Ophthalmology & Optometry/Query re Orthokeratology

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Question
Hi,

(NB:- I have put this as a private message):-
I was most impressed with your response to my previous question re orthokeratology.Many experts nowadays are too afraid to subvert conventional ideas for fear of being fired etc.. That said, I have to admit that I have very recently tried the orthokeratology lenses and I found it took far too long to insert and take out the lenses. Even worse, it took me c. 30 minutes to find both missing lenses, one after the other, on the first night. I might well consider trying the OK lenses again if technological advances happen etc. In the meantime, I would appreciate it if you could give me further tips re inserting/taking off Orthokeratology lenses in the meantime. I did note that the Ortho-K expert did not, until the 2nd session, give me any extra tips/advice on how to put on the Ortho-K lenses. They seemed to be happy enough to provide eye-glasses etc. if I did not adapt to the Ortho-K lenses.

In the meantime, given your impressive professional integrity,  I would like your opinion on the following methods to improve one's eyesight:-


http://www.ign.com/articles/2014/04/22/ultimeyes-is-an-app-that-will-improve-you

http://improveyoureyesight.org/blog/plus-lens-therapy-natural-therapy-for-myopia

Answer
Geoffrey,
First, thank you so much for your kind words. I know that people often do not get the information they need because they, rightly, have no idea what to ask.

As an overview generally visual therapy is considered a fringe segment of eye care. That said I know of otherwise orthodox eye care practitioners who refer patients to visual therapists, usually children. Successful patients of visual therapy are almost evangelical in their endorsement of the treatments. I have been given books by happy parents whose children have benefited authored by the doctors who treated them.

A fundamental fact remains, issues of acuity that are refractive in nature, correctable with glasses or contact lenses, are due to mechanical issues of the eye. Myopia, hyperopia, and astigmatism, the most common, are due to the axial length of the eye or the shape of the cornea. No amount of practice or exercise will address these causes.

Why then the success? It could be a number of reasons, it was a passing event, the treatment uncovered other issues like ADHD or Dyslexia, I have heard of muscle imbalance in children being treated with visual therapy, and that makes sense, strengthen the weak ocular muscle and correct the problem. Visual therapists focus on what optometrists often spend less time on as they have made a sort of sub-specialty from a segment of a full eye examination.  Visual therapists also work with athletes to improve their eye/hand coordination, visual tracking abilities and speed and much more and are used by many professional athletes and some Olympic teams.

I have requested additional information from Ultimeyes the iPhone application. As for what I found on their website it is vague as to its definition of “sight” and seems to claim “…reaction time…contrast level and accuracy…” as its improvement goals. It actually says “…that it's not going to correct your eyes' optics, so if you're reliant on glasses to see, don't expect that to change any time soon.”

As for Plus Lens Therapy, yes. For immerging, and as of late pre presbiopic people, computer users, and video game players. Those activities advance myopia. It is not, however, a treatment for reversing myopia or presbyopia just slowing its advance.

Otho-K is a great option. I am considering it myself. If you are properly trained on both the insertion and removal as well as the emotional aspects, learning curve, etc, you should be able to put them in in seconds and remove them in the literal blink of your eye. I have worked with patients for hours to get them to put in and remove their lenses for the first time (I require that all new fits do this before they leave with the lenses). I’ve had them take a break and go have dinner and come back, I have had them come in for an hour or so for several days, and I have had them learn in minutes. Your time was WAY better than average! And not to worry, you probably know this now, you cannot lose your lenses behind your eyes. Your sclera is the thick clear membrane that protects your eye and it attaches under your eye lids. So the lens can de-center, which could be a fit issue, but they can’t get behind your eye.  

Ophthalmology & Optometry

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Robert Sobotor LDO

Expertise

Eye Glasses: fit, adjustment, and function Frames and Lenses: materials, benefits, limitations,progressive vs. bi-focal and adaptation Contact Lenses: tips on wearing, insertion and removal, comfort and proper cleaning and care Visual Complaints: Whether you have a history of unresolved visual complaints, never had a pair of glasses “feel right” or “I saw better out of my old pair” I can help troubleshoot visual complaints resulting from new glasses by determining, based on your observations and feelings, what the likely causes are and explaining them to you in a way that gives you a clear understanding and a shorter adaptation period. Contact lens Care: Tips and suggestions that I have used to teach first time contact lens wearers, even pre-teen and adolescent children, to quickly give them the skills and confidence to put in and remove their contact lenses. Tips on getting them in fast in the morning and out quickly at night without having that itchy feeling when you remove them. I can explain to you the makeup of the tear layer and how it can directly affect the comfort of your contacts based on little thing like computer use, heating and air in the car and office, that cloudy afternoon vision or dry feeling later in the day. Lens Recommendation: Based on your prescription I can advise what lens materials and designs are best suited to your needs and which ones to avoid as well as direction on frames designs that would complement the selection. Proper Frame Adjustment: I can help identify the problems associated with painful glasses that pinch, or squeeze. I can help you avoid getting a pair of glasses that constantly slide down your nose no matter how many times you get them adjusted. I can teach you what to look for in a frame that is right for you. I can explain how to look for a good quality frame that is not the most expensive in the room. I cannot diagnosis disease, prescribe or offer price specific advice or information.

Experience

My background is as a Licensed Optician with over twenty years experience. I have had industry-specific work published and held management positions with the largest optical retailing companies. I have had operational oversight of the dispensaries of both Ophthalmologists and Optometrists I have also held management positions in optical manufacturing to include specialty design RGP's and surface manufacturing, lens coating, and edging of spectacle lenses. My bench work, adjustment and repair, is in the tradition of the Guild opticians - focused on quality. I am proficient in all facets of eyewear, spectacle and Rigid Gas Permeable contact lens manufacture and modification. I provide an extension of the doctor’s standard of care throughout the entire dispensing process as I work with the patient to understand their diagnosis and develop the best solution toward remediation.

Publications
Eye Care Professional Magazine The Price Bluff- Relationship based business http://www.ecpmag.com/1webmagazine/2008/01jan/content/independent-ECP-pricing.asp Size Matters- The application of ANSI standards http://www.ecpmag.com/1webmagazine/2007/10oct/content/size-matters.asp

Education/Credentials
Licensed Dispensing Optician 1991 The American Board of Opticianry (ABO) certified 1990 National Contact Lens Examiners (NCLE) certificated 1991 Georgia State University 87-88 Oglethorpe University 03-04

Awards and Honors
Lens Crafters Presidents Pin for outstanding customer service

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