EyeWear doesn't have to be boring...It can be intimidating to choose frames.

Guidelines on choosing your next pair of frames.

Choosing Eyeglass Frames for your Face Shape

Eyeglasses are no longer the nerdy necessity of those that are visually challenged. I have a more difficult time choosing my eyeglasses than I do choosing a pair of shoes. Walk into any eyeglass store and the choices are endless, the colors vast and confusion abounds.

The key thing to remember when choosing a frame is to forget about trends. What’s popular today might not suit you or flatter your face.The frames you choose form a part of your appearance and can be a way to show a part of your personality. The eyes are the windows of the soul and just like your brows frame your face, your eyeglasses can make or break your style so choose wisely and choose a style that will flatter your face shape.

Oval Face Shape
The oval face shape can wear any frame. It is more important to pay attention to the color of the frame whether you want a contrast to pale skin and wear midnight balck frames, or you want to show off your funky side and choose a frame with patterns and designs.

Diamond Face Shape
The diamond face shape has to be careful to choose frames that are not wider than your cheekbones. This will help to deemphasize the width in the middle of your face and balance the rest of your face. Good choices are square frames, or straight top and curved bottom. Slightly curved frames also work well with this face shape.

Round Face Shape
The goal for most with a round face to create some angles. Choosing rectangular or geometric shapes help to balance the roundness in your face and add some depth to your cheek area.

Square Face Shape
Choose a frame which is oval, or round or even slightly angular. This will soften the angles of your face.

Triangle Face Shape
Square frames, cat eye shapes and rimless bottoms all help to deemphasize the fullness of the bottom half of the triangle shape and add more dimension balancing out the top half of the triangle face.

Heart Face Shape
Heart shaped faces tend to look better in the aviator frames, bow tie or rectangular frames.

Oblong Face Shape
Choosing frames for an oblong face shape the goal is to shorten the appearance of a long face. Designs that are on the temples of the frames accomplish this; as does choosing round or geometric frames.

A good guideline in choosing your frame is whatever your face shape is, choose the opposite in your frames. If you want to accentuate your face shape, then choose frames that match, angular face shape, choose geometric or square frames.Another consideration is your features. If you have delicate facial features, choosing a frame that is too heavy or adorned can make you look like you’re wearing grandma’s glasses.
I find that once you narrow your choices down to 3 pairs of frames, our Optician’s assistance is invaluable and objective in deciding the final pair that you leave with. Don’t be afraid to ask for help! Our opticians at EyeHealth Northwest are American Board Certified and Frame Style specialist,  we will render our honest opinion and help you look your best.  Most importantly: Have fun! We want you to have the best in sight.

Visit http://www.eyehealthnw.com/ to find one our 11 opticals in the Portland Metro Area.

It’s August 4, have you scheduled your child’s back to school eye exam?

As a parent, you may wonder whether your preschooler has a vision problem or when you should schedule your child's first eye exam.

Eye exams for children are extremely important, 5 to 10 percent of preschoolers and 25 percent of school-aged children have vision problems. Early identification of a child's vision problem can be crucial because children often are more responsive to treatment when problems are diagnosed early.

According to the American Optometric Association (AOA), infants should have their first comprehensive eye exam at 6 months of age. Children then should have additional eye exams at age 3, and just before they enter the first grade at about age 5 or 6.

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses should be examined annually or as recommended by their eye doctor.

Early eye exams also are important because children need the following basic skills related to good eyesight for learning:

• Near vision

• Distance vision

• Binocular (two eyes) coordination

• Eye movement skills

• Focusing skills

• Peripheral awareness

• Hand-eye coordination

Preparing for your child’s eye exam

We understand that many children are apprehensive about visiting any doctor or are afraid that they will receive an immunization. You can assure your child that we will not use any needles to administer any shots. Your child may already know that we will be giving eye drops. You can prepare your child by explaining that the drops do not hurt, but that they feel like a drop of water going into the eye. If your child is seeing us for the first time, please be prepared for your visit to last, on average, one-and-a-half to two hours.

The visit

A parent or legal guardian must accompany all children age 17 and younger. During the visit, eye drops will be given, and the verbal consent of a responsible adult is required. If a grandparent or other adult will accompany the child, then a parent or legal guardian's written permission is required in order for us to give the eye drops and perform a complete exam.

After checking in at our reception desk, you will be given a health history form to fill out for your child, and will then be called back to the examination area by a member of our staff. Please let us know if your child has a preferred nickname.Please also let us know at this time if your child has any issues of which we should be aware. Typical concerns would be if your child seems to you to be unusually apprehensive, or if your child has any medical condition which could affect the examination. For example, children with Down syndrome can be sensitive to some of the eye drops we use and also often dislike having their eyes covered or their face touched. Children with autism often benefit from a different approach to the examination, which includes dimming the room lights and decreasing distractions in the room (which is the opposite of what helps most children to participate in an exam). Any health issue that you think is important is worth mentioning.

The initial examination will include a discussion of the reason for your child's visit. If you have noticed any particular problem, we will ask you about its severity in detail. Please bring any photos of your child which demonstrate the problem-these can often be very helpful, particularly if the problem is variable.

Your child's vision will be tested using one or more of several methods. For children who are verbal, this may include pictures, letter matching, or the full alphabet. We usually use an adhesive patch, which looks like an oval bandage, to cover the eye that is not being tested. This is because many children are skilled at peeking around normal adult eye covers.

As age and development allow, we will test your child's depth perception and color vision. All children will be checked for imbalance of the eye muscles. If any imbalance is noted or there is anything about the examination up to this point that is not completely normal, the doctor will see your child prior to dilation.

Next, your child's eyes will be dilated. Most children require three drops. The first is a numbing drop, which helps to decrease the sting of the following drops. The next drop is a combination drop that includes two dilating medicines. This drop is given twice. Some African American, Asian, Native American, and Latino children require an additional drop or a repeat of these drops, due to their dark pigmentation.

The dilating drops that we use in children last longer that the drops we use in adults, on average 12 to 18 hours. We must use these drops because the muscle which we need to relax is "stronger" (it has more tone) in children than in adults. Whereas adults are able to tell us with great accuracy which prescription lens is best, children cannot. We need full relaxation of your child's focusing system to accurately assess whether your child requires glasses or not. The vast majority of children are able to see clearly by the next morning; even if the pupils still appear a little dilated, the blurring effect of the drops has usually worn off.

The drops require, on average, 25 to 35 minutes to take effect. After this time, your doctor will check your child's refraction (glasses prescription) and examine your child's eyes, including the retina and optic nerve.

At the conclusion of the examination, your doctor will discuss their findings with you, recommendations for treatment, and suggest appropriate timing for your child's next examination. Please ask any questions you have. Feel free to bring a written list of questions if you like. The examination is not complete until all of your questions are answered. At the conclusion of the examination, the doctor may give you written instructions or additional handouts for your reference.

After the visit

Once you return home, you may think of, or your discussions with friends and family may prompt, additional questions. Please feel free to call our office at any time with any questions you have, 503-525.2020. Our goal is that you understand completely your child's condition and treatment.

Schedule an appointment at one of our 11 convenient locations:
Request an appointment on-line at www.EyeHealthNorthwest.com.
Call us:
Clackamas County: 503.557.4818
Portland Eastside: 503.255.2291
Portland Westside: 503.227.2020

Is "Bladeless LASIK" or "i-LASIK" the Best?

Many LASIK patients are doing research online to help them make good decisions about their vision. The natural fear of going blind leads many patients into an in depth technical analysis of LASIK in an effort to find reassurance from “experts” online or from the community at large. Anyone searching LASIK currently is going to quickly encounter clinics promoting the “superior safety” of their “latest” technology, especially “Bladeless LASIK”. I’d like to review the pro’s and con’s of “Bladeless LASIK” and share my experience with this technology. Since 1998 I’ve used many different lasers and techniques to correct vision. It’s amazing how sophisticated our LASIK techniques have become since the FDA approved LASIK in 1995. However, it’s easy for patients to assume that any new technology is better than the “old” one it replaces, and that logic runs contrary to my personal experience as a LASIK surgeon. I’d like to point out a few issues with this line of thinking and share some of our experience at EyeHealth Northwest regarding the safety of LASIK surgery.

LASIK is Safe

First and foremost I’d like to convey the message that LASIK surgery is indeed quite safe and effective at this point in time. Like any surgery, it has potential side effects. It always will. Better technology will never fully eliminate the human side of the surgery; the surgeon and clinical staff play a big role in the outcome, and to a greater extent than most patients realize, they themselves play a role in the outcome. Despite these pitfalls, the fact remains that on a national level the risks of losing vision from LASIK surgery appear to be about 3-4 times less than the risk of losing vision from a contact lens complication. Since most of our patients come to LASIK from wearing contacts, they are in fact decreasing the risk to their eyes in most cases. At EyeHealth Northwest we have never had an infection or serious loss of vision from LASIK since our center opened in 1999.

Marketing is Marketing

Secondly, I think we all realize that commercial interests often bias the information we get through the internet. For several years now there has been a big marketing push for “Bladeless LASIK”. The “Bladeless” part refers to how surgeons begin the LASIK procedure by making a thin “flap” of corneal tissue once the eye is numbed with drops. Many clinics advertise the “Bladeless” Intralase laser (also called i-LASIK by the manufacturer in an attempt to appeal to Apple fans) as being “superior, safer, more modern technology” as opposed to the alternative “blade” or “microkeratome” method of creating the flap. Patients should know that worldwide there have been over one million surgeries done with the Intralase laser. It’s no longer new, having gone through many improved models since 2003. It is now considered by most surgeons to be an excellent technology. However, the “old” blade based microkeratome technology has been used in over 15 million surgeries and has undergone development since the 1950’s. It remains the preferred technique for the majority of surgeons to date. I think patients should realize that in my searching of the internet I find almost exclusively biased commercial information on the intralase, with no real mention of potential downside. In contrast, searching our specialty medical journals and chat groups I find great diversity of opinion amongst surgeons and publications both supporting the safety of the laser as well as those pointing out new and serious complications from the laser.

When surgeons choose equipment they weigh factors of safety, efficacy, track record, ease of use, and yes even cost (which they may not be able to pass along to their patients). No wonder there is an active healthy debate amongst experts in this field as to which technique is “best”. I’d like to share my experiences and beliefs on this issue having used both “Bladeless” and “Blade” techniques.

Experience Counts

I have used a microkeratome called the Amadeus 2 with a special order medlogics blade since 2005. In that time, my partners and I have not experienced a single serious “blade” related complication over thousands of surgeries. The accuracy of the device in my hands is equivalent to the best published data for the intralase device.

In 2009 I performed a limited number of LASIK procedures with the “Bladeless” Intralase technique. My experience was favorable in terms of excellent outcomes and no complications, however, my patients were clearly less comfortable both during and after the surgery than my microkeratome patients. This finding was true for every patient and quickly led me to abandon the technique. I am not alone in making this observation; I have confirmed my experience with other surgeons who have broad experience with both techniques. It appears that patient comfort can vary from laser to laser using the “Bladeless” technique. While I fully appreciate the potential advantages of the Intralase technique, I am not prepared to use it in my surgery until further advances refine the comfort of the technique for all patients and surgeons. My surgical staff was truly relieved to go back to our “old” technique using the microkeratome which is so easy for our patients and gives such consistent and excellent results in my hands.

If the intralase (or indeed it’s formidable German competition) improves safety or efficacy substantially in the future compared to the latest microkeratomes (which also continue to improve) then we at EyeHealth would utilize a laser to create the flap. That decision would be independent of cost in our case. Until that time, we remain committed to using our current device with it’s proven track record in our hands.

Lastly, I’d like to point out a serious flaw in the argument that “Bladeless” LASIK is safer than any other LASIK. First, be aware that “Bladeless” LASIK still makes a cut on the eye, creating what we call a “flap”. In the majority of cases, a “flap” related complication is exactly that, related to the presence of a flap rather than how it was created. These should be rare complications (less than one in a thousand) in the hands of an experienced surgeon no matter which device is used. If surgeons are really concerned in a particular case that a complication may occur making a flap, they don’t use the Intralase, they simply use a no cut, no flap technique. This is done directly on the corneal surface and known as PRK or Lasek. It is routinely performed at EyeHealth (indeed it accounts for 20% of all “LASIK” surgery nationally) and is immune to flap complications simply because no “flap” is created! This is actually the safest "Bladeless", "All Laser" way to fix vision and it's an important part of my practice.

The best advice I can offer patients considering LASIK is to meet personally with an experienced surgeon and ask for detailed answers about their results, techniques, and complication rates. Any LASIK surgeon with experience and integrity should easily be able to answer your questions and make specific recommendations about your best options based on their experience and their preferred techniques independent of any marketing hype or commercial bias.

Scott Grealish MD
EyeHealth Northwest LASIK Specialist
Portland, Oregon

UV PROTECTION. IS IT REALLY IMPORTANT TO CONSIDER WHEN PURCHASING SUNGLASSES?

Ultraviolet (UV) protection is a concern for everyone, particularly in the summer months. However, most people think about sunscreen for their skin, not sunglasses with UV protection for their eyes. According to the American Optometric Association Eye-Q® survey, 40 percent of Americans do not think UV protection is an important factor to consider when purchasing sunglasses. What they don’t know is that prolonged exposure to the sun's UV rays without proper protection may cause eye conditions that can lead to a variety of vision disorders including cataracts, macular degeneration, pinguecula and pterygia(skin growth on white part of the eye).

The effects of sunlight exposure are cumulative throughout our lifetimes. Individuals who work outdoors or participate in recreational activities that involve lengthy exposure to sunlight are at the greatest risk. UV radiation also reflects off surfaces such as snow, water and white sand, so the risk is particularly high for people on beaches, boats or ski slopes. The risk for serious damage is greatest during the mid-day hours, generally from 10 a.m. to 3 p.m., and during summer months.

Children and teenagers are particularly susceptible to the sun’s damaging rays because they typically spend more time outdoors than adults, and the lenses of their eyes are more transparent than those of adults. Their transparent lenses allow shorter wavelength light to reach the retina of the eye. It’s important for young people to develop good sun protection habits early in life, such as wearing hats and sunglasses with UV protection.

When purchasing your sunglasses, style shouldn’t be the only consideration. To best protect your eyes, look for sunglasses that block 100 percent of UV rays. EyeHealth Northwest certified opticians can help you choose the best sunglasses for your individual needs. Take advantage of the 50% off select designer frames sale at our EyeHealth Northwest Happy Valley, Oregon City and Milwaukie locations. We want you to have the best in sight!