctor can evaluate:

• Centering
• Movement with blinking
• Rotation (for astigmatism lenses)
• Comfort
• Vision clarity

This ensures the lens is physically safe for your cornea.

There are many different elements that make up our eyes. One of these is the macula. This is part of the retina, which is found at the back of the eye. The macula contains a high concentration of light-sensitive cells. As they detect light that passes through the eyes, these cells send signals to the brain which then interprets them as images.

The macula contains three pigments. These are: lutein, zeaxanthin and meso-zeaxanthin. To preserve the health of the macula it’s necessary to maintain a deep layer of macular pigment. This will help to protect the cone cells from oxidative stress, keeping them healthy and functioning optimally for longer. The best way to achieve this is to find ways to replenish the macular pigment so that it remains thick and offers the greatest protection from the type of damage that characterizes eye diseases such as macular degeneration.

It’s true that lutein and zeaxanthin can be found in certain foods such as dark, leafy vegetables and citrus fruits, but you would need to consume large amounts to give the level of these nutrients an effective boost. Meanwhile, meso-zeaxanthin is much harder to increase through consumption alone. Fortunately, there is another option – supplements. Studies have shown that taking supplements that contain all three macular pigments can slow the progression of conditions like macular degeneration and keep vision optimized for longer.
 

Routine eye exams are an important aspect of maintaining one's overall health. As with an annual physical or dental exam, it is extremely important to have your eyes examined regularly. Regardless of how great your eyesight is, scheduling regular eye exams is a great way to stay on top of your overall health.

Adults should have an eye exam every 1-2 years, depending on any existing vision problems, eye conditions or being diagnosed with significant risk factors, such as diabetes, high blood pressure, thyroid disease, previous eye injuries or family history. The doctor will recommend a frequency for routine follow-up exams based on the patient’s medical history. For instance, a diabetic patient will need a dilated eye exam every year while contact lens wearers need exams every year in order to look for changes that might affect lens fit and eye health.

Regular eye exams will also ensure that prescriptions for glasses or contact lenses are current as well as offer an opportunity to check for early signs of certain diseases. Adults older than 60 should have an eye exam each year, as age-related eye problems are more common.

It may be important to see a doctor more frequently if one is experiencing any of the following:

• Blurry vision or loss of vision.

• Difficulty seeing things near and/or far away and perform basic tasks.

• Flashing light in the eye.

• Eye floaters, or small spots that appear in vision.

Amblyopia, also known as a “lazy eye”, is described as a reduced vision in one eye compared to the other. There are some rare forms of amblyopia that involve both eyes. Amblyopia is the most common cause of partial or total blindness in one eye in children.

The term lazy eye is misleading because the eye is not actually lazy. In fact, it is a developmental problem in the nerve connecting the eye to the brain, affecting the brain’s ability to use both eyes together. It is not a problem in the eye itself, but in the brain which actively ignores the visual input from the misaligned eye, leading to amblyopia in that eye.

In addition to poor visual acuity, people with amblyopia are more prone to having difficulties with depth perception, eye movements related to reading, and visual decision making while driving.
 

What Are The Causes of Amblyopia?

Amblyopia develops in childhood due to:

• Significant differences in the prescription (refractive) status between the two eyes due to nearsightedness, farsightedness or astigmatism;

• Constantly misaligned eyes or crossed eyes (strabismus);

• An obstruction of vision in early childhood i.e. cataract, ptosis (droopy eyelid)
   

It is important to note that, because amblyopia is typically a problem of infant vision development, symptoms of the condition can be difficult to detect. Symptoms may include noticeably favoring one eye over the other, an eye turn (either upward-downward outward or inward) or a tendency to bump into objects on one side.

The best way to identify children who are at risk for or already have amblyopia is by performing comprehensive eye examinations.
 

How Is Amblyopia Treated?

Amblyopia can be treatable at any age, although the earlier the problem is found and treated, the more successful the outcomes tend to be.

Regular eye exams are important for children since their eyes can change significantly in as little as a year as the muscles and tissue develop. Good eyesight is critical for a child’s life and achievements since success in school is closely tied to eye health. School demands intense visual involvement, including reading, writing, using computers, and blackboard/smartboard work. Even physical activities and sports require strong vision. If their eyes aren’t up to the task, a child may feel tired, have trouble concentrating, have problems in school or have difficulty playing their favorite games which may affect their overall quality of life.

When to Perform a Pediatric Eye Exam?

According to research, a child should have an initial screening between 6 and 12 months of age. After that, routine eye health and vision screenings throughout childhood should be performed in order to help detect any abnormalities as their eyes develop. Then, unless otherwise recommended, every two years thereafter until the age of 18.

For a newborn, an optometrist should examine the baby’s eyes and perform a test called “red reflex test” which is a basic indicator that the eyes are normal. In a case that the baby is premature or at high risk for medical problems for other reasons, has signs of abnormalities, or has a family history of serious vision disorders in childhood, the optometrist should perform a comprehensive exam.

A second eye health examination should be done to infants between six months and the first birthday. This examination includes tests of pupil responses to evaluate whether the pupil opens and closes properly in the presence or absence of light, a fixate and follow test to determine whether the baby can fixate on an object such as a light and follow it as it moves, and a preferential looking test which uses cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes and thus vision capabilities can be assessed. Infants should be able to perform this task well by the time they are 3 months old.

For a Preschooler, between the ages of 3 and 3½, a child’s visual acuity and eye alignment should be assessed. If the child is diagnosed with misaligned eyes (strabismus), "lazy eye” (amblyopia), refractive errors (astigmatism, myopia, hyperopia) or any other focusing problems, it’s important to begin treatment as soon as possible to ensure successful vision correction and life-long benefits.

At School age or upon entering school, the child’s eyes should be screened for visual acuity and alignment. In this age group, nearsightedness (myopia) is the most common refractive error and can be corrected with eyeglasses.
 

Both optometrists and ophthalmologists treat many common types of ocular disease. However, for the best outcome, it’s important to see an eye doctor regularly. They can identify any issues before they become serious problems.

Fortunately, they can treat all of the diseases mentioned below, and in some cases, you can do certain things to prevent them from developing. Look at the most recent statistics, and you’ll see why good eye health care matters.

Currently, more than 4.2 million people in the U.S. alone over the age of 40 are partially blind or have poor visual acuity. Although a lot of things cause these problems, the ocular diseases listed below are the most common.

Macular Degeneration

This is commonly referred to as “age-related macular degeneration” because it affects seniors. Not only does it cause blurriness and distortion but left untreated, individuals lose their central vision. In other words, they are unable to see anything through the center portion of the eye.

Two types of this ocular disease exist. First, wet macular degeneration means that abnormal blood vessels that are located behind the retina grow under the macular. Along with leaking blood and fluid, this leads to scarring and, sometimes, permanent damage. Second, dry macular degeneration progresses slowly as part of the natural aging process. Typically, it affects both eyes at some point.

Cataracts

Roughly 20 million people in the U.S. over the age of 40 have cataracts in either one or both eyes. While they can develop in children, teens, and young adults, cataracts are most often associated with age. With this, a film covers the eye, which, in turn, makes everything appear blurry.

Of all the different kinds of ocular diseases that lead to blindness worldwide, cataracts rank number two. Fortunately, an eye doctor can remove the damaged lens, followed by implanting an artificial one. After recovery, patients see amazingly well.

It is common knowledge that exercise plays a critical role in healthy living. Exercise can help improve energy levels, lower blood pressure, aid in weight loss, helps to build muscle and so much more. But one benefit of exercise that is not as well known is the profound impact on your eyesight. 

Based on recent research, eye conditions are usually a direct result of a health issue such as high blood pressure, diabetes, high cholesterol level, etc. While some of these diseases are unavoidable, exercising regularly can definitely help in the prevention of these diseases and in doing so, help keep the eyes healthy. In addition to physical exercise, there are even some eye exercises that can be done to keep your vision healthy. Some examples are focusing on certain points, rolling your eyes in different directions, writing with the eyes, etc.

Cataracts and Exercise

According to a study in 2003 and another in 2006, a relationship was discovered between an increase in exercise and a decrease in cataract. It emphasized that there is a greater chance for cataract if there is an absence of physical activity. This implies that taking a light walk or jog around your house or on a field track consistently can contribute to the fight against cataracts.

Macular Degeneration and Exercise

According to one study, exercising three times or more on a weekly basis reduces ones’ chances of developing exudative macular degeneration. Exudative macular degeneration occurs when blood vessels grow beneath the retina that are not needed and then leak fluid and blood into the eyes.

Glaucoma and Exercise

One major cause in the development of glaucoma is an increase in ocular perfusion pressure. Very light exercises like jogging or walking at least three times weekly helps to reduce the intraocular pressure and improves the flow of blood to the optic nerve and retina.

The benefit of eye exercises

• Protects against dry eyes. Eye exercises help maintain and improve the fluid level in the eyes, thus eliminating the probability of dry eyes because as the eyes are being exercised say by rotation, there is the tendency that fluid is produced.

• Reduces eye strain and tension. Exercising the eyes daily helps in reducing the strain and tension that has been placed on the muscle. Exercises like rolling the eyes and writing with the eyes help in the contracting and relaxing of the eye muscles. Long hours of study or use of a computer can cause blurry vision, but through exercise, clarity can be achieved by eliminating tension and unnecessary pressure.

• Make the eye muscles flexible. Exercises like shifting and swinging the muscles of the eyes help promote flexibility in the muscles of the eyes. Just like exercise helps the body muscles, the same thing applies to eye exercises.

Sports vision is a growing niche in the eyecare industry, helping athletes improve their performance skills through the enhancement of visual skills. While regular eye exams are important for checking the health of your eyes and your visual acuity (how clearly you can see a still object at different distances), sports vision testing is recommended for anyone who takes their athletic performance seriously. 

Visual skills needed for sports performance

There are several key visual skills that are enhanced through sports vision programs for athletes that aim to achieve their optimal sports performance, these include:

• Dynamic visual acuity: this refers to the patient’s ability to see objects clearly while in motion. This is exceptionally important as hand-eye coordination and reflex reactions are essential for success in most sporting activities.

• Contrast sensitivity: good contrast sensitivity is needed to determine the difference between an object and its surroundings. Contrast sensitivity is particularly important in situations where there may be low light, fog or glare that could diminish the natural contrast between objects and backgrounds. 

• Eye tracking: this refers to the ability to follow a fast-moving object, such as a ball or puck.

• Switching eye focus: athletes need to be able to change their focus quickly and accurately from one distance to another. 

• Binocular vision skills: also known as eye teaming skills, these skills determine how well your eyes work with one another to produce a single, clear image.

• Processing speed: visual processing speed is defined as the amount of time it takes to make a correct judgement about a visual stimulus – for example, how fast a ball is travelling towards them. 

• Peripheral awareness: athletes also need to be able to be aware of what is happening at the edges of their vision while also concentrating on a fixed object in front of them.

Sports vision testing can enable your eye doctor to spot any weaknesses that you may have in any of these key visual skills. By identifying them, it is possible for you to undergo treatment to overcome theses issues and meet your specific goals that will ultimately enhance your overall athletic performance. This is known as sports vision training.

We all want to enjoy healthy eyes and clear vision for as long as we possibly can. Fortunately, there are things that we can do to help make this possible. It’s easy to think that protecting our eyes from obvious harm, such as the harsh effects of UV light or potential injury during an activity like welding or woodworking, is enough. However, there are many other things that we can do to keep our eyes functioning well for as long as possible. This includes taking supplements to help ensure that we get the right nutrition for our eyes to be healthy.

EyePromise offers a range of highly effective and expert-recommended nutritional supplements that are designed to support optimal eye health.