About Cynthia Kiernan

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So far Cynthia Kiernan has created 427 blog entries.

What Is 20/20 Vision?

One of the most commonly asked questions in an eye exam comes right after the refraction, or glasses prescription check: “What is my vision?”

Almost invariably, people know the term “20/20”. In fact, it’s a measure of pride for many people. “My doctor says I have 20/20 vision.” Or, on the other side of that same coin, having vision that is less than 20/20, say 20/400, can be a cause of great concern and anxiety. In this discussion I will describe what these terms actually mean.

To lay the foundation, let’s discuss some common terms. Visual acuity (VA) is clarity or sharpness of vision. Vision can be measured both corrected (with glasses or contact lenses) and uncorrected (without glasses or contact lenses) during the course of an eye exam. The result of an eye exam boils down to two different but related sets of numbers: your VA and your actual glasses prescription.

The notation that doctors use to measure VA is based off of a 20-foot distance. This is where the first 20 in 20/20 comes […]

2023-11-07T05:00:00+00:00November 7th, 2023|Blog|

The Leading Cause of Blindness in Working-Age Adults

Diabetic retinopathy is an eye condition that can affect the retina of people who have diabetes.

The retina is the light-sensitive tissue that lines the back of the eye, and it detects light that is then processed as an image by the brain. Chronically high blood sugar or large fluctuations in blood sugar can damage the blood vessels in the retina. This can result in bleeding in the retina or leakage of fluid.

Diabetic retinopathy can be divided into non-proliferative or proliferative diabetic retinopathy.

Non-proliferative diabetic retinopathy:  In the early stage of the disease, there is weakening of the blood vessels in the retina that causes out-pouching called microaneurysms. These microaneurysms can leak fluid into the retina. There can also be yellow deposits called hard exudates present in the retina from leaky vessels.

Diabetic macula edema is when the fluid leaks into the region of the retina called the macula. The macula is important for the sharp central vision needed for reading and driving. The accumulation of fluid in the macula causes blurry vision.

Proliferative diabetic […]

2023-10-31T04:00:00+00:00October 31st, 2023|Blog|

What Is Refraction & Why Doesn’t Health Insurance Cover It?

A refraction is a test done by your eye doctor to determine if glasses will make you see better and what your prescription is.

The charges for a refraction are covered by some insurances but not by all.

For example, Medicare does not cover refractions because they consider it part of a “routine” exam and Medicare doesn’t cover most “routine” procedures–only health-related procedures.

So if you have a medical eye problem like cataracts, dry eyes, or glaucoma then Medicare and most other health insurances will cover the medical portion of the eye exam but not the refraction.

Some people have both health insurance–which covers medical eye problems–and vision insurance–which covers “routine” eye care (no medical problems) such as refractions and eyeglasses.

If you come in for a routine exam with no medical eye problems or complaints and you have a vision plan, then the refraction is usually covered by your vision insurance.

 

Article contributed by Dr. Brian Wnorowski, M.D.

This blog provides general information and discussion about eye health and related subjects. The words and […]

2023-10-24T04:00:00+00:00October 24th, 2023|Blog|

STOP Fishing Mucous out of Your Eyes!

The tears that coat the surface of your eyes have both a liquid and a mucous layer to them. It is normal to have a small amount of mucus in your tear film. But that mucus can significantly increase when the eye gets irritated.

Some of the most common causes of irritation that can make the eye overproduce mucus are:

  • Conjunctivitis, which could be caused by an allergy, bacteria, or virus
  • Blepharitis, which is an inflammation of the eyelids
  • Dry Eye Syndrome

When any of these conditions occur, the eye will begin to make more mucus.  

Sometimes the mucous production really is excessive and there is a temptation to keep pulling it out with either your fingers or a cotton swab. DON'T DO THIS–it will just lead to recurring irritation and problems.

Any mucus that gets deposited OUTSIDE the eye on the outer eyelid or on the lashes is fair game for removal. In fact, anything on the exterior of the eyelid or stuck to the eyelashes should be cleaned off.  Just don’t […]

2023-10-17T04:00:00+00:00October 17th, 2023|Blog|

When Your Retina Gets a Wrinkle

A wrinkle on the retina — which is also known as an epiretinal membrane (ERM) or a macular pucker — is a thin, translucent tissue that develops on the surface of the retina.

The retina is the inner layer that lines the inside of the back of the eye and is responsible for converting the light image into an electrical impulse that is then transmitted to the brain. An epiretinal membrane that forms on the retina goes unnoticed by the patient many times, and is only noticed during a dilated eye exam by an eye doctor.

Epiretinal membranes can become problematic if they are overlying the macula, which is the part of the retina that is used for sharp central vision. When they become problematic they can cause distortion of your vision, causing objects that are normally straight to look wavy or crooked.

Causes of a wrinkle on the retina

The most common cause is age-related due to a posterior vitreous detachment, which is the separation of the vitreous gel from the retina. The vitreous gel […]

2023-10-10T04:00:00+00:00October 10th, 2023|Blog|

Costume Contacts Can Make Halloween a Scary Time

Fall brings a lot of fun, with Halloween playing a big part in that.

But did you know that some Halloween practices could harm your vision? Take Halloween contacts, for instance. Costume contacts vary widely, with everything from monster eyes to goblin eyes to cat eyes to sci-fi or  glamour looks. They can be just the added touch you need for that perfect costume. However, some people do not realize that the FDA classifies contact lenses as medical devices that can alter cells of the eye and that can damage the eye if they are not fit properly.

Infection, redness, corneal ulcers, hypoxia (lack of oxygen to the eye) and permanent blindness can occur if the proper fit is not ensured. The ICE, FTC, and FDA are concerned about costume contacts from the illegal black market because they are often unsafe and unsanitary. Proper safety regulations are strictly adhered to by conventional contact lens companies to ensure that the contact lenses are sterile and packaged properly and accurately.

Health concerns arise whenever unregulated black-market contacts come […]

2023-10-03T04:00:00+00:00October 3rd, 2023|Blog|

Vision or Health Insurance?

The eye care medical field has an unusual split between two different types of insurance for covering eye issues: health insurance and vision insurance. Not all patients have both.

In most cases, your health insurance is used to cover medical and surgical eye problems but not routine exams or the cost of contacts or glasses. Those things are often covered by separate vision insurance.

Why the difference? Originally, health insurance was created to take care of health “problems” and wasn’t designed to cover “routine,” “screening,” or “wellness” exams.

Since health insurance wasn’t going to cover “routine” eye exams, the vision insurance industry arose to help insure/cover those routine exams as well as the costs of glasses and/or contacts if they were needed.

That dichotomy now often causes great confusion when you make an appointment at your eye doctor. When making your appointment, the office is going to need to know which insurance, if you have both, you are going to be using for this particular visit.

Why does the office need to know in advance which […]

2023-09-26T04:00:00+00:00September 26th, 2023|Blog|

Vision Problems After a Concussion or TBI?

The Centers for Disease Control estimates that around 2.8 million people in the United States suffer from a traumatic brain injury (TBI) every year, and vision can be affected.  Concussions are a type of TBI.

The rate of childhood TBI visits to the emergency department more than doubled between 2001 and 2009, making children more likely than any other group to go to the ER with concussion symptoms.

It was once assumed that the hallmark of a concussion was a loss of consciousness. More recent evidence, however, does not support that. In fact, the majority of people diagnosed with a concussion do not experience any loss of consciousness. The most common immediate symptoms are amnesia and confusion.

There also are multiple visual symptoms that can occur with a concussion, either initially or during the recovery phase.

Visual symptoms after a concussion include:

  • Blurred vision.

  • Difficulty reading.

  • Double vision.

  • Light sensitivity.

  • Headaches accompanying visual tasks.

  • Loss of peripheral vision.

Most people with visual […]

2023-09-19T04:00:00+00:00September 19th, 2023|Blog|

What Is This Bump on My Eyelid?

So you’re going about your day and notice a slight twinge when you blink. It starts off as a mild awareness, then proceeds to a painful feeling with every blink. You look in the mirror to see what could be causing it, and there you see a small red bump forming.

You decide to wait to see what happens and one of three things occurs. It might get bigger, redder, and more painful; it might shrink and goaway; or it might stay put, but it is no longer painful or growing in size. Let’s dive into one of the most common eye conditions we treat: hordeola (commonly known as “styes”) and chalazia.

Hordeola (or singular hordeolum), are infectious abscesses of the glands that line the eyelids. Bacteria that are naturally occurring on the eyelids and eyelashes can make their way into the gland and form what is essentially a pimple in the eyelid. If it goes untreated, hordeola can (rarely) lead to spreading of the infection throughout the eyelid (preseptal cellulitis) or even start to invade […]

2023-09-13T04:00:00+00:00September 13th, 2023|Blog|

My Eyes Feel Like a Desert!

Itching, burning, watering, red, irritated, tired eyes… what is a person to do? These symptoms are classic signs of Dry Eye Syndrome (DES), which affects millions of adults and children.

What causes this?  Dry eye syndrome can be brought on by many factors: aging, geographical location, lid hygiene, contact lens wear, medications, dehydration, etc. The lacrimal gland in the eye that produces tears, in a person over forty years old, starts slowly losing function. Females with hormonal changes have a higher incidence of DES (dry eye syndrome). Dry, arid climates or areas with high allergy rates tend to have higher incidences of DES as well. Another major cause is increased screentime–when we stare at a computer screen or phone, our blink reflex slows way down. A normal eye blinks 17,000 times per day, usually producing enough tears to be symptom free, if not contenting with other factors.  But blink rates go way down while using screens.

Blepharities, a condition of the eyelids, can cause a dandruff-like situation for the eye, exacerbating a dry eye condition. Contact […]

2023-09-05T04:00:00+00:00September 5th, 2023|Blog|