Sense of Smell

Why is an eye doctor writing about our sense of smell?? Because it is fascinating! Smell is an under-rated and under-appreciated sense in humans. People can easily imagine how devastating it would be to lose our vision, but we tend to think that losing our sense of smell would have little impact on our lives. In fact, a survey of young people indicated that most would rather lose their sense of smell than live without their smartphones!

Covid-19 has brought new attention to a condition called anosmia – the loss of smell. Anosmia is a common symptom of COVID-19 – up to 86% of people infected with the virus may partially or fully lose their sense of smell. Anosmia can be the first or only symptom of mild COVID-19 infection. Most people recover their sense of smell within days or weeks, but a small percentage of people are experiencing long-term losses.

When we stop to appreciate it, our sense of smell is wondrous. Our sense of smell enhances and broadens our taste and appreciation of food. But think too of the information that smell gives us… we can deduce that a lawn has been mowed just from the whiff of fresh-cut grass, or know that bread has been baked the moment you open your front door. Smell also provides essential information on dangers in our environment – the smell of smoke, gas leaks, or rancid food. Humans can even distinguish between the smells of sweat from exercise versus sweat from fear. We gain all this information almost instantly from breathing in some chemical molecules floating on airwaves – it is amazing!

Our visual system has been well studied and we know a lot about the structure and function of the photoreceptors (rods and cones) that provide us with sight. Our smell receptor cells (olfactory sensory neurons) were only discovered in the 1990’s, and there is a great deal to be learned about them. Viruses have been known to affect our sense of smell, but it was previously assumed that this was due to congestion in the nasal passages. With COVID-19, many patients with anosmia have no nasal congestion to account for their loss of smell. Researchers are now thinking that the COVID-19 virus may cause damage to the supporting cells to the olfactory sensory neurons, which in turn causes a loss of function of the actual nerves responsible for smell.

As this pandemic continues, please be alert to any changes to your sense of smell. A loss of smell and/or taste indicates a need to get COVID tested and isolate while awaiting results. So take a moment today to appreciate your amazing sense of smell (and don’t forget your vision too! – book an appointment for an eye examination if it’s been more than two years).

Dr. Lisa Scharf

IRITIS – An inflammation affecting the eye.

The iris is the colored portion of the eye. It contains muscles that contract and relax in response to light and other stimuli including emotional states. Muscle activity in the iris changes the size of the pupil, thus regulating the amount of light entering the eye.

Inflammation of the iris and other nearby structures is called iritis, also known as anterior uveitis or iridocyclitis.

Iritis has many causes including but not limited to eye trauma, following eye surgery, some medications, malignancy, infection, adverse reaction to contact lenses, and association with general health problems that often have an autoimmune component (for example inflammatory bowel disease, ankylosing spondylitis, juvenile rheumatoid arthritis among others).

Iritis may be acute or chronic. Nearly half of acute iritis is idiopathic, meaning that there is no cause found for it. Recurrent episodes of acute iritis, iritis involving both eyes, or chronic iritis often indicate a need for medical testing to search for an associated underlying general health condition.

Recurrent episodes of iritis and chronic iritis can be associated with development of glaucoma and premature development of cataracts, and may affect structures deeper within the eye thus compromising vision.

Symptoms of iritis include blurred vision, tearing, light sensitivity (also called “photophobia”), eye pain that often radiates into the brow or forehead, pain upon focusing for near vision, and redness of the eye that often increases towards the limbus (which is the junction of the white of the eye with the cornea). However, some patients with iritis have no symptoms.

Treatment of iritis typically involves the use of anti-inflammatory steroid eye drops coupled with drops that dilate the pupil of the eye. The frequency of these drops is adjusted based on how the inflammation responds. Medical treatment of any underlying general health conditions may also contribute to managing iritis.

Any time you have a new onset, red eye with aching pain and light sensitivity, you should contact your Doctor of Optometry immediately for diagnosis and treatment.

Dr. Tim Styles, OD

I have always enjoyed school and learning – as evidenced by my nine years of university completing my Bachelor of Science (Psychology) and doctorate degree (Optometry), plus a few extra meandering courses along the way! One of the things that I love about practicing optometry is the ongoing opportunity for continued learning and development of professional knowledge and skills.

Many regulated healthcare professionals are required to complete continuing education hours in order to maintain professional licensing. Optometry mandates a minimum of twenty hours of continuing education per year, with at least half of these hours dedicated to ocular disease courses. The remaining hours may be used to learn about product knowledge, business management, communication, and leadership.

This year brought a number of changes to the way I completed my continuing education requirements. Gone were the weekend conference “getaways” to the city, and instead courses were completed via online platforms at my kitchen table. I focused on glaucoma, diabetes, and retinal pathology topics this year. I also spent an inordinate amount of time learning about Covid-19 and all the associated protective and sanitization protocols.

I read a number of fascinating books about the effects of insulin resistance and type 2 diabetes on our overall health and wellness. A few excellent books on this topic:

The Diabetes Code and The Obesity Code by Dr. Jason Fung

Why We Get Sick by Dr. Benjamin Bikman

(You can also find YouTube talks by these authors if you prefer video content to reading!)

On personal values, communication, and leadership, I enjoyed the book Dare to Lead by Brene Brown. And this year was a great time to re-read the classic book Man’s Search for Meaning by Viktor Frankl, with its reminder that each of us have the freedom to find purpose and meaning in even the most difficult circumstances.

Dr. Lisa Scharf

Most of us now spend an appreciable amount of time using a computer, tablet, or smart phone for work or recreation. Computer vision syndrome is a term that was coined to describe eye and vision discomfort resulting from screen time.

Symptoms of computer vision syndrome include headaches, blurred vision, sore burning eyes, watery eyes, and ocular and general fatigue.

Many of these symptoms are related to the fact that the human eye is not well adapted to hold focus at one distance for extended periods of time. In addition, reduction in blink rates and widening of the eye as we stare at the screen can create surface dryness on the eye. Variations in the screen brightness as the image changes cause the iris musculature of the eye to work overtime to regulate light getting into the eye thru the pupil, thus causing fatigue.

Help and relief from computer vision syndrome may involve optical correction with glasses for computer work, often incorporating antireflection and blue light blocking filters to optimize vision. Adjusting workstation lighting and screen position can also be helpful. Increased awareness of blinking and taking regular breaks from the screen to look to a farther distance relaxes focusing muscles momentarily and can help avoid eye muscle fatigue.

If you suffer from computer vision syndrome, discuss it with your eyecare professional to help find a personalized solution to your symptoms.

–Dr. Lisa Scharf, BSc, OD

We all know someone who had perfect vision all their life, but then began to need reading glasses as they entered their mid-40’s. Why does this happen?

First – a short explanation of how the human eye focuses for near vision. Behind the pupil of the eye is the lens. The lens is attached via small ligaments (called zonules) to the ciliary muscle. As the muscle contracts the lens changes shape and we are able to “accommodate”, or adjust our focus to different distances.

As we go thru life the lens is constantly bombarded by light energy and UV radiation. This causes stiffening of the lens, much the same as how plastic left outdoors will stiffen and go cloudy over time. Throughout our life the lens also grows constantly like our hair and our fingernails, gradually becoming larger and rounder. These joint processes of hardening and growing create a situation where the lens gradually looses it’s ability to change shape, resulting in the loss of near vision that we call presbyopia.

In our climate people often start to notice their near vision changing in the decade between age 40 and 50. In other parts of the world, the Caribbean for example, where the locals may not wear sunglasses much and are exposed to high levels of UV from the intense sun, hardening of the lens can be accelerated and the onset of presbyopia can be earlier in life.

–Dr. Lisa Scharf, BSc, OD

Astigmatism sounds bad, but really it is just a type of blurry vision that is caused by the focussing parts of the eye (the cornea and the lens) not being perfectly round. Since the eye is a biological structure, it is common for some imperfection like this to be present. Subsequently, many people have some degree of astigmatism.

Along with nearsightedness and farsightedness, astigmatism is lumped into what are known as “refractive errors”. Refractive error means that the light entering the eye does not get focussed accurately onto the retina, and the result is blurry vision.

Astigmatism may occur together with nearsightedness or farsightedness, or may be present on it’s own. The blurry vision caused by astigmatism is usually easily rendered clear by the use of glasses, special “toric” contact lenses, or even laser eye surgery in some cases.

People with uncorrected astigmatism often complain of headaches and eyestrain when doing visually concentrated activities like long drives or computer work. They may note that the scenery looks pretty clear, but are unable to accurately read a road sign an appropriate distance away. People with uncorrected astigmatism may tire easily when doing visually concentrated tasks, and this can result in the inability to complete tasks and poor school performance.

Astigmatism is easy for your eye care professional to detect, measure and correct. If these symptoms are familiar to you, an eye exam is a good idea!

–Dr. Tim Styles, OD

Canadians planning their Halloween costumes should be wary of decorative contact lenses, according to health officials.

Health Canada warned in a recent release that while such decorative lenses are popular additions to Halloween attire, they can pose risks such as cuts or scratches on corneas, allergic reactions, impaired vision, infections and even blindness.

Decorative contact lenses, also referred to by other names such as “fashion,” “costume” or “cosmetic” lenses, don’t correct vision but change how eyes look.

The public health agency warned that such lenses can be sold at unlicensed novelty stores, flea markets or online, which means they could contain harmful ingredients such as toxic dyes.

Health Canada advises those who want decorative lenses to stick to companies licensed by the public health agency. These companies have products that are tested for safety and quality.

The following companies are licensed by sellers of decorative contact lenses in Canada: Alcon Laboratories Inc., Bausch & Lomb Inc., Ciba Vision Corporation, Coopervision Inc., Geo Medical Co., Ltd., Les Lesieur Enterprises Inc., Neo Vision Co. Ltd., Unicon Optical Co., Ltd.

The health agency also has a myriad of other tips for those using the lenses this Halloween, including properly cleaning and disinfecting them, never sleeping with them on, never sharing them with others, and talking to licensed eye-care professionals if there is any discomfort. Some forms of discomfort may include itchy, watery or red eyes and blurriness.

Several eye-care organizations in Canada have issued similar warnings urging consumers to stay away from such contact lenses.

The Canadian Ophthalmological Society (COS) said in a news release that these lenses can cause corneal ulcers, which can “quickly lead to permanent loss of vision if left untreated.”

“No one should purchase, and then wear, cosmetic lenses directly from a retail outlet without a prescription and professional oversight. The risks are far too high,” Dr. Allan Slomovic, who works with the COS, said in the release.

The Canadian Association of Optometrists added that those dressing up for Halloween should also stay away from applying makeup products near the lid or lash line that are not specifically designed for the area.

It noted that some people use blush or red lip liner around the eye, which could transfer bacteria from other parts of the face to inside the eye and cause an infection.

“Vision is precious. If novelty contact lenses are the finishing touch for your Halloween costume, see your doctor of optometry first,” a statement from the organization read.

I can still clearly remember becoming aware of floaters in my eyes as a young child. Lying in the sun with closed eyes I was able to visualize clear dots and tubules that would drift from side to side when I moved my eyes. I realized that the viewing conditions were what made the floaters visible, since I could not see them once I opened my eyes and looked at the world around me.
The floaters that I have described above are called hyaloid floaters, and they are optical imperfections left in the vitreous humor (the clear gel that fills the large back chamber of the eye) by the hyaloid blood vessel system that is part of embryonic eye development and largely disappears before birth.

As we age, many of us become increasingly aware and sometimes bothered by floaters. This is the result of a progressive change in the vitreous gel called syneresis, which results in liquefaction of the gel and the solid fibrils clumping together to form larger particles that can be visible and transiently obscure our vision.

Some floaters can be associated with eye health problems and require immediate assessment and treatment to prevent serious vision loss. Floaters that are new, changing, or appear suddenly – particularly if associated with flashes (arcs of light in the peripheral vision) – should be assessed on an urgent basis by your eye care professional to determine whether they are related to a tear or break in the retina, retinal detachment, bleeding in the eye, inflammation in the eye, or other pathological condition requiring medical treatment.

Many of us notice floaters in our eyes. Evaluation by your eye care professional can help to determine whether they are the result of normal aging process or are a cause for concern. If you experience floaters, see your eye care professional for assessment.

Dr. Tim Styles

Contact lenses aren’t that scary, we promise! Here is a break down to ease your mind on common questions revolved around our processes with contacts.

 

At Armstrong Optometry we are always staying up-to-date with new technologies and materials for contacts. If you have tried using them before, we encourage you to try again as they have come a long way in comfort, design, and the ability to accommodate high prescriptions. Contacts also come in multifocal and toric (for those with astigmatism). Lenses are designed for digital device use for the office or phones, and many come in dailies for part-time wear. Daily contacts are very convenient as you do not need to clean them, there is no hassle with solutions or cases and you throw them out at the end of the day!

 

The benefits of contacts:

– Great for active people or events

– Clearer vision as contact lenses have a wider field of view, they won’t change in the fog or rain and there aren’t any reflections.

– They can change/enhance your eye colour

– Extra UV protection

– Ability to wear any non-prescription eyewear (such as sunglasses)

– Awesome for kids who are tough on their glasses.

 

The process to wearing contacts for a first timer would be an hour long appointment with our Contact Lens Professional, Amanda. At the appointment she goes over care of the lenses, teaches you how to put them in and take them out without pressure, narrows down which contacts will work best for your lifestyle and contact wear, and sends you home with trial contact lenses. At the end of your appointment you will wear your contacts out of the clinic to help adjust to them. After two weeks of trying and wearing them, you then come back for a progress check with Amanda to ensure the lenses are fitting well on your eyes and that they feel comfortable. If not, we try as many times as we have to until we get it right!

For people who have unsuccessfully tried contacts before, your appointment is a half hour. Amanda will give you a consult and troubleshoot why they didn’t work for you, and re-fit you into new technology lenses. If you’re comfortable with putting contacts in, then that is awesome! If not, Amanda can give you a refresher lesson. Once you’ve worn your new lenses for two weeks, you come back for a quick progress check to ensure the lenses are fitting well on your eyes.

 

We know contact lenses can seem daunting, however we take our time and ensure you are completely comfortable with them.

It is well known that smoking is detrimental to your health. Smoking tobacco harms every organ in your body— your eyes included. Smoking tobacco is the single most preventable cause of death and disease in Canada.

Most smokers are not aware that their tobacco use is a preventable cause of blindness. Avoiding smoking, or taking steps to quit lowers your risk of vision impairment and vision loss. Smokers are at higher risk for the following conditions:

• Dry Eye and Contact Lenses: Smoking can affect the skin around the eyes and the tissues on the eye’s surface. Smoke is a drying agent that increases evaporation of the eye’s natural moisture which can lead to discomfort and irritation, especially when contact lenses are worn. The chemicals found in tobacco smoke have been found to cause cellular damage leading to delayed healing rates and increased risk of corneal infections. In some studies, smokers who wear contact lenses were shown to have a four times increased risk of infection.
• Uveitis: Uveitis is more common in smokers than non-smokers. Uveitis harms the structures of the eye, and can lead to cataract formation, glaucoma, and retinal detachment, and vision loss.
• Age-related Macular Degeneration (AMD): Macular degeneration is a condition that causes the center of your vision to blur while the side or peripheral vision remains unaffected. Age is the most significant risk factor overall, but smoking is the leading preventable risk factor for developing AMD.
• Diabetic Retinopathy: Diabetes and its complications can affect many parts of the eye. Diabetic retinopathy is the swelling and damage to the blood vessels of the retina related to diabetes. Smoking increases the risk of developing diabetic retinopathy, which can ultimately cause blindness.
• Cataracts: Cataracts are a cloudiness of the lens in the eyes that occurs with age. Smoking, UV exposure, or the use of certain medications are risk factors for the development of cataracts at earlier ages.
• Transient Ischemic Attack (TIA): Commonly known as a mini-stroke, TIAs can cause of temporary vision loss. A TIA may only last a few minutes but it should not be ignored; roughly 15 percent of patients who survive their first TIA will suffer another one within one year. Risk factors for TIA: High blood pressure, high cholesterol, smoking, IV drug use, cocaine use, excessive alcohol, use of oral contraceptives, and obesity.
• Grave’s Disease: Thyroid ophthalmopathy, also known as Grave’s Disease, is an autoimmune disease characterized by an increase in the volume of fatty connective tissue and enlargement of the muscles around the eye. Smoking is a major risk factor.
• Pregnancy and Infant Eye Disease: Smoking while pregnant increases the chance of many fetal and infant eye disorders, among other serious health problems. Studies have found that smoking during pregnancy is associated with premature births and higher rates of strabismus (crossed eyes), refractive errors, retinal problems, and optic nerve problems.