Using technology to better examine your eye health
For years the standard way of checking the health of the back of your eyes has been either direct ophthalmoscopy (when we get really close with the bright light) or slit-lamp ophthalmoscopy where you have your chin on a chin-rest and we look inside the eyes using a microscope, a bright light and a super-powerful magnifying lens.
All optometrists are highly skilled at recognising anything that may be wrong, the only problem with this is one of comparison. Judging whether the appearance of someone’s retina two or more years ago has changed or not, can be difficult, even when comprehensive notes are kept. That’s where photographs can be invaluable.
Many eye conditions can be particularly hard to detect because the changes in the appearance of the back of the eye can be very subtle and slow. If we take glaucoma as an example, the appearance of what’s called the optic disc, where the optic nerve joins the back of the eye, is one of the things that we monitor very closely. Glaucoma damages the optic disc and it’s shape and size change slowly as the damage occurs over time. If we have images to compare, then this damage can be picked up a lot earlier than would otherwise be the case. This is not just true of glaucoma, the detection of diabetes and other problems hugely benefit from this too. At Patrick and Menzies, we were early adopters of this technology, known as Fundus Photography over 15 years ago.
Since fundus photography became commonplace, a newer, more advanced technology became available, known as Optical Coherence Tomography or OCT. From the patient’s perspective the procedure is very similar to fundus photography. However instead of a flat 2D photograph of the retina, OCT uses scanning light beams to create a 3D image, not unlike an ultrasound, of the retina. The advantage of this is that we can see the deeper layers of the retina, nerve fibres and blood vessels underneath, things that can’t be seen on a conventional fundus photograph. Conditions like Glaucoma, diabetes and many others can be picked even earlier than before, enabling treatment before any significant sight loss or other complications can occur. We installed OCT in all our practices over 5 years ago and they have proved invaluable.
Our Braintree practice also has something called Optomap. These machines give us an ultra-widefield image of the back of the eye, enabling easier detection of any problems in the peripheral areas of the retina.
These more advanced ways of examining your eyes are a standard part of our private eye examination, and included if you are part of our VisionPlan scheme.
For anyone who receives a basic NHS check, they are available as an upgrade for a small fee.
For more information, or to book an appointment, just get in touch. We’d be very happy to look after you!
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Case Study | Mr Manton
The quick thinking actions of one of our optometrists proved to be life saving for our first-time customer Neil Manton.
Earlier this year Neil was driving home from Yorkshire in grey and rainy weather when he noticed a strange shimmering sensation in his right eye. Putting it down to tiredness, initially Neil wasn’t too worried, but when that shadow didn’t seem to go away after a few days he decided to book an appointment at Patrick & Menzies Braintree branch.
At Neil’s appointment our optometrist Charlotte Wearmouth listened carefully to Neil’s concerns and gave him a thorough examination which took almost two hours but couldn’t come to a definitive conclusion. Charlotte said, “Despite not finding any obvious cause, I was aware that Mr Manton’s symptoms were serious, especially as they developed suddenly and were not improving.”
Realising that the problem needed further investigation Charlotte sent the images of Neil’s eye and her findings to Broomfield Hospital with a request for them to follow up. Three or four days, later Neil was called into Broomfield for a further battery of tests, including a brain scan, which revealed that the carotid artery in Neil’s neck was 84% blocked, restricting blood flow to his eyes, and putting him at imminent risk of stroke or fatal heart attack.
Neil was admitted urgently for a 5-and-a-half-hour operation which resolved the issue and Neil was allowed home the following day.
Neil couldn’t be more grateful. “Patrick & Menzies are life savers! I really can’t praise them enough for the professionalism of the service I have received,” he says. “If Charlotte hadn’t been so thorough and taken so much time over my appointment when I went to her, I might not be here to tell the story today.”
Neil returned to Patrick & Menzies just six weeks ago for a further check-up and we are delighted to report that his eye health is even better now than it was before the operation.
Our eyes really are windows to our wellbeing, so if you have any concerns or notice any anomalies with your eyes or vision, please do make an appointment to see one of our optometrists today. We really do go the extra mile to make sure our patients stay well and happy and perhaps enjoy the odd game of golf, as Neil does!
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Glasses, Goggles and Contact Lenses for Sports
If you play a lot of sport then your regular glasses may be driving you a bit mad – misting up when you get sweaty, shifting when you swing the golf club or getting knocked off in a tackle. You may feel you need to take them off if playing a racquet or more intense contact sport like rugby where an impact could mean serious eye injury. In fact, if you’re a sportsman or woman then wearing your glasses may well be affecting your performance. So, what can be done?
Get Special Glasses or Goggles…
Lenses in sports eye wear are usually made of polycarbonate as it’s an impact-resistant lens material that works well to protect eyes from fast-moving objects. Polycarbonate also has built-in ultraviolet protection – especially important for golfers, cyclists, cricketers and runners who may spend many hours in the sunshine. Untreated polycarbonate lenses can scratch easily, though and so most will include a scratch-resistant coating on both the front and back surface to keep them in shape for longer.
Sport frames are usually constructed of highly impact-resistant plastic and most come with rubber padding to cushion the frame around the temples and on the nose, but sports glasses and goggles are made in a variety of shapes and sizes. There are different designs for different sports and some are even designed to fit inside the helmets necessary for cycling or American football, for example.
Sports protective styles of frames are often contoured, wrapping slightly around the face. They also sometimes come with an elastic restraining strap that hugs the back of the head to keep them firmly in place and they often come in rimless styles or with vents to avoid misting.
If you’re a shooter or sailor, the choice of lens tint may be your ultimate priority and styles popular with those who practice these sports even boast interchangeable lenses to ensure 20/20 visibility in all conditions.
Swimming and ski goggles can be made with lenses that correct your spherical powers (sphere only) or your full prescription, just like a regular pair of glasses. Ski hybrids can come with foam surrounds or side shields to protect from the cold.
The possibilities really are endless, so come and discuss your specific requirements with us.
…Or Switch to Contact Lenses?
Often the most appropriate way of correcting the vision for sport is with contact lenses and we have lenses for every sporting lifestyle: Whether your concern is that you spend a lot of time in the sun and want lenses with UV protection to make sure your eyes are protected, or you’re just tired of glasses which fall off, mist up or impede your peripheral vision at crucial moments, we will find the contact lenses to suit. And that includes those who have varifocal prescriptions or indeed astigmatism.
So even if you have been told you’re not able to wear lenses in the past come and have a chat – chances are we can help. (And for less than you may think!)
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Lens Treatments | Options and Benefits
When you buy a new pair of glasses it’s not just the frames that come in a myriad of options – these days your lenses can be ‘upgraded’ with various tints, coatings and treatments. But there are so many it can all be a bit confusing – let us break down the most common options and the benefits they bring:
Anti-Reflective
Anti-reflective coating (also called AR or anti-glare) is perhaps the most commonly offered lens treatment, and with good reason: AR coatings not only benefit vision and reduce eye strain, but they can also improve your communication skills! That’s because they make the lenses in your glasses look nearly invisible, so people can see your eyes and expressions more clearly, and you can make better eye contact with them.
An AR coating virtually eliminates reflections from the front and back surfaces of your lenses, meaning more light passes through, allowing your eye to receive a higher percentage of the actual light available – up to 99.5 percent. This means less glare, sharper vision and greater comfort. AR coatings are also a good idea for sunglasses, because they eliminate glare from sunlight reflecting into your eyes from the back surface of tinted lenses when the sun is behind you.
As an additional benefit, most anti-reflective treatments have a special layer that prevents spots and makes them easier to clean, although any scratches do tend to be more obvious on AR coated lenses, so be sure to only use products and cleaning methods we would recommend!
Photochromic
Photochromic lenses automatically darken in bright sunlight (triggered by ultraviolet radiation) to make your eyes more comfortable. Because UV rays penetrate clouds, photochromic lenses may darken on grey days as well as when it’s sunny and they will not darken inside a vehicle because the windscreen glass blocks most UV rays. However, some newer types of photochromic lens activate with both UV and visible light.
An added benefit of photochromic lenses is that they shield your eyes from 100 percent of the sun’s harmful UVA and UVB rays and because exposure to sunlight and UV radiation has been associated with cataracts later in life, it’s a good idea to consider photochromic lenses for children’s eye wear as well as for the spectacles of outdoor-loving adults.
Polarized
Polarized lenses are anti-glare and virtually eliminate bright light from reflective surfaces and so are especially popular with fishermen and sailors.
Scratch-Resistant
Untreated lenses are surprisingly fragile, and it’s very easy to scratch them by storing them incorrectly, placing them down hastily or even cleaning them with some kitchen roll rather than the proper cloth! Luckily, lenses that are treated front and back with a clear, scratch-resistant coating have a much harder surface that is more resistant to scratching and more durable. It’s worth asking about this, because scratches are not only unsightly but can also seriously compromise the clarity of your vision. Nowadays some lenses have a built-in scratch-resistant coating, but double check that this is the case with your prescription.
Lots of options, then! Pop in a have a chat with us to choose that which best suits your lifestyle.
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Brand Spotlight | Lulu Guinness Frames
Dare to be different! That’s the motto of Lulu Guinness, who is perhaps most famous for her statement handbags, much loved by trendsetters such as Kate Moss, Emma Watson and Paloma Faith.
Remember the red lips clutch bag that was much imitated a few years ago? That was Lulu Guinness and she makes a knowing little nod to that iconic image with her signature little red lips printed on the arms of each of the frames in her eye wear collection.
Lulu Guinness at Patrick & Menzies
We love the Lulu Guinness range here at Patrick & Menzies because they are definitely a talking point, but without being over-the-top wacky! Rather, they are sophisticated, with a touch of daring – featuring inter-plays of colour and dramatic retro shapes.
The collection is targeted “at women with a fierce sense of humour and an even fiercer sense of their own femininity” and we can see these frames being snapped up by our clients that are looking for something playful and modern, but with a touch of gravitas.
Style details are important to this designer and along with the red lips and metal logo inlay, these frames come in a veritable rainbow of colours, and patterns including animal print, glitter, polka dot, and the trademark black, white, and red – whether you’re looking for a striking silhouette, vintage glamour or subtle whimsy, there’s a frame in this collection to suit.
High Quality Frames
But style doesn’t come at the expense of substance – Lulu Guinness frames are made from high-quality materials, built for the rigours of everyday wear and some of the styles are offered in an alternative, more generous fit. They are super comfortable too, with adjustable or integrated ergonomic nose pad systems and cushioned hinge bracket arms.
“Glasses have become an expression of one’s individuality”, Lulu says. “I wanted my frames to be beautiful objects in themselves as well as flattering for the face”. And they certainly are – luxurious yet affordable, the Lulu Guinness range is in all our stores and, as you would expect, we can fit them with the highest quality lenses that are right for you.
Pop in and browse the collection. We look forward to seeing you!
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Finding the Right Frames for Your Face
While it’s wonderful that we have so much choice these days in terms of frames it does make the process of choosing the right pair for you somewhat more complicated!
If you’re finding it hard to narrow down the choices, then a good place to start is thinking about your face shape. Generally speaking, people tend to fall into one of five categories: Round, heart shaped, oblong, square and oval:
Round – a softly curving face that is as wide at the forehead as it is at the jaw and with wide cheekbones.
Heart-shaped – sometimes called an inverted triangle. Wider at the forehead and gently tapering to a more pointed chin.
Oblong – sometimes called narrow. A face that is longer than it is wide.
Square – a broad forehead and squarish jaw line.
Oval – a well-balanced face with defined cheekbones and no one dominant feature.
Most people have probably never thought about which shape their face most closely aligns to, and it may be that what you instinctively think you are isn’t quite true. Rather than relying on a friend cocking their head to one side and looking at you quizzically, it’s often easiest to look in the mirror and use a lipstick or a water-based felt tip pen to draw around your reflection (please don’t pick up a permanent marker by mistake!).
Once you’ve established which shape you most align to then see if these suggestions help you find a frame that suits your contours!
Frames for a Round Face
You may find rounder, smaller frames (think John Lennon) just make your face rounder still, so try out square and rectangular frames with strong angles for balance. Ray-Ban Wayfarer or Clubmaster-type styles (think James Dean and JFK) can also work well, if you prefer a quirkier look.
Frames for a Heart Shaped Face
Heart-shaped – over-sized, pilot-styles and half-rimmed frames don’t work on this type of face as well as oval shapes do, but rimless glasses in particular will also work incredibly well for you. (Think Kate Beckinsale and Richard Gere)
Frames for an Oblong Face
Now, pilot styles do work for those with narrower faces (Brad Pitt and Tom Cruise are particularly fond of these!) as well as square, angular frames. Steer clear of narrow frames as they can make your face appear longer.
Frames for a Square Face
Continuing on the opposites attract route, square faces should opt for round and oval frames that soften the angles of the features. (Think Kendall Jenner and Justin Bieber) Or go for browline frames for a vintage look. Anything too strong or geometric won’t work as well for you.
Frames for an Oval Face
We should be so lucky! Anything goes for ovals so just enjoy having the freedom to explore the entire range Patrick & Menzies has to offer and pick whatever makes your heart sing!
Whatever your face shape, pop into any of our branches to start your selection!
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Prescriptions | What does all that information mean?
For many of us, an eye examination is more about the immediate concern of whether your current prescription has changed or, indeed, whether you actually need glasses to help you see better, than anything else!
At the end of your appointment your optometrist will issue you with your prescription: A piece of paper with a series of numbers on it that tell us the sort of lens you need to correct your eyesight. It’s rather grandly known as your ‘refractive error’. The perfect eye projects a sharp, clear image onto the retina, known as ‘emmetropic’. If your eyes don’t do this (and most don’t) it’s most commonly because they have a refractive error and that means the image you see is blurry.
You may have heard the terms ‘short-sighted’, ‘long-sighted’, ‘astigmatism’ or maybe even ‘prisms’, but do you really know what they mean?
What’s a ‘Normal’ Eye?
The power of your lens is measured in units called ‘dioptres’ and most prescriptions are relatively low in power – for comparison, the NHS considers a complex prescription to be anything over 10 dioptres.
A ‘standard’ eyeball has a focusing power of +60 dioptres. This brings light rays coming from a distance to focus on the retina at the back of the eye which is considered to be 22.22mm in length. Around +45 dioptres is provided by the cornea (the front, curved, clear part of the eye) and around +15 by the lens inside the eye. Problems occur with this system if any of these numbers differ from the norm.
Short-sightedness
Let’s start with the most common problem: Short-sightedness. Short-sightedness is correctly known as myopia, which means you can only see objects close to you: The closer you have to be, the more short-sighted you are. If you have myopia then objects at a distance create a blurry image on the back of the eye. This happens because the parts of the eye that bend the light rays are too strong or the eyeball is too long. When you get closer to the object, the light rays arriving at the eye start to diverge, which counteracts the ‘over convergence’ of the light rays and pushes the focus back onto the retina.
Someone who has a myopic prescription will have a minus figure at the start of their prescription, meaning the lenses in their specs (or contact lenses) are diverging: This counters the eye which is effectively over-plussed.
Long-sightedness
Now let’s get onto the more difficult one! Long-sightedness! Hyperopia (sometimes called Hypermetropia) is more difficult to explain. If short-sightedness means you can see things up close, then being long-sighted means you can see things far away, right? Well, not really… although sometimes, yes, that is true! Bear with us!
In this case those light rays coming from a distant object are focused behind the retina. This happens because the parts of the eye that bend the light are not strong enough and the eye effectively doesn’t have enough power to bring the rays to the correct point on the retina.
Some people with a relatively low amount of long-sightedness can see objects clearer if they are really far away – for example, we hear of sailors saying they can see a buoy on the horizon, but they struggle to see the TV, or an HGV driver who can see motorway signs in the distance but not the train times on the monitors at the station.
Someone who is long-sighted will have a plus figure at the start of their prescription, their lenses are plus powered (converging). This compensates for the fact that the eyeball is too short.
Astigmatism
Ok, now let’s get into the tricky diagnosis: Astigmatism. If you have an astigmatism then your eyes don’t produce a single point focus, but actually produce two ‘line foci’. Effectively the eye has two different powers at 90 degrees to each other. This is caused most commonly by the cornea having two different curvatures. In an astigmatic eye the curvature of the cornea will vary: It will have two different curves, one steeper than the other, at 90 degrees to each other.
These curves mean that the eye may be more shortsighted in one meridian than the other, or more longsighted in one, or even long sighted in one and shortsighted in the other, which, as you can imagine, requires a more complex prescription.
Prism
Our eyes produce two images and send these back to your brain. These images are also upside down just to make things more complicated! So how do we see one of everything, the right way up?
Well, that relies on the precise co-ordination of both eyes and the fact that they both line up and point at the same object at the same time. The eyes do in fact produce two very slightly different images and that is how we perceive depth properly, but the difference between them is only slight. The images have to fall in corresponding areas on the right and left retinas for you to only see one of the object you are looking at. If the images fall partly or wholly outside these areas, the brain cannot match them up properly and they become blurred, or even double. The direction of gaze and how well controlled it is, is governed by six muscles around each eye which move left, right, up, down and obliquely. If you have a problem with one or more of those muscles, then it can mean that the images produced become too different from one another.
As the brain senses this mismatch it will tell the muscles to work harder to overcome the problem, sometimes they can but often this will lead to eyes feeling tired (it’s hard work!) or achy. Sometimes this can cause headaches too.
If we detect this issue in an eye examination, then in some circumstances we’ll prescribe prism. This allows the eyes to take up their comfortable position, thus removing the symptoms; and shifts the images on the retina, lining them up so the eyes don’t have to work so hard. In the vast majority of cases you wouldn’t know someone with prism has this correction as the deviation of their eyes is so small it’s not cosmetically noticeable.
You don’t need to worry too much about what your prescription says – that’s our job. But you do need to make sure you’re having regular check-ups to keep the information correct. Pop in and see us at any of our branches for an appointment so we can keep your sight crystal clear.
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