The old saying of life begins at 40, is also the age when people start to notice their near vision changing. It gets harder to focus on small details, things up close are harder so you start holding the page out a bit further. In low light it gets harder to see and you’ll start to find work-arounds – like enlarging the font on your phone, turning on more lights or just going over by the window to see more easily.  Those arms are just getting too short and your eyes need more light to see!

The average age for needing reading glasses is 43.  Some people need them sooner and others hang in there a bit longer.  But for many people, this is the first time they find an optometrist. At your eye examination there is not just finding out about focusing your vision but also the reality of the important eye health checks.  Chances of developing eye conditions, such as glaucoma, increase when you’re over 40, so as an optometrist, we’re really pleased to meet you and take care not only of helping you see more clearly but also ensuring your eyes stay healthy.  This is the annoying reality of actually being grown up.

The problem for all of us into our 40s is called “presbyopia”.. The Greek translation is from presbus “old man” and new Latin opia “vision problem”.  Really not very cheery, but our life expectancy is definitely longer than in ancient times.  Turning 40 is really only on the half way mark for the NZ average life of around 82 years!

So once we’ve worked out what lens power or prescription we need for your glasses, then it turns more technical options with different lens designs.  Depending on how much time you spend reading vs on your laptop or desktop, how many screens on your desk and what’s the mix of time looking up close and then further away eg meetings or shopping.  There are many different lens options to consider and recommend, as well as lens surface coatings that reduce reflections and give you the clearest vision.  There’s also the option to have coatings that reduce the blue light that transmits through the lens if you are doing a lot of time looking at screens.

For some people their glasses are entirely functional, and others are high fashion.  You only live once and so let’s make your glasses great.  If you are the functional person, you’ll be interested in the lightest weight glasses that fit your face for comfortable wearing.  And if you are into fashion there are so many choices, how good can you look in your new glasses!

Great glasses make you feel good, by looking great and seeing clearly again.  Don’t worry about the old Greeks, just think life begins at 40 - and if you’ve not needed an optometrist before, it’s time to add us to your team.

Many young people we see are myopic (short-sighted) ,and we spend a lot of time working with them and their families on treatments to slow the progression/worsening of their myopia.  The kids and teens with the blurry vision totally understand when their eyes are changing and vision getting worse – sometimes even more than some parents.

Myopia occurs when the axial length of the eye increases, stretching the eye and is associated with increased risk to longer term eye health.  The higher the myopia, the higher the risks.  So these health risks along with the person being more dependent on glasses with higher prescriptions that have thicker and more costly lens options mean that managing myopic progression is a priority for our young people.

Our treatment choices so far have been contact lenses with special optics or nightly eye drops that both have good evidence of slowing the rate of myopic progression.  Until now there hasn’t been a spectacle lens option that will significantly slow the progression of the myopia

Standard single vision spectacle lenses have a centre optical power to focus the vision, onto the centre of the retina.  But this single power results in the periphery of the retina having a detrimental focus effect, thought to increase the rate of myopic progression.

The optical effects from new types of contact lenses are used to slow myopia progression by altering the focus on the peripheral retina. But how to create a spectacle lens that the eyes move behind, focusing to the vision, but not triggering the peripheral retina changes that are likely causing the myopia to further increase?

Defocus Incoporated Multiple Segments (DIMS) technology gives us a spectacle lens to correct the myopia with hundreds of tiny lenslets that alter the focus on the periphery of the retina. 
A central optical zone with the required distance power is surrounded by a ring of the 400 tiny (1mm) +3.50 lenslets spaced over main lens power. So the general vision clarity is maintained, but the periphery of the retina receives a defocus effect.

The optics of the lens have shown to have minimal effect on the viewer’s quality of vision, although it is critical that the lenses are fitted accurately to an appropriate frame that is stable and sized so that the eyes are in the centre of the lenses.  The lens looks quite normal.

A study published in the British Journal of Ophthalmology showed over 2 years a 60% reduction in the rate of myopia progression, with DIMS lens, and for 21% of children there was no progression of their myopia.

We are recommending this as a first choice lens for their glasses worn for myopia.  At CapitalEyes we recommend review consultations 6 monthly for children and teenagers with developing myopia.  If the progression continues, then additional treatments may be recommended.

What a year!  and now we are adjusting to face masks being part of our new routine.  Whether it's a washable and personalised mask, or the standard disposable blue keeping us all a bit safer, they do affect our eyes. 

The increasing reports of more problems for people with dry eyes when wearing masks has started to catch the attention of the dry eye researchers.  Findings that not only people who already have dry eyes are worse, but there are also new dry eye sufferers.  The problem is the tear film that lubricates the front of our eyes, drying out faster.  The symptoms of dry eyes are sore, irritated, stinging, burning and sometimes watery and red eyes.

Wearing a mask keeps your breath close to you, but it still has to go somewhere - that fogging up of your glasses shows where the breath is going - upwards, and over the surface of your eyes, like a gentle breeze. Along with air conditioning, or screen time on your phone or computer when we blink less, the faster rate of evaporation of the tear film on the front surface of our eye makes them dry.

Those of us who wear glasses have worked out that a tighter fitting mask over our nose is a big help in reducing the fogging, and also helps dry eyes.  But we may also need to use lubricating eye drops to replenish our tear film. There are a range of lubricating eye drops that we can advise on, depending on how mild or severe the drying is.

So along with fixing the fogging up glasses problem, a tightly fitted mask over the top of your nose, will also help your dry eyes.

We know that our kids inherit all sorts of interesting genetic traits from us.  As a parent you gradually realise that not only will your kids likely follow with your height, or colouring, but also your eyes.  Chances are high that if you are myopic (short-sighted), that your kids will also likely develop this trait too.  Having one parent who is myopic doubles the chance your child will also develop myopia, but having both parents myopic, the risk increases 5 times!

But parents can’t take all the blame for their kids myopia, there are other factors too.  The environment of the child will affect their eyes, and likelihood of developing myopia.  Remember the bookworm (maybe you are/were one), spending long periods of time on close work is associated with myopia.  While there is varied evidence on time spent on screens, we are watching a generation spend more time viewing close up – books or screens than ever before.

You might have heard that time spent outside is protective for young eyes developing myopia.  The exact “why” is still being researched, however it is an easy recommendation for Kiwi kids.  More time outdoors seems to result in less myopia, with 2 hours a day being the recommendation.  We think in Wellington with our weather, sometimes it might have to be 14 hours over a week!
At primary school, our children seem to get this outside time, between lunch breaks, sport and walking to school.  Once at college this seems to drop off, with inside lunch breaks and time huddled over screens.  Some sports choices also mean that active kids might not actually be outdoors – think swimming, dance, karate – vs football, cricket, netball and hockey.

Previously the standard approach to myopia was to provide glasses, and see if things changed – and if they do, just make the glasses stronger.  The big change in thinking now is to consider the risks for each child/teenager with myopia, and so a consultation at age 6 is the first starting point for assessing likely future risks. 

Why wait?  As there is new and developing research on treatments to slow myopia progression, this is becoming the new standard of care for our young clients.  The options include different lens types in their glasses, soft contact lenses with different peripheral optics or a nightly eye drop of very weak atropine.
Myopia management requires a very individualised approach, and there are options, which we customise to each person.  The earlier this approach is started, the better – why wait until their myopia is bad? The sooner the progression to higher myopia is slowed or stalled, the better!

Lastly, we occasionally have a parent pointing out that “it’s ok” their child can just have laser surgery when they’re older, and it will all be fixed.  While the surgery will likely “fix” the need for glasses or contact lenses, the eye has not changed on the inside.  The myopic eye has stretched longer, and the eye is now at much higher lifetime risk for conditions such as cataracts, glaucoma, retinal detachment and myopic maculopathy.  The higher the myopia, the higher the likelihood of these conditions.  For those of us adults who are already myopic, we can’t change this, but how exciting to be able to help the next generation have better vision and lifelong eye health.

Almost all of us have some “screen” time every day – and the past 2 months it’s upped and for some of us it feels like “all day”.  Getting through the COVID lockdown would have been so very different without the screen time and technology that let so many people continue with work, school, uni and keeping in touch with family and friends. 

Since we’ve been back to Level 2 and re-opened to seeing people again, the high level of screen time has been a frequent cause of symptoms such as sore and tired eyes.  When you think about our days of laptops and phones, these are closer to our eyes than the traditional desktop back in the office.  Added in is that instead of walking to meet someone for a meeting, or to see your teacher, it’s all just a click away and then more screen time.  And once work or school is over, there are movies, computer games and even dance lessons on the screen still.

So what is different for our eyes with all this screen time?  In short, we just weren’t built to sit inside and stare at screens, we are meant to be outside hunting and gathering our food, and this means looking far away and being outside.  Our eyes focus by adjusting the ciliary muscle to keep the lens focus set at a close distance for long periods of time.  For many of us this is tiring, and even harder with even a low level of long sightedness (hyperopia) or astigmatism, or we are approaching 40, when our focusing reserves naturally decrease.  Added to this our eyes need to team together and align accurately for comfortable vision, so if your eye “posture” is naturally over or under converging, this is also tiring.

Then our blink rate slows when we look at screen, so the front surface of our eye is more likely to dry.  A dry eye feeling includes not just sore, stinging, red or watery eyes but also we often hear “just tired eyes”.  We are more likely to have a dry eye problem as we get older, for women (thanks hormones!) and if you take certain medications, including anti-histamines during allergy times.

On top of our visual system is the screen and ergonomics of our set up.  Ideally our eyes should be looking slightly down (10-20 degrees), not straight ahead.  Increasingly people are using multiple screens! When you pick up your phone, then naturally we hold this closer.

The screen itself emits blue light, which can affect our melatonin.  Melatonin is key in our sleep wake cycle, and it’s hard enough to have that routine working well at the best of times!

So it’s hardly surprising that we start to have some problems, ranging from eye strain with tired sore eyes, headaches, neck or shoulder pain, dry gritty or even red eyes, blurred or double vision at close range or far vision to just general fatigue.

And all this screen time isn’t going away, in this next-normal of COVID-19 changes there will continue to be more screen time for most of us, and so what should we do?

• Make sure you’ve had thorough assessment of your vision – this takes time and is part of a comprehensive eye examination.  You may or may not need glasses for screen work.

• The 20-20-20 rule after 20 minutes of screen time, look into the distance 20 feet away for 20 seconds.  A bit American not being metric, but it is easy to remember.

• Deliberate blinks – during a mini break, take 10 deliberate blinks.

• Think posture – starting with feet flat on the floor, knees at right angles, and desk height so that your forearms make a right angle with your elbow.

• Screen set so you have downward gaze of 10-20 degrees.

• Reducing blue light by a combination of screen settings, and glasses with coatings that protect your eyes.

• Get our kids outside – more time reading or on screens is associated with more myopia (short sightedness), while time outdoors is protective for younger eyes to slow myopia developing.

Writing this blog was also my screen time, and it was a good reminder to adjust my posture, and have regular breaks.  Time for all of us to look after ourselves.

Like the rest of NZ, we are all very excited to move to Level 2, which means that we are back OPEN, and starting our “next normal”. As optometrists this means things here are a bit different, with super-clean disinfecting processes, contact tracing, physical distancing and ideally appointments for everyone coming to see us.

To keep you and us safe, we’ve set up some specific changes, firstly that if you’re unwell, please wait until you’re better before you have an appointment. If you can’t wait and have vision concerns, please phone us and we’ll work out how we can help. It may well be that we can help with contactless service, as we’ve all been adapting to in the past 7 weeks anyway.

Then, entry to our place is limited to ensure we can keep the physical distance, contact trace and keep up with all the sanitising needed to keep things super clean. From wiping hard surfaces, to our testing equipment and sanitising all the glasses frames, there’s a lot more to do in a people orientated work place. So with all this, we are asking our clients to book appointments, for their convenience and to enable us to provide a smoother and more efficient service. We’re loving the new floor signage that goes with this, and as Wellingtonians, the yellow and black colour theme feels like we’re supporting a sports team.

With all the disinfecting, washing, splashing around we’ve also made a change for our team work-wear. For now we’ll be looking a little more casual, with very washable tops for all. Once we’ve all had our hair cuts caught up, we’ll all feel a lot more glamorous!

Our optical dispensers and optometrists are available over the phone for queries. And for vulnerable people, we have the option of a free 10 minute phone consultation with the optometrist, so we can work out how best to help you.

To make on line booking even easier, there are links on our website for all 3 branches, and if we send out our reminder notices, either by email or text, we now have links directly for this. Comments abounded from our lockdown lives – things need to be simpler, so we think booking on-line is a simpler way to find times that suit you.

All of our team at CapitalEyes have said how much they miss being at work, they miss meeting new people every day, and so are very keen to be back. Ready to put all the new routines into action, spray lots of disinfectant and sanitise our way forwards. Yay Thursday 14 May 2020

Day 41 & settled into Level 3

We're settled into Level 3 – which opens us up to being able to help you better – for urgent eye appointments or if you need your eyewear to be able to function, then we can now help you.  Whether that’s with new glasses or repairs. Contact lenses and solutions are available – again we can arrange most things by phone or email – just let us know.

It’s not business as it used to be- we need to keep you safe, so we have contactless arrangements, and if we do need to see you in-store, it’s appointment only.  We have excellent disinfection processes, supported by being able to discuss things further by phone before and again after your appointment if needed.

For the routine eye care appointments, we have been advised that we need to wait until the Levels are lower.   But in the meantime if you have any questions or concerns, please phone or email us and we’ll see what we can do to help.

If you are over 70 or vulnerable, and need our assistance, please do contact us and we’ll see what we can work out to help you, without breaking your bubble.  Again, we’re only a phone call away.

Level 4 Lockdown meant different things for everyone in NZ.  We’ve new words like “bubble”, which sounds so nice, and learning to “sit & stay” like we train our puppies to do, was harder than you’d think.  While at CapitalEyes our doors are still closed, our computers have been working hard.  We’ve been answering emails from our clients, and pleasingly using our pre-arranged direct delivery for contact lenses.  Broken glasses are a bother, and we’ve had a few people who have checked about repairs, which we’re now able to do at Level 3.  The many people who have back up glasses – we’re proud of you! 

As we return we’re getting to see all the creative repair techniques that the no 8 wire people have used – glue tends to go everywhere and permanently damages the lenses and frame, sellotape is better, blue tack doesn’t usually last.  Paper clips and wire instead of a screw can strip out the thread, so also less than ideal.  Our recommendation is stick to tape!

Our staff have all been working on their optical knowledge with on-line learning, and Zoom is our new way of catching up.  Strange times, but what an unprecedented opportunity to have the time to spend learning from home. We are very much looking forward to re-opening our actual doors, and even if everyone is 2m away, some normal again will be great.  However it is likely to be a slow path with lots of disinfecting going on for what we used to think of as a “normal” eye examination.  The guidelines are there to keep us all safe, so will continue to be our “normal”.

It has been commented that the effects of lockdown are like a tornado – some people and businesses will be severely affected, to the point of destruction and others barely touched.  Some parts of NZ will be affected more severely than others, with tourism all but stopped.  Perhaps in Wellington as we miss the sight of the cruise ships, we’ll also miss the slightly lost people wandering along Lambton Quay.  And for our over 70s staying safe at home, it’s tough.

As the doctors are saying 2020 stands for “20 seconds of hand washing, 2m and zero excuses”.  And we thought it was going to be the year of eye jokes – the cornea the better!

Interesting times, and thought we’d blog a few thoughts from the perspective of optometrists– as we all see the world through our own lenses!  Thank you for the many lovely messages we’ve received since the COVID-19 lock down was announced, and we’ll continue to try and help as best we can moving forward.

So kids and teens – we’re still concerned about you developing myopia (short sightedness).  It’s well known that a lot of time on your phone, ipad or reading is more likely to make your eyes change and develop myopia.  But the GOOD news is that time outdoors is protective.  So while you’ll likely be doing more screen time than usual, having 2 hours a day outside will help your eyes long term, even on cloudy days.

And all the DIYers, please wear safety glasses.  The hospital doesn’t want to see you with an eye injury, unless they really have to.  If there aren’t any safety glasses in your work shop, find some eyewear to use and as long the lenses are resin/plastic and not glass, you’ll be safer.

If you need us, just email your local CapitalEyes, our doors are temporarily closed, but we’ll try and help you out.

Air conditioning and too much screen time won't help your tear film.  The front surface of the eye needs to be well lubricated with the thin tear film, and if it dries out too much then you'll be feeling it.

Eyedrops that lubricate the front surface will not only make the eyes feel better, but also improve your vision consistency.  We recommend preservative-free drops; either the single use type (pictured) or the clever and safe bottle-like Hyloforte, or the break-through new chemistry of NovaTears.

Watching your child's development is one of the joys of parenthood.   Children just assume that the way they see things, is just the same as everybody else. If the pages in a book or the board at school seem a bit of a blur, or reading is really tiring, they think it's that way for everyone.

Poor vision or poor visual skills can affect a child's development in many ways. It can make learning more difficult, it can make the child clumsy and un-coordinated and it can even affect the child's personality development. Our optometrists as parents understand just how important your child is.

There are many visual skills needed for complete vision development, starting from birth to age 7.  Then as they grow through into puberty there are further vision changes which can affect both school work and myopia development and progression can affect their adult eye health risks.

Your child's vision is precious and we want to help them be the best they can be. So a child's visit to CapitalEyes is different to elsewhere. We are looking to see if the visual skills are being learned, if they have clear and sharp vision but also accurate focusing and a high degree of co-ordinated activity of both eyes.  Once clear vision is developed, then the child's more advanced visual skills are assessed by our optometrists.  These checks include the ability to change focus, fix and converge the eyes (aiming the eyes), eye tracking and saccadic ability (eye movements) and also depth perception (important for sport).

Assessing a child's vision is much more than just reading a letter chart, and if your child does require glasses, regular review appointments to followup are very important to ensure that their vision development is optimised. Eyecare and vision is more than just buying a pair of glasses.

When your child's vision is so important, why would you have a free quick check when the underlying reality that it's free because selling glasses collects the payment? Yes, we do charge consultation fees at CapitalEyes, but we don't recommend glasses lightly for children.

Our desks have changed so much, and thus our vision demands have changed.

This video shows so it all, that you might need to watch it more than once.

Uploaded by Kevin O'Connor on 2018-05-10.

Myopia (short sightedness) is predicted to affect every second person in Australasia by 2050. Researchers in Sydney working with the World Health Organisation have predicted this to be a global problem. In our part of the world currently 20% of people are myopic, but the predicted rise to 55% by 2050 is very concerning. Worldwide the rate is predicted to be over 50%, and Africa with a very low level of myopia is set to increase 6 times from 2000 to 2050.

While we can correct myopia with glasses, contract lenses, or for adults with laser surgery, the bigger concerns are the underlying eye health changes that occur particularly with higher myopia - classified as those people with -5.00D of myopia or higher.

The eye health risks for our future children and grandchildren are very real causes of blindness, so as optometrists, we are working hard to slow down the progression of myopia in children and teenagers. These approaches are usually tailored to the young person following their regular eye examination. However the community messages revolve around the known risks of children not spending enough time outdoors, and too much near time.

There is also a genetic link, so if you are a myopic parent, your children have double the risk of developing myopia, and if both parents are myopic the risk increases to five time. We can't change our genes, but we can alter the environment for young peoples vision devleopment.

The "myogenic" environments we live in, can be modified - parents and schools just need to know how important time outdoors is, and balancing time spent on near work.

We're loving that there is more information for parents about children's vision, and especially myopia development.  Check out www.mykidsvision.org for up to date and key information to determine your child's risk of myopia development.

Caffeine is the most widely used drug in history, with more than 70% of New Zealanders consuming it daily in their coffee, tea, chocolate and caffeinated soft drinks - maybe more in Wellington where our coffee is so good! 

Interestingly there's emerging evidence that caffeine increases the eye's intra-ocular pressure (for a short period 1-2 hours after consumption).  Higher IOPs are associated with glaucoma, and the caffeine increase in IOP is worse in people with glaucoma, or who have a family history of glaucoma and seems to double their chance of developing glaucoma.  As they say "everything in moderation", more so for glaucoma risk people and their caffeine.

There is now new and developing research with options for slowing myopic progression. For a long time it has been known that there is a genetic component to myopia. Having one parent who is myopic doubles the risk of developing myopia, and having two parents increases the risk by 8 times.

If your child is myopic, the likelihood is that it will progress as they grow. For some children this is a slow rate of progression, while others have rapid vision changes.

The treatments which the research has shown to slow myopia progression include assessment of near binocular alignment which may benefit from glasses for close work. Also use of weak atropine eye drops used nightly, or contact lenses specially developed with advanced optics in soft daily disposables.

We recommend all children with myopic parents be examined before the age of 6, to establish risks for further vision changes. These are individual approaches and we are happy to discuss these further with you. 

Click HERE to read more about it.