An Optometrist's Guide to Hunting

Hello Hunters and Non-Hunters,

I thought I'd write this blog posting about deer hunting in Pennsylvania, which in case you haven't heard, is a pretty big deal! I'm not a hunter myself, mostly because my dad wasn't a hunter. He played golf, and I ended up choosing golf as my sport vs. hunting. If he was a hunter, I'd probably be a hunter myself.

When I was still in high school (just a couple of years ago, ahem!), I remember having that Monday off from school after Thanksgiving. I appreciated the day relaxing at home, while many of my hunting friends would rise early in the cold November air and go hunting with their dads.

There are many, many, MANY hunters out on that first day. For example, in 2011 there's a quota of 50,000 deer licenses in Eastern Berks (area 5B) alone, and they are all sold out. Sure one person can buy multiple licenses, but still, that's a lot of hunting going on. Eastern Berks and neighboring counties (area 5C) have a quota of 117,000 licenses. So if you're a lazy hunter, or were lucky enough to use up all of your licenses that you purchased, in area 5C there's still 13,764 available.

There are no vision requirements for hunting in the state of Pennsylvania. However...there is a mandatory vision examination according to Section 2522 if you happen to shoot at or cause injury to another human being.

"g) Mandatory Vision Examination: Any person whose privilege to hunt or take game is suspended under section (c) shall present to the commission, prior to obtaining a license after the period of suspension, evidence of having taken and the results of a vision examination administered by a licensed ophthalmologist or optometrist subsequent to the suspension of the license. The commission, based on the results of the vision examination, may deny a person a license or place on the license a restriction requiring the person to wear corrective lenses when the person hunts or takes game"

Obviously, vision is important when hunting, because you can't shoot what you can't see. And if you can't see your target clearly, you really shouldn't be shooting at it in the first place (especially if you are using a bazooka!). However, every year there are reports of hunting related accidents and deaths for a variety of reasons. Maintaining excellent vision, using common sense and implementing hunting safety are surefire (sorry for the pun) ways to reduce the risk of hunting accidents.

As a Sports Vision member of the American Optometric Association, I learn about different visual and perceptive requirements for different sports. My advice for hunters is to ensure that they are seeing as clearly as possible before pointing their gun at anything. I've mentioned this before, but I have had patients that claim to see just fine and when I ask them to read the chart, they struggle to see The Big E (20/400 vision) even with their "current eyeglasses." Like any sport, seeing as clear as possible provides a competitive edge, because if you can't see, you lose that ability to perform 100% of your ability when things get tense. Clear, comfortable vision allows the hunter the confidence and ability to do what they need to do when the excitement of a deer walking in sight occurs. So, even though there are no vision requirement for a hunting license, getting an eye exam before you point your gun at something is probably a good idea.

Other Hunting Tips from the Local Optometrist

It's important to realize that your normal and every day dress pair of eyeglasses may not be the best pair of glasses for hunting. Many times, hunters have a second or third pair of eyeglasses to give them the most optimal vision while in a hunting situation. For example:

1) Protective eyewear is important while hunting to prevent eye injury from debris, backfires, gunpowder, etc. Polycarbonate and Trivex are the most shatter-resistant materials available. Regular plastic lenses will chip and/or break, while glass lenses will shatter, certainly causing a traumatic eye injury. Polycarbonate and Trivex is available in everyday dress eyeglasses, but if you do not have that material in your eyeglasses, it may be a good idea to get that second pair just for hunting to protect your eyes.

2) Some people who wear glasses DON'T wear their glasses while hunting because "they just get in the way." Visual acuity and contrast sensitivity are important to see clearly in normal and low light/hazy environments. If you need an eyeglass prescription, and you are not wearing the prescription while you are hunting, the decrease in vision may much worse on a cloudy day. So if you need to wear glasses to see clearly, you should wear your glasses while hunting.

3) For those who wear eyeglasses, a slight yellow tint improves the contrast sensitivity on cloudy days or when it's raining/foggy. On sunny days, a normal grey tint is optimal. Both options should be polarized to protect your eyes from sunlight glare reflected from snow, morning dew from a large field and streams and lakes. Both options should also have an anti-reflective coating on the lenses as well to allow more light to enter your eyes, allowing for better vision all around.

4) Hunters should use their dominant eye to sight the target. An easy "party trick" to test this at home is to just make a "thumbs-up" gesture and use the thumb to hide a doorknob 10-20 feet away with both eyes open. Then alternate closing your eyes one at a time without moving your thumb. The eye that is open when the thumb blocks the doorknob is your dominant eye. (You may want to double- and triple-check this to be sure.) The dominant eye tends to be optimized for distance vision. Also, being right-handed doesn't necessarily mean that your right eye will be dominant. Another also: your dominant eye may not be your better seeing eye. The dominant eye is just the eye that you prefer to use when looking at an object at a distance. So if you're shooting "righty" and your left eye is dominant, you may want to learn to shoot "lefty."

5) Some hunters complain that their glasses fog up, which is why they don't wear them when hunting. Well, there is a new coating available for eyeglasses that are Anti-Fog. They need to be treated every so often with an Anti-Fog applicator that you can do on your own. If you haven't heard of this before, it's because the Anti-Fog technology is brand new and now available. Also, contact lenses may be an option as well. They don't fog up, they provide better peripheral vision AND they don't distort the vision perception like many high prescription eyeglasses can. I have also customized bifocal contact lenses for older gentlemen who have trouble seeing both the gun's sight and the distance target with their current eyeglasses.

So, I guess what I'm hoping to get across is that vision is important to hunting. And the better you see, the better you hunt. That won't make a deer come into view, but it will let you see it more clearly when it does.

Sincerely,
Dr. Weaver

Decorated for the holidays!

Part-time Medical Receptionist/Assistant Wanted

Here's a copy of the craigslist ad posted this evening:

Front desk staff person needed for medical office in Bernville, PA. A positive and friendly attitude towards patients in order to provide excellent customer service is a must. Duties also include check-in/check-out patients, scheduling appointments, answering phones, verifying medical insurance, using electronic medical records, etc. Also, computer and typing experience is mandatory. Looking for intelligent, hard working and dedicated individuals looking for a long-term position.

This is a growth position into more hours and benefits for the right candidates. Will train the right individual. Pay is based on experience. Hours are afternoons and early evenings on Mondays, Wednesdays and Thursdays, with possible more days and hours depending on candidate availability and training. Please email resumes and minimum hourly wage to wecajobs@gmail.com, or fax to 610-488-5296. This is an exciting opportunity in a great working environment.

More information about the practice at => www.weavereyecare.com

Children and Eye Exams

Hello,

Here's a question: when should you bring your child in for an eye exam?

It's a very good question because the answer is not known by many. Eye exams check for vision problems AND eye disease. You'd be surprised how many patients that I see who are in their 40's...who come in for their FIRST EVER eye exam. Many people think that if they can see fine, then their eyes are fine, too.

The American Optometric Association (AOA) recommends that asymptomatic children get checked at 6 months, 3 years AND before the First Grade. That's three different eye exams BEFORE a child starts school.

The reason for this to to prevent amblyopia. Amblyopia is a fancy name for "lazy eye," which can happen for a variety of reasons. Amblyopia is a term used for an eye that is not seeing it's full potential, which is weaker than the better-seeing eye.

Did you ever hear the phrase, "Use it or lose it?" Well, that's the rule when it comes to amblyopia. An amblyopic eye is at risk for not developing the proper neuronal connections that allows the eye to see properly. If you have an eye that sees great and an eye that sees not-so-great, the eye that sees great will do all of the work. This causes neuronal connections of the not-so-great eye to NOT develop properly.

Sometimes the amblyopia is caused from an actual and physical eye turn. The turned eye is caused from an eye muscle imbalance. This causes double vision, so for the brain to compensate, it learns to turn off one of the images. It get rids of the double vision, but now the brain is refusing to use the turned eye. This is bad.

Amblyopia can also be caused by an eye that has a much higher prescription than the other eye. Since the two eyes are never in focus equally, the brain chooses to favor the eye that's more in focus and ignores the more out-of-focus other eye. This is also bad.

Finally, amblyopia can also be caused by ocular disease, such as congenital cataracts, corneal opacities, problems with the retina, and a variety of other ocular conditions. This is very bad!

Amblyopia doesn't just cause one eye to see poorly. It causes problems with depth perception, reading, learning and behavioral difficulties.

The good news is that amblyopia is correctable. If it's something like a cataract, surgery is required. If it's a turned eye or weaker eye, eyeglasses, patching an eye and/or eye exercises (vision therapy) allow the amblyopic eye to see better, which forces the brain to start using it. Surgery can also be a form of treatment when it comes to eye muscle imbalances.

Many kids aren't brought in for an eye exam until AFTER they begin school when they're in the 5-7 year old range, and some wait to come in until much later. The brain and the neuronal connections in a child are very flexible. Meaning, that if amblyopia is found, the EARLIER the treatment, the BETTER! As a child gets older, those neuronal connections get "hard-wired" into place, so that treatments such as eye exercises (vision therapy), eyeglasses and surgery won't correct the vision as well (if at all).

Many pre-schools and schools have vision screenings, which are extremely helpful to "catch" children who have an eye problem that may not have been detected until they were much older. However, vision screenings are not a substitute for an eye exam. Also, vision screenings do not "catch" all children with vision problems. Also, not all kids found to have a problem at a vision screening get that problem checked by an eye doctor.

So, here are just some of the things to look out for in a infant/child: does not recognize faces, a physically turned eye, a white pupil, avoids reading, frequent headaches (especially with near work), covers or closes one eye for certain tasks, bumping into walls, holds reading material extremely close, squinting, trouble seeing the television or board in school, etc.

Lazyeyetest.org has an online test as a screening tool (remember the difference between screening and exam) for children, which also has more information about amblyopia as well.

So, if you ever form the question in your mind, (When should I bring my child in for an eye exam?) you probably already know the answer.

Sincerely,
Dr. Weaver

My vision is excellent...was that a STOP sign?

Hello everyone,

You may have read the recent New York Times article about how the New York state Department of Motor Vehicles considered dropping the eye exam requirement for driver's license renewals. Well, it only took a week for the New York state Department of Motor Vehicles to reinstate that briefly dropped requirement. Evidently, vision is important while driving. Who knew?

(Ah...the DMV!)

Well, in Pennsylvania, if a person can see at least 20/40 vision combined with both eyes together without glasses, that person is legal to drive without any optical correction. If the vision is worse than 20/40, then it must be corrected by glasses and/or contacts to the best vision possible. If a person has an eye condition that limits the best corrected vision to only 20/40 or 20/70, restrictions are imposed on the driver (ie. driving only during the day and more timely vision evaluations). If a person cannot see better than 20/100 with both eyes, it is illegal for them to drive, for their own safety and the safety of other drivers and pedestrians.

In addition, a person's horizontal peripheral vision must be intact, at least 120 degrees. Someone with sight in only one eye may still meet the vision requirements, having a restriction that requires additional mirrors while driving.

The vision can change from one year to the next. With conditions such as cataracts and macular degeneration, sometimes the vision change is so gradual, that no decrease in visual acuity is perceived by the patient until they get their eyes examined. I have personally had patients that claim to see just fine, and then when it's time to read the vision chart, they struggle to see the "Big E." The "Big E" is 20/400 vision...not legal to drive in any state.

This is why the vision requirement for driver's licenses is important: it keeps the drivers honest about their vision. The Pennsylvania Department of Transportation randomly sends out a vision examination form to be filled out by an eye doctor to ensure the driver's vision is where it should be. Some people don't get their eyes examined every 1-2 years like they should; to check for vision changes and ocular diseases such as glaucoma.

I also have patients that have a complaint of glare and light sensitivity when driving at night or when it is raining. Many times, it is because they are "only" seeing 20/40. Even though they are legal to drive without glasses, and 20/40 is decent vision, getting a mild eyeglasses prescription to clear the vision to 20/20 or better eliminates that glare and light sensitivity complaint. Seeing more clearly would also allow that person to see signs further down the road than what they are used to, and possibly improve their reaction time as well.

(The above is NOT likely to occur with excellent vision and improved reaction time)

I'm due for my driver's license renewal this November, and just checked each eye on the vision chart (20/15 in each eye with glasses...excellent). I know that I need glasses or contact in order to see when I drive, and I don't try to "just get by." If you think you should be seeing better when you drive, get your eyes checked out. You may be surprised to see what you've been missing.

Sincerely,
Dr. Weaver

Health Fair Updates!

Hello everyone,

Weaver Eye Care Associates is on a health fair kick! We wrapped up the CEFC 2nd Annual Health Fair on September 24th in Strausstown with great reception! Now, this Saturday, October 8th from 10am-4pm, Dr. Weaver will be at the Renew, Transform, Take Charge! Health Fair at Glad Tidings Church at 1110 Snyder Road, West Lawn.

Dr. Weaver will be having a drawing at the Weaver Eye Care Associates booth for a Complimentary Free Eye Exam plus $100 credit towards new glasses (frames and lenses). A similar door prize will also be donated.

The winner of the Complimentary Eye Exam and $100 credit towards new glasses from the CEFC Health Fair was Nancy M. Congratulations, Nancy!

For directions to the event, please click on the Google Maps link => http://g.co/maps/jxdh5

For more information about the event, please visit the church website => http://www.gtaog.org/ministries/support-ministries/gt-health-ministry/

The event is free to attend! So, if you're not doing anything this Saturday, please come on out and join the fun.


Sincerely,
Dr. Weaver

"I don't know how to put this but I'm kind of a BIG DEAL."

The Reading Eagle Big Deal sneak peak from Weaver Eye Care Associates, for all of you loyal blog, Facebook and Twitter followers:

Weaver Eye Care Associates -- $30 for an eye exam, an $85 value, plus $100 towards glasses for a total $185 value, 65% off eye exam and 84% off overall.

Link is now live!!!

Once you buy the deal, if you refer 3 friends that also buy the deal, you end up getting yours for FREE! For more information and sign up, go to www.readingeagle.com/bigdeals

Those eyelids have a lot of work to do...

Hello everyone,

I just posted a fun fact on the WECA Facebook page about Pharaohs and ancient Egyptians. In summary, ancient Egyptians wore black eye makeup, not only to look good, but to also help fight ocular infection. The black makeup contained two non-natural lead chlorides--laurionite and phosgenite--that boosted levels of nitric oxide in the skin. Nitric oxide is a key signaling agent to stimulate the immune system to fight infection. If you're really curious about this, check out the Review of Optometry excerpt as well.

I also had a recent WECA Facebook post in early August about how hard the eyelids work for you. Basically, the eyelids of each eye covers the distance of a marathon from blinking in one year's time.

Well...these recent posts got me thinking about how important the eyelids are, what can happen when eyelid hygiene suffers and how you can keep your eyelids (and your eyes) happy all day long.

When reading, using a computer, playing video games, or anything else that requires reading and/or concentration
Everyone has a normal blinking rate that's involuntary. This is done to coat the surface of the eye with your natural tears so that your eyes do not become dry. When you concentrate or perform extensive reading tasks, you tend to blink less than normal, which then causes dryness symptoms such as irritation, excessive reflex tearing (to combat the dryness), redness and blurred/fluctuating vision.

Lots of bad things can happen to those eyelids and eyelashes
A stye can develop due to a clogged oil gland at the base of an eyelash. This creates a hardened bump that's cosmetically unappealing that can eventually become infected, causing redness, pain and swelling of the eyelid.

Those eyelashes should always turn outwards. However, sometimes an eyelash may decide to become a non-conformist and turn inwards and poke you in the eye instead, causing irritation and discomfort every time you blink (and you blink many, many times a day).

A piece of debris (dirt, a small fuzzy, mascara) may get trapped underneath the eyelid (usually the upper eyelid). Similarly to the inward-pointing eyelash, an eyelid foreign body may cause irritation and discomfort eye time you blink, as well.

During allergy season, or from an allergy reaction, the eyelids may become red, puffy and itchy.

Eyelashes can become crusty with yellow matter, due to the presence of normal bacteria around the eyelash/eyelid region. This, in turn, can cause inflammation of the eyelids to create problems with redness, dryness and itchiness as well.


What you can do to help your eyelids
I have to be honest...when I wash my face in the morning and at night, I typically don't like to wash my eyes too well because if I got soap in there, it would sting like crazy. And I'm sure many other people wash their faces and ears and necks...but forget about the eyes.

It's very important to maintain excellent eyelid hygiene. The easiest way to do this is to make sure to use hot compresses (not so hot to burn the skin), and to feel that heat on the upper and lower eyelids. This heat stimulates tear production, and with styes, it melts the hardened material stuck in the gland...like melting butter. If you're afraid to get soap in your eyes, a gentle over-the-counter eyelid scrub in a pad or foam format will clean your eyelids and eyelashes well. Also, a less costlier way would be to use Johnson's Baby Shampoo by applying the shampoo to the hot washcloth, getting it nice and soapy/sudsy, and massage the eyelids while your eyes are closed to clean them...and then just rinse them. Doing this morning and night (just like brushing your teeth) will minimize the chances of blepharitis and styes.

When it comes to allergies, the main symptom is the itching. In this case, cold compresses are what works best. Sometimes an eyelid allergy (dermatitis) can be so bad that cold compresses may not be enough, and getting professional help from your eye doctor would be the way to go. Also, any symptoms of redness, decreased vision or pain that doesn't go away or worsens, should be checked out immediately by an eye doctor to figure out exactly what's wrong.


So, don't take your eyelids for granted. They do a lot of work. Keep them healthy and they'll treat you good.

Sincerely,
Dr. Weaver

Ps. This is the photo from the Reading Eagle article written about the practice in January. If you're nostalgic, you can check out the original article here.

Teacher, teacher! I'm squinting and I still can't see the blackboard...

Dear students (and their parents),

Where, oh where, did the summertime go?

As the summer comes to an end, it approaches the time of year where kids are both nervous and excited to head back to school. Children reconnect with classmates they may not have seen over the summer, as well as meet new teachers and other new students. Parents are busy making sure their kids are well-prepared, having the clothes, backpack, rulers, pencils, calculators and packed lunches all lined up and ready to go.

August is typically a busy month at an eye doctor's office. Teenagers and young adults make sure they get their eyes checked out to get their updated contact lens supply before heading off to college. Kids get new frames to replace the ones battered over the summer during soccer games, or to replace the ones lost during the family vacation.

The first couple of weeks in September is typically slow at an eye doctor's office. Parent's are so relieved that they survived the summer, they just need to chill for a bit. Students are still re-learning how an alarm clock works and trying to get to their bus stop on time, as well as adjusting to their school environment. Getting the eyes checked are the last thing on the list, especially since those two weeks include the Labor Day weekend--a last chance at a mini-vacation before things really start picking up.

However, when the kids finally start getting over the lazy hangover of summer and make an attempt to read the blackboard (or the whiteboard), some children realize that it's a little more difficulty to read what the teacher is writing...and it's not the messy handwriting, either.

A child's vision is dynamic. As a child grows, the vision usually changes as well. There is a time, usually in the late teens, when the vision changes tend to stabilize somewhat. However, until that point in time, the vision can worsen with in a year, in as little as 6 months...and maybe even 3 months, the length of a summer vacation.

It's important for parents, teachers and the student themselves to recognize when the vision begins to get worse. Squinting, frontal headaches and eyestrain are signs that the vision may not be optimal, and that a visit to the eye doctor may be what's needed to get back to seeing 20/20.

Even if these changes aren't noticed immediately, school vision screenings usually administered by school nurses can help identify students who may not "pass" the Snellen eye chart at distance or near. If a student's vision is suspect, that child is usually given a form from the school nurse to give to the student's parents to have the child's eyes checked by an eye doctor sooner than later.

Having a child see perfectly at distance and near allows for better school performance. If a student can't see what's written on the board or in a book, learning and comprehension can be compromised. Also, homework may take longer than it's supposed to if a child can't see the problems they're supposed to solve. Seeing more clearly also helps with sports vision performance as well.

So students (and their parents), make sure to get your vision and your ocular health checked out at the start of the school year, to make sure that your eyes aren't straining more than they should (they shouldn't strain at all) and that you're eyes are in tip-top shape. If you wait, that's okay too. But make sure you can tell a "T" from an "F" on those True-False tests...

Sincerely,
Dr. Weaver

Announcing New Hours and Additional Practice Locations!

The following is Weaver Eye Care Associates new office hours in Bernville:

Monday 9:00am-7:00pm
Tuesday 8:00am-12:00pm
Wednesday 9:00am-7:00pm
Thursday 9:00am-7:00pm
Friday CLOSED
Saturday 8:00am-12:00pm (1st & 3rd Saturday of the month)

If you need to reach Dr. Weaver on Fridays or Saturdays when he is not in his Bernville office, please contact him at the following locations:

Fridays
Eye Consultants of Pennsylvania (Pottsville Office)
100 Schuylkill Medical Plaza
Suite 100
Pottsville, PA 17901
(570) 621-5690


Saturdays
Pearle Vision
Coventry Mall
351 W Schuylkill Rd Suite H-1
Pottstown, PA 
(610) 327-2620

Thank you,
Dr. Weaver

Your time is important...what is your longest wait time at a doctor's office?

Hello,

Many, many times have I visited a doctor or specialist and many, many times have I waited at each office of varying times. A busy office can lead to longer wait times if the check-in process and flow of examinations don't run smoothly. This can also hold true with larger practices for a variety of reasons. Unfortunately, at many offices, you spend minutes (and maybe hours!) waiting to be called.

When you hear your name, you feel relieved. "Whew! I made it!" you may say. You finally make it back to the examination room, and then...you're left waiting, again! Then you may say, "At least they had magazines out in the waiting room. Can I wait back out there? Darn!"

Well, a new article by The New York Times talks about waiting times at offices. They find that Optometrists (yup, that's me) have the shortest wait times, 17 minutes on average. The average wait time to see a doctor is 23 minutes. Are you spending more than 23 minutes waiting for the doctor? Is he/she worth your valuable time? Hmmmm...

I bring this up because many people don't enjoy going to the doctor. Add this to long wait times to see that doctor and that equals some unhappy patients.

As a new practice, one thing that I can offer my patients is minimal to NO wait times. I'm the only doctor in the office, I set aside an hour for each comprehensive patient exam and I make an effort to NOT double book examination times. The amount of time that I set aside gives me enough time to perform a thorough eye examination, as well as some time to get to know the patient, which is how I enjoy practicing optometry and why I opened up my own business.

So, I hope that your eyes are getting the care and attention that you need, without having to wait to long. If not, I know of a good place that you may want to check out.

Sincerely,
Dr. Weaver

Medications and their (many) side effects... Plaquenil...

Hello everyone,

I'm writing from Delaware today, taking a mini-vacation to visit my sister, brother-in-law and their dog, Ace. We have plans to visit the pool and the shore today and tomorrow, but due to the extreme heat, we may just be there for a couple of hours each day before our skin melts off.

Anyway, I was thinking about the many, many, many ocular side effects to commonly used medications. Sometimes, I've wondered if I would have really taken a medication I was prescribed if I actually read the numerous side effects on the warning label. Similarly, you've probably seen the familiar commercials advertising new drugs that come out. The start of the commercial usually shows someone in misery and then they "talk to their doctor about" X drug, and now their life is wonderful, making flower arrangements, chasing their dog through the park and laying in a bathtub on a the side of a mountain. And in all of these, the low-voiced announcer spends at least thirty seconds mentioning pretty severe side effects while the subject of the commercial is trying to distract your ears by smiling and having a good time.

Unfortunately, medications have side effects. And unfortunately, these same medications are needed by people to live better lives, regardless of the side effects. It's up to the doctor to balance the benefits vs. side effects and in most cases, the benefits win out. However, the patient should be made aware of the possible adverse reactions so that they can report to the doctor what's going on; to make a change if necessary.

If you're taking a medication, look at the warning label. Relating to the eyes, the side effects are numerous (these are generalized): blurred vision, decreased vision, double vision, eye dryness, light sensitivity, increase in intraocular pressure, conjunctivitis, color vision changes, and eye inflammation, among others.

Plaquenil is a medication used to treat lupus and rheumatoid arthritis. And like I mentioned before, any medication that has benefits probably has some side effects. Here are the ocular side effects of Plaquenil:

1) Ciliary body: This is the part of the eye that is responsible for focusing the lens in your eye. Disturbance of the ciliary body affects accommodation, which causes the blurred vision. This reaction is dose-related and reversible with cessation of therapy.

2) Cornea: This is the very front portion of the eye. The cornea can experience mild edema, patches of dryness and decreased corneal sensitivity. This will contribute to blurred vision, halos around lights and light sensitivity, which are reversible. Deposits of the medication can also appear in the cornea as early as three weeks following initiation of therapy.

3) Macula: The macula is the very center-most portion of the retina, which is responsible for your fine visual acuity. Edema, atrophy, and abnormal pigmentation ("bull's eye" appearance) of the macula can cause enlongated recovery times to bright lights and decreased vision.

4) Visual field defects: Due to the macular changes, blind spots may occur close to and in the exact center of your central vision. The most common symptoms due to this are difficulty reading and seeing, blurred distance vision, and missing or blacked out areas in the central vision.

The most severe is the retinopathy affecting the macular area, which is dose related and has occurred within several months to several years of daily therapy. This retinopathy may continue even after the drug is discontinued. The good news is that the retinopathy can be reversible with discontinuing Plaquenil therapy.

It's important for patient on Plaquenil to obtain a baseline eye examination and annual follow-up visits to ensure that none of these side effects take place. The testing typically includes a comprehensive eye exam with pupil dilation, as well as a macular visual field, color vision test, and retinal photography.

Although side effects are rare, patients on Plaquenil may or may not have visual symptoms so it is important to get your eyes checked out if you are taking the medication AND to also communicate with your doctor if you're having any side effects while on any medication to make your life as comfortable as possible.

Take care,
Dr. Weaver

Six months in the making...keeping it current...Groupon...thank you's!

Hello,

On July 2, 2011, Weaver Eye Care Associates will have been open six months! Whoo-hoo! And oh my, those six months have gone very quickly!

I've done various things on getting the word out about the practice. Probably the most important method is just doing my eye doctor thing and trying to provide the best customer service that I possibly can. This in turn creates a positive impression on those patients so that they hopefully tell their neighbors, friends and family.

I try to keep things current in my practice:

1) Digital visual acuity charts in the exam room = how many times have you gone to an eye doctor and tried to strain your eyes reading that faded projector screen? This should be the fun part of the exam.

2) Digital photography of the front and the back of your eyes = if there's something peculiar that should be followed, taking a picture is much better that making a drawing or writing a description. The saying "a picture is worth a thousand words" is definitely true. I have a digital camera adapter for my bio-microscope in the exam room and a digital camera conversion on my retinal camera in the back diagnostic testing room. There's no more guessing when it comes to checking things out a year later.

3) No paper charts = everything is going to be electronic at some point or another, it's just a matter of time. That's why I chose electronic medical records software from Practice Director for all of my documentation. I try to stay with the leading edge of things, because technology moves so darn fast, it's easy to lose one's balance and fall behind. I have computers in every room in the office: reception, business office, optical department, the exam room and the diagnostic testing room (okay, I don't have one in the bathroom, but that's self explanatory).

4) The latest styles of frames with good warranty = frame representatives visit my office on a regular basis to keep my frame inventory fresh and lively! New colors, styles and models of men's, women's and children's frames arrive from the various vendors, swapping out what's discontinued and out of warranty. This is done so that when you buy a frame from Weaver Eye Care Associates, you're buying a frame that's current, unlike buying online from vendors with shoddy materials and poor workmanship.

I also try to keep things current in my promotion:

1) Blog, blog, blog = I don't blog to the point where it's annoying and I only write when I have something to write about. I try to keep existing patients and (hopefully) soon-to-be patients informed with news about my new practice and anything related to the eye (see previous posts). I enjoy writing, and probably would have been a writer if I hadn't done the optometry thing. But at least I can get my writing fix while supporting the career that I love to do: optometry.

2) Facebook, Twitter, MySpace = MySpace not so much anymore, since most people these days are on Facebook and Twitter. I post links on Facebook and Twitter whenever I have a new blog post, or whenever there is just something exciting happening with the practice. Like when Kaylee was helping me set up the frame boards when I first opened, I posted pictures on Facebook documenting the event. Or as progress occurred with the build-out between September and December last year, I posted pictures of that as well.

3) Practice Website = Personally, I don't go to a business if they don't have a website. I just like to know about the place when I visit there or buy something from there. I thought it important to have a pretty comprehensive website to describe who I am, what I do and what I have to offer.

4) Groupon = Groupon seems to be the next best thing out there right now for small business and consumers. Groupon will be featuring my practice (with a pretty slick write-up, I may add) on Thursday June 30th...two days from now! I'll be checking the discussion boards on the Weaver Eye Care Associates feature page to answer any questions you may have about the deal. I don't want to reveal anything about the deal, but all I have to say is this: if you haven't visited the practice for an eye exam and glasses yet, I strongly suggest that you check out the feature. It will be the best deal around...for a long, long, long while!

I've promoted by traditional methods as well: newspapers ads, direct mail postcards, and yellow pages (coming later 2011, missed the cut for the 2010 book). I've also been trying to hand out my business cards like crazy and get to know as many people in the area as I can.

The practice will only get busier, so have many thanks to hand out! (Sorry, if this sounds like an award speech. At least I won't get cut off by an orchestra if I go to long...)

First, big thanks to the Man Upstairs for giving me the courage to do this and making all things possible.

A close second to the many current patients of the practice who was curious enough to check out the practice. I truly appreciate your business and thank you for your support.

Big thanks to my wife, Laura, for supporting me in taking the plunge with opening a brand new business and enduring this adventure together. Laura helped me out with the wall colors, carpeting and tiles, since I'm pretty useless when it comes to color coordination (yes, she picks out my shirt and tie combos as well). :) And Kaylee for keeping things interesting and entertaining at the practice.

Another big thanks to my parents and Laura's parents for their unending support, as well as watching Kaylee many, many times when I have meetings and work-related things to do.

Also, another thanks to the band-mates, Derek and Tim for giving me the time to get things settled. We're recording in the studio right now and if all goes well, the band will be doing shows soon afterwards once the mania settles down a bit.

Thanks to Kim, the lovely Weaver Eye Care Associates receptionist, for treating patients with respect, for staying on task during the slow times and the crazy times, and learning just as much as I am with insurances and all of that other "fun" stuff.

And many other thanks:

George H. Longenecker's and Sons = the fine craftmanship on the build-out and setting up the optical and reception furniture

EyeDesigns = designing the office space and the awesome craftmanship on the frame displays, dispensing desk and reception desk

Three Rivers Optical and Zeiss Lab Kentucky = for their excellent optical work and warranty on all of my eyeglass orders

ClearVision, Modern Optical, Europa International, Silhouette, Live Eyewear and Bushnell = for their wide array of stylish frames, sunglasses and clip-ons

Vision Systems Inc. = for all of their awesome equipment that I needed to open up shop

Practice Director = for the electronic medical records and practice management software, and their excellent customer service and technical support

PC Ninja = Mel for hooking up the network, computers, phone system, printers, security and back-up. Awesome work, man!

Wells Fargo = for the business loan capital to get things off the ground. (Although, you should be thanking me for all of the interest.)

And to anyone that I may have missed, thank you to all...and to all a goodnight!

Sincerely,
Dr. Weaver

Ps. Don't forget the Groupon...

UV is bad.

Hello everyone,

Summertime is upon us. The weather is warming up. I remember myself squinting for the longest time when the rainy and cloudy days of April and May gave way to the sunshine days of summer.

And with the summer is more time outdoors. Hopefully, when you spend some time out in the sun, you lather up the SPF 500 so that you skin doesn't fall off when you get older. It's also important to protect your eyes from the harmful UV rays as well.

The UV can affect the front, the inside AND the back of your eye.

The front: For those who do a lot of fishing or boating, spending numerous hours on the water can cause a lot of reflected glare from the water's surface. This can actually cause a sunburn on the cornea (similar to a welder's flash) and can be very painful. The skin around the eye is very thin and sensitive, and very prone to damage from the sun's rays.

The inside: There is a lens inside each eye and as everyone gets older, this lens can develop a cataract of varying degrees. Some studies have shown that UV radiation can accelerate the formation of cataract growth.

The back: Have you ever heard of macular degeneration? (If not, see my previous blog post.) Well, not only is getting older and smoking increase your risk of getting the disease, but so is UV exposure. Your eyes focus all the light that enters your eye onto the macula to allow you to see. So if you're getting years and years of UV light getting in there as well, it's going to cause some toxic damage to the sensitive retinal tissue in the back of your eyes.

So what should you do about all of this? Well, for starters, wear SUNGLASSES for cryin' out loud, but not just any old sunglasses. Make sure they provide 100% UV protection AND make sure they are polarized. The polarization will provide the most comfortable vision by reducing reflective glare off of road surfaces, other automobiles, snow, water, your wet dog...you get the idea.

People who wear contact lenses should have the polarized UV sunglasses to protect the eyes. However, what about those who don't wear contacts? Certain materials and certain eyeglass lens options have UV protection built-in to that feature: the ultra-thin lenses (Hi Index) do this, Transition lenses (change from dark to light to dark) do this, polycarbonate lenses (the most shatter-resistant lenses) do this. If you feel you don't need any of these features, you can get a UV coating applied to your eyeglasses to protect your eyes. Also, clip-on lenses (to convert your regular glasses to sunglasses) are typically polarized and provide 100% UV protection as well.

(NOTE: We just got the customized Cocoon Clip-On lenses in the office. Make sure to stop by the office to check them out. Only $34.95 to convert your regular glasses to kickin' suns!)

So, make sure your eyes are protected from the UV, which we all know is bad. And if you need a customized recommendation, make sure to visit your local, friendly optometrist. :)

Take care,
Dr. Weaver

My Eyes are on Fire!

Hello everyone,

Yup! It's that time of year again: allergy season! Hooray! Don't you just love the itching, coughing, congestion, sinus pressure, tearing, headache, malaise, sniffling that happens this time of year? Isn't it just wonderful?

Well, I hope that you can tell the previous paragraph was pure sarcasm. Allergies stink! I suffer from it. My wife suffers from it. And most of you suffer from it as well. I've heard from many people this year who don't get allergies who are experiencing allergy symptoms for the first time ever!

Every allergy season feels like it's the worst ever, since the memory of the previous season is difficult to remember (or it was so bad you blocked it from your mind). But this year with warm temperatures, and an insane amount of rain, this year's allergy season is longer and more robust! So it may actually be the worst ever!

If you take oral allergy medication (OTC or Rx), it's important to start taking it before the season starts. Yes, I know that advice is a little too late for this year, but getting your body ready for the influx of allergens and pollen is important to minimize your reaction to the particles floating in the air into your nostrils.

The thing with oral allergy medications is that one of their main side effects is eye dryness. So, while you're thinking that taking your allergy medication is helping your eyes, it's probably not. The dryness can exacerbate the itching, watering and redness, making you miserable.

And wearing contact lenses? Forget it! Wear them on a minimal basis during this troubling time of the year, or switch to daily disposable lenses to minimize the build-up on allergens on the lenses from day to day.

The key thing to getting eye relief is to get some medication right on the eyes...and getting the RIGHT medication on the eyes. Over-the-counter eye drops can be absolutely fine if you know which ones to use. For my patients, when I examine them and determine they are suffering from ocular allergies, my recommendation is typically Alaway (Bausch & Lomb) or Zaditor (Novartis). These drops contain both an anti-histamine AND a mast cell stabilizer. These components are the BIG GUNS when it comes to kicking butt in the allergy department. Both of these brands are used two times a day, and I usually say to use them right when the patient wakes up and at night shortly before going to bed. The drops then can be used as needed once the allergy symptoms are under control.

I'm not a fan of the Clear Eyes by Visine. It contains only naphazoline, which is a decongestant that constricts the blood vessels to reduce the redness appearance. It's helpful, and sometimes a vasoconstrictor is beneficial, but when it comes to allergies, having an anti-histamine AND a mast cell stabilizer is typically the best option, which is why I prefer Alaway and Zaditor.

Naphcon-A and Opcon-A are other drops that may work well. These drops are used four times a day. They contain naphazoline, but they also contain an anti-histamine. In this case, the decongestant works well with anti-histamine to provide allergy relief and are a good option if Alaway and Zaditor are unavailable.

There are two drainage ducts in each eye close to the nose. The ducts are pathways that drain your natural tears and any eyedrops from your eyes through your nasal passage to the back of your throat. So taking an allergy eyedrop may not only be good for your eyes, but if you're suffering from sinus congestion, allowing the allergy eyedrops to run through this drainage system may cause direct relief of the sinus symptoms as well.

Now, if all of this over-the-counter business isn't helping out, then some prescription options are in order. After a visit to your local optometrist (hint, hint), he will be able to assess the allergy situation and cater all of the options to your specific needs. Sometimes, steroid eyedrops are recommended to suppress the inflammation, which allows the anti-histamine and mast cell stabilizers to be more effective.

Although this is common sense to most people, I must leave the disclaimer that this blog post is not a substitute for an eye exam. It's just some helpful and friendly advice to get you through the allergy season this year. However, my recommendation is to see an optometrist if you are suffering from any eye problems so that the cause of your problems can be determine and treated most effectively.

Best regards,
Dr. Weaver

Golf Fore-ever! May 7, 2011 Golf Tourney Results...

Hello,

Those who know me can attest to my love for the game of golf. I've been playing the sport (yes, it's a sport) since I was five-years-old. My dad sawed off some old clubs, put them in a little golf bag and took me out to Indian Mountain Golf Course, a local 9-hole public course in Kresgeville, PA that was my "home course" for most of my life. My dad would take me out on late weekday afternoons for 4 holes, and then later 9 holes and 18 holes as I got older.

I remember taking golf lessons only a couple of times. I remember playing in the Henry Moyer Junior Golf Tournament a few times at the Mahoning Valley Country Club, and winning a few (I still have the hardware to prove it, too). I ever remember the video footage from the Blue Ridge cable news (channel 13) from their coverage, and the announcer saying about my swing "He looks like a dapper Bobby Jones," which he probably wouldn't have said if he saw the actual ball flight (video camera = nervousness = shankasaurus).

I've played competitively at the high school and college levels. My swing is a work in progress, taking information from reading books on golf (Harvey Penick) and watching the pros on TV. My swing has modified as I've grown older and wiser, because when I was younger, I just thought about hitting the ball, which is probably why I didn't play as good then as I am now. (I still shot in the 70's in high school and college, but not consistantly.) I'm a "feel" player, meaning I don't really worry about the technical stuff. I have a few things that I think about now: shorter stance, strong grip, keep the left arm straight on the takeaway, make good contact and swing down the line where I'm aiming.

If I didn't do optometry, I always wondered the result of going the professional golf route. But then I realize I probably wouldn't think it as fun as I do now, and my back probably wouldn't have held up for this long, either.

So when I do feel competitive and want to have fun, I look for local scramble golf tournaments in which to play. Yesterday (which was a gorgeous day), I played in the Rehrersburg Lion's Club Annual Golf Tournament at Green Acres Golf Course. Not only did I play in the event, but I sponsored a tee, #15:

It was my first time playing in the event, and it was well-organized! Plenty of food, soda, beer and snacks! I even got to place some Weaver Eye Care Associates pens and magnets in the goodie bags for everyone to take home, so I'm hoping that helps get the word out about the practice. Thanks to Derek DeLong, Jim Yost and my dad for making up our group for the tourney.

So, after 18 holes of club swinging, our team placed in Second!!! We were only 1 stroke behind the winners, and we account that to a bad hole on number 6. We had a bogey, which is a major no-no in a 4-person scramble. Despite that, we hung together and finished the round.

My tee shot on the Par 3 #2 landed just a few inches outside of the Pot o' Gold hole. However, I did win closest to the pin on that hole, since no one landed inside the five-foot radius circle the whole tourney. Jim and I also won some non-skill prizes from the raffle afterwards.

It was a great day, and we're all planning on playing in the tournament next year. So, thank you to Green Acres Golf Course for having a wonderful site for a scramble golf tournament. And a big THANK YOU to the Rehrersburg Lion's Club, who will use the proceeds to benefit individuals with vision care needs, the blind and the maintenance of the park in Rehrersburg. Hoping to win it next year...

Dr. Weaver

Cataracts LESS LIKELY in those who eat their veggies

Hello everyone,

When I was a young lad, my mom would ALWAYS tell me to eat my vegetables. I'm certain that I wasn't the only one who has received this constant advice. However, I was notorious for shunning whatever vegetable I was served. Whether it was green beans or a medley of corn, carrots and lima beans (ugh!), the vegetable portion always ended up as a cold pile of food at the edge of my plate, at the furthermost position from my mouth.

I guess my mom was onto something. There's a report on WebMD that says "people who eat meat may be at increased risk of developing cataracts compared to vegetarians," according to a study in the American Journal of Clinical Nutrition.

For the study, they divided the people into groups according to how much meat they ate.

Highest meat consumption: 3.5 ounces or more a day

Mid-range meat consumption: 1.7 to 3.4 ounces a day

Low-meat consumption: less than 1.7 ounces a day

Fish eaters: Those who ate fish but not meat

Vegetarians: Those who did not eat meat or fish but did eat dairy products and/or eggs

Vegans: Those who did not eat meat, fish, dairy products, or eggs.

And the results? The researchers found that "mid-range meat eaters had a decreased cataract risk of 4%, low-meat eaters 15%, fish eaters 21%, vegetarians 30%, and vegans 40%."

When I see a patient that has a cataract and I bring it to their attention, some patients ask if there's anything they could do about it. If you weren't aware, other risk factors for increasing the risk of developing cataracts include smoking, diabetes and UV exposure. Now, I would mention eat more vegetables/cut out red meats to the list.

Now that I'm older, I'm much better at eating vegetables. But lima beans are still UGH!

Dr. Weaver

Gut check! Increased waistline = higher risk of macular degeneration?

Hello everyone,

There are always an assortment of studies that you hear about in the news. Beer is good for me. Really? Caffeine increases my lifespan. Really? Sleeping more than 10 hours is bad for me. Really? Chocolate makes me strong like Superman? Okay, that last one may be believable...

And then you hear the studies that give you the opposite opinion, as well. So, how can you believe anything that you hear in the news? This brings me to the article that I just read, saying how if you have a big belly you are more likely to go blind from macular degeneration. REALLY?!

The UK's Daily Mail website said that "an expanding waistline puts men in danger of developing age-related macular degeneration (AMD)." After monitoring "changes in the waistlines of more than 21,000 men and women, aged between 40 and 69, over several years," then following the study population to determine how many cases of AMD developed, Australian researchers discovered that "even small increases in waist size seem to raise the risk of AMD by up to 75 per cent" in men. Women do not seem to be affected, however.

It is an actual study in the American Journal of Epidemiology. Their efforts were to try and show a correlation between obesity and developing macular degeneration. In my previous blog post, you should be aware that smoking is a risk factor. Increasing age, light-haired/light-skinned individuals and UV exposure are all risk factors as well.

What you also learned from the Smoking = Macular Degeneration post is that if a patient is told to have signs of macular degeneration, the patient is usually monitored and/or started on a multi-vitamin using minerals and vitamins investigated in AREDS (Age-Related Eye Disease Study) in the early stages of AMD. On a separate note, previous studies show that increased waist size is also a good predictor of having a stroke.

So what does all this mean? To me, it sounds like it all comes down to having a good diet and maintaining an active lifestyle. If you eat right and stay in shape, your body gets the correct nutrients it needs, which helps with the slimmer waistline. Your eyes get the components they need (leafy green vegetables are an eye's best friend). Exercising gets the juices flowing to burn the fat that tends to collect in the belly zone of men.

So, now that winter is behind us (hopefully), get out of hibernation mode and into active mode. Your eyes and belly will thank you for it.

Take care,
Dr. Weaver

The moment you've all been waiting for: PHOTOS!

Hello everyone,

Here are the photos of the finished product. The main reason for waiting was the Weaver Eye Care Associates sign behind the reception desk, which you will see shortly. For now, some external shots:

Now for some interior shots after entering the vestibule, standing in the waiting area:

And now some pictures of the optical department:

And some pictures of the lighting that makes the optical look sooooo good:

Pictures of my office (spectacularly clean for the photos):

Looking at the insurance statements, and then FINALLY figuring it all out:

 The pre-testing room, with an auto-lensometer (to read the prescription from your glasses) and an auto-refractor/auto-keratometer/corneal topographer that measures your refractive error and the surface of your cornea:

Some of my credentials, diplomas from the New England College of Optometry, Elizabethtown College and my Pennsylvania state optometry license:

Exciting pics ahead! Pictures of the exam room, complete with digital visual acuity chart (LCD monitor connected to the main exam room computer), exam chair and stand, slit lamp, BIO, manual keratometer, phoropter and handheld instruments. Main exam room computer is used for electronic medical records for a more modern look, keeping it 21st century:

Tile work in the bathroom and pictures of the lounge:

Pictures of the "second exam room," which is currently used as my specialized testing room. It has a lot of updated diagnostic equipment that allows me to manage and treat conditions such as glaucoma, macular degeneration and diabetic retinopathy:

On of the instruments in the diagnostic testing room is the HRTII, the Heidelberg Retina Tomograph II. This uses a scanning laser to analyze the optic nerve, which is essential in the diagnosis and management of glaucoma:

Opposite of the HRTII, is our digital retina photography setup and computerized visual field instrument.

A Topcon TRC-NW5 Polaroid camera was upgraded with a Canon Rebel digital camera that's connected to specialized software called Imacam. All pictures taken of the back of the eye (diabetic retinopathy, macular degeneration, choroidal nevi, glaucomatous optic nerves) are stored onto the computer and can be analyzed in detail by tools found with the program.

This compact computerized visual field unit is called the Oculus EasyField. It is used to measure a person's peripheral vision. It is helpful in glaucoma diagnosis, as well as measuring those with visual field loss from a stroke and those on high-risk medications such as Plaquenil that can affect the macula.

The total space available was 2500 sq.ft., which was a bit much for me as a start-up business. So the landlord allowed me to split the space down to 1250 sq.ft. This is the other unfinished half, which is pretty much what things looked like before the office even took shape. And then below is how the back hallway looked early on, and then the finished product:

And just a few more photos of the hallway, and optical/reception areas:

Hope you enjoyed the tour!

Take care,
Dr. Weaver