Optifog, The New Kid on the Block

Ever walk into a car on a cold winter day, and your glasses / sunglasses fog up leaving you blind temporarily?  Ever open a dishwasher and your glasses completely fogs up?  Well, now there’s a solution for that.  Up until about 3 months ago, there were no solution for it.  But now here’s a “new kid on the block”, Optifog, that has been making a lot of our patients quite happy.

What causes that fog on your glasses when you get into your car on a cold winter morning?  Fog is condensed droplets of water vapor lying on a surface especially when going from a cold to a hot environment.  This can obscure vision significantly, albeit temporarily.  Fog on the lenses depends on 3 factors as per Essilor (creator of Optifog): (1) Temperature difference between two environment.  (2) Relative humidity in the hot environment.  (3)  Time of exposure which allows the lens to adopt the temperature of the surrounding.

This experience of “temporary blindness” can be quite common.  Following are several scenarios that one can experience on their glasses:

  • Changing environment:  going for a cold air-conditioned room to the hot outside or going into a heated place on a cold winter day.
  • Indoor activities, such as drinking a hot cup of coffee, opening a dishwasher, eating hot food, also can lead to foggy lenses
  • Outdoor activities such as cycling, running, skiing can cause fog as well.

Essilor, one of the leaders in the ophthalmic industry, developed “Optifog”, lenses with anti-fog properties.  These are lenses with unique fog repellant properties, activated by an activator.  In order to activate the anti-fog property, simply put a drop of the activator on your lenses and wipe with a microfiber cloth to coat the entire lens surface.  This will keep the lenses fog-free for approximately one week.

Be sure to ask about this new innovative technology when you come into our office for your next pair of eye-glasses or sunglasses.

To Drive or Not to Drive

After the fifth patient in two weeks that failed the DMV test at my office, I thought it’s very important that I write this blog. My first patient H.M. was an 88 year old man that came in with a DMV form. During my exam, I discovered that his best vision is about 20/70. I refused to fill out the form that the patient brought in. And then I cringed at my patient’s next comment. “But I was told I shouldn’t drive at my last exam (8yrs ago), and I’ve been driving for all these years.” I, then offered to fill out a “limited License” form. Patient did not want a limited license. So this blog explains the vision requirements for NY state and forms required in case of a vision impairments.
Initial and renewal applicants are required to take and pass a vision exam before being issued a license. This test can be done at a DMV site or at an optometrist’s office. Drivers who renew their license by mail, must submit a MV 619 form (http://www.nydmv.state.ny.us/forms/mv619.pdf), which should be filled out by your optometrist (or an ophthalmologist, nurse or a physician’s assistant). This form will suffice if the applicant’s best-corrected vision (vision with/ without glasses or contacts) is 20/40 or better.
If the applicant’s vision is worse than 20/40 and better than 20/70, an MV 80L form (http://www.nydmv.state.ny.us/forms/mv80l.pdf) has to be submitted. These applicants cannot have the test done at the DMV, instead it must be done at an optometrist’s office. Horizontal, binocular visual field must be no less than 140 degrees. This form must also indicate whether or not the person has a vision condition that is deteriorating; and must include recommendations for driving restrictions that the Commissioner should consider; and recommendations relating to a vision examination on a 6-month or 12-month basis, if any.
Telescopes are prescribed for patients if their best corrected vision is 20/100 or worse. These patients must have 20/40 thru the telescope and 20/100 or better through their regular eyeglasses and a horizontal binocular visual field of 140 degrees. If the applicant uses telescopic lenses, it must be specified in the form and the telescope has to have been in the applicant’s possession at least 60 days prior to the application. Telescopic lens wearers must pass a road test wearing the telescopic lenses. The minimum training requirements are listed in the DMV website for individual states.

While this can be a life-altering experience, and not to mention the feeling of “loss of one’s independence”, its very important that these applicants and their families are aware of the seriousness of situation. This is easier if family members are on board with the eye doctors, unlike my last patient that had 20/80 vision and was taking care of an elderly cousin that is terminally ill. I was told that he drives her to her ER visits. Quite scary!

I’m Perfectly Healthy, Doc!

 

Without a doubt, all my challenging patients come to me on saturday mornings, when my day is booked, and double booked.  So of course, on a saturday morning, my office receives a call from a patient’s sister that reports that her brother, who is here in the US for vacation (from Brazil), woke up that morning and could not see out of one eye.  As any of my optometrist friends would do, I told him to come in ASAP.  About ten minutes later he was at my office along with two of his sisters.

My patient, the 47year old Brazillian Pediatrician tells me that he had LASIK about 4yrs ago and has had perfect vision since….until this morning, that is.  He woke up that morning and noticed that he could not see anything out of his right eye.  He reports that he is in “perfect health”.  His best corrected vision was worse than 20/400 (he couldnt see the big ‘E’) in the right eye and 20/20 in the left.  Looking at the way his pupils reacted to light told me that there was something seriously wrong.  So I went ahead with a complete dilated exam, with showed significantly swollen optic nerves and a lot of scattered hemorrhages.

At that point I put on my “detective” hat, and started asking more questions.  When asked when his last medical exam was, I was shocked at his response: “15years ago”.  So I brought out my blood pressure cuffs and checked it.  His blood pressure was 170/120.  So I explained my findings to the patient, and being an MD, he understoood the seriousness of it.  I sent him off to the ER, and told his sisters to go home and pack a bag for him, since he will be at the hospital for quite sometime.

The American Heart Association has recommended guidelines to define normal and high blood pressure.

  • Normal blood pressure less than 120/80
  • Pre-hypertension 120-139/ 80-89
  • High blood pressure (stage 1) 140-159/90-99
  • High blood pressure (stage 2) higher than 160/100

The swelling of the optic nerve are due to the lack of oxygen to the nerves.  Hemorrhages can happen because of the thinning of the blood vessel wall from the persistent pressure of the blood against the blood vessel walls.  My patient was in the hospital about 10 days before they were able to get his blood pressure under control.   He eventually regained most of his vision back after the blood pressure was brought under control.

Lesson learned:

  1. Make sure to go for your annual physical consistently.
  2. Annual Comprehensive eye exams are very important, including a dilated exam

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