This Blog Will Cure Your Blindness

“I was legally blind before I had LASIK.”

“I can see ten miles away with my glasses on, but without them I’m legally blind.”

“My vision is great; I don’t need glasses or contacts. But you should see my wife’s thick glasses; she must be legally blind!”

NO.

NO NO NO.

memegen

Now, I don’t want to sound belligerent, but we really need to have a dialogue about the definition of “legal blindness.” Its misuse is something that really shouldn’t make me angry, but lately it’s been grinding my gears a little bit. I know, I know; there are better things to be miffed about – the Middle East is still in turmoil, unemployment numbers in the U.S. are still not great, they took away the McRib again – but gosh darn it, the record needs to be set straight. So I’m sorry for my ill-masked disgruntledness. Hopefully by the end of this post I’ll feel more gruntled.

Before we get into the real educational portion of this post, let me first attempt to justify or at least explain my anger (which by the way isn’t really anger, but more like anger’s little brother; I’d like to think that I never get truly angry about anything, except maybe when contestants on Wheel of Fortune buy vowels when they obviously already know that the vowel they’re buying is in the place they expect it to be – like “Well Pat, that word is three letters and starts with a T and an H, I’d like to buy an E.” Those vowels cost you money, dummy! I don’t care if there might be other E’s in the puzzle; it’s the principle of the thing.).

Anyway, my mini-anger. It’s just that I have yet to hear a single person in casual conversation use the term “legal blindness” correctly. Heck, I probably did the same thing before I went to optometry school. But now that I have a blog and a few people actually read it, I’m going to use this chance to give people the knowledge that I never received as a youngster. Frankly, I’m tired of cringing every time I hear one of the statements that I put at the beginning of this post. I guess you could call it a pet peeve. If you’re a patient of mine and you’re guilty of this and have said it in front of me, I hope I concealed my inner pain well enough (just kidding; you know I love you).

On to the definition. The United States government defines “legal blindness” as a visual acuity of 20/200 or worse in the better seeing eye, with best correction, or less than 20 degrees of visual field irrespective of visual acuity. If you need a refresher on how visual acuity works, click here.

Let’s break this down.

Possibly the most important phrase in that definition is “with best correction.” What does this mean? Glasses and contact lenses qualify as vision correction, so your best vision with your glasses or contacts would be your “best correction.” Thus, the statement “I’m legally blind without my glasses” makes no sense, because in order to meet the definition of legal blindness, you have to have poor vision (i.e. worse than 20/200) WITH YOUR GLASSES OR CONTACTS.

To use myself as an example, with my glasses on, I can see 20/20 on a standard visual acuity chart. Without my glasses, I can see about 20/800 (essentially I can see blobs of color. For reference, look at a Monet painting). Despite my awful vision without my glasses on, I am not legally blind. If you have a driver’s license, you are not legally blind.

That’s the long and short of it. If you feel absolutely inclined to portray to another individual just how poor your eyesight is, may I suggest the phrase “figuratively blind?” It may not roll off the tongue as nicely, but it’s much more accurate.

Thanks for reading! I’d continue, but I have an anger management class to attend.

Let’s Get Superficial

Optometry has the unique distinction of being a profession that encompasses both medical care and fashion (although I guess you could include podiatry in this category; those big metal orthopedic boots are pretty chic).  In honor of the more superficial side of my chosen occupation, I thought it’d be fun to explore some of the more memorable trend-setting styles in eyewear and the people who have made them famous.  That’s right, get ready for

Apertis Oculis:  FASHION EDITION

Kicking things off in our retrospective of fashionable face-wear is a fairly recent entry in the Great Gallery of Glasses.  Her politics may be controversial, but her fashion sense is not.  Just four short years ago she single-handedly ignited a trend in eyewear that had opticians everywhere scratching their heads trying to find “Sarah’s frames.”  Nowadays rimless/drillmount frames are definitely in, and it’s hard to dispute that she played a big part in their popularity.  Of course I speak of Sarah Palin:

Even grizzly moms can be near-sighted.

Say what you will about her social views, the woman can rock a pair of spectacles.

Next up is a look that’s been championed by many a celebrity, so it’s sort of hard to trace it back to its roots.  Personally, I think of them as “Buddy Holly glasses.”  They’re the thick plastic dark/black specs that make it easy to identify nerds everywhere.  They’re plastic, they’re sturdy, and if you sit on them, they’re cheap to replace.

Musicians wear them.

Modern musicians wear them.

Actors wear them.

Screenwriters/directors wear them.

And then there are some people with their own sense of style.  You can see it in their clothing, you can see it in the things they create, and sometimes you can see it on their face.  Well, in this case, you can definitely see it on his face.  He hasn’t exactly started a trend with his eyewear, but no list of fashionable glasses would be complete without a mention of the man who waved goodbye to the Yellow Brick Road, the Crocodile Rocker, the Piano Man (…no wait, the OTHER Piano Man)…Sir Elton John.

Now that guy has style.  Or something.

BONUS GLASSES PICTURE:

This one has sort of flown under the radar, but is becoming iconic nonetheless.  Sometimes fashion takes a backseat to functionality, but at the same time functionality can breed fashion (philosophical, no?).  Now I’m not claiming that the following design of spectacles is going to start a trend (although hipsters have done stranger things), but I can say with 100% honesty that when I turn 50 I will be rocking these glasses, with the utmost capacity that they can possibly be rocked.  I give you Walter White:

Anti-reflective coating, Transitions, and morality are optional.

It’s not flashy, it’s not ground-breaking, but when you have to throw on a gas-mask and cook some meth, it gets the job done.  Legal note: the author of this blog does not condone the cooking of meth, no matter what kind of glasses you’re wearing.

That rounds out some of my personal favorites.  I’m sure within the next year or two, some celebrity or political figure or television character will show up on the scene with a never-before-seen style of eyewear, and we’ll all be drooling over them and trying to find where we can get our own.  Just remember that glasses only improve your eyesight if your peepers work properly, so get an annual eye exam.

See what I did there?

Tyrannosaurus Rx

Ever looked at your eyeglasses or contact lens prescription?  If you’ve ordered eyewear online you certainly have.  To those uninitiated in the science of refraction, that prescription probably just looks like a big jumble of nonsensical numbers and plus/minus signs.  Well, for those of you who want to know, this post is for you!  Your very own post!  If we’re lucky we might even get to the bottom of that pesky PD thing.

What language is this written in? Sanskrit?

So let’s start with the bare-bones basics:  abbreviations.  Your prescription probably has the letters “OD” and “OS” somewhere on it, and I would imagine that you’ve used the POWER OF LOGIC to determine that these refer to your right and left eye.  More specifically though, OD is short for oculus dexter, which in Latin translates to “the eye of an HBO serial killer series.”  Either that or “right eye.”  By process of elimination, OS is short for oculus sinister, which of course is Latin for “evil eye.”

You might also see the abbreviations SPH and CYL on your prescription.  These refer to the shape of the lenses:  SPH stands for sphere (a spherical lens), while CYL is for cylinder (a cylindrical lens).  If you are near-sighted (myopic) or far-sighted (hyperopic) you will see a number in the SPH column; if you’re myopic it’ll be a negative number, and if you’re hyperopic it’ll be positive.  If there is a number in the CYL column, it means you have astigmatism.  This number indicates how many days you have left, so live them well.

Just being completely serious kidding.  Astigmatism is not a life-threatening condition, and it’s actually a condition that the majority of humanity suffers from.  That’s right; most people have some amount of astigmatism.  Makes you feel less special, doesn’t it?  In addition to the CYL value, you’ll also see a number under a column marked AXIS; this is because a cylindrical lens must be specified at a particular orientation, or axis (measured in degrees, and falling between 1 and 180), in order for your astigmatism to be corrected.

Alternatively, SPH is the sound you make when someone tells you an outrageous lie, and CYL is the part of the window where your cat sunbathes.  I never said optometry makes any sense.

This is my favorite cyl.

Speaking of astigmatism, there are contact lenses available that correct it.  However, they can be somewhat limited in the amount and orientation of astigmatic correction that they offer; usually your optometrist can ballpark it so that you can still see clearly.  That being said, sometimes your vision may fluctuate if the contact lens rotates when you blink; unlike glasses, contacts are free to rotate on the eye.  You would look pretty goofy if your glasses spun around on your face.  Like a nerd-copter.

Depending on your age, you may also see a number in a section marked ADD; this is the power of your bifocal.  Here’s a little trick regarding this number:  if you wear contacts that correct your distance vision but require a bifocal in your glasses, you can use the ADD number to buy a pair of over-the-counter reading glasses to wear on top of your contacts to improve your near vision.  Don’t say I never gave you anything.

And last but not least, the revered PD.  This is the limiting factor that most patients curse when they’re trying to order glasses online.  It can be elusive – I would imagine that most optometric offices don’t include it on the prescription form.  PD stands for pupillary distance, and this is an important measurement because it determines where the optical centers of your spectacle lenses reside – if it’s measured incorrectly, you may experience unnecessary distortions through your glasses.  This may lead to nausea and explosive vomiting.

So in a nutshell, that’s how your RX works.  And outside of a nutshell, that’s also how it works.  Questions?

Windows to the Soul (also the heart, lungs, et cetera)

Recently I had a family member question me about the importance of annual eye examinations. Ballsy, right? His rationale was that if he does not need glasses, then why go to the eye doctor every year? So, Anonymous Family Member, in your honor, here is the answer.

With an annual dilated eye examination, optometrists are capable of detecting the following:

Diabetes

Hypertension

High cholesterol

Carotid stenosis

Hyperthyroidism

Sickle cell anemia

Lupus (but it’s NEVER lupus!)

Cancer

Multiple sclerosis

Marfan’s syndrome

Albinism (before you scoff that even YOU can detect albinism, there is a type that’s exclusively ocular in nature)

Sarcoidosis

Herpes

Syphilis (now it’s getting interesting)

Seasonal allergies

And those are just the tip of the Titanic-buster. All of the above can be detected with a simple eye exam, and you don’t even have to be symptomatic for them to be detected. Wouldn’t you like to know if you’re diabetic before the symptoms even show up? I mean, not that you would LIKE to know that you’re diabetic, but you get what I mean, don’t you? I hope you do. This conversational style is hard to do when there’s no one to have a conversation with.

ANYWAY, as if the above isn’t reason enough to get your eyes checked, here’s Reason Numero Dos. Glasses make you [look] smarter. Even if you don’t necessarily need glasses; although eventually you will be stricken with presbyopia and then you will need them. For more on that, see this post.

For more proof on the whole “glasses make you smarter” maxim, look no further than this news story, in which a two-year-old was inducted into Mensa after she was prescribed glasses to correct amblyopia (known more popularly as lazy eye). Now I’m not guaranteeing that glasses will get you into Mensa, but if you do get accepted at least you’ll fit in with all the other four-eyed members.

You might even stumble upon a trend of your own or become recognizable just by your spectacles.  Look at guys like Woody Allen, Harry Caray, Buddy Holly, Sarah Palin, that dude from Weezer – all of whom would not be the same without their trademark face-clothes.  Eye-jewelry?  Ocular accessories……..Occessories!

Screenwriters, sportscasters, musicians, and politicians all look better with spectacles!

And so, dear family member, and all of you who don’t understand why it’s important to have a yearly eye exam, consider the following:  your optometrist can help you stay healthy AND can make you look snazzy.  What other health care professional can lay claim to both?  And if you say plastic surgeon, I’m going to admonish you thoroughly in my next blog.  Be afraid.