Published: 11 December 2023

Your Eyes Are A Precious Gift--Protect Them During The Holidays “I want an official Red Ryder, carbine action, two-hundred shot range model air rifle!” “No, you'll shoot your eye out.” This line from “A Christmas Story” is one of the most memorable Christmas movie quotes ever. Funny in the movie, but the holiday season does present a real eye injury threat. For those who celebrate Christmas, that risk begins even before the actual day. Some of the most frequent holiday-related eye injuries come from the Christmas tree itself. Holiday eye safety begins with the acquisition of the tree. If you are cutting down your own tree, please wear eye protection when doing the cutting--especially if you are going to be using a mechanical saw, such as a chain saw or sawzall. You need to also be careful of your eyes when loading a tree on top of the car. It is easy to get poked in the eye when heaving the tree up over your head. Once back at home, take care to make sure no one else is standing close to the tree if you had it wrapped and now need to cut the netting off. The tree branches often spring out suddenly once the netting is released. Other injuries occur in the mounting and decorating phase. Sharp needles, pointy lights, and glass ornaments all pose significant eye injury risk. If you are spraying anything like artificial tree snow on the branches be sure to keep those chemicals out of your eyes. Having now successfully trimmed the tree without injury, let’s move our holiday eye safety talk to the toys. We want to spend the holiday happily exchanging gifts in front of a warm fire, drinking some eggnog, and snacking on cookies--not going to the emergency room with an injury. The Consumer Product Safety Commission reported there were 254,200 toy-related emergency room visits in 2015, with 45% of those being injuries to the head and face--including the eyes. In general, here are the recommendations from the American Academy of Ophthalmology in choosing eye-safe toys for gifts: “Avoid purchasing toys with sharp, protruding or projectile parts." “Make sure children have appropriate supervision when playing with potentially hazardous toys or games that could cause an eye injury." “Ensure that laser product labels include a statement that the device complies with 21 CFR (the Code of Federal Regulations) Subchapter J." “Along with sports equipment, give children the appropriate protective eyewear with polycarbonate lenses. Check with your eye doctor to learn about protective gear recommended for your child's sport." “Check labels for age recommendations and be sure to select gifts that are appropriate for a child's age and maturity." “Keep toys that are made for older children away from younger children." “If your child experiences an eye injury from a toy, seek immediate medical attention.” More specifically, there is a yearly list of the most dangerous toys of the season put out by the people at W.A.T.C.H. (world against toys causing harm). Here are types of toys to avoid: Guns that shoot ANY type of projectile. This includes toy guns that shoot lightweight, cushy darts. Water balloon launchers and water guns. Water balloons fired from a launcher can easily hit the eye with enough force to cause a serious eye injury. Water guns that generate a forceful stream of water can also cause significant injury, especially when shot from close range. Aerosol string. If it hits the eye it can cause chemical conjunctivitis, a painful irritation of the eye. Toy fishing poles. It is easy to poke the eyes of nearby children. Laser pointers and bright flashlights. The laser or other bright lights, if shined in the eyes for a long enough time, can cause permanent retinal damage. There are plenty of great toys and games out there that pose much lower risk of injury so choose wisely, practice good Christmas eye safety, and have a great holiday season! Article contributed by Dr. Brian Wnorowski, M.D.

Published: 13 November 2023

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 from. In Europe, since they use the metric system, it is based on meters. The 20/20 equivalent is 6/6 because they use a 6-meter test distance. The second number is the smallest line of letters that a patient can read. In other words, 20/20 vision means that at a 20-foot test distance, the person can read the 20/20 line of letters. The technical definition of 20/20 is full of scientific jargon - concepts such as minutes of arc, subtended angles, and optotype size. If you’d like to read more of the technical details there is a well-written article with illustrations by Dr. John Ellman, you can find here. For the purposes of our discussion here I’ll try to explain it in less technical terms. “Normal” vision is somewhat arbitrarily set as 20/20 (some people can see better than that). Let’s say you have two people: Person A with 20/20 vision and Person B with 20/40 vision. The smallest line of letters that person B can see at 20 feet is the 20/40 line. Person A, with “normal” 20/20 vision, could stand 40 feet away from that same line and see it. There is somewhat of a linear relationship in that the 20/40 letters are twice the size of the 20/20 letters and someone with normal vision could see a 20/40 letter at twice the distance as the person with 20/40 vision. So how does this translate to a glasses prescription? Eye doctors can often estimate what your uncorrected VA will be based on your glasses prescription. This works mainly for near-sightedness. Essentially, every quarter step of increasing glasses prescription (i.e. -1.25 as compared to -1.50) means a person can see one less line on a VA chart. A prescription of - 1.25 works out to roughly 20/50 vision, -1.50 to 20/60 and so on. Anybody with an anatomically sound eyeball, meaning the absence of any kind of disease process, should generally be correctable to 20/20 with glasses or contact lenses. It is important to note, however, that rarely a person’s best corrected VA may be less than 20/20 with no noticeable signs of disease. Far-sightedness is more difficult to estimate because it is affected by a number of other factors, including one’s age and focusing ability. But that’s a topic for another article. So there you have it! Hopefully this has shed some light on what these measurements that we take actually mean, and it has allowed you to understand your eye health a little bit better. Article contributed by Dr. Jonathan Gerard