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Pain In The Neck and Shoulders

What does neck and shoulder pain have to do with an optometric blog?  The answer deals with individuals wearing bifocals who work with desk top computers.  When bifocals are prescribed, they’re usually for reading through the bottom part at lap level and looking at the distance through the top part.  If a person is viewing a computer that’s at eye level, in order to use the bifocal, they’ll have to tilt their head back and generally lean into the screen.  Hence the neck and back pain.  Also it’s critical that the eye doctor ask the patient about their work station.  That includes if there are multiple monitors and what distance the user is from the monitor and what the monitor’s height is..  Also the age factor is important.  There’s a big difference in prescribing for the first time bifocal wearer who is 43 years old vs the bifocal wearer who is in their 50s or older.

 

Here’s just one example Let’s say we have a 55 year old individual who is looking at a monitor about 22 inches away and at eye level and viewing text at 16 inches.  I will often times prescribe a bifocal (or no line progressive lens) with the top part of the  prescription for 22 inches and the bottom part of the prescription for reading.  The patient needs to know that this pair of glasses is only for work and that it will blur out distance.  The patient here could sit back and view the monitor with out having to alter their posture.

In future blogs we’ll discuss contact lenses and viewing a monitor.

 

 

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Networking

I was at an event yesterday at The Radisson Hotel in Ontario, CA.  They had sponsored a party for many of the businesses in the area.  I belong to three chambers of commerce in the area as well as enjoy getting on line and discussing my  profession.  There’s nothing like personal contact.  There were quite a few individuals whom I haven’t met before, one of which was a young unassuming man who turned out be a co-owner of Fully-Verified, a company doing identity verification over the internet.  I had an interesting conversation with the man which thought me a lot about online safety while conducting business.

As usual, many of the people I had conversations with had questions regarding their own vision.  They included questions, about contacts, computers and vision and vision as pertaining to their family.  I sincerely enjoy answering these questions.  Of course, finding out about the individuals who are there is wonderful.

A frequently asked question is whether we take their insurance.  I usually tell them to call the office and we could find out online what their status is.  We do take most vision plans.

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Personal Development

In business as in life, personal development teamed with persistence and passion help to develop a more fulfilling life.  There is such great material on YouTube including videos of Jim Rohn, Darren Hardy, Napolean Hill, Andy Andrews and others.  You can learn so much and feel great after viewing some of these individuals.  I, personally, love sharing what I’ve viewed with some of my patients (only if they’re receptive to it).  It makes for great conversation.

 

On most Thursdays at 7:00 P.M. at my office we have a Mastermind Group discussing various ideas of self improvement.  Most of the individuals including myself feel energized after the meeting.  If you’re interested in joining us, please give us a call at (909) 980-3535.

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Personal Development

Over the last several years I’ve gotten so involved in my own personal development.  A good part of that is the immense amount of material presenting itself in the form of books, cds and videos.  Books from authors like Jim Rohn, Darren Hardy, Napolean Hill, Andy Andrews, Tony Robbins and  are such a great source of information.  There are so many other authors also to choose from.  In addition to the books, there are cds and videos that appear on Youtube that are immense in content.  In my opinion, it sure beats the heck out of listening to the news.  As stated by some of the above authors,  it’s just as important to fuel the mind with positive information as it is to fuel the body with nutritious food.

 

As an optometrist, I feel so fortunate in working in a field I sincerely feel passionate about.  Most of this stems from the wonderful interactions I have with my patients, staff and the community.  I feel a lot of this has developed from listening, reading and learning from the above authors.

 

 

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Still Passionate After 32 Years

It’s hard to believe I graduated 32 years ago from Pacific University College of Optometry.  I’ve currently owned my own practice here in Rancho Cucamonga since 1989.  I’ve examined kids back then who now bring their own kids in.  I’ve had patients who have moved away a fairly good distance and still come back.  A good part of our practice is based on patient referral.  I have belonged to and active in three local chambers of commerce.  I really enjoy this.

 

The developments in my practice have also been great.  We’ve had expansion in our scope of practice since I was first licensed.  I am also independent of any corporate control so if I feel the patient needs to be referred to another professional, I can do so without someone looking over my shoulder.  We have also been able to move into a much larger and more up to date facility within the same shopping center in February, 2012.  It’s a real source of pride.

 

Finally I really feel we’ve had a significant impact on the lives of a number of our patients.  This includes improving a child’s ability to learn, helping individuals with their employment, saving individuals from possible blindness and even saving some individual lives from certain conditions including aneurysms.  Some of these conditions can be read about in the “testimonial” section of the website.

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Considering Lasik At 40

If you’re considering lasik after 40, there’s a major consideration.  When corrected for distance, what happens to the reading?  Some of my patients who are 40 and older and moderately nearsighted, take their glasses off to read.  It’s easier.  These patients who have lasik have one of two choices.  Use reading glasses to read or have the surgeon set you up with one eye for reading and one eye for distance (monovision).  There are considerations.  If you are doing a lot of close up work, or a drive for a profession, monovosion can be a strain on the eyes for both far and near.  Patients who already wear contacts know about this situation.  If you’ve had monovision with contact lenses, chances are monovision will work with the lasik.  If you don’t wear contacts, ask your eyecare professional to try contacts on you to see if you’re a candidate for monovision.  This should be  a fairly straight forward procedure.  If  you feel awkward, you’ll probably have to have both eyes corrected for far.  If you take your glasses off to read normally, this might not be an ideal situation leading to frustration.

 

I’ve had quite a few of my patients option for lasik with excellent results.  We try to cover this above situation so the patient understands what their options are.

 

 

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Vision and Sports, An Interesting Case

I had a patient referred to me.  He had an eye injury a couple of years ago and is noticing that his vision is changing.  The patient still sees 20/20 in both eyes.  I did note that there was a small piece of peripheral vision missing out of his left eye probably due to the injury.  The patient feels that his performance in football isn’t as good as it was.  He saw clearly enough but he was unable to take in all the visual information he felt he needed to.

 

There is more to good vision than 20/20.  Having good ability to team the eyes (binocular vision) is paramount.  This helps lead to good depth perception and being able to be aware of what’s on the football field fit athletic (or any sports field or arena).

 

The first thing I’m requesting from the patient is a follow-up with his specialist to rule out any pathological (disease) problem associated with the original injury that is getting worse.   After that, I am hoping we can get the patient started in vision training to help improve his performance on the field.  We’ll let you know what happens.  This to me is a very interesting case.

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Patient Conditions

Technology plays such an important part in all our lives.  One of the neatest things is when I diagnose a condition concerning a patient, many times I can pull it up online and visually demonstrate the condition to the patient.  For example, if a patient is overwearing their contact lenses, certain findings on the corneal part of the eye can be seen by me with a biomicroscope.  I can actually show the patient on the computer what their condition is.  Neovascularization or new blood vessel formation on the cornea can be very serious.  I am actually able to show the patient what this looks like.  Then the patient can realize what addiction centers is, Another condition that can be looked at on the computer is macular degeneration.  This demonstration to the patient is such a powerful tool in helping them undertand their eye health so go to https://burniva.com/ and why they’re possibly seeing so poorly or why glasses can’t fully correct their condition.  There are a myriad of conditions that I can show the patient that are found online.  Cataracts or even the retinal effects of diabetes are just a couple of other eye conditions that can be viewed.

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Mastermind Group Thursdays

On most Thursdays, about ten to fifteen individuals meet discussing different success principles as outlined by Jim Rohn.  The backgrounds and ages of the participants vary widely.  Areas including but not limited to marketing, networking, accelerated learning, and physcial well being are discussed.

As stated, the meetings occur on most Thursdays, the Fourth of July is an exception as is July 25.  They occur at 7:00  P.M. at my office, 7211-A Haven Avenue in Rancho Cucamonga.  We’re in the Ralph’s Shopping Center at Baseline and Haven.  The sign over the office says “optometry.”

I think you’ll find them very interesting and rewarding.  For more information you can call us at (909) 980-3535.

We really hope to see you.

 

Bob Rothbard, O.D.

 

 

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A Patient In Pain

A patient was referrred to me from a friend of mine who’s a psychologist.  He was suffering from extreme headaches and shoulder pain.  He was receiving injections from his physician to help relieve the pain.  The psychologistwanted to know if there were a vision component to the pain.  In a nutshell the extreme discomfort the patient felt while viewing the computer was due to his visual condition and the set-up of his work station.

The patient was basically using single vision reading glasseseven though he was in his 50’s and his computer was about two feet away from him while the text he was viewing was about 16″ away.  That meant the patient had to lean into the screen, constantly fix body group. OUCH.  Also the prescription he was using was different from what I found.  One last thing.  The patient had a small but significant distant prescription and warned them of flexeril cyclobenzaprine sideeffects. that he was not prescribed for.

When I showed the patient the presciption (mounted in a trial frame) for the computer, you could see the comfort that ensued. I am looking forward the patient receiving the presciption in the next week or two and seeing the results.

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