Saturday, July 15, 2006

Contact Lens Complications

For a great summary of Corneal Infiltrative Complications Associated With Contact Lens Wear see this webpage in Review of Optometry Online.
A number of distinct sterile keratitis entities with differing clinical presentations are discussed, including CLPU, CLARE, infiltrative keratitis (IK), asymptomatic infiltrative keratitis (AIK), and asymptomatic infiltrates (AI). Careful examination techniques are necessary to make an appropriate differential and tentative diagnosis of these relatively benign conditions, as well as to distinguish them from the rarer but potentially sight-threatening infiltrative ulceration known as microbial keratitis (MK).


  1. Dude, of course you would say vision therapy doesn't work you're an OD and it jeopardizes your livliehood!

    Honestly, VT worked for me because I was able to reduce my perscription. Granted, my eyes weren't that bad to start off with, maybe -2.75 and I was able to go down to -1.50 in one eye and -1 in the other. The reason why I didn't continue with it when I moved to SF is 1) it was super expensive to see the one VT certified Dr. out here and 2) I was lazy.

    Maybe we should talk about how my laisk surgeon didn't tell me that my eyes would loose their natural ability to focus up close after surgery because now the eyes were relying on muscles to do the focusing that they never had to before. How about when I decided to apply VT exercises to strengthen those muscles so that I CAN see clearly up close and it working? How about that Dick...I mean Doctor. Sorry to burst YOUR bubble.

  2. Hez,
    First of all, V.T. does not jepordize my livelihood because it offers no competition to what I do, prescribe glasses and contact lenses.

    Secondly, I refer patients to visual therapists (by the way, they are optometrists) when they require one.

    Thirdly, in my reply I didn't doubt that it worked for YOU, I just stated that this is not usually the case. I'm happy that it did work for you!

    Of course you didn't leave my reply to your post here, only your response to my reply.
    If you'll recall, I stated that vision therapy DOES work, but not to correct nearsightedness, farsightedness, or age related focusing problems (presbyopia).
    Also, my challenge to you was to show me clinical evidence or research to support claims that vision therapy works for correction of refractive error. Rather than accept my challenge, you stooped to hurling insults.
    (Dr. Dick? That's the best you got??)
    It seems you're in search of validation, not facts.
    I'd be happy to talk with you anytime regarding eyecare. By the way, I'm not saying I'm an expert by any means, just experienced.

  3. For a look at the original post and reply see:
    But here it is in full too:
    Tuesday, February 21, 2006
    More Eye Stuff

    You know what's weird? Going through the last decade thinking that you were seeing stuff and then learning that you really weren't.

    It sounds strange, but for a very long time my glasses perscription was never right. The long story is that I believe there is an eyewear conspiracy. That Optometrists are in cahoots with eyewear/lens companies because the Optometrists never tell you that there is such a thing as Vision Therapy (exercises you can do to strengthen your eye muscles therefore reducing your dependancy on perscription lenses and ultimately frames).

    Lots of people pshaw vision therapy, especially your eye doctor, and claim that there isn't any clinical proof that vision therapy is effective. That said, I used to do vision therapy. While working at Harvard I had the opportunity to meet Antonia Orfield who was offering VT at their University Health Services. I saw her once a week for about a year and in that time I was able to reduce my perscription twice because my eyesight improved! A requirement, though, is to always wear a perscription that is less than you need in order to make the eyes work harder. Sounds kinda weird but the idea is to not help your eyes along with a stronger perscription because your eyes will rely on it and get lazy. VT ain't cheap and most of the eye exercises you can do on your own at home. With me, I needed to be accountable to someone and I was really lazy, so going once a week to the doctor kept me on track, and luckily, the fee was reduced because I was a Harvard employee.

    Then I moved here. There is only one certified vision therapist in all of the Bay area and he charged $100 a visit. I started to see him and then it just got too much. Then I stopped doing the exercises at home and my eyes gradually went back to what they were. I was reluctant to increase my perscription because of my conspiracy theory belief and because I didn't want to be fully dependant on my glasses. I didn't start wearing glasses until I was 22 and then I only needed them for distance. I could manage around my house without them and I didn't own a car so did not have to worry about seeing while driving. As I got older, I needed my glasses more and more until I was wearing them all the time.

    Wearing glasses just got to be such a hassle! I never wanted to wear contacts because they freak me out. And by the end of the day my glasses felt like 5 tons of bricks on my face. Hahaha. VT works, but its very time consuming and takes a while to see results and you probalby have to do it the rest of your life. That is why I opted for Lasik. Ironincally, I now think there is a VT conspiracy among Lasik doctors. When I was shopping around one of them vehemently denied that VT actually works. Well of course he does because it effects his job...jerk. (I didn't get my surgery done by him).

    So, that was my uber long story to explain why, even though I wore glasses, that I still had a hard time seeing. But now, wow! I can see so far into the distance that its amazing. On my dirve to work this morning I saw so many things that I had never seen before. Like the San Mateo bridge! There is that point on 280 when you are zooming past SFO that the bay and bridge are visible. It was so beautiful with the sun glistening off the water. Here's something else amazing. I never realized how much I was missing. I have been continually surprised when I SEE people's faces in their cars. Or on the street! That sounds so stupid, but before I could never see their faces clearly and I never knew it. In fact, I thought I could see my own face clearly but the other day while I was blowdrying my hair in the mirror I was shocked at how clear it was.

    Here's my philosophical moment. As I was driving to work and seeing all this stuff for the first time off in the distance, I wondered how often I had only been seeing things in my 6 foot radius and not seeing the full picture (so to speak) of it all. Dr. Orfield told me that over time people tend to focus on this small distance in front of them in their lives. Especially when walking or driving. Just seeing what you need to see but not seeing everything. It made me kind of melancholy and a little anxious. I have all this stuff I need to see now and I here I was, driving to a job that I'm not really happy in, where I am going to be cooped up all day in a cube. Just the thought of that, doing something because I need to and not because I want to really got me down, but at the same time, I feel so hopeful about how I might approach the future.

    And you know I can't resist the opportunity to tie classic rock into this, I was listening to Boston on the way in and realilzed that I just love them so much. That, yet again, I am really hearing the music and lyrics for the first time (like I did with Triumph) with new ears and hearing that this band is all about the positive word and how, when growing up, I never really understood that. That while loving Boston may make me ultra-cheesy, I don't really care because to me, I love what makes me happy and singing at the top of my lungs and blasting out air guitar solos in my car does just that.

    posted by hez @ 12:14 PM

    At 10:03 AM, willo said...
    hahhaa. you're awesome. xoxo

    At 1:43 PM, Ajax said...
    Boston rules. An unpopular opinion? They came from outer space to rock us.

    At 10:39 PM, Mario said...
    I admit it I like Boston too. espicially when I'm cruising down the freeway... haha

    At 9:22 PM, Ken Jeffers, O.D. said...
    You're testimony is inspiring, I'm glad vision therapy worked for you.
    I don't doubt that you're prescription changed for the better, because why would you make it up? I do, however, doubt the claims of vision therapists who tout they can help you get rid of glasses with eye excercises. I am an optometrist and I can tell you there is no consiracy with lens companies to sell glasses.

    First of all, show me the clinical research to validate the claims of these vision therapists.

    Second, vision therapy has been around for nearly 100 years. Do you really think glasses would still be necessary if V.T. (vision therapy) worked? Why is LASIK so popular? Why would millions of people risk eye surgery with the non-surgical, less expensive alternative of V.T.?

    I ordered the "See Cleary" Method of vision correction myself. It didn't work, and their company couldn't offer me clinical evidence of effectiveness, only personal testimonies like yours.

    I'm happy to hear stories like yours in which the V.T. seemed to help, but more studies and evidence need to be brought forward to prove these claims. The scientific method requires repeatable results, not just the claims of a few people who happened upon good results.

    By the way, V.T. is a very viable science when used in the right way. V.T. can help children with "lazy eye", eye muscle imbalances, focusing problems, etc. but has not been shown effective for anyone over the age of 9 or so in most cases.

    I don't mean to burst your bubble, but the facts is the facts!

    Dr. Ken Jeffers

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