Monday, December 8, 2014

Do Eyes "Compensate?"

I hear this all the time, from patients and colleagues alike. People tell me that one of their eyes is blurry, so the other one "compensates". Does it? I think most of the time the eye that they told me is "compensating" is just seeing clearly while the other one is not. There is no real compensation going on. Since a person cannot focus (accommodate) one eye without the exact same amount of focusing for the other eye (since it's all controlled by one nerve), I just don't see how any eye can comensate for the other eye. If a pallet that is heavier on one side than the other gets lifted by a forklift, is one fork "compensating" for the other? Parents of amblyopes are asking me this all the time. "Since one eye is lazy, the other one compensates, right?" Er, no. The lazy eye just sees bad. The non lazy eye doesn't. That's it. The non-lazy eye is not somehow helping the lazy eye see better...if it were, we wouldn't need patching regimens that force the patient to use the lazy eye. There is no eye/vision "compensation". I just don't personally believe that exists.

Wednesday, October 22, 2014

Migraines and Eyes...Are They Related?

No. They're not very related. You might think they are or might have heard that they are, and maybe even your doctor told you they are, but they're not. I have a patient almost every day tell me that their eyes and vision have caused them to have migraines. They don't. I frequently have patients who are known and previously-diagnosed migraine sufferers coming in because their doctor told them to "get their eyes checked to rule out vision as cause of their migraines". Well ok that's real easy: it's not. Migraines are poorly understood in medicine, and they have a lot of visual SYMPTOMS: aura, flashing lights, "zig zag" patterns, glowing/growing spots, temporary vision loss, blurry vision, pain in/around/behind the eye, etc etc etc. So migraine sufferers often end up in the OD's chair complaining about their eyes and vision, but no eye problem causes migraines. None. Not refractive error, not the need for glasses, not the glasses themselves, not eye disease, not glaucoma, etc etc etc. When I figure out that a patient is having or had a migraine, I tell them to talk to their PCP about it and maybe consider a referral to a neurologist. But I don't worry too much about my Rxs "causing" them to have migraines b/c that's not possible. A migraine is a neurological problem, not an ocular one, despite it's obvious ocular and visual symptoms. I'll tell you something else about migraines: they're not "really bad headaches". When I hear a patient tell me something like "by the end of the day I've used the computer so much I have a MIGRAINE!", that pretty much rules out a migraine diagnosis right there. That's a tension headache or a stress headache or something else, but it's not a migraine. That sounds nothing like a migraine. Migraines can cause some serious pain, but not all head pains are migraines. In fact relatively few are. Just because you have headaches, even "really bad" ones, does not mean you have migraines. Migraine sufferers probably laugh at people calling their really bad headaches "migraines". They're not the same. Headaches are common, and eye/vision CAN cause some headaches (although IMO not nearly as many as they're blamed for). But no eye problem causes a migraine. That does not exist.

Thursday, October 16, 2014

Blog Action Day "Inequality" Post

So for Blog Action Day I'm supposed to blog about "inequality". I'm sure I could post about plenty of inequal things in life: inequal pay for women in the workplace, inequal college admission rates among races, etc. From viewing the Blog Action Day website I'm pretty sure wants me to talk about how the rich are getting richer and the poor are getting poorer. But instead I am going to talk about: inequal charitable contributions among conservatives and liberals. Apparently according to multiple studies conservatives give nearly twice as much to non-government charitable organizations as liberals do, despite making up to 38% less income. Blue states are less charitable than red ones, and 9 of the top 10 charitable states are either heavy Morman populations (Utah and Idaho) or in the Bible Belt. So why is this? Here's my probably-not-very-popular-on-the-web opinion: conservative Christians care. Non-conservative, non-Christians don't, or at least not as much. And when liberals do care, they tend to petition to have taxes be raised and re-routed to fund government programs to fix the things they care about, they don't give their time or money to nonprofit charities to do it. They're more likely to give to and campaign for a political candidate who they think will "take care" of the people they're worried about (sick, homeless, poor) than they are to do it themselves or give to a church or charitable organization that is actually out there taking care of these people. Is that really what's happening? I mean I don't profess to know for sure, that's just what the numbers look like to me. What do you think? Which group (conservatives or liberals) really do "think of the children!"? Be nice! :;

Wednesday, October 15, 2014

Acuvue in the News

No surprise that Johnson & Johnson's contact lens arm has been and is still the #1 seller in the U.S. with their excellent Oasys product line. Recently they made a few changes that affect their consumers: Firstly, boxes of Acuvue products are no longer sold in 6 packs. 12 packs only now. The cost did not increase, you just have to buy more at a time. Secondly, the Acuvue Oasys for Astigmatism lens now has increased parameters to include -2.75 cylinder! In English that means more astigmatism! Many of the folks who had "too much" astigmatism to wear any silicone hydrogel lens can now wear Acuvue! That's exciting because many "high cyl" cases very much need to be wearing silicone for both comfort and corneal health, but until this time could not b/c of their "high" astigmatism. Pretty cool. The best part IMO is that the new higher-astigmatism powers are the SAME COST as the lower astigmatism powers. Many high cyl patients are accustomed to paying more than 2x the price of their non-high-cyl counterparts, so they're going to be pretty happy with the news.

Tuesday, October 14, 2014

Home Recording on a Budget

I am in the process of recording my debut solo EP. I liked working with my brother on our Christian band TACKAPBAND, but he doesn't really have time. His job is too demanding. And so I have decided to branch out and record my own EP at home and I'm using a different approach than I've used in the past. Our 3 song TACKAPBAND EP cost about $1800 to record, mix, master and produce. I won't tell you how much we "made" on it, but it was WELL under $1800. This time I'm spending very, very little. I hope to have the EP finished before Christmas of 2014, not because it will have any Christmas songs on it (hey not a bad idea tho...), but rather Christmas time was just an arbitrary constraint I put on myself. It's a goal I think I can achieve. Anyway it will be a 4-5 song EP, 1 or 2 of which will be instrumentals and three praise/worship songs. I'm going to provide the songs free for download to churches and music ministers/praise bands, with words and chord charts, etc to help them perform it completely for free if they so desire. But the point of this blog post is how I am going about recording this very inexpensively. The big cost is that I'm using my Samsung Galaxy s5, which is...not cheap. But the software works on other, older, cheaper android devices like the Galaxy s3 and s4, the Note 2 and 3, etc. any device that runs Android OS 2.2 or higher. 1st I bought this $6 device on Amazon
It's a guitar-to-USB interface, but it works with microphones as well. I also purchased a micro USB cable for $2. I already had microphones (my main microphone was purchased for $5 in a TJ Maxx clearance bin!), headphones, guitar cables, an acoustic guitar, a bass guitar, a drum machine (used/cheap on ebay!), an electric guitar, etc. The Software I use is Audio Evolution for Android, which I found in the Google Play app store for $7.99. I had to purchase the in-app $6.88 charge to use the USB function. The interface, cable, app and in-app USB purchase totaled just under $25. I don't really count my Samsung Galaxy s5, guitars, amps, guitar cables, drum machine, microphones, etc as part of the cost of this project because I already had all of those. After a few days of recording demos and scratch tracks to learn how to use the software, I began recording in earnest last night on the 1st song of the EP, "This Grace". After the song is written and mapped out (verse 1, chorus, verse 2, chorus, bridge, etc etc) my 1st task is to record the drums. I have an old Alesis SR-16 which I use for this. I play thru the song with guitar, and record the drums using the pedal function of the drum machine to add appropriate fills and changes in drum patterns. After the drum track is down, I play the acoustic guitar part on track 2, add an electric guitar on track 3, bass on track 4, and so on. Later I go in and change the sounds, adding compression, chorus, reverb, etc to the existing tracks as well as change the levels and do some "mixing". When the backing tracks are mostly finished I start adding in the vocal parts one at a time. It takes hours but is pretty much my favorite thing to do so it doesn't feel like work to me. It's hard to find time to do it with 2 kids still at home and a wife getting her double masters haha but I'm making progress. Pray for me! Here's my project website: As I get tracks up I'll post them to SoundCloud and have them available though my site and will also link them here.

Wednesday, September 17, 2014

I Just Performed an Eye Exam on Peter Parker aka "Spider Man"

Famously in both the comic book and the movies, Peter Parker wears glasses, until his spider bite. Then he suddenly sees perfectly and no longer needs glasses! Impossible you say? Well I just saw it happen with my own eyes! Read further b/c it's not quite as miraculous as you think! A patient came in this morning saying that a few weeks ago he had been bitten on the left upper eyelid by a spider. The bite caused his eyelid to swell up nearly shut and be "hard", full of infected material (I promise not to get too gross here), that's called "preseptal cellulitis". He was put on antibiotics by his primary care provider. The swelling subsided as the infection was treated, and when his eye started being open enough to see again he noticed that he now sees better out of the left eye WITHOUT his glasses! He came in telling me that he thought the poison from the spider bite made that eye not need glasses anymore! And when we evaluated him...he was right! His formerly nearsighted left eye was...NO LONGER NEARSIGHTED! It was "mixed astigmatism", and his uncorrected acuity in that eye was 20/25! So here's the skinny: the swollen, hard left upper lid temporarily deformed/distorted/flattened his left cornea, temporarily eliminating his myopia (but inducing astigmatism) making his myopic glasses blurry and his uncorrected vision in that eye BETTER. The topographical map shows central and superior flattening ("ortho-k" effect) from the constant pressure of the swollen/hard/closed left eyelid. Pretty interesting! Unfortunately I had to inform him that it was not the "poison" (not directly, anyway) that caused his vision to improve, and that sadly this was a temporary effect and will wear off when his corneal distortion resolves after his eyelid swelling goes down. Ah well. It was too good to be true anyway!

Thursday, September 11, 2014

Whew BTS is Over, Now on to Fixing my Galaxy s5

BTS = "Back To School: *THE* busiest time of an optometrist's year. Everyone needs a new look and a new prescription for glasses & contacts when school starts. Students, teachers, well as their accompanying parents, spouses, etc. It's good for optometrists because we finally get in the black for the year (most optometrists operate in the red until sept/oct), but it's really no fun. 35+ exams per doctor per day from the beginning of July thru the 2nd or 3rd week of Sept. It's BRUTAL. Exhausting. Anyway today was the 1st kind of normal, "not-insanely busy" day I've had in months and I am very, very thankful for it. So I finally got to mess with my 1 mo old Galaxy s5. Chrome recently had an update that I *hate* (multiple button-pushing to reload a page) so I'm ditching it for CM Browser by Cheetah, which has an easy-to-locate 1-touch reload. I'm already loving it. It's notably faster than Chrome, and has a great interface. Also ditched this round is HootSuite, which I've used for years but irritates me b/c it's hard to change your profile pic and now on my Galaxy s5 it frequently just refuses to reload. Push reload...nothing. Have to close it and reopen THEN reload. This occurs probably 30% of the time. It's really bad. I'm trying "Plume", which was an easy setup and is easy to change my profile pic and background...and also loads instantly every time. I could do w/o the banner ads at the bottom, tho...might hafta pay the $5 to get the premium version to get rid of that. Oh well!