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How we are Utilizing VR Technology to Give More Advanced Eye Exams

With the continual advancement of new and exciting technologies, we are excited to announce that new tech has come to theIMG 9818 optometry space. Our latest piece of equipment, the Virtual Field, is our new way of testing peripheral vision. For years, we used the Humphreys Visual Field machine to test peripheral vision.

If you have been a long time patient of our practice you probably remember the peripheral vision testing sequence: 1) place a patch on an eye, 2) stick your head into a large, heavy half dome shaped machine, then 3) click a button whenever you see a flash of flight. While that Humphreys visual Field Machine served us great for many years, it had a few drawbacks including a large footprint and accessibility issues for certain patients.

The Virtual Field brings all that the Humphrey’s Visual Field test has to offer into a virtual reality headset. Due to Virtual Field’s sleek software – patients no longer have to worry about putting a patch on (the machine covers one eye for the patient), the test runs much quicker, the button is wireless and the patient can sit in whatever position is most comfortable due to the portability of the headset. From an environmental standpoint, the unit uses much less energy, has much less plastic in its construction and also takes up much less space. Additionally, the instrument gives patients instructions through an automatic robotic voice!

At Los Altos Optometric Group, we seek to always have the most innovative and technologically advanced equipment in our office to ensure the best exam possible. Make sure to schedule an appointment with us today!

-Dr. Aaron Neufeld


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Dr. Aaron Neufeld is the Chief Optometrist at Los Altos Optometric Group and primary author and editor of The EYE Digest.

To contact him with questions or make an appointment call: (650) 948-3700 or send him an email:

What is Vuity™, and How Can It Help my Vision?

Over the last few weeks, I have had many patients call me and make appointments to ask questions regarding a new eyedrop that was recently announced – Vuity™. Questions ranged from:

  • “Am I a good candidate?”
  • “What exactly does this drop do?”
  • “Are there side effects?”
  • “How often do I have to use it?”
  • In the next couple minutes I hope to answer all these questions and more!

So let’s start with the basics. Vuity™ is a medication used to treat age-related farsightedness, a condition known as presbyopia. Presbyopia universally starts occurring around the age of 40. The natural lens inside the eye that focuses lightdownload (2) on the retina doesn’t change shape as easily as it once did. Traditionally, glasses such as readers, bifocals or progressives, and/or contact lenses are used to correct presbyopia in order to enable presbyopia individuals to see clearly again.

Vuity™’s active ingredient is a drug called Pilocarpine. Pilocarpine’s primary mechanism of action is to shrink the size of the pupil, inducing a process called miosis. With the pupil shrunken substantially, it becomes pinpoint and a pinhole effect is induced.

downloadThe “pinhole effect” is an optical concept suggesting that the smaller the pupil size, the less defocus from spherical aberrations is present. When light passes through a small pinhole or pupil, all unfocused rays are blocked, leaving only focused light to land on the retina to form a clear image. This in theory allows the individual to see clearer.

Pilocarpine has actually been around for decades, and was once a mainstay treatment for glaucoma. However, side effects such as troubling vision in dim light and frontal headaches allowed for different medications to be favored for glaucoma. Despite the new iteration of pilocarpine in the form of Vuity™, both poor vision in dim light and headaches remain potential listed side effects for the medication.

Vuity™ is instilled once daily in each eye and claims to provide benefit for the whole day. Ideal candidates for Vuity™ aredownload (3) those suffering from mild to moderate presbyopia, which translates to the age range of 40-55 years old. Additionally, due to the side effect of reduced vision in dim light, Vuity™ is most effective during the day time hours.

At the time of publishing this article, I have prescribed Vuity™ to over 10 patients. In an effort to approach Vuity™’s clinical effectiveness through the scientific method, I made sure that all candidates had similar prescriptions with no eye health conditions. So far, the response has been mixed. Certain patients have definitely noticed a difference and improvement in near vision, while others did not see any difference whatsoever and also noted prominent side effects.

Ultimately, time will tell how effective Vuity™ is as we continue to prescribe the medication to more and more curious patients in their 40s and 50s. If you are interested in trying Vuity™, do not hesitate to make an appointment with our office for a consultation and eye examination!

-Dr. Aaron Neufeld

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Dr. Aaron Neufeld is the Chief Optometrist at Los Altos Optometric Group and primary author and editor of The EYE Digest.

To contact him with questions or make an appointment call: (650) 948-3700 or send him an email:

The Benefits of Daily Contact Lenses


Leonardo da Vinci’s original sketch outlining his radical idea for a contact lens

The history of contact lenses spans over five hundred years. Contact lenses initially started as an idea Leonardo da Vinci had in the early 1500s, when he drew sketches of an object that could be placed on the eye to alter its optics. However, it was not until the late 1800s that the first contact lenses were created – out of glass!

These early contact lenses covered the entire eye, were rather uncomfortable, and could only be worn for a couple hours. In 1948, a California optician named Kevin Tuohy created the first PMMA (polymethyl methacrylate) hard contact lens, which allowed contact lenses to be worn comfortably for multiple hours and officially put the idea of a mass marketing contact lenses “on-the-map.”

download (1)However the most notable revolution in the history of contact lenses was the invention of the first hydrogel soft contact lens material by Czech chemists Otto Wichterle and Drahoslav Lim in 1959. If you wear a soft contact lens today, you have these two to thank! Ultimately, the first marketed soft contact lens came in 1971 – the time of the launch of the first FDA-approved soft contact lenses in the United States — Bausch + Lomb’s “SofLens.”

Currently, daily soft contact lenses have been all the rage, in fact, in our practice they account for nearly 80% of our contact lens wearing patients. So why is this case and why should you consider daily contact lenses?

Eye Health

By far, the best aspect of wearing daily contact lenses from an optometrist’s point of view are the health benefits bestowed. download (2) Unlike monthly/bi-weekly contact lenses, daily contact lenses possess a far less likely chance of developing a serious eye infection (such as a corneal ulcer) since a fresh pair is used every day. Monthly/bi-weekly contacts hold a higher chance of this happening since they are saved over a period of time and could possibly be slept in.


Patients have almost universally stated that daily contact lenses feel more comfortable on the eye and can be worn longer throughout the day than their monthly/bi-weekly counterparts. Once again, part of this is using a fresh lens every day, download (3)however another aspect of this is the advanced lens wetting technology and oxygen permeability.


Being able to take a contact lens out and simply throw it away is much more convenient than going through a step-by-step lens care and cleaning cycle at the end of the day. Wearing daily contact lenses simply reduces the time spent on contacts whether it be putting them or taking them off – it’s as simple as that.


But what about excessive waste from using new lenses every day?

This is a common question I get from patients, and a very valid one. There is quite a bit of waste that goes into daily contactdownload (5) lenses. However, here are a couple things to consider. 1) If you are using monthly/bi-weekly contacts, you must use bottles of solution and contact lens cases, which equate to quite a bit of waste as well, 2) Contact lens waste can be recycled. Simply bring old contact lens blister packs to our office and we will recycle them to help our environment.


Surely the cost for dailies must be astronomical compared to monthly/bi-weekly contacts?

Not necessarily! While having a fresh pair of contacts every day does have a higher sticker price on paper, the cost of daily contact lenses are offset by a few things. First, with daily contact lenses, there is no longer a need to buy costly bottles of contact lens solution. Additionally, daily contact lenses, if purchased in a practice like ours, come with great mail-in rebates and prices that are competitive with online retailers.


If you are interested in daily contact lenses, give our office a call. We are happy to book you for an appointment and see if you are a candidate for the latest and greatest in contact lenses!


-Dr. Aaron Neufeld

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Dr. Aaron Neufeld is the Chief Optometrist at Los Altos Optometric Group and primary author and editor of The EYE Digest.

To contact him with questions or make an appointment call: (650) 948-3700 or send him an email:

How Los Altos Optometric Group Fosters Future Doctors

There are many aspects of optometry that help fulfill my spirit and drive my passion forward. At the forefront of this is patient care and running our practice here in Los Altos. Every patient exam serves as a constant reminder of why I get out of bed every morning.

Optometry, just like any other industry, is an ever-evolving field. In order to achieve growth and better serve our patients we need to look to the future. While new technology and techniques are always being sought out in the exam room, influencing future practitioners also carries an immense amount of weight for the profession.


As a seasoned optometrist, I am happy to be a mentor to both optometry students at UC Berkeleyberkeley optometry through the BAOC-Berkeley Mentorship Program as well as to newly graduated optometrists through the SCCOS Mentorship Program.

Currently, I have two optometry student mentees at UC Berkeley and two optometrist mentees that are two years out of school. We meet quarterly, and I also have one-on-ones with the mentees if they have specific questions or discussions they wish to have.

Making a Difference

Due to the coronavirus pandemic, valuable time spent in the clinic gaining experience through doing was cut short for UC Berkeley students. Yet, despite the pandemic, school


must still go on, and these students must still complete their program in four years. That’s where the beauty of our practice comes in.

Since we only work a half day on Fridays, I invited my two mentees Vivian (1st year UCB) and Graham (2nd year UCB) to have a clinic day after we closed. We brought in four volunteer patients for the students to conduct full examinations on. I was able to bounce between our two exam rooms to help instruct and give constructive criticism while maintaining a stress free environment. Between examinations, we went over interesting case studies, so that the students could exercise their theoretical muscles as well as their practical muscles.


Mentee Feedback

Overall, our clinic day went well. Our students had positive feedback about the experience. Second year mentee Graham had this to say:

I thought it was an amazing opportunity and I haven’t stopped boasting about it to myimage4 friends in my class. The diverse patients we saw (ranging from easy myope to strabismic ambylope) was such a great experience. Honestly, I was telling Vivian that I was sad that I wasn’t able to do this last year. I definitely would recommend it for any of your mentees to do.

It was low stress, but high reward. I was kind of sad that it was only one day and only a couple hours but I genuinely couldn’t have asked for a better experience. The patients themselves were so understanding as well and any advice that you gave me was appreciated.

Like I said, I genuinely can’t say anything bad about the experience! Thank you for letting us do this once again

First year mentee Vivian had these remarks:

I personally really liked it, and I think the pacing and set up was perfect! It was really stress-free, I got my first taste of refracting non-optometry patients, and I got good pointers from you!

I especially appreciated being able to do BIO on somebody with a larger forehead arch and learning how to navigate around that. 80% of my class are females, and I’ve only been assigned to clinic lab teams with females, so I haven’t had any experience navigating around forehead arch anatomy like that.



I cannot wait to see the talent and empathy that these two students will bring as doctors in the next couple years. I look forward to continuing this program and watching it grow.

Not only do we foster better doctors, but we foster better care for you as the patient; and when it comes down to it, that is ultimately what matters the most.


-Dr. Aaron Neufeld

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Dr. Aaron Neufeld is the Chief Optometrist at Los Altos Optometric Group and primary author and editor of The EYE Digest.

To contact him with questions or make an appointment call: (650) 948-3700 or send him an email:

COVID-19 and The Eye

A lot of on-going research is still being done about the new onset of coronavirus and whether it can still be truly transmitted through the eyes. We will cover some facts and questions about how COVID-19 can affect your eyes and your relationship with your eye doctor.

(1) Can tears transmit coronavirus?

The most recent study done by the National University Hospital in Singapore concludes that it is download (1)unlikely that COVID-19 can be transmitted through the tears. However, there are anecdotal reports around the community that possible tear transmission can occur – so caution should be taken.

(2) Can COVID be transmitted to the eyes through other mechanisms?

While tears are low risk for transmission for COVID, the latest report from the CDC states that it is possible for COVID to be spread from person to person through airborne “respiratory droplets” which are produced when someone coughs or sneezes, similar to how the flu is spread. These droplets can land in the mouth or noses of nearby people and can possibly be inhaled into the lungs. Lastly, these droplets can also be spread when you touch your face and eyes with unwashed hands.

(3) What can I do to protect my eyes?

Again, while tears are unlikely to transmit COVID, remember that there are still two main ways that COVID (as well as other viruses) can get into the eyes via mucus membranes and cause conjunctivitis such as:

(1) Coughing/Sneezing: COVID can still get into the eyes via aerosol transfer, so if you are standing within six feet of any affected person, they can sneeze and release droplets toward your face and eyes. If you are not wearing any protective eyewear, then risk of transmission is high.
Solution: For any personnel required to be in close contact with any possibly infected individual, protective eyewear like face shield or eye goggles is definitely a must. For the typical population, 6 feet of social distance is more than adequate

(2) Touching the eyes: COVID-19 can also be transmitted from hand to eyes. So if you touch a contaminated grocery cart, and then proceed to touch your eyes, you are at higher risk.
Solution: Avoid touching your eyes and face while constantly washing hands

(4) Can the coronavirus give you conjunctivitis (“Pink eye”)?

UV Keratitis.jpgWhile infected droplets (or mucus) can end up in another person’s mouth, nose & lungs, the latest study by American Academy of Ophthalmology (AAO) indicates that coronavirus might enter through the conjunctiva (clear part covering the white part) of the eyes and spread throughout the body via blood vessels within the eyeball. This can result in conjunctivitis (“pink eye”) – but more specifically viral conjunctivitis.

It is recognized that any upper respiratory tract infection may result in viral conjunctivitis as a secondary complication, and this is also the case with COVID-19. However, it is unlikely that a person would present with viral conjunctivitis secondary to COVID-19 without any other symptoms such as fever or a continuous cough.

Recent studies show that only 1-3% of affected COVID-19 people displayed symptoms of conjunctivitis. So fairly low risk.

(5) What are symptoms of viral conjunctivitis?

As mentioned above, any possible, low-risk COVID-19 related viral conjunctivitis will be treated as a typical viral conjunctivitis prior to the pandemic.
Viruses are actually the most common cause of conjunctivitis and usually affect both eyes. Symptoms normally last 5 to 12 days and include:

-Redness in the conjunctiva (white part of the eyes)
-Eyelid Swelling
-Sandy/gritty feelings in the eyeball
-Tearing (clear)
-Watery or slightly thick whitish draining

(6) How do you treat viral conjunctivitis?

If you suspect that you have any kind of conjunctivitis, contact your eye doctor for an in-person or virtual consult in order to confirm the viral diagnosis. This is because conjunctivitis can be caused from an array of sources such as dry eyes, bacteria, allergies and more seriously, iritis (severe inflammation of the eye).

While there is still on-going research on how to treat possible COVID-related conjunctivitis, the standard medicine 415397 960 720.jpgof care is to treat it similarly to how we would treat any typical viral conjunctivitis.
Viral conjunctivitis are usually self-limiting and will resolve on itself within 5-12 days. Your doctor might recommend some treatment to reduce your symptoms:

-It is highly contagious so practice good hygiene by washing your hands often and avoid cross contamination
-Over-The-Counter Artificial tears and cold compresses help to relieve symptoms
-Discontinue all contact lens wear during the acute phase
-Topical antihistamines or steroid eye drops may be used to relieve redness or discomfort
-Antiviral eye drops might be prescribed depending on the severity of the viral infection
-Antibacterial eye drops are not effective for viral conditions

(7) Are there other ocular or retina symptoms associated with COVID-19 exposure?

A recent but small study of 12 adults with COVID-19 show that there might be mild changes in the blood vessels of the retina also known as “hypertensive retinopathy” related to COVID-19, but without any loss in vision.

This is still on-going research. In addition, there have been anecdotal reports of optic neuritis (inflammation of the optic nerve, which can lead to permanent vision loss) from around other eye care providers but no confirmed studies.

(8) What if I wear contact lenses?

Proper hygiene care of your contact lens is especially important during this viral pandemic, in order to maintain optimal ocular health and prevent transmission:
Wash your hands with soap/water for at least 20 seconds and then dry them with a lint-free towel prior to handling your contact lenses. If soap and water are not available, using a hand sanitizer (with at least 60% alcohol) is acceptable

16247 tears shutterstock news.jpgDisinfect your contacts properly with the recommended cleaning solution as recommended by your optometrist. Do not use saline solution or OTC rewetting drops to disinfect your contact lenses.
Dispose of your daily disposable contacts each evening, or dispose of your 2-weeks or monthly lenses as instructed. Over-extending your contact lenses will increase risk of infection.
Discontinue lens wear if you are feeling sick with cold or flu-like symptoms and wear your back-up glasses as needed.

(9) Can my glasses get infected?

The latest studies show that new coronavirus can remain on hard surfaces for hours to days, and therefore can transfer to your face, then to your glasses. Therefore, glasses should be cleaned more regularly (daily if possible) with a mild dishwashing liquid soap (non-lotion) and lukewarm water.

Gently rub each lens and all part of the frame with your fingertips for a few seconds. Then dry off with a clean, cotton lint-free towel (ideally those used to clean fine glassware). Finally, remove any streaks/smudges with a clean lint-free microfiber cloth.
Here are some tips to avoid damaging the anti reflective coating of your lens or paint finish of the frame.

Avoid using your shirt or other cloth type, paper towels, tissues or toilet paper especially when the lens is dry to prevent scratching.
Do not use household glass-cleaner since these products have ingredients that can damage the lens and coating.

Avoid alcohol wipes and other disinfection methods such as Lysol wipes since they can damage the AR coating of the lens and frame paint.

Please note that a solution of warm water and hydrogen peroxide at 0.5% concentration is recommended for optimal disinfection of frame, but we are aware that these disinfection products are not widely available to consumers.


In conclusion, there is a lot of new and ongoing eye research in relation to COVID and we expect more evidence to come out as new studies get completed. In the meantime, keep practicing proper eye health hygiene and if there are any concerns, please don’t hesitate to reach out to us!


-Dr. Aaron Neufeld

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Dr. Aaron Neufeld is the Chief Optometrist at Los Altos Optometric Group and primary author and editor of The EYE Digest.

To contact him with questions or make an appointment call: (650) 948-3700 or send him an email:


Welcome to Los Altos Optometric Group!

Currently, we are seeing eye exams by appointment only. For frame selections, appointments are highly recommended, however walk-ins are also welcomed. Our front door is locked to ensure safety and quality service. Please call or ring the doorbell upon your arrival.

We look forward to SEEing you!