This month, we’re excited to have Dr. Angela Tsai, O.D., F.V.A.O, from Premier Eyecare as our expert! We covered tons of eye care during our conversation. She broke down misinformation on conjunctivitis, a best practices timeline for getting your family’s vision checked, shared her three eye care facts she wishes everyone knew and more!

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What makes Premier Eyecare stand out?

Premier Eyecare has been serving the Rappahannock region for over 70 years. We are a full scope practice with five doctors and 20 staff members offering primary eye care, ocular disease management and treatment, specialty contact lenses and vision therapy. We have state-of-the-art technology including equipment that can help detect potential macular degeneration up to three years earlier. Our vision therapy clinic treats patients of all types and ages. We offer therapy for patients who have decreased vision, lazy eye, learning-related visual issues, traumatic brain injuries such as strokes and concussions, and sensory processing disorders as ADD/ADHD, Down Syndrome and autism.

What three facts about eye care do you wish people knew?

eye chart(1) A comprehensive eye exam is only performed by an eye care professional. Screenings at the pediatrician’s or at the school nurse’s office only test if a person can see a distance chart. Screenings do not tell you if a person needs glasses for reading up close, how the eyes team together or eye health.

(2) Just because a person can see well does not necessarily mean the eye is healthy. Many eye diseases in their early stages, such as glaucoma, macular degeneration, retinal tears and bleeding in the back of the eye, do not have symptoms of pain or decreased vision. A comprehensive eye exam with a retinal health check is crucial. Comprehensive eye exams can aid in the detection of other medical issues hence why the eye is the window to the soul.

(3) Approximately 75 percent of learning-related issues are secondary to some type of vision or visual processing problem. Most of these issues can be remediated so long as they are identified at the proper age and treated.

How often should children and adults have their eyes checked?

The American Optometric Association recommends all patients have their first eye exam between the ages of 6 months and 1 year old, and then at 3, 5, and yearly after. My office participates in a program called InfantSEE. An infant between ages 6 months and 1 year old can obtain a comprehensive ocular and visual examination free of charge.

Does staring at a screen really affect your eyes? If so, how?

Digital eye strain can occur from prolonged use of computers, tablets and cell phones. Blink rates decrease, and incomplete blinks increase while on digital devices which causes an increase in dryness and discomfort. Also, because there is not a change in focus from distance to near, the muscles and lens within the eyes do not flex as much and can cause focusing issues, blurriness and headaches. Finally, the lens within the eye blocks the majority of UV rays and some short-wavelength harmful blue light. Harmful blue light is emitted from these digital devices which increases the damage to the retina and increase macular degeneration. I always suggest the 20/20/20 rule. Every 20 minutes of digital device use focus on an object at least 20 feet away for at least 20 seconds.

Can reading difficulties be tied to an issue with your eyes?

Approximately 80 percent of learning is through the visual system. Problems with reading comprehension, fluency, attention, handwriting, math, spelling and test taking can be caused by issues with the eyes or how the brain processes the visual information. If the eyes are not teaming together, a student can see double vision when reading, or skip letters, words, numbers or punctuation. If the eyes tire too quickly or cannot see clearly, the eyes cannot attend to what is on the page and the person can have trouble transcribing from the board to their computer or paper causing his or her attention span decreases. Issues with tracking can lead to issues with handwriting, reading fluency and math. Problems with visual processing can cause deficiencies in visual memory, decoding, and visualization as a whole. Many patients diagnosed with ADD/ADHD are misdiagnosed and actually have a visual processing issue. My practice offers testing for learning-related visual issues and offer vision therapy, both at home and in-office. Vision therapy is the most effective when the child is younger.

Why does pollen make my eyes itch?

Pollen can enter into the nose and the eyes and trigger an allergic response. The fine particles cause histamine release which activates inflammatory cells called mast cells. An increase in these cells irritate the clear tissue covering the white part of the eye—the conjunctiva—causing swelling, redness, tearing and itching. In contact lens wearers, it can lead to Giant Papillary Conjunctivitis, which decrease lens wear time and tolerance. Other reasons the eyes can itch include dryness, fatigue from focusing issues, digital eye strain and over exposure to harmful blue light.


What is pink eye, and how can I keep my kids from getting it?

Pink eye is also known as conjunctivitis. The most common causes of conjunctivitis are from bacterial or viral infections and allergies. Contrary to the belief, not all conjunctivitis needs antibiotics. At our practice, we offer testing to determine what the causative factor may be, as well as determine the appropriate treatment. The best ways for anyone, especially children, to prevent contracting it is to wash their hands after touching dirty objects, keep their hands away from their eyes, and clean debris and sweat from their face and eyes every night and day.

Am I crazy or can pregnancy affect your sight?

During pregnancy hormone levels change and estrogen and progesterone levels increase. Estrogen receptors are in the cornea, the Meibomian glands of the eyelid, and the retina. Estrogen causes the corneas to thicken and elongate the overall length of the eye which causes a nearsighted shift. Usually, this is temporary but for some women it can be permanent. Gestational diabetes and high blood pressure can also affect the vision, as well as the health of the eye. Hormonal changes can also cause an increase pressure in the cerebral spinal fluid leading to symptoms like headaches, vision problems, nausea, and dizziness causing a condition caused pseudotumor cerebri. A retinal check is crucial for those who are diagnosed with any of those conditions.

Do you have questions for Dr. Tsai, O.D., F.V.A.O? You’ll definitely want to jump in on this month’s “Ask The Expert” Facebook Live chat this month. Details will be announced on our social media channels, so be sure to follow us:
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