Do We Need Specific Eyewear For Specific Vision Conditions?

TRANSCRIPT

0:05

Glasses are just something we wear on our face to make the world less blurry. Sounds right, doesn't it? Well, guess what?

0:13

13 seconds

It's not that simple. Sure. Glasses help to see clearly, but they can also do much more.

0:19

19 seconds

Did you know, for example, that the right pair of glasses can actually help with migraines, stop double vision, and even make you more productive if you are looking at a screen all day.

0:31

31 seconds

Today, we're going to explore the amazing potential of So joining me is Paul Graham, lead optometrist and owner of Harmony Vision Clinic on the Gold Coast.

0:46

46 seconds

Paul knows the ins and outs of how glasses can do more than just sharpen your vision. They can improve your whole quality of life.

0:54

54 seconds

So, if you've ever wondered if the right pair of glasses could do more for you, you're in the right place. But first, who am I? My name is Paul Sallaway.

1:01

1 minute, 1 second

I'm the owner of Optics Digital Marketing, an agency that helps independent optometrists to grow their practice. So, hi, Paul. Good to see you again.

1:09

1 minute, 9 seconds

Likewise, Paul. Happy New Year. Yeah. Happy New Year. Another year's rolled around. Yes.

1:15

1 minute, 15 seconds

So I don't know about you, but, like, in my, YouTube feed, I get a lot of see a lot of videos about eye care and and eyewear.

1:23

1 minute, 23 seconds

I've noticed some recently that talk about, like, smart glasses, you know, like, I think, Meta Meta and and Ray Bans.

1:31

1 minute, 31 seconds

That's right.

1:31

1 minute, 31 seconds

They've got some smart glasses with cameras and whatever, and there are others coming out now. They've got, like, AI assistants and a lot of this type of stuff.

1:39

1 minute, 39 seconds

So and it made me think that, you know, glasses these days are more than just solving, you know, prescription refraction issues.

1:46

1 minute, 46 seconds

They're even more they're even more than just protecting our eyes from UV rays.

1:51

1 minute, 51 seconds

So we actually, you know, use glasses for a whole lot more than that, and no doubt in your practice, you know, glasses are and lenses are an important tool in in what you do.

2:02

2 minutes, 2 seconds

So I thought that would make a a good topic for us today. Yep. Absolutely.

2:07

2 minutes, 7 seconds

And, obviously, when people think about sort of seeing the optometrist glasses are the first thing that come to mind.

2:12

2 minutes, 12 seconds

And and, you know, one of the things we'd like to talk about that, you know, good vision is more than just being able to see clearly.

2:19

2 minutes, 19 seconds

There are plenty of other things we can do with lenses and glasses that can can improve your quality of life, based on what you're presenting with.

2:29

2 minutes, 29 seconds

Excellent.

2:29

2 minutes, 29 seconds

So maybe the first one I'd like to talk about is lenses, glasses that help with migraines, a fairly common thing, unfortunately,

Chapter 2: Do Glasses Help Manage Migraine Attacks?

2:40

2 minutes, 40 seconds

and there are a lot of different triggers for it, and but, I believe light is is a very common one.

2:47

2 minutes, 47 seconds

So can you tell us about how migraines are related to vision and what type of lenses can help with that? Yeah. Look.

2:55

2 minutes, 55 seconds

And, certainly, there are a few different types of migraines, and what we look at are the ones where light flicker or light or brightness of light could be one of the triggers for a migraine.

3:04

3 minutes, 4 seconds

And the other side of it is that once you actually get a migraine, a lot of people become very light sensitive.

3:09

3 minutes, 9 seconds

So one of the common things you hear about when someone's having a migraine is that they need to go find a dark room to hide themselves away in to while it sort

3:19

3 minutes, 19 seconds

of passes because the, the light sensitivity they get during a migraine attack is is almost debilitating in many cases.

3:27

3 minutes, 27 seconds

And, you know, there's been some tense around for a long time.

3:31

3 minutes, 31 seconds

You know, the FL - 41 is probably the one that a lot of people sort of know about as a as a classic migraine assistance.

3:39

3 minutes, 39 seconds

And look, none of these are cures.

3:41

3 minutes, 41 seconds

The idea is that we're we're just trying to improve quality of life around migraine.

3:46

3 minutes, 46 seconds

More recently there's been one where Avulux is a specific type of tint that was,

3:53

3 minutes, 53 seconds

specifically targeted and researched to look into light sensitivity with, with and without migraine.

3:58

3 minutes, 58 seconds

And, they discovered that there are frequencies, light frequencies, or wavelengths on either end of the spectrum that are pain inducing. So there's some blue and there's some of the amber.

4:08

4 minutes, 8 seconds

And they also found that there are green wavelengths that actually reduce pain. And so they combine that together in a tint.

4:15

4 minutes, 15 seconds

And what they basically look at it it falls into 2 categories of uses.

4:20

4 minutes, 20 seconds

You get the people who know a migraine is coming and start wearing the tint in order to make sure that the migraine that follows is not as severe.

4:31

4 minutes, 31 seconds

So they can get on with the day. They can still be productive. They don't have to kind of lose a day or or more to recovering from a migraine.

4:40

4 minutes, 40 seconds

And then you get people who maybe know what certain light situations might trigger their migraines.

4:46

4 minutes, 46 seconds

They may use an Avulux tint in those kind of situations to try and avoid the migraine being triggered to begin with.

4:52

4 minutes, 52 seconds

And certainly people who get migraines very frequently, you know, 2 or 3 times a week, might choose to wear a tint if they find it useful to reduce the number of migraines and the severity that they get.

5:05

5 minutes, 5 seconds

And the challenging part of it is that, you know, this is something that we need to trial.

5:10

5 minutes, 10 seconds

Not everyone responds, but that's why we set up a trial sort of situation for the right patient who presents with migraine.

5:17

5 minutes, 17 seconds

We obviously also wanna, you know, so anyone who's got a new migraine needs to have a full health and vision check done just to ensure that it is a migraine and not symptoms or something that could be a bit more serious.

5:29

5 minutes, 29 seconds

But once you once you it's, you know, it's medically satisfied that it is migraine, then then there is some,

5:36

5 minutes, 36 seconds

an element of light sensitivity in leading up to it or during, then the Avulux makes a, a tool that, you know, some people find, beneficial in managing their symptoms.

5:48

5 minutes, 48 seconds

And those actually are lenses, they're available as prescription lenses as well, aren't they? Both. Yeah.

5:55

5 minutes, 55 seconds

So if we do a trial and we find someone, they find that the Avulux improves their symptoms, then they can get it as a fit over so

6:04

6 minutes, 4 seconds

that, you know, when an attack's coming or if there's a particular situation where they know that tint is beneficial, then they can get a a frame.

6:11

6 minutes, 11 seconds

This is not a fit over, but it you know, it's like they all fit over sunglasses that go over the top of your glasses.

6:16

6 minutes, 16 seconds

So it gives you some flexibility of having your prescription glasses on and then just buying the tint if you need it.

6:21

6 minutes, 21 seconds

For those people who like to work in their Avulux tint or find that they're wearing it a lot of the time, and so then we can make them up as an actual prescription with the tint in there.

6:33

6 minutes, 33 seconds

There's an Australian lab that has the distribution license and rights to make the Avulux tints in Australia.

6:40

6 minutes, 40 seconds

So you can put those lenses into somebody's existing frames if that's what they want then? Yeah.

6:46

6 minutes, 46 seconds

So it's a it's a whole new lens, which is not a tint that we can apply to existing lenses. They have to make the lenses from scratch.

6:54

6 minutes, 54 seconds

So when would you suggest, like, Avulux versus the FL - 41 lenses?

7:01

7 minutes, 1 second

Like, how would you make that decision about who's, you know, best suited for for each of those types? And that's the tricky part sometimes with colour.

7:10

7 minutes, 10 seconds

Sometimes, you know, someone may even benefit just from a simple grey lens, just reducing the overall amount of light that they're dealing with.

7:17

7 minutes, 17 seconds

Whereas others have to be, some people are very specific it appears in the colour of the tint that actually makes them more comfortable.

7:25

7 minutes, 25 seconds

And we can talk about it a bit more when we get into sort of pattern glare later on.

7:33

7 minutes, 33 seconds

I have probably more experience with the Avulux because it looked a little bit more comprehensive in what, like, wavelengths it was dealing with.

7:43

7 minutes, 43 seconds

And it's probably a, you know, just from a, you know, wearability point of view, it's a more neutral looking sort of tint. It's not quite so obvious.

7:52

7 minutes, 52 seconds

and we always sort of so we do a questionnaire on when someone gets their light sensitivity, how it sort of operates.

7:58

7 minutes, 58 seconds

And then if they look suitable, then we offer the trial.

8:02

8 minutes, 2 seconds

Certainly we can do some sort of chairside assessments because you get some people who are sensitive and you you put them on and they may immediately dislike that colour personally, and that's what we might look at.

8:14

8 minutes, 14 seconds

Or maybe an FL-41 tint of some sort might be more suitable. So it's the, the FL-41s are the rose tinted ones.

8:24

8 minutes, 24 seconds

The rose coloured. Yeah. Literally looking at the world through rose coloured glasses. That's right.

8:31

8 minutes, 31 seconds

So would like, are one of those types better for outdoor use than the other, or sort of like much and muchness, really? Much and muchness.

8:39

8 minutes, 39 seconds

I mean, I tend to think that the tint colour in the Avulux is a little bit more natural.

8:45

8 minutes, 45 seconds

So the one outside, some people who find a tint beneficial, still want something a little bit darker, so they might have a traditional pair of dark sunglasses for in that time.

8:55

8 minutes, 55 seconds

Again, some people don't like sensitive to even polarising. So this is some of the things you've got to kind of, find your way through.

9:03

9 minutes, 3 seconds

Yeah. Alright. Interesting. Okay.

Chapter 3: How Does Occlusion Reduce Double Vision?

9:07

9 minutes, 7 seconds

Well, let's let's talk about, double vision and an approach that I understand you take, which is occlusion.

9:18

9 minutes, 18 seconds

Now I've heard about occlusion. I think that's similar to patching, isn't it? Yep. Exactly.

9:24

9 minutes, 24 seconds

Which, you know, might be something that, you know, traditionally we've done with kids when they have lazy eye, but maybe I think there's more to it than that.

9:34

9 minutes, 34 seconds

So can you tell us a little bit about occlusion and how you use that with with different types of eyewear, for example? Yeah.

9:40

9 minutes, 40 seconds

So we have one visual world that we perceive, but we've got 2 channels.

9:47

9 minutes, 47 seconds

And so our brain has learned how to integrate those 2 bits of information together, create this single perception of the world.

9:55

9 minutes, 55 seconds

And there are times where someone's ability to maintain, 2 eyes looking in the same place in space can be impacted on something congenital

10:05

10 minutes, 5 seconds

or one of the cases we're dealing with after an injury, a brain injury of some sort where a muscle movement gets restricted, either through the nerve damage or the muscle itself being damaged.

10:16

10 minutes, 16 seconds

In which case that might be that they they have single vision looking straight ahead.

10:20

10 minutes, 20 seconds

But as soon as they look to the side, they start to get vision or looking up, or they may you get some, very different and and sort of fascinating restrictions in eye movements from brain injury.

10:32

10 minutes, 32 seconds

And we see it from anything from a traumatic brain injury to post surgical kind of things.

10:36

10 minutes, 36 seconds

And you might have someone who's got full movement of one eye, but the other eye can't move up and down. So it creates diplopia or double vision in different environments.

10:45

10 minutes, 45 seconds

And one of the classic ways of managing diplopia in someone who's had a brain injury is to simply just patch the whole eye.

10:52

10 minutes, 52 seconds

And in, in some cases, some people's double vision is temporary.

10:56

10 minutes, 56 seconds

So that's, you know, maybe a satisfactory thing if they recover within a few days or a few weeks, they're able to take away and they go back to their regular single view of the world.

11:05

11 minutes, 5 seconds

But for someone who's got more long term double vision, particularly if it's in one field, you're you're sort of blocking this entire field of one eye when you could be more selectively occluding part of it.

11:18

11 minutes, 18 seconds

So we might find that if you were, you know, moving your eyes out to one side and you're starting to get double vision, we might simply just block the view of one eye on that side.

11:28

11 minutes, 28 seconds

So you still got the per view peripheral vision out here, but you've blocked the the central double vision part.

11:33

11 minutes, 33 seconds

And so they're able to learn how to just simply switch and and and get used to having that occlusion there.

11:40

11 minutes, 40 seconds

And because it's so close, they, the the relief that you get from not having double vision in that field, then you, can be quite remarkable, actually.

11:51

11 minutes, 51 seconds

Because your visual system's designed for moving through the environment.

11:55

11 minutes, 55 seconds

You know, you get some people where they might get double vision when they look down, as an example.

11:59

11 minutes, 59 seconds

And if you can sort of block out one eye in the lower field, they've no longer got double vision. They can be a lot more sure of themselves when they're walking around.

12:07

12 minutes, 7 seconds

And that's obviously pretty important as we're discussing with elderly parents and folks. Yeah. You know, that's a very important consideration.

12:15

12 minutes, 15 seconds

But it's also freedom too. They're not restricted. They're not having to have someone hold their hand everywhere. So, it can be quite life changing.

12:22

12 minutes, 22 seconds

But it is one of those things that you bring on your skills and experience to basically, you know, you work with the patient

12:30

12 minutes, 30 seconds

to explore what things you can be doing for their specific presentation because everyone presents very differently with double vision, diplopia,

12:39

12 minutes, 39 seconds

again, particularly when we're talking about muscle restrictions from accidents, disease, and things like that.

12:45

12 minutes, 45 seconds

So if I understand this correctly, so you're actually, like, adjusting parts of the lenses to to occlude or to block out vision.

12:54

12 minutes, 54 seconds

So it's not like the whole lens where it's just a section of a lens. Is that right? Yeah. So the idea is that you're just doing a section of it.

13:01

13 minutes, 1 second

So to avoid blocking that whole field unnecessarily, you might block just a part of it using and we start with just using frosted tape.

13:09

13 minutes, 9 seconds

It's really low tech kind of stuff.

13:11

13 minutes, 11 seconds

And find a portion that what we're really looking for is trying to give us the biggest visual field.

13:19

13 minutes, 19 seconds

You know, I use what's the smallest amount of occlusion that maintains the biggest field and tries to drop the double vision as much as possible?

13:30

13 minutes, 30 seconds

So, like, are there any maybe, like, less obvious ways to do that occlusion with a lens?

13:38

13 minutes, 38 seconds

Like, you know, if you if you're walking around everywhere with some tape on your on your lenses, and it might be quite obvious.

13:45

13 minutes, 45 seconds

Sometimes it's a matter of moving the tape to the back of the lens, and that might be a situation where we don't use an anti-reflection coating lens.

13:52

13 minutes, 52 seconds

So the white reflections off the front of the lens tend to hide the occlusion.

13:57

13 minutes, 57 seconds

If it's really bothersome, we can use a more expensive kind of specific foil or filter, that degrades the image,

14:04

14 minutes, 4 seconds

allows light through, but degrades the image enough that the brain can suppress that second image and ignore it.

14:11

14 minutes, 11 seconds

To be honest, a lot of the people that were using this on, the relief they get from being able to have more freedom, visual freedom,

14:19

14 minutes, 19 seconds

they often, they don't care what it looks like because they're at a situation where they've been battling. You know, some significant changes in their lifestyle.

14:28

14 minutes, 28 seconds

So they're quite happy to have the film there. Let's talk about anti-fatigue lenses now.

Chapter 4: How Do Anti-Fatigue Lenses Reduce Eye-Strain?

14:35

14 minutes, 35 seconds

So we hear a lot about eye strain these days, digital eye strain. You know, we're all spending more time on computers and looking at digital devices.

14:44

14 minutes, 44 seconds

So I've heard some people describe anti-fatigue lenses as being like reading glasses for younger people.

14:53

14 minutes, 53 seconds

Tell us a little bit about what they are and and, you know, how you recommend them to patients.

14:58

14 minutes, 58 seconds

The idea of prescribing a little bit of extra assistance at near is not new, and we can call them a reading addition or a near add.

15:06

15 minutes, 6 seconds

Anti-fatigue, is a way of helping people understand that near work is not something they're designed to do for a long period of time.

15:14

15 minutes, 14 seconds

You know, we've got a I think a little bit of a soapbox of mine.

15:18

15 minutes, 18 seconds

We've got this incredibly sophisticated, you know, visual system designed to help us move through a three-dimensional world with two eyes, and we sit still looking at two dimensional things instead as part of modern life.

15:32

15 minutes, 32 seconds

And so much like other parts of our muscle musculature, you know, our skeletal system fatigues, visual system is no different.

15:39

15 minutes, 39 seconds

So and if and as I like to talk to patients that, you know, your eyes are organs.

15:45

15 minutes, 45 seconds

Because, you know, the fear is that people worry, "Oh, do you make the eyes weak by providing some assistance?" And it's like, well, fatigue is overwork.

15:52

15 minutes, 52 seconds

Organs work all the time. Eyes are organs, and it's overuse that creates the problem.

15:58

15 minutes, 58 seconds

And, you know, it's in a bit of an individual difference based on the way you go about doing your near work, how much intensity do you use, the sort of the tasks.

16:08

16 minutes, 8 seconds

But generally, if you spend a long time doing near work, you do start to get eye strain symptoms.

16:15

16 minutes, 15 seconds

And I've forgotten the exact numbers in the research, but we're talking the majority of people if they do, you know, a reasonable bit of, device use or computer work, get some sort of eye strain.

16:25

16 minutes, 25 seconds

And so it's a it's a modern twist on a modern problem.

16:29

16 minutes, 29 seconds

You know, back before devices and computers, it was the people who read a lot who tended to get eye strain.

16:36

16 minutes, 36 seconds

And I only had a gentleman in the other day who, you know, he's a tradesman, and and he's now, you know, got a promotion.

16:43

16 minutes, 43 seconds

He's a supervisor, and he's a manager now, and he's in the office, and he's getting eye strain, you know, because he's the way he works has changed.

16:52

16 minutes, 52 seconds

And so the idea of an anti-fatigue lens is that they show that with fatigue and eye strain, you start to get fluctuations in your focusing.

16:59

16 minutes, 59 seconds

And that's linked with what we loosely call, which is a group of symptoms called asthenopia, which could be headaches, eye strain, loss of concentration, those sorts of things.

17:09

17 minutes, 9 seconds

And the idea of an anti-fatigue is its way of providing you with some relief. Take away a little bit of the effort up close.

17:14

17 minutes, 14 seconds

I like to call them an ergonomic device, much like having an ergonomic chair or an ergonomic keyboard to keep you in good posture and keep you comfortable.

17:22

17 minutes, 22 seconds

And the specifics about an anti-fatigue is it allows you then to be able to see across the room while you're wearing it.

17:28

17 minutes, 28 seconds

So it provides that support at near, on your device or your iPad, and still be able to see whether you've got a prescription whether you need

17:35

17 minutes, 35 seconds

a prescription or not now further in you use whatever you normally use to see clearly further away.

17:41

17 minutes, 41 seconds

And I think there is a fair degree of confusion out there when it comes to anti-fatigue glasses.

17:49

17 minutes, 49 seconds

People talk about they need blue light glasses. Okay?

17:53

17 minutes, 53 seconds

It wasn't you know, we can talk about that like lenses that cut out particular type of light, blue light.

18:01

18 minutes, 1 second

And so anti-fatigue glasses are are not exactly that, are they? So there are some important differences there. Absolutely.

18:08

18 minutes, 8 seconds

And anti-fatigue lens is not just something you throw on too, and it is something that's prescribed and carefully thought about based on the results of your vision exam.

18:19

18 minutes, 19 seconds

And it is actually a prescription that we add into your lens when we make it. So it's a custom, you know, individualised approach.

18:27

18 minutes, 27 seconds

And then you've all lots of different coatings. So you've got plastic lenses, have a soft surface. So they're easier to scratch the glass. You don't wanna wear glass anymore because they break and they're heavy.

18:37

18 minutes, 37 seconds

So it's even harder. It's even hard to prescribe glass now. A lot of the labs just don't need supply. So we have this plastic with a hard coating.

18:45

18 minutes, 45 seconds

So think of it a bit like you're baked on two pack paint that they put on cars.

18:50

18 minutes, 50 seconds

It's quite tough, but it can still scratch, but it's still better than the underlying plastic that the lens is made from.

18:59

18 minutes, 59 seconds

And then so hard coats are fairly simple layer to reduce scratching.

19:02

19 minutes, 2 seconds

And then you get to get a thing called a multicoat, which is also called an anti-reflection coating. And they're actually quite sophisticated.

19:09

19 minutes, 9 seconds

They're very, very small thin layers and usually anywhere between 7 and 9 layers to create this effect where you're getting a hard

19:17

19 minutes, 17 seconds

coating, but it also reduces the amount of reflections of that white light off the front of the lens.

19:24

19 minutes, 24 seconds

And a version of that is also you can add in a filter for blue light.

19:28

19 minutes, 28 seconds

And so there's been a lot of noise made around the dangers of blue light for long term eye health. And we also there's evidence that blue light interrupts sleep patterns.

19:38

19 minutes, 38 seconds

And so, there is a place for blue coatings, but I think some of it, is a little exaggerated.

19:47

19 minutes, 47 seconds

There are many people who don't actually like the blue coating when you put it on their lenses. So, we're always careful to show people the difference. And some people absolutely love it. They like that little bit of yellowing.

19:55

19 minutes, 55 seconds

They find it comfortable because they might have a bit of light sensitivity.

19:59

19 minutes, 59 seconds

But that's very different again to the sort of fatigue that you get, which is, you know, a combination of muscles, your ciliary muscles getting tired over time while you do near work.

20:10

20 minutes, 10 seconds

So could you get a blue light filter added to your anti-fatigue lenses? So it's not like it's not a mutually exclusive thing.

20:18

20 minutes, 18 seconds

No. So you can have an anti-fatigue with a hard coat, with an anti-reflection coating, with tints, etcetera, and and likewise, you can put a blue coat on any optical lens. Yeah.

20:29

20 minutes, 29 seconds

And I've heard some people talk about computer glasses as well, so I don't know if they are, like, a, you know, an actual

20:38

20 minutes, 38 seconds

unique type of lens that's, you know, designed for looking at screens on arms ring arms length away or whether, you know, again, people are confusing computer glasses with anti-fatigue glasses.

20:48

20 minutes, 48 seconds

Well, away from the blue light again because. The blue light.

20:51

20 minutes, 51 seconds

You know, a lot of people buy blue light glasses for using the screen and using the computer.

20:55

20 minutes, 55 seconds

So, there are lots of different labels out there, and a lot of it's just to try and convey.

21:00

21 minutes

I'm sure some of it's marketing, of course, but a lot of it's to try and convey what they've done. So if you're advancing in years, like a few people that are close to home right now.

21:09

21 minutes, 9 seconds

Yeah, nobody I know.

21:11

21 minutes, 11 seconds

Maybe, even been interviewed on YouTube here, you start to lose your new vision and it becomes less and less flexible over time.

21:18

21 minutes, 18 seconds

And so, you know, you might have a pair of reading glasses that are suitable for both your reading distance here and have no problem with the computer screen.

21:27

21 minutes, 27 seconds

But as your flexibility deteriorates further, those lenses become for reading,

21:33

21 minutes, 33 seconds

become a lot less flexible in terms of their range that they're now here, but you can't use it for the computer screen.

21:39

21 minutes, 39 seconds

So we have to use you know, you can call them an enhanced reading lens or an extended focus lens.

21:46

21 minutes, 46 seconds

Loosely, they they call it occupational lenses because they're typically the type of lens.

21:50

21 minutes, 50 seconds

I like to call them an office lens, because typically what it does is it puts in the upper half of the lens, you know, around that sort of 60 to 80

22:00

22 minutes

centimetres away and provides a nice big broad area for you to be able to look at your screen and your desk, and then it'll have an additional bit

22:07

22 minutes, 7 seconds

of reading power down the bottom for things that are closer, like your keyboard, your phones, book work, those sorts of things.

22:13

22 minutes, 13 seconds

And so there's a whole different variety of those extended focused or office style lenses that are that are available.

22:20

22 minutes, 20 seconds

It's they have a good place because when people start wearing progressive lenses, sometimes that middle zone that they might wanna use for computers is a little small and restricted.

22:32

22 minutes, 32 seconds

And so, you know, if you do a lot of computer work, sometimes you just need to get something specifically for it. It's a bit like putting more pair of work boots on when you go to work.

22:39

22 minutes, 39 seconds

You know, it's you know, work boots are there for a reason. You can't wear sneakers at work and vice versa. So yeah. That's a good analogy.

22:47

22 minutes, 47 seconds

Alright.

22:48

22 minutes, 48 seconds

Well, if you're watching this and you found this content to be valuable so far, don't forget to hit the the like button because it really helps us out with the YouTube algorithm.

22:58

22 minutes, 58 seconds

And, also hit the subscribe button if you'd like to be notified when Paul releases more YouTube videos like this one.

23:07

23 minutes, 7 seconds

Alright. So, we've talked about, tints for migraines. We've talked about adjusting lenses for occlusion.

23:15

23 minutes, 15 seconds

We've talked about anti-fatigue lenses. Now what about pattern glare?

23:19

23 minutes, 19 seconds

Because this is something that I really wasn't aware of until I started talking to you about about this interview.

Chapter 5: What is Pattern Glare?

23:25

23 minutes, 25 seconds

So tell us more about what pattern glare is and how eyewear can address that kind of condition.

23:31

23 minutes, 31 seconds

So, there are there are a number of different conditions that can be considered under the banner of of some sort of cortical hypersensitivity

23:38

23 minutes, 38 seconds

where you, you sort of get a, almost a sensory overload migraine might fit in that category, tinnitus, which is the ringing in the ears kind of fits in that category.

23:48

23 minutes, 48 seconds

Visual snow is thought to be one of those sorts of things. And we've also got pattern glare.

23:53

23 minutes, 53 seconds

And so in the natural environment, we have these sort of multiple different patterns that are kind of chaotic is not the right word,

24:01

24 minutes, 1 second

but you don't get this kind of real regular pattern too often in the environment.

24:05

24 minutes, 5 seconds

And in artificial environment that we sort of tend to live in, we get these very strong patterns.

24:12

24 minutes, 12 seconds

So, you know, put the doors behind you or hats on my shirt, a lot more regular than what we see, in nature.

24:21

24 minutes, 21 seconds

And it happens that print on a page can be thought of like stripes.

24:27

24 minutes, 27 seconds

And it happens that the most common range of size of text is also

24:35

24 minutes, 35 seconds

equivalent to a pattern that's found to be quite triggering for some people in terms of discomfort.

24:41

24 minutes, 41 seconds

And my I like to go down little rabbit holes in the literature, and it's interesting to see lots of people talking about the same thing.

24:47

24 minutes, 47 seconds

And and so you have different names that have popped up in literature that can be called visual stress or visual discomfort, and pattern glare is another one.

24:56

24 minutes, 56 seconds

But they're all talking about essentially the same thing, that there's a certain, size of pattern that people find visually uncomfortable to look at, and they create similar symptoms to eye strain.

25:07

25 minutes, 7 seconds

And in extreme cases, some people can find the flicker when you're driving in the car, and you've got a line of trees, and you get that light flicker coming through.

25:16

25 minutes, 16 seconds

Some some people find that the fluoros, they find the flickering uncomfortable.

25:20

25 minutes, 20 seconds

If you think of the the grocery aisles, local supermarket, there's very strong lines from the shelves. Some people don't realise why they feel overwhelmed and uncomfortable.

25:30

25 minutes, 30 seconds

And so they're actually finding it's actually the stripes in the environment are quite triggering.

25:36

25 minutes, 36 seconds

And it was discovered a while ago by quite by accident probably 40, 50 years ago that some people find text a lot more comfortable to look at when they're looking through tint.

25:47

25 minutes, 47 seconds

And there's still a lot of conjecture around why.

25:51

25 minutes, 51 seconds

Unfortunately, tints were then linked with reading disabilities, and it's not about reading disability. It's about looking at text more comfortably.

25:59

25 minutes, 59 seconds

If you've got a severe pattern glare, then it can seem quite remarkable how much easier reading becomes that I can understand why it became a bit of a reading kind of cure in some circles.

26:12

26 minutes, 12 seconds

And what all it said was for that particular person, they never had a reading problem to begin with. They just had pattern glare. You have a remarkable change. Reading wasn't the issue.

26:20

26 minutes, 20 seconds

It was the pattern glare stopping you from being able to read it best.

26:23

26 minutes, 23 seconds

And there are pockets of research that demonstrate that people who suffer with visual discomfort or pattern glare do have similar accommodation or focusing problems to what we might describe a an anti-fatigue lens for.

26:35

26 minutes, 35 seconds

And so we might find that if someone's got a bit of pattern glare, we look after their binocular vision and their focusing and their accommodation well, than their sensitivity to pattern glare might drop off.

26:46

26 minutes, 46 seconds

And so they become a lot more comfortable.

26:48

26 minutes, 48 seconds

But there are a certain group of people who remain sensitive to those patterns and find them quite triggering and find that the only way they can get relief is by using a tint.

26:59

26 minutes, 59 seconds

So I have a fairly rigorous way of working people through that.

27:03

27 minutes, 3 seconds

So we're not just sort of prescribing tints willy nilly like some sort of cure.

27:09

27 minutes, 9 seconds

We use that pattern I showed you to sort of get a sense of are they in that pattern glare where sensitive kind of spectrum?

27:17

27 minutes, 17 seconds

Because if you show use a larger pattern, so like a big, grid like this.

27:23

27 minutes, 23 seconds

Or if you use a smaller pattern, a lot of people are a lot that sensitive to that even though that's harder to see. It's not as triggering.

27:30

27 minutes, 30 seconds

And so we've got a way of exploring and seeing who had is more likely to have that genuine kind of audible hypersensitivity patterns.

27:39

27 minutes, 39 seconds

And that's when we then might then explore, okay, what do we do?

27:41

27 minutes, 41 seconds

Are we just a matter of managing your focusing problems, or do we then need to explore a very specific tint?

27:47

27 minutes, 47 seconds

Some people can be very, very particular about the tint that settles the pattern glare down, whereas others might just need something sort of simple and grey to to take the edge off things.

27:58

27 minutes, 58 seconds

How how prevalent is this patent glare?

28:01

28 minutes, 1 second

Because it seems like something that might be, like, underdiagnosed in the community. So, like, what does the research suggest on that?

28:09

28 minutes, 9 seconds

Look, a lot of these things seem to fit.

28:12

28 minutes, 12 seconds

Right off the top of my head with pattern glare, I would think it would probably sit in that sort of less than 5%.

28:19

28 minutes, 19 seconds

Visual snow seems to sit in that category.

28:21

28 minutes, 21 seconds

A lot of visual conditions sit in those smaller categories, and I'm sure it's some I'm sure you were if you were to be able to get

28:29

28 minutes, 29 seconds

the millions of dollars it would take to research it really thoroughly, that you probably find it's a bit of a spectrum that I certainly believe that stress increases your risk of being triggered by patterns.

28:41

28 minutes, 41 seconds

And so I'm sure there's a it's natural to be finding it's natural to be uncomfortable with those very strict kind of patterns.

28:53

28 minutes, 53 seconds

It's just that some people get triggered earlier than others.

28:55

28 minutes, 55 seconds

And if they've got other conditions they're dealing with or they're stressed or they're unwell, then they're more likely to get triggered. So I'm sure it's some sort of spectrum there.

29:04

29 minutes, 4 seconds

But, yes, I'm sure it's probably in that less than 5% category like we see the visual snow and other things.

29:10

29 minutes, 10 seconds

Well, let's before we move on, let's, just I wanna ask you about visual snow because this is something that I've, you know, I've heard you mention a few times, but I'm not really sure what it is.

29:20

29 minutes, 20 seconds

So can you explain to us what is visual snow? So there are people who experience static in their vision.

29:27

29 minutes, 27 seconds

And so those, again, a bit of age reference if you were remember the TVs when the signal used to stop, used to get static on the TVs, so black and white pixels everywhere.

29:38

29 minutes, 38 seconds

And so they see a form of pixelation in their vision.

29:41

29 minutes, 41 seconds

And it falls into 2 categories where you get sort of approximately the research is indicating approximately half people have it for as long as they can remember, so it's something they've noticed since childhood.

29:53

29 minutes, 53 seconds

And then you get the other group, which I guess you would call acquired in some way. We sometimes see it with, you know, migraine sufferers.

30:01

30 minutes, 1 second

You sometimes see it in people who have had concussion.

30:04

30 minutes, 4 seconds

There's question marks over whether some people have it triggered by some medications.

30:08

30 minutes, 8 seconds

There are certain certainly some types of static that are triggered by, this drug use. They're not necessarily considered to be visual snow.

30:17

30 minutes, 17 seconds

That's a separate kind of condition.

30:19

30 minutes, 19 seconds

The actual syndrome, you can go to the Visual Snow Initiative website, and they'll specify what it is.

30:26

30 minutes, 26 seconds

So to have visual snow, you need to have had the static present for a few months, and often you'll have other visual disturbances.

30:33

30 minutes, 33 seconds

So, you know, if you see something move across in your environment, it has a little bit of a a comma tail or an after image.

30:40

30 minutes, 40 seconds

Some people have tinnitus at the same time, so some hearing the buzzing in the ears.

30:47

30 minutes, 47 seconds

And for some people, it can just sort of sit there in the background, but others, it can be quite debilitating because it actually comes up in a time.

30:54

30 minutes, 54 seconds

And so just like pattern glare, it's a condition that certain tints can help with?

31:02

31 minutes, 2 seconds

It's still the recognition of visual snow, I'd have to say, is quite new.

31:07

31 minutes, 7 seconds

So that's something that's being explored on a, you know, if you're a practitioner, then you if someone presents you, you're trying to do your best to help them in any way.

31:18

31 minutes, 18 seconds

And so tints is something we might look at just to see if they get any response.

31:22

31 minutes, 22 seconds

And if so, if you have someone where they might try an FL-41 tint and and go, I can't see my snow anymore. Well, that's a remarkable change.

31:30

31 minutes, 30 seconds

Now that's not, you know, that's not everyone, that happens sometimes, but, you know, not super frequently. But you know that, that person's going to benefit from tint.

31:39

31 minutes, 39 seconds

So at this stage, it can do it'll be a bit of a little bit trial and error. Right.

31:43

31 minutes, 43 seconds

We do have some emerging evidence that that types of vision therapy may be beneficial in helping them improve their quality of life.

31:50

31 minutes, 50 seconds

It doesn't mean the visual snow disappears completely, but it can become a bit more of a background thing, so it's a lot less spots.

32:00

32 minutes

Okay. Alright. Thank you for explaining that.

32:04

32 minutes, 4 seconds

Well, the last thing I'd I'd like to talk about today is prism lenses. This is another thing that is new to me.

Chapter 6: When Do We Use Prism Lenses?

32:12

32 minutes, 12 seconds

So I understand prism lenses are connected with the treatment of binocular vision dysfunction.

32:20

32 minutes, 20 seconds

So can you tell us more about that? What are prism lenses? You know? What is BVD (binocular vision dysfunction) for that matter? Yeah. Okay.

32:27

32 minutes, 27 seconds

Well, if we start with binocular visual dysfunction is a very broad term where where you have issues with being able to assimilate the two, information from the two channels together into a single clear perception.

32:41

32 minutes, 41 seconds

You might be achieving it, but it might be a lot of hard work for you.

32:44

32 minutes, 44 seconds

So in the background, you might be burning up concentration that could be using other things to maintain a single and clear perception of the world.

32:53

32 minutes, 53 seconds

It could create headaches or eyes.

32:54

32 minutes, 54 seconds

You in some cases, some people get depth perception issues, get vertigo and dizziness, extreme for cases.

33:02

33 minutes, 2 seconds

So, it's basically an eye teaming issue is the simple way of looking at it, but it covers a broad range of different labels of binocular of dysfunctions of binocular vision.

33:13

33 minutes, 13 seconds

And you might hear convergence insufficiency, convergence excess, convergence dysfunction.

33:17

33 minutes, 17 seconds

There's all different names, but it's just about binocular visual system not working efficiently.

33:23

33 minutes, 23 seconds

And if you take a fairly mechanical view of, you know, not being able to turn the two eyes in together, then you might use a prism to push

33:31

33 minutes, 31 seconds

the light in a particular direction so that you don't have to move your eyes far, and, therefore, it's less work to get the two images to work together.

33:40

33 minutes, 40 seconds

And the challenge with prism is that it's thought to be, if we remember the classic dark side of the moon album, go and Google it if you're not sure.

33:51

33 minutes, 51 seconds

And again, Pink Floyd. Pink Floyd. And so you see that that prism in the, white light hitting it, and then the light coming out of the other side spread out.

34:01

34 minutes, 1 second

So a large prism will obviously spread white light to its very colours. But if you take a much narrower prism, that spread is a lot less obvious.

34:09

34 minutes, 9 seconds

And so it seemed to just bend the light.

34:11

34 minutes, 11 seconds

But they're actually very, very fairly simple prisms, but they're actually very complex optical devices.

34:16

34 minutes, 16 seconds

And so you need to be careful about, once you start using stronger prisms, that not inducing other kind of aberrations and things that people find uncomfortable.

34:25

34 minutes, 25 seconds

And that could be part of the limitation.

34:27

34 minutes, 27 seconds

Now if you're dealing with certain types of binocular visual dysfunction, you may get some initial immediate benefit from prism feeling easier and more comfortable.

34:37

34 minutes, 37 seconds

But there is a term in optometry called eating prism, where because you're dealing with the end what looks like a mechanical issue,

34:47

34 minutes, 47 seconds

and you're prescribing for it, you actually haven't really got to why the person might have developed the binocular dysfunction to begin with, and they start developing the binocular dysfunction again through the prism.

34:58

34 minutes, 58 seconds

So they come back few months later wanting or needing more prism again and again. That's not actually solving the problem very well over the long term.

35:06

35 minutes, 6 seconds

And so we tend to use prisms for very specific situations.

35:10

35 minutes, 10 seconds

So our preference is if you are in a situation where your dysfunction's that bad, then maybe you might be a better candidate for doing some eye exercises or

35:19

35 minutes, 19 seconds

visual training and actually learning how to use your visual system better rather than just using a an optical device to align the eyes.

35:27

35 minutes, 27 seconds

There may be situations where you have a physical restriction.

35:30

35 minutes, 30 seconds

So if we talk about like we did with the occlusion where you simply can't move your eye as well because of a an actual mechanical restriction or some

35:38

35 minutes, 38 seconds

sort of loss of function, that's certainly where a prism can be beneficial to, get someone, you know, fusing and seeing single vision again.

35:46

35 minutes, 46 seconds

So they certainly have a place.

35:50

35 minutes, 50 seconds

So, like, I've seen some some images on Google of these prism lenses, and it is kind they are kinda noticeable, aren't they?

35:57

35 minutes, 57 seconds

They're like, you can see actual, like, lines on the on the lenses if somebody was to take a close look at your glasses. Yeah.

36:04

36 minutes, 4 seconds

So, if you wanna prescribe a fairly large powered prism, they become very you'll probably have one here as an extreme example.

36:17

36 minutes, 17 seconds

These are flat prisms. So, what we prescribed in glasses occurred. That's what we consider a fairly large prism.

36:25

36 minutes, 25 seconds

Okay? And so and you can see how it bends the light, moves the light there. Now if we would prescribe that in in a lens, obviously, becomes quite thick.

36:34

36 minutes, 34 seconds

And so there's a thing called a Fresnel prism, which breaks it up into little line segments.

36:41

36 minutes, 41 seconds

So you can put it on as a film on on all ends.

36:44

36 minutes, 44 seconds

So the Fresnels have an advantage that even if you're wanting to explore the use of a low prism, you can put a Fresnel on without having

36:52

36 minutes, 52 seconds

to make a whole pair of glasses and get to see what prism's needed, how does a person start to eat prism, are they is it actually providing any

37:00

37 minutes

benefit, right through to, okay, well, we can't put a big prism in a pair of glasses satisfactory, so, we use this film made up of lots of little lines of prisms to generate the effect.

37:12

37 minutes, 12 seconds

I see. Alright. Well, that's been some fascinating topics that we've covered today.

37:20

37 minutes, 20 seconds

Is there anything else that you that you wanted to add, Paul, before we before we finish? No. I think we've explored that fairly, very well.

37:29

37 minutes, 29 seconds

Well, I wanna correct the record before we end.

37:32

37 minutes, 32 seconds

So in our last interview, we had that famous conversation about the the octopus' eyeball.

37:37

37 minutes, 37 seconds

You remember how the you know, through the miracle of convergent evolution, that their eyeball, is, in some ways, designed better than ours.

37:45

37 minutes, 45 seconds

I actually, I commended you for using the correct plural of "octopi" rather than octopuses. Turns out that octopuses is the correct plural.

37:54

37 minutes, 54 seconds

It's got something to do with Greek origins rather than Latin origins.

37:58

37 minutes, 58 seconds

If any if there are any linguists out there who wanna explain that further better than me, please leave it in the comments.

38:03

38 minutes, 3 seconds

And on another level, I was wrong anyway because I said octopi was the collective noun, but, of course, collective noun is like a, you know, herd of cattle or flock of seagulls or something.

38:13

38 minutes, 13 seconds

And you'll love this. Do you know the collective noun for octopuses? No. Not at all.

38:21

38 minutes, 21 seconds

It's a "consortium". Consortium of octopuses. Sounds very, very corporate.

38:25

38 minutes, 25 seconds

So I have these images of, like, octopuses with their briefcases and ties going to work.

38:30

38 minutes, 30 seconds

They're very serious looking intelligent beings, so I think a consortium is probably an appropriate- Right. term for a collection of octopuses.

38:38

38 minutes, 38 seconds

Indeed. Alright.

38:40

38 minutes, 40 seconds

Well, so please tell us how can people get in touch with you at Harmony Vision Care. Yeah.

38:46

38 minutes, 46 seconds

So, we have the website, We're based on the Gold Coast in Australia.

38:53

38 minutes, 53 seconds

If you're local, you can call us on or if you go to the website, you can contact us through the CONTACT US page or you can book online.

39:04

39 minutes, 4 seconds

Alright. And, yeah.

39:05

39 minutes, 5 seconds

So please follow Paul's Facebook business page to see him post updates on the latest news, promotions, and events at his Varsity Lakes practice.

39:13

39 minutes, 13 seconds

Alright. So, thanks a lot, Paul. And thank you.

39:16

39 minutes, 16 seconds

And just remember, everyone, and I hope, what we did today highlights it. Indeed. Alright. Well, until next month, everyone.

39:24

39 minutes, 24 seconds

So have a great day. Fantastic. Thanks, Paul.