Dear Dr. Tracy,

I just wanted you to know how completely happy I have been with my Minima prescriptives. In the past I have always had trouble adjusting to new glasses, but these were really easy and I find no strain or effort in using them.

I have also been able to use them playing squash which I had a lot of trouble doing with the prescriptives I had from another optometrist. They are so light you hardly know you are wearing them.

Thanks very much to you and your staff for making this possible.
Best regards,
Louis Goldring

Posted by Gary Tracy on June 01, 2008 | Permalink

As reported back in our December newsletter, classic frames from the 1960s and popular again -- click here for more...

Posted by Gary Tracy on February 21, 2008 | Permalink

If you're an eye drop user, these two tips will help ensure they work!

TIP #1: ONE DROP ONLY

Sometimes I see my patients squirt multiple eye drops of fluid into their eyes. I then see most of the fluid spill out and run down their cheeks.

I recommend using only one drop per eye. That's all the eyelid can hold. No need to waste drops - especially when using expensive medication.

TIP #2: PRESS YOUR LOWER LID

In the inner corner of the eyelids are the puncta. These are openings where tears drain out. There is one in the top and one in the bottom. Most tears flow into the punctum of the lower lid.

After you apply your medication (one drop only) press your forefinger into your lower lid, against the base of your nose. That will close off the punctum, allowing the medication deeper penetration of the eye before it drains out.

This technique is especially useful for glaucoma medications and topical steroids for internal eye inflammations.

Posted by Gary Tracy on February 21, 2008 | Permalink

Many patients use Visine to "get the red out" of bloodshot eyes. Is that a good idea?

First, a little background. The eyes become red when blood vessels dilate to fight the source of irritation -- whether wind, infection, allergy, dryness, smoke, crying, inflammation, alcohol, anything really.

Visine and similar medicated drops contain a "vasoconstrictor" chemical that shrinks the blood vessels that cause "rednesss," for about 45 minutes.

Such products mask the symptoms of irritation, but don't address the cause. In fact, prolonged use may even increase redness --a situation called "rebound hyperemia." The more you use them, the more you need them.

Dr. TRACY'S TIP:

There's no harm in using Visine or similar products sparingly -- say, for a photo shoot, an important meeting or public appearance.

But please don't use them on a regular basis.

If red eyes are a reoccurring problem, I'd prefer to see you to diagnose and eliminate the cause -- whether it be lubricants for dry or irritated eyes, antibiotics for infection, steroids for inflammation, or other solutions.

Oh, and one more tip -- applying a cold washcloth to your eyes for 30 minutes will shrink swollen blood vessels significantly. A chemical-free and relaxing technique!

Posted by Gary Tracy on February 21, 2008 | Permalink

Hi everyone - Mitch Teplitsky here. I've been Dr. Tracy's client forever (well, nearly 20 years). And for the past 2 years, his web marketing consultant.

Usually Dr. Tracy writes his own blogs and newsletters. But this month I wanted to share my own story, about how Dr. Tracy helped my wife Doris wear contact lenses for the first time.

Doris is from Peru, and had never tried contacts before. Last summer we visited friends on Cape Cod, where Doris left her glasses on the beach. Lost at sea.

We hopped on our bikes to the nearby optometrist at Walmart, where Doris figured she'd try contacts.

The optometrist did a thorough exam and fitted her with a reputable trial brand. But Doris couldn't tolerate them. Her eyes got red and irritated.

Did this mean Doris couldn't wear contacts? Was it some pre-disposed condition? Maybe the type or brand of contacts wasn't right? The store didn't have other trial brands in stock to try.

Having edited several blogs about contacts with Dr. Tracy, I decided to place a call to The Man himself.

"Fitting contact lens is as much an art as a science," Dr. Tracy explained. "I have to really examine the health of Doris's eyes, her history, and then try to match her up with the right lenses -- and the right solution. It takes time. And some people just aren't meant for contacts at all, their eyes can't produce enough tears to support comfortable wear."

Doris saw Dr. Tracy upon returning to New York. In fact it took several exams and fittings to hone in on a system of lenses and solution that worked comfortably. We discovered that Doris's eyes were unusually sensitive, and worked best with a chemical-free solution.

It's one thing to edit and read Dr. Tracy's blogs about the art of fitting contacts, but another thing to witness it up close on one's wife! I was grateful. And it's nice to have a doctor who takes such pride in his craft.

"After many years of fitting contact lenses, I find it's very satisfying to fit someone successfully, who was unable to find a comfortable lens in the past, sometimes having tried many times."

Posted by Gary Tracy on January 18, 2008 | Permalink

Anything that comes into contact with your eye can potentially introduce micro-organisms (bacteria, virus, fungus) that can cause eye infections. Here's how to prevent that:

1. WASH YOUR HANDS
Always wash your hands before handling contacts. Use a soap that contains an antibiotic, but avoid brands with scents or moisturizers, which reduce contacts' ability to absorb tears and stay wet.

2.RUB THOSE LENS
Many cleaning solutions boast "No Rub" on the label. Ignore that. After hours of wear, lenses attract proteins, oils, mucous and external debris. Rubbing the surface does a much better job of cleaning than rinsing alone.

3. ALWAYS USE FRESH SOLUTION
Some patients leave old disinfecting solution in the case, and "top it off" with fresh solution. Bad idea. Older solution loses effectiveness and accumulates debris. A better tactic: throw out used solution each morning. Wipe cases with a clean tissue, and and let them air dry.

4. REPLACE YOUR CASE OFTEN -- as least every 2-3 months.
Think of your case as disposable. Yes, you should air dry and wipe them clean, but cases still get contaminated with coatings that harbor micro-organisms. (Ask us for a complimentary case).

5. DISINFECT YOUR CONTACT LENSES
I find many patients store their lenses overnight in saline, which has no disinfecting properties. Disinfecting only occurs in a Multi-Purpose solution -- basically a saline with a disinfecting and cleaning agent added -- or by soaking in a hydrogen peroxide-based system like Clear Care.

Posted by Gary Tracy on January 16, 2008 | Permalink

Patient: "Doctor, sometimes my eyes seem to tear and water."

Doctor: "You have dry eyes."

This paradoxical response tends to confuse patients until the logic behind the answer is explained.

TWO TYPES OF TEARING

There are two types of tearing. One is baseline tearing -- a constant release of tears from the
lacrimal gland, located in the inner area of the upper lid.

The second type is "reflex tearing," a sudden outflow set off by irritation, emotions, bright lights, etc. that protects the eye by diluting or flushing out the offending substance.

Aging and some medications or medical conditions can reduce baseline tearing to the point that the eye tissues get dehydrated and irritated, provoking the reflex tearing that offers relief.

MAIN CATEGORIES AND TREATMENT OPTIONS

Dry eyes can be classified into three main categories, each of which require a different level of treatment.

Mild -- occasional dryness or grittiness. Symptoms can be relieved by over-the-counter re-wetting drops (also called artificial tears), used as needed.

Moderate -- symptoms occur regularly. Re-wetting drops used on a regular schedule (e.g. every 2 or 4 hours; the frequency will vary with the patient) may eliminate or greatly reduce symptoms. Symptoms may vary according to environmental conditions like humidity levels or type of heating or a/c unit.

Severe -- Constant irritation and burning with dehydrated eye tissues, sometimes accompanied by ailments like rheumatoid arthritis or Sjogren's Syndrome. These patients may need stronger prescription medication, both topical and oral, and the constant use of rewetting drops in the daytime and a thicker ointment at night.

CAN DIET HELP?

There is some evidence that an increase in Omega 3 fatty acids may help improve the quality of the tear film and reduce dye eye symptoms. Omega 3's can be found in flax seed, cold water fish (salmon, anchovies, sardines) and supplements.

FIRST STEP: EVALUATION

Before treatment can be started, an evaluation of one's health history should happen, to help determine the nature of the dry eye.

1. Evaluation - determine the extent of the dry eye
2. Medical - is there a medical condition that is causing the dry eye?
3. Ocular - is there a problem with tear production of any of the layers? Are there any lid or lash problems that may add to the irritation?
4. Medications - determine if one is taking any medications (anti-histamines, birth control pills, etc) that may contribute to the problem
5. Environmental - is the heating or cooling system removing humidity from the air?

WHICH BRAND OF ARTIFICIAL TEARS IS BEST?

Many companies offer different types of artificial tears, but no one brand is considered superior. It's more a trial and error to find the drop that works the best for you. Symptoms of dry eye can be treated and relieved, but it is rare that a permanent cure can be found.

Posted by Gary Tracy on November 27, 2007 | Permalink