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Diabetes and The Eye

The retinal image pictured above is from a patient that came to me for her annual eye exam. The patient was a 40 year old female that stated she had no had a regular health exam or eye exam in over 5 years, but was “perfectly health” and on no medications. Her retinal image showed a different story.



The image shows severe diabetic retinopathy. This patient had been suffering with diabetes for years and had no idea. I immediately sent her to our local hospital for treatment. I received correspondence later in which a doctor stated “I can’t believe she was even alive.” Our patient was stabilized after going on a host of medications and lifestyle changes, however she did not have to get a toe amputated in the process.


November is National Diabetes Month. Diabetes affects over 100 million Americans according to the CDC. The disease costs America nearly $250 billion per year. While diabetes deals with blood sugar and insulin levels, it also has many correlations with eye health.

Diabetic complications can show up on nearly every part of the eye including the cornea, iris, lens and retina.

Retinal complications are of considerable importance for two reasons:

1) These complications are the ones that eyecare providers must be most vigilant of since they can lead to vision loss and blindness if not treated in a proper time frame

2) These complications are often noted upon retinal examinations, sometimes before a formal diagnosis for diabetes is given.

So what’s the moral of the story? It’s simple. Have your eyes checked regularly if you are a diabetic and also if you are not. Individuals living withCanva   Black Contour Ts Displaying at 4.8 diabetes should have annual and sometimes more frequent eye exams that thoroughly evaluate the retina for any diabetic complications. Individuals living without diabetes should also have a yearly eye exam to check for possible health issues such as diabetes as well for an overall vision and health evaluation. Being vigilant about the health of your eyes can benefit your body as a whole. Pass the knowledge on as we get underway with National Diabetes Month.

Schedule an appointment with one of our doctors 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:


The Importance of Vision in a Child’s Learning

October is National Learning & Development month, as well as National Dyslexia Awareness Month and National ADD/ADHD Awareness Month. While many educators and parents view learning and development in children as purely a brain activity, the eyes play an important factor in a child’s education.

At every step of learning, the eyes are constantly involved since vision is one of the key components of both comprehending and retaining information on a subject. Specifically, we can break down eyesight as it relates to learning into three broad categories:

1) Visual Acuity – Sharpness of vision both in the distance and up close

2) Eye Teaming – The ability of the eyes to work together

3) Eye Motility – the ability of the eyes to move in certain ways

These three broad categories of eyesight must all be working at an effective and efficient level in order for a child to achieve his/her maximum potential when learning. So how do these three categories work in synergy to allow for learning? Let’s take a look.

Snellen chartVisual acuity refers to an individual’s ability to see clearly at a distance and up close. Obviously, if either of these are hindered, a student’s ability to learn drastically decreases since the visual material is not legible. Often, children do not complain about reduced visual acuity (blurry vision) because they view their vision as normal. Reduced visual acuity can be corrected with glasses or contact lenses.

Eye teaming is the ability of the eyes to work together and is often referred to as binocular vision. Eye teaming also is responsible for “3D vision” or stereopsis. When eye teaming does not work properly; eyestrain, headaches and sometimes double vision can result. In children, these symptoms often manifest as disinterest in reading or learning, since a constant discomfort is felt when trying to read, write or focus on a given object. Eye teaming issues are dealt with through prescription glasses and sometimes through vision therapy.

Eye motility is the ability of the eyes to move in certain ways. In general, we categorize eye motility into two movements: 1) pursuits, which are smooth tracking movements and 2) saccades, which are quick jerking movements from point A to Things Children Learn From Preschool 300×200point B. Efficiency and efficacy of these two movements are vital for reading. Pursuits are used to read across the page and saccades are used to jump from line to line. When one or both of these are lacking, students often find reading and following along with lessons difficult. This in turn leads to frustration and disinterest. Eye motility issues can be fixed through vision therapy programs.

In conclusion, eyesight plays an important role in children’s learning. Often, the underlying problem for a child diagnosed with a learning deficiency is actually related to vision. This is why it is vital to schedule school aged children for an eye exam once a year. Not only is eye health checked, but key components for effective learning and happiness are examined to ensure a positive growth experience while in school.

Schedule an appointment for your child 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:

Golf Vision – Improving Your Game through Better Vision

Eyesight on the golf course is vital to your game. golf 1486354 960 720

Whether you are looking at the ball while swinging or spotting the ball after driving down the fairway, your vision is constantly being used while on the course. With the The Masters Tournament finishing up and golf season in full swing, here are 4 ways that proper golf glasses/sunglasses can help you:

1) Distance Correction – Sharpness and max acuity are vital for spotting your ball and looking down the fairway. Make sure you have an updated prescription in your glasses and visit us even if you think you have perfect vision – there may be a slight distance correction or astigmatism correction that can be found that can give you an advantage if utilized in lenses.

IMG 59652) Contrast Enhancing – Colored lenses like the rose tint seen in the pair of Oakley Golf Prizms that I am holding in the picture enable you to have better depth perception and read the green better.

3) Tint – Darker tints will enhance comfort, concentration and vision on sunny days. Polarization is often a controversial topic – while it may help reduce low angle glare, it can affect depth perception – thus it is up to the individual golfer whether or not to have polarized lenses

4) Wind/Dust Protection – Having glasses on will physically protect you from oncoming wind, dust and debris. This in turn will prevent eye irritation and allow better focus.


Now that you know all the advantages of wearing a pair of glasses/sunglasses for golf, here are three vital eyesight tools to carry in your golf bag when playing a round of 9 or 18:

1) Artificial Tears – especially on windy, cold and dry days, the eyes tend to dry out when playing golf. This is not only due to the elements, but also due to the lack of blinking that occurs when you are medicine 415397 960 720intently focusing on the golf ball. Playing out of a sand trap (hopefully not too often!) also opens up the possibility of getting sand/debris in the eyes. Artificial tears are great for flushing the eyes out. For specific brands, I recommend Systane Complete, Blink Tears or Refresh Optive.

2) Allergy Drops – Playing golf, especially during seasons with a high pollen count, increases your chance of developing seasonal allergies. These allergies can affect your eyes by causing itchiness and watering. Thus, it is wise to always carry an allergy drop that can provide quick relief. I recommend either Alaway or Zaditor. These are safe, over-the-counter drops, dosed twice a day, that stop allergy symptoms in the eyes.

3) Spray Cleaner and Microfiber Cloth – Face it, if you’re golfing with glasses or sunglasses, they’re going to get dirty. Whether it be from sweat, oil, fingerprints, moisture in the air or debris; your eye-wear will get dirty when on the course. I recommend carrying our own branded spray cleaner and microfiber cloth. The best part? We give them away at absolutely no cost. Just stop by our office and pick up what you need!

-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:



Snow Blindness – Can I Really Go Blind from the Snow?

-The EYE Digest-

Snow Blindness – Can I Really Go Blind from the Snow?

In short, no, snow blindness doesn’t actually cause blindness, but read on for more information!


What is it?

Snow blindness is also known as photokeratitis. “Keratitis” means inflammation of the cornea (the Snow gogglessensitive, clear part of the eye in front of the colored iris), while “photo” means light. Snow blindness is when the cornea becomes inflamed after being overexposed to light, or more specifically ultraviolet (UV) light. To put it simply, snow blindness in a sunburn on your eye!


What causes it?

The most common cause of snow blindness is just as you may have guessed…snow! More specifically, it is the UV light that is reflected off the snow and into your eyes. Approximately 80% of the UV light that hits fresh snow is bounced back into the air and potentially into your eyes. This is significantly greater than sand or water which have UV reflectance of 15% and 25%, respectively. To make matters worse, many snow related activities such as skiing or snowboarding occur at higher altitudes where UV light is stronger – with every 1,000 ft of elevation from sea level, the intensity of UV light increases by 4%.

Snow, sand, and water aren’t the only sources of snow blindness/ultraviolet keratitis. Tanning beds and arc flashes from welding can also cause ultraviolet keratitis. When it is associated with welding, it is called a flash burn.


What are the symptoms?

UV KeratitisEye pain, irritation, and a foreign body or burning sensation are a few of the symptoms you can experience. Other symptoms include light sensitivity, watery eyes, red eyes, and blurred vision.


What is the treatment?

The treatment goals of snow blindness are first and foremost to prevent worsening by staying indoors or wearing UV eye protection and second, to keep the eye comfortable as it heals itself. Luckily, snow blindness resolves on its own within 24-72 hours. In the meantime it is advised to avoid rubbing your eyes and remove contact lenses.

Non-preserved artificial tears and lubricating ointments are recommended to act as a cushion between the sunburned cornea and the mechanical motion of your eyelid rubbing across the cornea. Artificial tears and ointments on a sunburned eye have a similar affect as putting aloe vera on your sunburned skin.

If the pain is still too much to handle, then over the counter pain relievers such as Tylenol or Advil can be used. Topical pain relieving eye drops (NSAIDS) can be prescribed by your eye doctor.

If the degree of ultraviolet keratitis is significant enough, your eye care provider may prescribe a topical antibiotic to prevent a secondary infection.


How do I prevent it?

Tanning bed

Just like a sunburn on your skin, once you’ve become symptomatic,

you have already been in the sun for far too long. Fortunately, snow blindness is completely preventable by wearing snow goggles or eye masks with 100% UV protection. If you are at the beach, lake, or any body of water wearing sunglasses with 100% UV protection is recommended. The best type of eye protection is the type


that wraps around the face reducing the amount of UV light

that can reach your eye from the sides, top, or bottom of the frame. And remember, UV light is still present even on an overcast day, so when in doubt, where eye protection!


Welders are advised to wear welding goggles or welding helmets.


-Dr. Janelle Santa Maria


Dr. Janelle Santa Maria is an optometrist at Los Altos Optometric Group and contributing author and editor of The EYE Digest.

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

Comfort, Clarity and Cleanliness – The Beauty of Daily Disposable Contacts

-The EYE Digest-

Comfort, Clarity and Cleanliness – The Beauty of Daily Disposable Contacts

According to the CDC (Center for Disease Control), roughly 45 million Americans wear contact lenses. That translates to about 13% of the US population placing a conta16247 tears shutterstock newsct lens in the eye everyday! Contact lenses are a fascinating invention that allow for sharp vision without the burden of standard eyeglasses.

In this decade, when we refer to contact lenses, a soft lens is probably what comes to mind. While hard lenses (rigid gas permeable, scleral or reverse geometry like Orthokeratology) with certain long term wearers as well as correcting certain corneal conditions, soft contact lenses have become much more prevalent.

Offering advantages such as ease of use and comfort, soft contact lenses come in a variety of offerings. Soft contact lenses can correct for astigmatism using toric technology, and can even correct for presbyopia and be offered as a stand-in for bifocals/progressive lenses through the use of multifocal technology.

There are three main replacement schedules that soft contact lenses can come in:

-Monthly replacement

-Bi-weekly replacement

-Daily replacement

While monthly and bi-weekly modalities dominated the contact lens industry for a while, we are increasingly seeing a shift towards the daily replacement modality. Why? Well there are 5 great reasons to wear daily contact lenses:

  1. Lower Risk of Eye Infection – A monthly/bi-weekly lens requires cleaning and storage of the lens contact lensesover a long period of time. This allows for harmful bacteria and other bugs to grow on the lenses. Additionally, the oxygen lacking environment that sleeping in certain monthly lenses causes can lead to painful eye infections. Daily lenses essentially eliminate this risk by using a fresh lens everyday.
  2. Better Comfort – Since you are using a fresh lens everyday, there is an added level of comfort when popping the new lens in!
  3. Better Clarity – A fresh lens everyday also eliminates the protein and lipid build up that is standard on monthly/bi-weekly lenses. This allows for less cloudy and thus sharper
  4. Convenience – Lost a lens? No worries, just pop another one in! No more waiting another month replace that lens or buy another box.
  5. No More Solution – With their unique individual blister packs, the need for contact lens solution is virtually eliminated.

A Note about Disposal

Recent media articles have pointed to many daily disposable lenses ending up in pipelines and sewers. If you are wearing or plan to wear daily disposable lenses, make sure to always throw them away in the trash can! Never flush them down the toilet or place them in down the sink drain.

In conclusion, daily disposable contact lenses offer a lucrative vision correction alternative that results in healthy eyes and better vision! With roughly 70% of contact lens wearers in our practice wearing daily disposables, we truly believe that these lenses can positively impact your well-being and lifestyle if your eyes fit the parameters for wearing a daily lens.

Give us a call and schedule a contact lens fit today, your eyes will thank you!


-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:

Spring Has Sprung: Allergies and the Eye

-The EYE Digest-

Spring Has Sprung: Allergies and the Eye


Spring time is in full swing and while many welcome the warmer weather and the longer daytime hours, there are others who dread spring and what it gives rise to…allergies from blooming flowers and the pollen they release.Allergens

Allergies occur when an environmental irritant causes cells to release histamines which cause inflammation.


What are the most common sources of allergies?

Allergies can be broken down into two categories: seasonal and perennial. Seasonal allergies are caused by pollen from flowers, trees, grasses, weeds as well as spores from mold. Seasonal allergies usually begin in spring and can last well into autumn. Perennial allergies, on the other hand, occur year round and are triggered by pet dander, dust mites, perfumes, smoke, and some cosmetics and medication.


Is it a cold and a “pink eye” or allergic rhinitis and allergic conjunctivitis?

ConjunctivitisCommon allergy symptoms include sneezing, sniffling and sinus congestion. These symptoms are classic for allergic rhinitis (allergies affecting the nasal passages). Since these symptoms present similarly to the common cold, those with allergic rhinitis often spend their time convincing others that they don’t have a cold and aren’t infectious, but instead, are suffering from allergies. In addition to affecting the nose, allergies can also affect the eyes. Those with ocular allergies have red, puffy, watery or mucous discharge, and itchy eyes that seem to get itchier the more they rub. These symptoms can affect the eyelids and the conjunctiva (the clear tissue that sits on top of the white part of the eye). When the conjunctiva is affected, it is considered an allergic conjunctivitis. Fortunately, this type of conjunctivitis is not contagious like your typical viral or bacterial “pink eye”.


How do I alleviate my symptoms?

The best way to prevent the symptoms is to avoid the trigger. If you’re allergic to cats or a certain type of perfume, then stay away from them. Sometimes it’s not so easy to avoid your trigger especially if it’s caused by pollen or spores. Fortunately, there are websites such as or that track pollen count across the United States and categorize the pollen count from low to high. Certain lifestyle modifications such as avoiding out door activities during high pollen counts can be beneficial.


ClaritinWhen your allergen can’t be avoided, there are medications, both over the counter and prescribed, that can improve symptoms. Oral over the counter medications such as Claritin, Zyrtec, and Allegra have anti-histamines that work against the histamine molecule which causes the inflammation and symptoms in the first place. If you primarily have ocular symptoms and minimal to no nasal symptoms, then a topical eye drop may be more beneficial. These topical eye drops include ketotifen


For an added “boost”, try putting the eye drops in the fridge for a nice, cooling therapy. A clean, cold wash cloth can have the same affect.

(e.g. Zaditor, Alaway) and olopatadine (e.g. Pataday, Patanol). If your symptoms are mild, you may even get away with using over the counter artificial tears.


Why does my eye doctor tell me to stay away from “get the redness out” type of eye drops?

Redness relief eye drops like Visine and Opcon A are great at getting the red out, which is important if you have an important meeting or event, but with extended use they can cause rebound congestion and redness that can be worse than the initial symptoms!


These eye drops aren’t helping, I need something stronger!

If antihistamine eye drops aren’t enough to alleviate your symptoms, then your eye doctor can prescribe a nonsteroidal anti-inflammatory drug (NSAID) or a steroid.


-Dr. Janelle Santa Maria


Dr. Janelle Santa Maria is an optometrist at Los Altos Optometric Group and contributing author and editor of The EYE Digest.

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

Age-Related Macular Degeneration (AMD) – A Definitive Guide

-The EYE Digest-

Age-Related Macular Degeneration (AMD) – A Definitive Guide

When the term chronic disease is stated, what pops into your mind? Diabetes, heart disease, and cancer are a few common and quite frankly, scary diagnoses. Now let’s dig a little deeper, when you think of a chronic disease that can debilitate an organ, what is the scariest we can think of? Certainly a large majority of individuals would choose the eyes. Vision is a vital sense after all. 1Cataracts and glaucoma are common, worrisome disease that rob eyesight, but what about that other one? The one that can be really bad and can drastically reduce the central vision?

Age-related macular degeneration (AMD) is a diagnosis that no one wants to receive. It has a reputation of blinding individuals and making life absolutely miserable. Worldwide, it is estimated that roughly 6.2 million people suffer from AMD.


So what exactly is AMD and how can we prevent it?

Age-related macular degeneration, as defined by its namesake, is a disease that affects the macula. The macula is a tiny pit of concentrated photoreceptors on the retina (back of the eye). This area is responsible for our central vision, and due to its concentration of photoreceptors, also happens to be point of sharpest vision.

The progression of AMD tends to be slow. Early signs of AMD are often detected at an annual eye exam by means of dilated retinal exam or retinal photos. AMD may present in one eye or both eyes. If it 2occurs in both eyes, the severity between eyes may be different.

As the disease process progresses, the patient slowly begins to lose his/her central vision. This becomes problematic since this is the sharpest part of our vision, responsible for recognizing faces, reading or driving. Even if central vision is completely compromised, advanced AMD patients tend to still have some peripheral vision left, so they are not completely blind.


Types of AMD

There are two types of AMD, dry and wet. 3 The type of AMD is diagnosed based upon its appearance. Dry AMD unfortunately has no treatment options. Wet AMD can be treated with a variety of methods including laser photocoagulation and injection of anti-VEGF factors such as Lucentis or Avastin. Keep in mind that these treatments do not cure AMD, they simply try to slow down or possibly halt the disease where it is at.



What Causes AMD?

AMD finds its roots in genetics, demographics, environmental and lifestyle factors.

5Genetic mutations in genes including HTRA1, SERPING1 and Fibulin-5 have all been linked to development of AMD. Current genetic testing technologies are able to locate these genes and help with early treatment.

Demographics play a big role in development of AMD. As stated in its name, the disease is age-related and most often occurs in older individuals. Individuals with fair 4complexions and lighter skin seem to develop AMD at a higher rate than their counterparts. Related factors that can further put the patient at risk for AMD are atherosclerosis, hypertension (high blood pressure) and family history.

Lifestyle factors, especially smoking, can lead to AMD. Besides smoking, diets that are deficient in leafy green vegetables and frequent unprotected exposure to UV light can lead an individual down the road of developing AMD.


So how do we prevent AMD from occurring?

There a few preventive measures that an individual can take to stave off AMD. These measures mainly revolve around lifestyle:

The Big Four Ways to Prevent/Slow Down AMD

  1. Don’t Smoke
  2. Wear Sunglasses outside
  3. Daily intake of dark leafy green vegetables
  4. Visit your eye doctor regularly


How do we treat AMD when it does happen?

AMD is slow, progressive disease and generally comes in stages. During early stages, there is often no treatment, and the condition is monitored with regular eye exams and devices such as the Amsler grid, which is pictured below.


During the early to middle stages of AMD, eye doctors may recommend an AREDS II supplement, in 8addition to the Big Four. Brand names for this supplement include Preservision, Ocuvite and Tozal. The AREDS II supplement formula is a variety of vitamins and antioxidants that have shown to be beneficial in slowing AMD through clinical trials.

When AMD gets to the more advanced stages, certain variants such as advanced wet AMD may require intravitreal injections such as Lucentis, Avastin or Eylea. These injections are administered into the eyeball and contain factors that slow the disease from progressing even further.


-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:

Floaters: The Definitive Guide to those Pesky Squiggles and Dots

-The EYE Digest-

Floaters: The Definitive Guide to those Pesky Squiggles and Dots

Dots. Squiggly lines. Worms. Spots. Gnats. FloatAndSpotSome are large, some are small. Sometimes they move, sometimes they stay in one spot. They’re especially prominent if we stare at the blue sky or a white background. What are those pesky things that interfere with our vision?

Vitreous floaters, or more simply, floaters, are a common ailment in the human eye. The majority of the US population reports seeing a floater that either bothers or hinders vision at some point in life.

So how do floaters occur?

Inside the eyeball, a clear gel-like substance called the vitreous humor resides. The vitreous humor helps vitreous detachment 330×320@3xgive the eye its round shape and provides a clear unobstructed medium for light rays to pass through and focus on the retina. It comprises about 80% of the volume of the eye.

In our younger years, the vitreous presents as a solid, but as the eye ages the vitreous material slowly begins to liquefy and shrink. As the vitreous shrinks tiny, stringy solid remnants are left over. These remnants can float around and move in conjunction with eye movement. This movement of remnants is what we see as floaters.

How about that one large floater that came with flashing lights in my mid-50s?

Posterior vitreous detachment is a process where the vitreous separates from the retina. Initially, the vitreous starts out attached to retina much like wallpaper. Over time, as the vitreous goes through itsvitreous detachment usual wear-and-tear (as discussed in the previous paragraph), it can start to pull away from the retina. The beginning of the process can be thought of as a sort of “tugging” on the retina. This tugging creates the sensation of a flashing light due to the activation of retina, which in turn is neurological tissue. When the vitreous finally detaches, it leaves large and sometimes multiple floaters.

Can floaters be a sign of something more serious?

Yes. Floaters may be an ominous sign of retinal tears or detachments. Retinal tears or detachments are a medical emergency that require immediate attention. Other signs of retinal detachments are flashing lights or retinal detachment 2the feeling of a veil/curtain over the vision. If you experience any of these signs, it is important to see your eye doctor right away.

Floaters may also occur from infections, inflammation and injury. Once again, if you experience a floater outside of the norm, it is important to have an eye care professional examine your eyes.

Is there treatment for floaters?

For most individuals, floaters are unfortunate, pesky nuisance that requires not treatment. In very rare cases where floaters become dense and block vision, a vitrectomy may be performed. This process involves surgically removing the vitreous from the eye and replacing it with a solution or gas bubble. This procedure is very risky and is only done in special cases.

-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:

Myopic Insight – How Did We Become Nearsighted?

-The EYE Digest-

Myopic Insight – How Did We Become Nearsighted?


Glasses. Contact Lenses. LASIK. All of these terms are commonplace in modern society. You may be 635951720420731698 419509801 glassesfamiliar with one or more of these modalities from your own vision care or a family member or friend. The truth is, nearsightedness (myopia) has become so prevalent that there are no degrees of separation when we seek to find individuals suffering from the condition.

globe 1348777 960 720In fact, a recent study has shown that myopia affects nearly 1.6 billion people across the world. The incidence of myopia is nearly 42% in the US, and in countries such as Singapore and Hong Kong, it is a staggering 80%!

So the question arises: how did we become nearsighted? Additionally, why are the rates of myopia increasing at such a drastic rate in the modern age? Sure, myopia will always have a genetic component, but certainly an environmental component must also be coming into play. In fact, it is more than likely a mixture of the two components is responsible for most cases of myopia. Let’s take a look at the theories that have been postulated to explain this phenomenon.


Genetic Theory – Mutation in LEPREL1

It is generally accepted that if a parent or both parents of a child are myopic, this places the child at a higher likelihood of developing myopia. In fact, a genome-wide linkage analysis has found that a mutation on exon 10 of the gene named LEPREL1 has a direct correlation with myopia.


Environmental Theory #1 – Reading Time vs. Outdoor Activities

The most common theory used to explain the up tick in myopia is the amount of time children

spend indoors performing up close tasks (such as reading) vs. the amount of time they spend outdoors playing. Prolonged amounts of time performing activities such as reading books, looking at laptops, playing on tablets, and working on smart phone screens have been linked to myopia in children.

ThinkstockPhotos 478145143

The idea behind these activities causing myopia deals with the higher amount of accommodation and strain involved with prolonged near work, which can have a link to increased axial length, which subsequently can turn an emmetropic (no prescription) eye into a myopic eye.

We can see the correlation between myopia and near activity through a historical standpoint. One hundred years ago, many children spent most of their time outside tending to farms and handiwork while doing minimal indoor close up work. The incidence of myopia around this time was much lower than it is today.

Further evidence comes from the Avon Longitudinal Study of Parents and Children (ALSPAC), which found that longer amounts of time spent outdoors resulted in a lower incidence of myopia in children 3 years of age and up.

The correlation between outdoor activity and less myopia has also led researchers to believe that amount of exercise during childhood may also lead to a lower incidence of myopia.


Environmental Theory #2 – Direct Light Exposure

While the reading/near activity link seems to be the most accepted theory for environmental causation bde308a08d2dad7a32a5deea84c3f315of myopia, recent research has shed some light on the effects of sunlight on myopia development. Specifically, it may be the outdoor activities that are helping to prevent myopia, rather than the indoor activities that are causing myopia.

Correlation between increased exposure to light and a lower incidence of myopia has been found. Two hypotheses exist for this correlation. The first hypothesis is that sunlight causes the release of vitamin D, which may have an affect in halting eye growth and thus myopia. The second is that sunlight causes a dopamine release in the retina, which results in a cascade of cellular reactions that lead to normal eye growth.


In conclusion, the moral of the story is that a genetic component as well as an environmental component comes into play with development of myopia. With the knowledge we have, a two-fold plan can be made to potentially reduce the risk of myopic progression in children:

  • 1) Make sure your children spend an ample amount of time playing outside, especially if you or your spouse is myopic!
  • 2) Make sure your children take frequent breaks when performing near tasks. We often recommend the 20-20-20 rule: every 20 minutes, take 20 seconds to look 20 feet away.


-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.

Contact him with questions or ideas for future articles at (650) 948-3700 or

Feeling Blue – Blue Light and Its Effect on the Eyes and Body

-The EYE Digest-

Feeling Blue – Blue Light and Its Effect on the Eyes and Body

In modern times, screens have become a ubiquitous and often necessary means of production, education, and entertainment. Computer monitors, TVs, tablets,a1 and phones constantly surround us. In the year 2017, you would be hard pressed to find an individual, young or old, that does not spend some time per day on a screen. Heck, you’re reading this article right now on a screen (unless if you printed it out, then kudos to you!).

A hot button topic that has been thrown around with computer screen usage is blue light. You may have heard that blue light can cause eyestrain, or even affect the sleep cycle. But what exactly is blue light and how can it affect our eyes and overall health? Let’s take a deeper look.


What is Blue Light?

Light can be broken down grossly into two types: visible and invisible light. Invisible light includes infrared, radio, ultraviolet, X-ray, and gamma ray. Visible light includes all light emitted with wavelengths that range from 290 nm to 700 nm. In this range of wavelengths, the color spectrum is contained. Blue light specifically, encompasses the range of 380 nm – 500 nm. These wavelengths are shorter than the “warmer” colors such as red and orange.


Where is Blue Light found?

Blue light is found nearly everywhere. The sun is constantly emitting blue light, so if we are outside we are constantly being exposed to blue light. The indoor environment presents blue light through tablets, computer screens and fluorescent lights.


Does Blue Light cause eyestrain? And if so, how?

Blue light is a big culprit in causing eyestrain. Blue light is of higher energy than other colors of light due to its low wavelength. This causes blue light to scatter easily and thus makes it more difficult for the natural lens inside the eye to focus on blue light.

When looking at a computer screen light of all colors is emitted. When the eye tries to focus on an image on the screen it must focus while trying to filter out the scattered blue light, which essentially creates visual noise. When the eye is subject to doing this for long periods of time, it becomes strained from constant focusing and refocusing.


Can Blue Light affect sleep/Circadian Rhythm?

a5Yes! Blue light does have an affect on the sleep cycle and can disrupt the Circadian Rhythm. A Harvard research study found that blue light can substantially alter melatonin (a necessary chemical in the sleep cycle) production in the body. This is due in part to blue light’s natural tendency to stimulate and awaken the body.

Further conclusions from this have shown that blue light is affecting us more than ever before. Why? Device usage, including tablets and phones, before bed, is at an all time high. This blue light blitz before bed can have a drastic effect on both falling asleep and sleep quality.


How about Blue Light and Macular Degeneration?

A few years ago, a link between blue light exposure and macular degeneration was established. However, the topic is highly controversial and there is very little scientific evidence supporting blue light being a causative factor of macular degeneration.


How can we stop Blue Light?

a4There are a variety of ways that we can stop or limit blue light exposure in our daily activities. The first and most obvious is to avoid blue light altogether. This means spending less time on phones and screens.

The second method is to employ blue light filter screens on our devices and monitors. These can substantially reduce blue light exposure. Additionally, devices like the iPhone have a settings option called Nightshift, which reduces the amount of blue light emitted by the phone.a3

Finally, one can use blue blocking lenses (sometimes called computer lenses). These lenses, which may be clear or have a slight yellow tint, filter out blue light, enabling the eyes to work with substantially less strain on screens and devices.


-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.

Contact him with questions or ideas for future articles at (650) 948-3700 or


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