March Is Save Your Vision Month

In December 1996 I was entering my final year at BYU.  I was the BYU Optometry Club president and I had the opportunity to interview at Southern California College of Optometry (SCCO) over the Christmas break.  It just so happened that I was flying in from Florida after meeting my fiancé’s parents for the first time.  Needless to say, life was happening.  It was an exciting time and things looked bright.

The in-person interview process at SCCO had three stages.  First, I had to write two essays within a given time on topics that I drew out of a hat.  Second, I was invited to meet with three faculty and an upper class student who grilled me with questions.  Lastly, I was invited to tour the campus with the student.

During the question and answer session one of the faculty asked what appeared to me the simplest of questions:  What’s the difference between an ophthalmologist, optometrist and optician?  My answer was straight forward.  Ophthalmologists perform eye surgery, optometrists perform eye exams and opticians provide the eyewear.  Little did I realize how distinct each of these professions are and yet how much we have in common and truly overlap in our overall eye care efforts.

As health care professionals, each of us has a specific role we play in caring for our patients’ eye health and wellness, and we coordinate care with one another in providing appropriate and timely treatment for each of our patients.  When one professional needs assistance, we refer to the other who specializes in that area of expertise.

For instance, I prefer to be in my exam lane providing comprehensive eye exams, yet I also provide eyeglasses following the exam.  We’ve hired an ABO certified optician who specializes in helping patients select frames that best match their facial features, determine lenses based on lifestyle needs, and adjust and dispense eyeglasses.  She also repairs frames as occasion requires.  In other offices, the optician may even fabricate the lenses to fit the frames.  We order ours from a lab that specializes in this.

For another example, as an optometrist, I see people who have cataracts.  As long as their vision and lifestyle are not impaired I’ll continue to monitor yearly.  When the cataract progresses and vision blurs without sufficient improvement from glasses or contacts, I then refer to an ophthalmologist who determines if it is time to perform cataract surgery.  Following the cataract surgery, I’ll see the patient back for follow-up visits and glasses, and continue their annual eye health evaluations.  On the flip side, the ophthalmologist may be following a patient due to a specific eye condition and when it comes time to help with vision, the ophthalmologist refers the patient to my office for eyeglasses.

Another area of referral most people don’t consider is the referral by the optometrist to the patient’s primary care physician to be evaluated for diabetes, high blood pressure and other systemic conditions.

As I’ve related these various examples that each of these eye care professionals participate in, one common theme permeates through them:  doctors of optometry are the primary eye care provider.  We act as the gate keeper in many situations in helping patients receive the eye care they need.   We examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.  When it’s time to refer for surgery or more specialized treatment, we coordinate care.  We see patients of all ages.

Healthy eyes and clear vision are important to everybody.  For the child, vision is responsible for 80% of all learning.  For the adult in the work force, comfortable vision on the computer can improve productivity and clear distance vision can improve safety.  For seniors, age related eye conditions become more of a concern as they try to maintain quality vision.

Comfortable, clear and healthy vision is important indoors and out of doors for work, relaxation and recreation.  As an optometrist, that’s what I do.  I help people see clearly and comfortably.  It’s my job to detect early changes in eye health and help maintain healthy vision throughout life.  Yearly exams can detect vision problems that, if caught early, can be treated.  Yearly exams can fine-tune glasses and contact lens prescriptions maintaining the crisp, clear image people like seeing.

We often take our vision for granted until something goes wrong.  This month as you go about your day- to-day activities, take time to appreciate your vision and consider how healthy your vision may be.  You may have noticed lately that you’re having a harder time reading.  Perhaps, you get tired more easily as you read or work on the computer. You may have noticed that you’re having just a little more difficulty seeing at night or detail at far just isn’t as crisp as it has been in the past.  Perhaps you’ve been distracted by glare as you drive to or from work.  Or, perhaps your eyes frequently itch or feel gritty and dry.

If any of these things are bothersome or you’re noticing changes call and schedule an eye exam.  If it’s been more than a year, let’s get you in for a comprehensive evaluation so that we can look at your eye health as well.  Remember, healthy vision is more than 20/20 vision.

Dr. Joseph Fife, O.D.
Paradise Canyon Eye Care

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February Is AMD (Age-Related Macular Degeneration) & Low Vision Awareness Month

I recently received a visit from Milo Waddoups, a vocational rehabilitation counselor with the Division of Services for the Blind and Visually Impaired, who coordinates low vision rehabilitation here in St. George.

He was escorted by Troy Stoddard, a counselor at the main office in SLC.  Having only been in practice here for the past two years, I was previously unaware that this program existed.  My background, however, lends itself to recognizing the benefits that this program provides here in our community.

During my fourth year in optometry school, I was given the opportunity to rotate through various modes of practice. For instance, I spent some time in a private practice setting seeing patients under the direct supervision of the private practice optometrist.  I also spent some time working at Camp Pendleton, doing eye exams for our military personnel.

For another rotation, I worked at the VA clinic in downtown Los Angeles and for another I worked at the Los Angeles Veterans Administration Hospital.  In each of these last two facilities I had the opportunity to care for the eyes of our veterans and I gained a great deal of knowledge with respect to the eye diseases that affect this population.

One of my favorite rotations, however, was when I spent three months at the Center for the Partially Sighted in Los Angeles, a nationally and world renowned Low Vision Center.  The mission of the Center for the Partially Sighted is to promote independent living for people of all ages with impaired sight.  At this center patients could receive optometric care (which I helped provide), counseling and support groups, rehabilitation training and specialized services and devices to help them in their specific needs such as Books on Tape or magnifying devices.

Support programs geared toward specific eye diseases such as diabetes or macular degeneration were also available to help people understand and better adapt to their own individual needs teaching them what to do to take better care of their eyes and overall health.

It was an enlightening experience to first of all recognize that despite all my efforts, people still go blind and second, when blindness does happen know that there are programs in place to help these individuals learn how to develop and maintain independent living skills.

What a delight to learn that a Low Vision center exists right here in St. George with the capacity to send people to SLC for further training at no cost to the participants.  Not only that, but the center in SLC is as fully functional as the one I worked at in Los Angeles.

The mission of the Division of Services for the Blind and Visually Impaired is to assist individuals in achieving maximum levels of independence and, whenever possible, developing goals toward competitive employment.  That means they not only provide visually impaired individuals with counseling and training to learn how to orient themselves and function in the world around them, but they also provide them with the training needed to gain employment and in some cases pay for schooling.

Remember, I am here to help people achieve their best vision and try to prevent long term vision loss due to preventable eye diseases, but when vision loss does occur, I will help coordinate care for low vision services.

Our community is greatly enriched with the services that the Division of Services for the Blind and Visually Impaired provides.  If you have any questions regarding these services, don’t hesitate to call our office and we can schedule an evaluation and, if necessary, put you in touch with Milo.

Dr. Joseph Fife, O.D.
Paradise Canyon Eye Care

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Offering True Value and Understanding Your Insurance

Happy New Year!  2011 promises to be an exciting year for our office.  We are in our third year since opening our doors and we have a lot to offer our patients and are excited for the growth that we will experience.  Having spoken with other optometrists who have opened cold, each of them have shared with me that it was in the third year of being in practice when their practice started taking off.  The fact that we are still in business despite opening our doors right at the beginning of the economic downturn, speaks volumes about our office and our patients’ willingness to refer their friends and family to our office.  Thank you one and all.

As I consider the reasons we receive so many referrals, I believe it is due to our commitment to provide a tailored experience, quality products and excellent service to each and every person who enters our office.  As an example, we recently had a prior patient return for her annual contact lens and glasses exam.  She explained that she had no insurance and was willing to pay cash for the examination and products.  During the course of the evaluation we discussed some findings that would require further testing.  She was very comfortable waiting until next year’s exam rather than this year due to financial constraints.  Recognizing that she was not aware of all of her options, I explained that her medical insurance would cover these additional tests.   She was still pretty certain her health insurance wouldn’t cover it so I had my office staff contact her insurance company and ask them directly.  Sure enough, her health insurance covered it.  She just needed to pay her co-pay and any unmet deductible.  She was pleased to learn this.  During the process of waiting on hold with her insurance company, my staff noticed a vision plan logo on the back of her health insurance card and asked her if she was aware that she had vision coverage.  She was certain she had none.  My staff checked it out online and learned that she actually had very good vision coverage with an exam co-pay of only $5.  She was elated.  She left our office paying much less after learning that she had vision benefits she was previously unaware of, her health insurance covered her medical eye care and she received a large rebate for ordering a one year supply of contacts.  The amazing thing is that this is not the first time this has occurred in our office!

Many people are unaware that they have vision plan coverage.  Another individual had gone to a retail store the past few years and paid out of pocket.  They finally got fed up with the quality of product they received and decided to come to our office this past year and were willing to pay out of pocket again.  Similarly, just by checking, we learned that they also had vision coverage of which they were unaware and which the retail practice failed to inform them.

Other people are unaware that their health insurance will cover medical eye conditions such as pink eye, eye allergies and dry eye as well as more concerning eye problems such as cataracts and glaucoma.

We recognize that health care can be expensive so we’ve created ways to save on your eyeglass purchases.  For each person you refer to our office, who has an eye exam, we offer additional savings of $20 off your next purchase.  This can add up.  We had one family who brought in their entire family and only paid $7 for a complete pair of glasses for one of their children.  The savings is real!

We even recently changed our soft contact lens fees for returning patients.  If there has been no change in the type of soft contact lenses worn and the prescription hasn’t changed we charge a reduced fee for the contact lens evaluation.  We want to treat you like we want to be treated.  It’s that simple.

If you are wondering about your vision plan coverage or unsure if your health insurance includes vision coverage, give us a call at 435-656-2003.  We can help explain and simplify your benefits to your understanding.  If you truly don’t have vision coverage, we are still reasonably priced.  And if your eyes are dry, itchy, red or watery come in for a medical eye evaluation so you can find relief.  Remember, health insurance plans cover medical eye conditions.  As you set your goals for 2011 make sure you include ‘Eye Exam’ on your list to check off as ‘done’.  Healthy vision will improve your day-to-day life.

From all of us at Paradise Canyon Eye Care, we hope you have a wonderful and exciting New Year!

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Patients Are Listening, But Do They Hear What You’re Saying?

As many of you know, I donate many of my hours educating the community about the importance of eye health.  I have given various presentations to my networking groups and to my rotary club, Red Rock Rotary.  I’ve presented to the school nurses, to the elementary schools’ staff and faculty and I have done fun presentations with students from 3rd to 6th grades about the eyes and the importance of taking care of them.  I have also done several presentations to Senior Citizens groups including speaking at Sun River, Foremaster Auditorium by the hospital and the Senior Companions at the Five County Association of Governments building on Dixie Drive.  In my estimation, some of the most important educating I have done is in the exam lane…one on one.

I often hear my patients commenting that the exam they had in my office is the most thorough eye exam they have ever had.  In many ways, I feel it is due to the educational process that is occurring as they progress through the exam so that by the time the exam is complete they better understand their own eyes.

However, I recently read an article calling into question how much our patients are actually hearing what we are saying despite the fact that they are actively and conscientiously listening.

The topic dealt with patients who wear 2-week replacement contact lenses.  According to a study, this group of contact lens wearers were least likely to adhere to this recommended replacement schedule as compared to patients who wear 1-day disposable or even 1-month replacement lenses.

The question posed by the researchers was ‘why’?  The benefits of frequent contact lens replacement – fewer deposits, fewer complications and improved lens performance – are well-documented. What they found through patient surveys was that a significant gap existed “between what was recommended and what patients thought was recommended”.

Insightfully, when researchers asked noncompliant patients directly why they wore their lenses longer than recommended, the number one reason among 2-week and 1-month lens wearers was that they forgot which day they were supposed to replace them.

Compliance is generally considered to be important for continued success in contact lens wear.  So, how can I as a practitioner help my patients be more compliant so they can continue to enjoy wearing contact lenses long term?  Previously, I believed it was all about educating the patient because an educated patient is more likely to make correct decisions. I still believe that this is the first step, but patients make their own decisions – some of which are counterproductive to wearing contact lenses despite their desires to wear them.

In the same survey it was found that patients wearing daily disposable lenses were most compliant, and this modality has been shown to eliminate many of the overwear complications associated with “stretching” a lens. Even switching to a monthly lens may improve compliance somewhat over the 2-week modality.

This is just one topic in which what is discussed in the exam lane does not necessarily equate to what is done in real, everyday life.  Nutrition is another of these, but that is for another newsletter.

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Sunwear for the Active Lifestyle

We all understand the importance of applying sunscreen before spending the day in the sun.  And if we don’t, we pay the price with a painful, tender sunburn and future risk of skin cancer.  What about the eyes?  Although the eyes may not get sunburned (though this is a real possibility) they too need sun protection.  Sunglasses do for the eyes what sunscreen does for the skin.   Many people are completely unaware of the damage they are causing to their eyes by not wearing proper sun protection or worse, wearing sunglasses that don’t provide proper sun protection.  I have identified six areas that people should consider in purchasing sunglasses.

  1. Optics – Have you ever compared the optics of a cheap pair of sunglasses to a quality pair?  Not only can the cheap, stamped out lenses result in distortions and aberrations causing blurred vision and image warpage, they can induce incorrect prescription resulting in headaches when worn.  Quality lenses such as from Maui Jim can actually improve the clarity verses not wearing sunglasses at all.  Quality lenses are distortion free.  If they also happen to be polarized, they will knock out offending glare reflecting from surfaces such as water, snow, windshields of other vehicles improving the overall visual comfort.
  1. Lens Material – If your sunglasses have a prescription in it they are typically made from CR39, polycarbonate or even hi-index plastic.  High quality nonprescription sunglasses have the same or similar materials.  Cheap sunglasses are stamped out of a sheet of tinted plastic.  Polycarbonate and hi-index materials automatically block out ultraviolet light.  It’s part of the lens material itself.  Other materials must have UV protection added on.  The methods used to do this vary and not all methods result in long term UV protection.  Consider the significance of a dark lens with little or no UV protection:  it can actually cause more damage from the sun than wearing no sunglass at all.  Why?  Because a dark lens will cause your pupils to open up wider allowing more UV light into the eye.  Just because the sunglass blocks out visible light, does not mean it blocks out UV light.
  1. Frame material – Have you ever left a pair of glasses baking in the car in the middle of a hot summer?  Cheap frame materials are more likely to soften and lose their shape when exposed to warmth and are difficult to reshape correctly.  They also become brittle over time and are not easily adjustable.  Quality frames are more likely to retain their shape and if they do need adjusting can be reheated without melting.  This gives them longer durability.  Nike uses magnesium temples in some of their frames that don’t heat up and remain cool while you wear them.  Nike has also used light weight materials for improved running comfort.
  1. Nose pads – There is some personal preference when it comes to having nose pads or not.  Nose pads, however, are created for a reason.  They allow adjustments to be made to improve comfort and to position the lenses properly over the eyes.  Nike has created a fenestrated nose pad that allows better ventilation to help prevent fogging of the lenses when running.
  1. Price – I understand trying to stretch your dollar to get the most value for the buck.  When you are looking strictly at price it’s hard to pay more when you perceive no difference in quality.  Make no mistake about it, there is a wide range in quality between name brand and the $10-$15 knock off sunglasses.  Name brands have to maintain quality to keep their customer base.  They have an image to uphold.  Is there any difference to quality sunglasses such as Nike or Maui Jim compared to a $10-$15 pair purchased at a discount store or even some optical retail stores?  Absolutely!  Quality equals comfort, clarity, less fatigue and healthy eyes!
  1. Performance – What are the sunglasses’ intended use?  Are they for running, golfing, skiing, tennis, pickleball, driving, fishing, hunting, or purely just for fashion and all around use?  There are three main categories of sunglasses:  Tint, Transition and Polarized.  Each has its place depending on its purpose.  Do you want to see the lay of the green when you golf?  Do you want your everyday glasses to transition to dark and then clear up when you go inside?  Do you want to eliminate offending glare to see into the water when you fish?  We can help you determine which selection to make based upon their intended purpose.

One last thing:  Why do parents buy quality sunglasses for themselves and not for their children?  Is it because they are afraid the child will not take care of their sunglasses?   Possibly.  What they don’t understand is that 80% of UV damage occurs before the age of 18, the effects of which are not felt for years to come like skin cancer when not using sunscreen.

We have decided to carry Baby Banz which has created a quality sunglass for infants and children that are polycarbonate and polarized which means they are break resistant and eliminate 100% of reflectant glare, and they are reasonably priced.  They make a great gift for birthdays and holidays!

We have a wide variety of quality sunglasses for all ages to choose from in our optical showroom.  We invite you to stop by and check out our selection.

We have sunglasses for every activity

· Maui Jim polarized bifocal sunglass for fishing and all-around use

· Drivewear, a transitional sunglass that changes in varying outdoor lighting conditions

· Transitions SOLFX Sunwear for golfers

· Nike Sunglasses designed for runners and active adults

· Coach and FENDI fashion sunglasses

· Kidz & Baby Banz for children

· And many, many more!!!

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