Published: 28 August 2023

Despite requests that patients bring their current glasses to their office visit, many show up without them. Sometimes it’s an oversight: “I was rushing to get here and forgot them”; “I left them in the car”; “I picked up my wife’s glasses instead of mine by mistake.” Doctors have heard them all. Sometimes it is unavoidable: “I lost them”; “They were stolen”; “I ran them over with the car”; “I left them on the roof of the car and drove away and now they are gone.” Frequently, however, it’s intentional. There is a perception by some people that if they don’t like their current glasses or feel like they are not working well for them that they are better off having their eye doctor start from scratch. “Why would I want the doctor to utilize a pair of glasses I’m not happy with as a basis or starting point for my next pair of glasses?” But bringing your glasses to an appointment is important. There are two main reasons for eye care professionals to know what your last pair of glasses were. The first is to see what type of glasses they are and how you see out of them. Are they just distance? Just reading? A bifocal? A trifocal? A progressive? Even if you feel they aren’t working for you, it is essential for doctors to know the type of lens you had previously. It is also important to know how you see out of them and what the previous prescription was. This can help eye care professionals determine a new prescription that will work better for you. The second reason doctors like to know what was in your last pair of glasses is that the majority of people who wear eyeglasses have some degree of astigmatism in their eyeglass prescription. A significant change in either the amount or axis of the astigmatism correction from one pair of glasses to the next is often not tolerated well, especially in adults. If there is too much change from the previous prescription, many people experience a pulling sensation in their eyes when they wear the new glasses. It can cause symptoms of eye strain, headaches, and distortion, making flat objects like a table look like they are slanted. Many of the problems that occur when we try to give someone a new eyeglass prescription could be avoided if doctors knew the last prescription and how you did with it. Anytime you are going to the eye doctor, it is essential to bring your most current pair of glasses with you to the exam--whether you love them or hate them! Article contributed by Dr. Brian Wnorowski, M.D.

Published: 31 July 2023

The Background Over the last several years, research has indicated a strong correlation between the presence of Obstructive Sleep Apnea (OSA) and glaucoma. Information from some of these pivotal studies is presented below. Did you know Glaucoma affects over 60 million people worldwide and almost 3 million people in the U.S. There are many people who have glaucoma but have not yet had it diagnosed. Glaucoma is a leading cause of blindness in the United States. If glaucoma is not detected and goes untreated, it can result in peripheral vision loss and eventual, irreversible blindness. Sleep apnea is a condition that obstructs breathing during sleep. It affects 100 million people around the globe and around 25 million people in the U.S. A blocked airway can cause loud snoring, gasping or choking because breathing stops for up to two minutes. Poor sleep due to sleep apnea results in morning headaches and chronic daytime sleepiness. The Studies In January 2016, a meta-analysis by Liu et. al., reviewed studies that collectively encompassed 2,288,701 individuals over six studies. Review of the data showed that if an individual has OSA there is an increased risk of glaucoma that ranged anywhere from 21% to 450% depending on the study. Later in 2016, a study by Shinmei et al. measured the intraocular pressure in subjects with OSA while they slept and had episodes of apnea. Somewhat surprisingly they found that when the subjects were demonstrating apnea during sleep, their eye pressures were actually lower during those events than when the events were not happening. This does not mean there is no correlation between sleep apnea and glaucoma - it just means that an increase in intraocular pressure is not the causal reason for this link. It is much more likely that the correlation is caused by a decrease in the oxygenation level (which happens when you stop breathing) in and around the optic nerve. In September of 2016, Chaitanya et al. produced an exhaustive review of all the studies done to date regarding a connection between obstructive sleep apnea and glaucoma and came to a similar conclusion. The risk for glaucoma in someone with sleep apnea could be as high as 10 times normal. They also concluded that the mechanism of that increased risk is most likely hypoxia – or oxygen deficiency - to the optic nerve. The Conclusion There seems to be a definite correlation of having obstructive sleep apnea and a significantly increased risk of getting glaucoma. That risk could be as high as 10 times the normal rate. It's highly recommended that if you have been diagnosed with obstructive sleep apnea that you have have a comprehensive eye exam in order to detect your potential risk for glaucoma. Article contributed by Dr. Brian Wnorowski, M.D.