Fact or Fiction: Common Eye Myths Debunked

November 24, 2014 10:14 am

Does eating carrots really improve vision? Can excessive computer use cause permanent damage to your vision? Here are a few truths and myths commonly encountered by eye care professionals.

Eating carrots can improve visual functioning: FICTION (mostly) 

The Allied fighter pilots in WWII believed carrots improved night vision, making it easier for them to target enemies in the dead of night. While carrots do contain beta-carotene (Vitamin A)—a very important component of the visual pathway—unless an individual is heavily deficient in vitamin A, munching on all the carrots in the world will not help improve vision. That being said, there are foods high in Lutein such as broccoli, spinach and kale, which can be beneficial in the prevention of certain eye diseases including macular degeneration. Found in fish, Omega-3’s have also been shown to help with the prevention of macular degeneration and help people who suffer from dry eye disease.

Excessive computer use can cause degradation in vision: FACT 

Although it won’t cause a permanent decrease in vision, excessive computer use can cause the eyes to dry out leading to a temporary blurring of vision. We tend to blink 50 per cent less when looking at a computer screen or cell phone. This reduction in blink rate can cause a degradation in the tear film that normally coats the front surface of the eye which can in turn cause temporary blurring of vision. Remembering to blink and using artificial tears can help to reduce dry eye symptoms related to computer use.

Children don’t need an eye exam if their vision seems fine: FICTION

Studies show that one in four children have an eye disorder that can interfere with learning and development. Even though a child may be able to see 20/20, there are many other eye conditions such as amblyopia (lazy eye) that need to be addressed at an early age to reduce the likelihood of permanent vision loss in the future. Eighty per cent of learning done by children is visual which is why it is so important for them to have an eye exam at least before they start junior kindergarten.

Eye Exercises can improve vision and reduce the need for glasses: FICTION (mostly) 

This is a common eye myths encountered by optometrists. Eye exercises, otherwise known as ‘vision training’ can help alleviate some binocular vision issues, but only in individuals with pre-existing eye conditions. For individuals with otherwise healthy eyes, eye exercises will not reduce the need for glasses in the future.

Optometrists in Ontario can prescribe medications for the treatment of ocular diseases: FACT 

Certified optometrists in Ontario are specifically trained and have the tools to prescribe and treat many ocular diseases such as eye infections, dry eye, pink eye and glaucoma. They also work closely with general physicians and ophthalmologists to provide comprehensive eye care.

By John-Paul Muggeridge and Dr. Thomas-A. Noël

The Damaging Effects of UV Light on the Human Eye

July 14, 2014 9:21 am
Adorable girl on vacation

As Canadians, we know a thing or two about eye protection. If we are not dealing with the bright, muggy Canadian summers, we are dealing with the snow-blindness inducing long winters. Heck, we even invented them! It was the Inuit who were living in what is now northern Canada, who invented the first sunglasses composed of two horizontal slits fashioned out of ivory or bone.

We hear a lot in the news about the damaging effects of sun-exposure to the skin, but rarely do we hear about the significant damage the sun can have on the eyes. A recent study conducted in the United States showed that 79 per cent of people believe that sun is harmful to the skin, but only six per cent of people believe it is damaging to the eyes.

The eye is an incredibly complex and sensitive structure composed of many vital and vulnerable tissues. UV radiation affects almost every one of these tissues, starting with the eyelids, as well as the cornea and lens. It even affects the deepest structures within the eye, including the retina.

UV is considered, by the International Agency for Research on Cancer—an offshoot of the World Health Organization—as a group 1 carcinogen, which is the highest designation for cancer causing entities, sharing the spotlight with the likes of tobacco, x-rays and asbestos. More than one-third of all new cancers are skin cancers and up to 90 per cent of skin cancers are caused by UV exposure. The eyelid is an incredibly sensitive structure composed of the thinnest skin on the human body, making it more susceptible to UV damage. This explains why 5-10 per cent of all skin cancers originate around the eyelids.

Sun exposure can also lead to changes of the cornea, the clear front tissue of the eye. It can lead to formation of a growth on the cornea called a pterygium. If left untreated, a pterygium will continue to grow, eventually affecting an individual’s central vision. Another type of sun-causing growth is called a pinguecula. These types of growths are yellowish in colour and, if they grow large enough, can start to cause unsightly irritation and redness.

UV light is also linked to cataract formation. Cataracts are caused by oxidization changes within the lens, a structure located deeper in the eye. Cataracts are the leading cause of blindness in the world. Each year 12-15 million people around the world become blind from cataracts, of which up to 20 per cent may be caused or aggravated by sun exposure. It can also penetrate the far recesses of the eye and can even affect the retina contributing to the development of macular degeneration—a potentially vision-threatening disorder.

With the ongoing depletion of the ozone layer over the last decade, more and more UV light is penetrating the atmosphere—meaning it has never been more important to protect the eyes from the damaging effects of the sun.

Eye Health: Indicator of Overall Wellness

March 3, 2014 9:44 am

It is often said that the eyes are the windows to a person’s soul. Although observing the soul has been rather elusive in my clinical experience, the eyes are like windows in many respects. They are the windows we use to help us understand and process the world. As a practicing optometrist, the eyes also offer us a unique view into the overall health of the body. In fact, it is the optometrist who is often the first health professional to detect systemic disorders such as diabetes, high blood pressure and even multiple sclerosis.

The eyes are wonderfully complex and unique in many ways. One of the ways they are unique is that they are one of the only parts of body where it is possible to non-invasively view internal blood vessels in their natural state. Subtle changes in the blood vessels located in the retina; a very thin vital tissue covering the back inside surface of the eye could be warning signs for more global, systemic health concerns.

Take diabetes for example. Nearly 1 in 4 Canadians suffer from either diabetes or pre-diabetes. Uncontrolled diabetes can cause changes in the blood vessels throughout the body including the eyes—changes that can be detected even before an official diagnosis of diabetes has been made. Likewise, high blood pressure, which can also cause structural changes to blood vessels, can be detected during a regular eye exam.

In addition to allowing for insight into an individual’s cardiovascular health, the eyes also provide insight into the health of the brain and can even lead to the diagnosis of multiple sclerosis. In up to 20% MS cases, the initial manifestation of the disease is inflammation of the optic nerve which can be detected during a routine eye exam. New research is also suggesting that an eye exam might someday help to detect certain types of dementia, specifically Alzheimer’s disease, long before the symptoms of confusion and memory loss happen. This would be a massive breakthrough in the medical profession especially because presently the official diagnosis of Alzheimer’s can only be made after post-mortem analysis.

Probably the most shocking example of ocular symptoms relating to overall health of the body is gout. Gout is a common type of inflammatory arthritis which primarily affects the big toe joint. Remarkably, gout is also linked to inflammation of the eye causing pain and redness to the ocular surface. In other words, a disease that primarily affects the big toe can also cause changes to the eyes, located on the exact opposite end of the body!

There is no other part of the body that offers such a unique and clear insight into the global health of the body than the eyes. This is why, in addition to getting your glasses prescription, a simple visit to your optometrist can play a crucial role in ensuring good ocular health as well as overall wellness.

Online Medical Devices: Sacrificing Safety for Price

November 21, 2013 11:14 am

In this fast-paced age of the Internet and instant information it can become easy to overlook safety when buying medical devices online. Yes the internet makes it more convenient for us to purchase items, but is buying something online always better? Are there ever circumstances where sacrifice must be made for convenience and price?

The eyewear industry much like many other industries has been greatly affected by the Internet age. The difference is glasses are a medical device which should be obtained with a prescription from a regulated professional. It’s one thing buying a new pair of shoes online. It’s a whole other thing purchasing a customized medical device online especially when that device can mean the difference between seeing trouble on the road ahead or not.

There is a lot more to a glasses prescription than just the numbers. The prescription you get from your optometrist is contingent on various measurements. If these measurements are off even slightly, and the eye is not looking through the perfect optical center of the glasses, eyestrain, headaches, and most importantly distorted and sub-par vision can occur.

Online glasses companies do not take into account these important measurements. In fact, a study done by Pacific University College of Optometry in 2011 evaluated 154 pairs of spectacles from 10 popular online glasses vendors. Of these glasses, 28.6% (1 in 4 glasses) failed a tolerance standard for at least 1 optical parameter and 22.7% failed impact resistance testing. If this is the case, why are we still buying glasses online? There are two reasons: price and convenience. But have you ever stopped to think why it is that online glasses are so inexpensive?

When glasses are purchased at your local optometrist office, various measurements are taken including the tilt of the glasses when they are sitting on your face (pantoscopic tilt), the distance between the pupils (interpupillary distance)—which changes depending on whether you are looking in the distance or up close—the distance of the lens to your eyes (vertex distance) and how high your eyes sit when the frame is on your face (segment height). Your optometrist will take all these measurements into account when they design lenses for you to ensure clear and non-distorted vision. Except for the interpupillary distance, online optical do not take into account these important measurements.

Once the lenses are ordered and verified by the regulated professional, the glasses are then fitted to the patient based on the measurements taken earlier. By not using regulated health professionals to verify and adjust the glasses, online glasses companies are able to skip these crucial safeguards which allows them to charge much less for their product.

Again we return to the question, is buying online worth the price and convenience? Most people wouldn’t dream of buying a specialized medical device such as a customized hearing aid or customized knee brace online, so then why are we buying a customized optical devices online?


By: Dr. Thomas-A. Noël, B.Sc., O.D. & Dr. John-Paul Muggeridge, B.Sc., O.D

Ocular Dryness: There is more than meets the Eye

November 13, 2013 11:41 am
eye drops

Winter has arrived in Ottawa, which means it’s time to dust off the old shovels and ice scrapers we have joyously stashed away for the summer. For people suffering from dry eye the arrival of the dry winter air is also the time to dust off the eye drops.

Dry eye syndrome (DES), affecting up to 20% of adults, is one of the most common conditions seen by primary eye care providers.  Dry eye disease is characterized by an inadequate volume of tears or quality of tears leading to inflammation, irritation, redness and a decreased quality of vision that cannot be corrected with glasses. It is a complicated disease with many causes making it challenging to treat, however with the right approach, an eye care professional can tailor a treatment plan that will reduce the symptoms of dry eye.

Dry eye can be grouped into two categories: evaporative dry eye and aqueous deficient dry eye. Aqueous deficient dry eye causes a reduction in the quantity of tears produced by the eye. A decreased production of tears is generally followed by an increase in concentration of inflammatory products on the surface of the eye leading to the sensation of dryness. Evaporative dry eye, on the other hand, is caused by a decreased quality of tears. Lower quality tears lack an important component called the lipid layer of the tears, that prevents them for evaporating too quickly. When the tears evaporate too quickly the eyes tend to dry out, leading to dry eye symptoms.

There are many causes of dry eye syndrome. It is the job of your optometrist to determine what the cause of your dry eye is in order to create a specific treatment plan. The more commonly known causes of dry eye include age, hormonal changes, allergies, contact lenses and environmental causes such as a drafty, low-humidity environment. There are also many less-known causes of dryness including certain systemic diseases and medications, inflammation or infections of the eyelids and even too much time in front of a computer screen (we blink 50% less in when in front of a computer!).

The type of treatment for dry eye disease depends on the cause and severity. For many years, the first line treatment for dry eye is lubricating eye drops. Although they work in some cases, there are other, newer treatment options that can help to relieve the symptoms of dry eye.  Eyelid scrubs, warm compresses and even omega-3 supplements can help increase the quality of tears leading to a reduction in dry eye symptoms. For more severe cases, anti-inflammatory drops such as Restasis can help rejuvenate the ocular surface of the eye and relieve dry eye symptoms.

In addition to booking an appointment to get the winter tires installed, consider booking an appointment with your optometrist today to learn more about how to treat your dry eyes.

Volunteering for Your Eye Health – Diabetes

March 13, 2013 12:11 pm
Close-Up of a Blue Eye

Dr. Thomas A. Noël

There is a pressing need to promote inter-professional collaboration to optimize eye care for Ontarians. For the past three years, I have served as co-chair of the Eye Health Council of Ontario (EHCO), which has the mandate to support provisions of accessible, quality eye care to the population of Ontario. One of our main objectives is to improve eye care for diabetic patients.

In 2011, EHCO developed guidelines to coordinate the services of eye care providers and primary health care providers in the management of patients with diabetes, in order to reduce the incidence of ocular complications.

Diabetic retinopathy is the leading cause of legal and functional blindness for persons between the ages of 25 and 75 worldwide. In Canada, it’s expected that all patients with type 1 diabetes and more than 60% of patients with type 2 diabetes will develop some form of retinopathy in the first two decades following the diagnosis of diabetes. Diabetic retinopathy, if left untreated, can cause blindness. However, early screening and assessment with regular follow-up can lead to prompt diagnosis and successful treatment of this debilitating condition.

Presently, one million people live with diabetes in Ontario. In the Ottawa region alone, it’s estimated that over 83,000 people over the age of 18 live with diabetes. Yet nearly one in three living with diabetes in the Ottawa area have not had a retinal eye exam in the past two years. This is a great concern because untreated diabetic retinopathy can lead to blindness.

One of these reasons is a lack of knowledge on the part of the patient. Patients need to understand that they can help prevent vision loss and slow the progression of diabetic retinopathy by controlling their blood sugars, maintaining healthy blood pressure and cholesterol levels, and by having regular eye exams at recommended intervals. Early stages of diabetic retinopathy have no warning signs, so getting regular eye exams is vital for detecting the disease.

For patients with diabetes, OHIP covers the cost of one major eye exam per year, including a retinal assessment. The optometrist may recommend a retinal image. This is a great educational tool for patients, because it shows them if there are any signs of diabetic retinopathy such as leakage of the blood vessels or the capillaries, and demonstrates the importance of maintaining stable blood sugars. Year to year, you can compare and see if there’s actually improvement or deterioration with retinal imaging.

Physicians and nurse practitioners can expedite the initial screening process for diabetic patients by referring them to optometrists – professionally trained eye care providers who have the knowledge and skills to perform dilated eye exams for diabetic retinopathy assessment. The optometrist can identify patients who require therapy and fast-track a referral to a retinal specialist for treatment.

If you suffer from diabetes, see your optometrist!

Eye See You Series: The University of Ottawa Eye Institute at the Ottawa Hospital

January 21, 2013 11:23 am

Proper eye care is something that must be approached from many different perspectives. Individual eye care is just as important as surgical, clinical, and preventative care for maintaining proper vision and healthy eyes. At the University of Ottawa Eye Institute, eye care is top priority, with a dedicated staff of individuals working in a number of different fields and capacities promoting healthy eyes.

The Eye Institute is a world-class facility that houses clinical, education, and research departments all dedicated to promoting, advancing, and investigating important issues related to ophthalmology and eye care, such as epidemiology, ocular pathology, ocular genetics, neuro-ophthalmology, cornea, uveitis, and glaucoma.

First opened in 1992, the founders of the Eye Institute sought to create an eye care facility that promoted a holistic approach to visual health. Today, their mission continues to be upheld in practical ways, as the Institute promotes advances in visual disease and disorder research, prevention, and treatment.

Their staff all come from a variety of specialized fields of eye care. With a medical staff touting subspecialty training at some of the most prestigious fellowship training centres in North America, the Institute staff have created and contributed to programs in the fields of cellular and molecular biology, electrophysiology, sensory perception, optical care, visual performance, and biomedical technology. Through cooperative efforts, these experts have also worked extensively in refractive surgery, tissue engineering, and ocular genetics. There are very few eye care centres in the world that have achieved the same levels of collaboration between specialized fields.

Margaret Beddaoui measures the activity of Sarah Wassmer’s retina with an electroretinogram. PHOTO COURTESY CIHR

According to Dr. Steven Gilberg, who works on the general campus of Ottawa Hospital  as the chair and site chief of the department of Ophthalmology for Ottawa Hospital among other important roles,  the Eye Institute has “a strong dedication to giving medical students an exposure to ophthalmology.” Students educated at the Institute are given the opportunity early in their academic experience to work alongside various ophthalmologists in different disciplines. “It’s almost a ‘Bring Your Medical Student to Work Day,’” said Gilberg. “It encourages what elective [the students] choose in later on, but also allows them to become familiar with all the different fields they could be a part of. They understand the basic tenants of different fields, which gives them a backup plan if they end up changing disciplines.”

The Eye Institute offers four-year programs for its 160+ medical students from all around the world. They also accept two new residents a year, carefully selecting the crème-de-la-crème from over 150 applicants every year. The Institute also offers two-year fellowships for specialists in retina, neural ophthalmology, oculoplastics, and cornea studies, as well as ophthalmologic general technician training programs for those looking to become medical technicians.

Residents and fellows are given the freedom to become specialists in whatever field they choose, working on their own research projects. Projects are presented annually on Resident Research Day, a special event held to encourage individual research among the residents. Esteemed professors from around the world moderate the event and distribute prizes to the best research projects. Last year, Dr. Robin Ali, an expert in the field of Human Molecular Genetics, came all the way from the University College to participate in the event.

The Eye Institute also hosts the Sally Letson Symposium, the largest ophthalmologist meeting in  Canada. Specialists from Austra, France, Germany, England, the US, and across Canada came to discuss clinical cases and technological innovations in ophthalmology and eye care. This past year, Dr. John Marshall, the inventor of the revolutionary excimer laser treatment, came to talk about cataracts and issues with the cornea.

Many new and exciting discoveries and innovations have been made at the Institute from fellows and residents working closely together. Dr. Cathy Tsilfidis, for example, is currently conducting advanced studies of cell-regeneration on newts, looking to create working regenerative medicine models that would use the XIAP gene to prevent cells from dying. The findings from her team’s studies could potentially help prevent ocular cell damage that occurs from glaucoma, macular degeneration, and diabetes, resulting in vision loss. Meanwhile, Dr, Valerie Wallace is conducting research on stem cell regulation in eye development. She and her team hope to control cell growth in the retina to allow the cells to grow rapidly without becoming cancerous. Advanced retinal electrophysiological studies are also being conducted by Dr. Stuart Coupland using electronic signalling to better understand how retinal damage can be prevented.

Along with its excellent reputation for academic research and education, the Eye Institute’s staff has been internationally praised for excellence in medical care for their patients. With the latest technology and a multi-faceted approach to study and discovery, the experts at the ocular branch of the Ottawa Hospital are able to offer the very best testing and treatment to their patients.

If you are interested in getting a check-up, ophthalmic diagnostic services are available on site. Please check with your ophthalmologist or eye doctor for more information.


TOP PHOTO: Dr. Steven Gilberg, University of Ottawa

Eating Healthy, Seeing Great!

November 21, 2012 9:00 am
Dr. Thomas Noel

By  Dr. Thomas A. Noel

There’s an old saying: you are what you eat. This proverb is closer to the truth than we might expect, even in the context of, believe it or not, your sight. The eye has a very thin tissue called the retina which helps us see. The retina consumes the most oxygen per grams of tissue in our body. Therefore, systemic diseases such as diabetes, hypertension and age-related macular degeneration (ARMD) can be diagnosed via the retina.

Research has established that healthy eating with vitamin supplements is crucial in preventing or slowing down the progression of ARMD, which is the leading cause of blindness in people age 65 and over in the western hemisphere. To address this issue, I recommend several important nutrients to help preserve your vision for years to come.

First, eat more fish (omega-3) such as sardines, mackerel, lake trout, Atlantic halibut, herring and wild salmon (which are high in a super carotenoid called astaxanthin that is proving to be a key nutrient in the nutritional approach for combating ARMD). Omega-3 also provides anti-inflammatory agents in the body.

You can also get more omega-3 fatty acids by taking micro-distilled triglyceride from fish oil. (However, stay away from the ethyl ester form of fish oil. Alcohol attaches to the molecule which results in poor absorbtion, compared to triglyceride from fish oil.

Consume dark green leafy vegetables like spinach, kale, collards and Swiss chard. Carefully boil, steam or simmer these in extra virgin olive oil. Gentle cooking helps to break down the cell wall, releasing the bio-availability of the greens. Lutein is abundant in dark green leafy vegetables and has been shown to potentially help slow down the devastating properties of ARMD. Lutein and its related compound zeaxanthin are highly concentrated in the macula, providing a yellow color known as the macular pigment, which acts like a built-in sunscreen protecting the macula from the damaging photo-oxidative effects of ultra-violet (UV) rays. Eating more foods that contain lutein or taking a supplement with 10-20 mg of lutein daily will help replenish the macula pigment density that you are more prone to lose as you age.

Orange bell peppers are high in zeaxanthin. Scientists believe this nutrient when combined with lutein filters out dangerous UV rays and may help maintain macular health. Another option is goji berries which are one of nature’s most powerful antioxidants.They contain a very high concentration of zeaxanthin. Goji berry is one of the richest edible plant sources known for zeaxanthin content.

Lastly, drink red wine! New research seems to indicate that drinking red wine in moderation may have some positive impact on ARMD since resveratrol (found in red wines) is a powerful antioxidant proving to have many health benefits.

Enjoy years of great vision by eating healthy!


Eye See You Series: Protect Vision and Eye Health Against Damaging UV Light

June 7, 2012 1:14 pm
Feature Image

Essilor, the world leader in ophthalmic optics, recently launched Crizal UV, a clear eyeglass lens offering the most advanced protection against damaging UV light. This exclusive lens blocks UV rays entering the eye from the front and back sides, while maintaining unmatched clarity of vision. This innovation is currently available in Canada as Crizal Sapphire UV, Crizal Forte UV and Crizal Sun UV lenses and will be applied to the entire Crizal range by summer. Essilor also introduces a new “Eye-Sun Protection Factor” for lenses, in order to drive consumer awareness about the importance of global UV protection for eyewear.

“Essilor is proud to be once again at the forefront of innovation, being the first to launch an eyeglass solution offering protection for eyes and the surrounding area against UV damage. This issue is so important that we have also introduced the Eye-Sun Protection Factor to build consumer awareness and understanding about this issue” says Catherine Quézel, Brand Marketing Manager at Essilor Canada Ltd.

UV rays have a direct and irreversible impact on eye health

UV Light: A Significant Threat to Healthy Vision 

UV rays have a direct and irreversible impact on eye health: UV light has been proven to accelerate eye ageing, skin cancer and the appearance of cataracts. It is estimated that 15 million people worldwide become blind from cataracts annually, of which up to 20 per cent may be caused or aggravated by UV exposure. In addition, 5 to 10 per cent of skin cancers, also directly linked to UV rays, appear in the eye periphery. UV rays pose a threat 365 days a year, even in cloudy weather as 40 per cent of UV exposure occurs when people are not in full sunlight.

Essilor’s New Solution: Exclusive Backside UV Protection

Most lenses prevent transmission of most of the UV rays hitting the front side of the lens. However, up until now, even the best clear eyeglasses did not protect against the danger of the UV rays coming from the back and side of the lens, which can represent up to 50 per cent of damaging UV light.

The Essilor innovation involves a new anti-reflective coating on the backside of the lens – called the Broad Spectrum Technology – which virtually eliminates UV light reflection into the eyes while maintaining the premium transparency of the lens.

The launch of the new Crizal UV constitutes a breakthrough which has the potential to make an impact on the lives of individuals with all types of vision needs.

Introducing the Eye-Sun Protection Factor to Drive Consumer Awareness

A recent consumer survey* in Europe showed that more than two-thirds of consumers were unaware that clear lenses offered any protection against UV and over 90 per cent recognized the utility of a UV protection index for eyewear.

More than two-thirds of consumers were unaware that clear lenses offered any protection against UV.

To increase consumer awareness about efficient types of UV protection for eyes, Essilor has developed an Eye-Sun Protection Factor (E-SPF) rating system, inspired by the systems used to rate the efficiency of skincare and sunscreen products. This evaluation system provides an objective laboratory index for eyewear, certifying the global UV protection of a lens. It will help consumers understand the level of UV protection provided by their eyewear. Values vary from 2 to a maximum of 25 for clear lenses and “50+” for tinted as well as polarized sun lenses. With an E-SPF of 25**, Crizal UV lenses are the only ones to reach the best level of protection in the clear lens category and outperform other lenses on the marketplace.

Developed and studied in collaboration with independent third parties, the E-SPF protocol and values have been endorsed by Dr. Karl Citek, American Professor of Optometry, Doctor of Optometry (OD), PhD, Foundation of the American Academy of Ophthalmology (FAAO), and one of the first researchers to have established the hazard linked to UV backside reflection.

Essilor is convinced that this unique evaluation system, along with Crizal UV, will improve consumer knowledge about visual health protection from the invisible and often irreversible dangers of UV light.

For more information, contact Marie-Claude Deschamps, Communications Manager, Essilor Canada Ltd; 514 337-2943, ext. 3218; mdeschamps@essilor.ca

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