Thursday, September 18, 2014

School Special: Learning Disabilities and Vision

The label of Learning Disability is often placed on children as a catch all for any child that has difficulty with any aspect of reading, whether in basic “learning to read” or “reading to learn” stages.

Learning to read difficulties include but are not limited to difficulties with letter recognition, word formation, sight word recognition or phonetic decoding. These are considered some of the basic “learning to read” skills, based upon accurate development and, if necessary, remediation of vision perception skills.

Reading to learn difficulties occur when a child has “broken the reading code”, has sight word and decoding skill along with a reading vocabulary, but has difficulty performing to an academic level where they are intellectually capable. This is often described as lack of speed, fluency, comprehension or retention. There are many sources of these difficulties, which include oculo-motor based focus, fixation, tracking, and binocular integration deficits which can mimic true learning disabilities.

As an Optometric Physician I am charged with and concentrate on reducing or providing compensation for any measurable physical deficits that can impair either the reading to learn or reading to learn processes. Specialists including developmental-behavioral optometrists, specially trained public or private educators, occupational therapists, speech and language therapists and others focus on various developmental aspects of the learning to read process including the many components of visual perception required for all learning.

Studies of brain activity during reading are more and more accurate and specific in monitoring brain activity when engaged in many activities including reading. Functional Neuro-Magnetic Resonance Imagery (FNMRI) is an exciting component of my work as a member of the Rogue Valley Medical Center and Providence Medford Medical Center In-Patient Rehabilitation Staff. The effects of materials and procedures that have been clinically applied for generations are now documented as contributing to neuro-processing improvement, in both neuro-muscular control and information processing.

Clinical recommendations for spectacles or therapeutic intervention are based on clinical experience and supported by measurable physical response. Spectacles, contacts or a combination provide a first line of intervention when indicated. They remove measurable physical barriers to efficient uptake of visual information. If the uptake of information is physically compromised educational or therapeutic interventions will not be as effective or efficient. Spectacles are often a necessary and effective adjunct that will enhance and often abbreviate other interventions.

Visit us online or call us at 541-773-1414 to schedule an appointment today with Dr. Douglas Smith, O.D. to evaluate your child's vision today.

Bison Vision Center   |   585 Murphy Road   |   Medford   |   Oregon   |   97504   |   541-773-1414 (o)   |   541-773-5613 (f)

Friday, August 22, 2014

Cataracts - An Overview of the Causes

With over 35 years of practicing optometry, I've seen my share of individuals with cataracts. However not all cataracts develop equally. Here are some of my professional insights regarding the causes of cataracts:

The lens of the eye is a uniquely constructed tissue as it allows light to pass through it allowing us to see. The lens is made up of protein that is vulnerable to many things that can cause it to become cloudy or opaque which we call Cataracts.

Most frequently, we know of the cataracts experienced by people as they “season” a bit. The lens absorbs ultraviolet light as it allows visible light to pass through to the retina, through out life. Think of the clear lens as a glass of pure water. If you add milk a drop at a time the pure water becomes cloudy. If you add enough milk the water becomes too opaque to see through. Every birthday is potentially a drop of milk. Stack up enough birthdays and you may develop cataracts.

Age isn't the only factor with regards to cataracts. Diseases, some medications and genetic problems can cause cataracts at any age. Babies are sometimes born with Congenital Cataracts require early removal to prevent lifelong visual problems. Trauma to the eye can also cause the lens to become cloudy. For example, a BB gun injury often results in cataracts in youth especially if the eye is penetrated. Industrial accidents, auto accidents, sports injuries, and blows to the eye are common causes of Traumatic Cataracts. Disease processes such as diabetes can cause cataracts. Some medications, such as steroids prescribed for many conditions can result in Iatrogenic (medically caused) Cataracts. Finally, there are genetic conditions that cause early onset of cataracts.

The good news is that advances in cataract surgery and management can remove the cloudy lens and replace the lens which restore sight with synthetic lenses at any age.

If you have questions about cataracts for you or someone in your life, contact me for an evaluation.

Your Protector of Vision,

Dr. Doug Smith, O.D.
(aka. Doc Bison)

Call 541-773-1414 or go online to schedule an appointment.

Friday, September 6, 2013

Babiators - the awesome new sunglasses for babies and kids!

Bison Vision Center is an authorized retailer of Babiators - safe, durable and awesome sunglasses for kids - for only $19.95*!

age 0-3 Blue Angels Blue

Babiaors are the hot new thing in kids fashion...and Babiators' lenses keeps babies and kids safe from the harmful effects of UVA and UVB rays. There is a lot of scary information out there about UV rays and sun exposure during daily activities (macular degeneration, pinguecula and pterygium - growths on the the eye's surface - cataract formation, photokeratitis (snow blindness) and skin cancer on the eyelids) but what it comes down to is being safe.

Classic Blue Angels Blue
They come in numerous colors and sizes which include Junior Babiators (ages 0-3) and Classic Babiators (ages 3-7+). And to top it off, if they have an incredible guarantee: Register your child's classes and if your child's Babiators are lost or broken, they will replace them, no questions asked! (see here for full details)

age 3-7+ Black Ops Black
Just like wearing a helmet when riding a bike, wearing UV tested sunglasses protects your precious vision. You wear sunglasses, shouldn't your kids?

For more information on how children’s eyes are different from adults’ eyes, and why UV protection is especially important for children, click here.

For more information about the UV Index, check out this document published by the EPA.

Contact us at bison@bisonvisioncenter or call 541-773-1414 or stop in our office to get a pair today!

*No tax. S&H not included, USPS Priority Flat Rate $5.80

Thursday, September 5, 2013

LATISSE® Now Available at Bison Vision Center

I am very pleased announce that I am qualified as a registered provider and my staff as certified trainers and dispensers of LATISSE®. This is an incredible opportunity for those individuals who have sparse or thinning eyelashes, similar to balding, regardless of age. There are many ways to maintain or enhance your eyelashes such as mascara, fake, enhancers or extension eyelashes, or finally a medical solution.

I take my commitment to your eye health as seriously and follow reasonable protocol for eye safety, including the prescribing and dispensing of LATISSE®.. While you or your friends may have already experienced casual (i.e., non-complaint) dispensing of LATISSE® from other sources, when considering LATISSE® note that the parameters I have established are in your best health interest, allowing me to confidently prescribe LATISSE®.
I require baseline findings of IOP, lid color and Iris color as well as baseline visual skills and photo documentation at the patient option prior to prescribing.

Bison Vision Center will provide LATISSE® upon presentation of a valid written prescription for patients under another doctor’s care. Bison Vision Center will not provide any additional services, other than dispensing.

For Existing Patients
If you are a patient of Bison Vision Center, there is no service charge associated with the data gathering, documentation and dispensing of LATISSE® as long as all the findings currently exist in your patient chart. Occasionally some additional observations must be made and documented and there would be a nominal fee (please contact us to discuss).

For Non-Patients
Individual who are not patients of Bison Vision Center or in possession of a written prescription and under the ongoing care of another physician will be managed as follows. For only $260.00* **, Bison Vision Center will provide:
  • Initial Examination (limited to LATISSE® protocol): $135.00
  • Initial Photo Documentation: $125.00
    • 6-Month Follow-Up with Photo Documentation: included
*Full payment is due prior to examination and dispensing of LATISSE®.
**In all instances, our billing service (MMSS) will bill your Major Medical Insurance for any allowed benefit reimbursement or plan deductible credit covered medical examination services and procedures.

LATISSE® is a drug developed and used to treat Glaucoma. The side effect of lash growth on eyes treated with this prescription drug led to the approval of this drug as a therapeutic and cosmetic prescription treatment for thin, scattered, colorless and short lashes. LATISSE® is a drug available by prescription only.

To obtain any prescription drug, an appropriate examination must be documented in the physician’s chart, reflecting observations, tests, diagnosis and proposed therapy. A WRITTEN prescription must be presented to the dispenser and kept on file by the dispenser of the drug.

Obtaining LATISSE® even in trial form from anyone without examination and prescription is in violation of federal law and accepted standards of practice.

The examination does not need to be provided by an eye care specialist. The prescribing physician, whether a  specialist,  or general practitioner should verify that baseline Intra-Ocular Pressure findings exist in an eye care specialists records or request that an eye specialist measure and record baseline Intra-Ocular Pressure.

Eye care specialists are best prepared to document and monitor baseline ocular pressure and lid findings, subsequent changes and if necessary to monitor and treat any conditions resulting from discontinuing of LATISSE®.

Manufacturer’s Warnings

Side effects of LATISSE® include but are not limited to:
  • Darkening of the lid where the drug is applied
  • Permanent darkening of the Iris of the eye
  • Lowering of Intra-ocular pressure (though “not to a dangerous level”) as the manufacturer literature states.
The admitted side effect of lid darkening confirms absorption by the lid. The darkening of the Iris and lowering of the pressure confirm that the agent does indeed filter into the eye itself, even though the drug is promoted for external use only.

The manufacturer does not address the effects of discontinuing LATISSE®, other than indicating that the lashes will ultimately return their pre-treated appearance and that darkening of the lid and the iris are permanent.

What is not addressed is the intraocular pressure that may have been lowered during use of LATISSE®.

Discontinuing any drug can cause rebound effects, specifically in this case returning pressure measurements not only to levels present prior to the treatment, but often to a higher level than was initially present.  The occurrence, duration and effect of this potential side effect can be best monitored by an eye care provider with the proper equipment and experience to detect, monitor and treat Glaucoma.  You may need guidance to discontinue LATISSE® safely,

Proper LATISSE® Protocol

Schedule an appointment for:
  • Examination and diagnosis of existing eye lid and lash conditions.
  • Documentation of baseline Intra-ocular Pressure
  • Documentation Iris color before therapy
  • Documentation of lid / lash profile before therapy
  • Instruction and demonstration of proper use, storage and how to reduce the amount of LATISSE® used with each application.
  • Photo-documentation at patient option
The doctor should:
  • Create a record for each patient and document all findings.
  • Provide a written prescription to obtain LATISSE® from an approved source
  • Visit with the patient quarterly and then at longer intervals as success is achieved
  • If there is a medical condition underlying lash pathology, major medical insurance may participate in many or all of the above steps
 Thank you and see you soon.

Dr. Doug Smith, O.D.
(aka. Doc Bison)

Thursday, July 25, 2013

Vision Fatigue: Causes and Solutions

What is different about the way we live that has more and more patients increasingly fatigued? Our environment and how we function in it has drastically changed in the past few years, and has changed faster than in any other time in our history.

  1. Our indoor world and media consumption habits have changed.
  2. The symptoms of Computer Vision Syndrome and Digital Eye Strain include chronic headache, blurred vision and overall fatigue are more prevalent.
  3. Viewing digital screens has substantially increased with the use of smart phones, tablets and computers.
  4. The light transmitted from devices to and around the eyes is full of visual noise from high-energy visible (HEV) light waves that are just beyond the visible spectrum.
  5. High-efficiency compact fluorescence and LED lighting have replaced inefficient incandescent bulbs.
Visit us online or call us at 541-773-1414 to schedule an appointment today with Dr. Douglas Smith, O.D. to relieve the visual stresses of your electronic world with Recharge.  

Bison Vision Center   |   585 Murphy Road   |   Medford   |   Oregon   |   97504   |   541-773-1414 (o)   |   541-773-5613 (f)

Thursday, June 27, 2013

Quick Tips for Seasonal Allergy Symptom Relief

Depending on where you live, you could already be experiencing seasonal allergies. Here are some quick tips for quick relief. And as always, if you have questions or concerns, schedule an appointment for a full evaluation.

Tips for Happy Eyes

  • Apply a cold wet wash cloth over the closed eyes when the lids or eyes are teary, red, puffy or itchy.  Do not cold pack with ice!!
  • Wash your hands,  face and eyelids frequently to remove offending agents
  • Over the Counter (OTC) anti-histamine products:
    • Similasan Allergy Relief drops (this is a homeopathic product that is effective for some people)
    • Zaditor (Ketotafin) (a safe and effective antihistamine product for ages three and older)
  • To use the drops:
    • Apply one drop to each eye. Form a pocket by pulling the lower lid out while looking up
    • Apply the drop in the pocket from about 1” away
    • Do not touch the bottle tip to the eye to avoid injury or contamination
    • First days of use: apply one drop in the morning and one drop at bedtime to each eye
    • When your eyes feel better after a few days, apply bedtime drops only
    • If the symptoms remain under control discontinue all drops after 5 days
    • If the symptoms reappear return to the AM -PM drop schedule
    • Place drops 10 minutes BEFORE inserting contacts in the morning and anytime AFTER removing contact lenses for the day
    • Wait 5 minutes before using any other eye drops or the effect of each drug will be reduced or eliminated 
  • If symptoms are not controlled within 10 days, an in office examination is recommended

Tuesday, June 11, 2013

UV vs. UB Rays

This article is a bit misleading. UV protection is provided by most ophthalmic lenses and can be improved with coatings even on sunglasses. Polarization reduces the total amount of light striking the eye behind the sunglasses from a specific angle of reflection.


Schedule an appointment today to find the right sunglasses for you from our wide collection!