NEWS: Potassium and Blood Pressure

High blood pressure is a disease that causes vascular damage, which, left untreated can destroy the gift of sight. Hypertensive Retinopathy destroys vision by causing poor perfusion, fluid leakage, and macular swelling. It can also cause strokes inside the eye. We urge our patients with high blood pressure to keep it well controlled for their eyes' sake, and have regular visits with the doctor to ensure treatable problems don't go unnoticed.

Here is an interesting piece of "news you can use." This report of a recent study on Potassium finds that it may help lower blood pressure. Click here for the report.

http://www.upi.com/Health_News/2009/01/28/Potassium_may_help_lower_blood_pressure/UPI-12251233197984/

MARIUS MOREL 1880

It is time for Contemporary Retro Chic! Vintage styling comes to St George with the addition of Marius Morel's 1880 line. This distinctive frame line is a fresh, but nostalgic take on quality and style, without rehashing today's boxy retro styles.

This new line consists of some titanium offerings and some handmade acetates. The fit and finish of the Morel 1880 line fits our criteria for select, top shelf quality. These French made frames are not the mass produced disposable stuff that floods the market, rather, are of an heirloom quality that are made to last as long as you want them--which is just how we like it.

Consistent with all of our lines, these frames are warranted, unlimited for two years. They are very reasonably priced because their label is the manufacturers own, not requiring designer licensing. Come see how we can customize your look today with timeless styling that is fresh Retro Chic!

Thanks to our Model and fantastic Frame rep, Jay Hornsby for taking the runway...

News: SCHIP expansion

The State Children's Health Insurance Program (SCHIP) was originally set up as a stop gap to cover children in families that made too much to be covered under medicaid programs, but presumably, not enough to afford health insurance. Currently, the U.S. Senate is getting ready to consider a bill passed by the House that would expand SCHIP after provisions to protect private insurance companies were removed.

At issue is the concern that public insurance "crowds" out private insurance. Several studies conclude that the effect of this crowding leads to more expensive insurance for those in the private market. Here is the reference to one such study for which I couldn't find an online source: David M. Cutler and Jonathan Gruber, "Does Public Insurance Crowd-out Private Insurance?" Quarterly Journal of Economics, Vol. 111, No. 2 (May 1996), pp. 391-430.

In my opinion, this represents a dangerous trend that will be nearly impossible to undo. Generally, this sudden rush to move private business into the public sector saps vital market energy from the productive segments of our economy--all at a time when our economy needs all the energy it can get. Click here for some solid analysis of the SCHIP expansion by the Heritage Foundation.

Dr. Gooch

I Tried To Save My Glasses.

As a child I think I looked some what like Ralphie and I had about the same luck with glasses as him. Tackle football and glasses just never got along all that well. I know many of you parents can relate to mine as I would come home with pair after pair of destroyed, or worse yet, lost glasses. If you are tired of this as my parents were, now you have another option for your active pre-teen or teenager. Paragon Corneal Refractive Therapy, also known as CRT.

Paragon CRT is a specifically designed therapeutic contact lens worn during sleeping hours to gently reshape the cornea without permanently altering its physiology- which is important, as the eyes of children and teens are still maturing. Your child simply wears the lenses at night and takes them out in the morning. The result is clear vision all day long with no more glasses to lose or break. The procedure has been proven safe and has been approved by the FDA for patients of all ages. I have personally have had great results on children as young as eight. It is a paticularly great option for young atheletes.

Another area where CRT can be of great use is in children who seem to be getting more and more near sighted rapidly. CRT is thought to slow or stop this refractive progression. We have used it successfully in our practice in just this way.

CRT is a great option for adults who are not ready for laser vision correction but would still like to have day time freedom from glasses and contact lenses or are unable to have laser vision correction for a variety of reasons. For more information please give us a call, stop by and see us or visit the link above.

Dr. David I Jones O.D.

Check out those new Schnuchel's!!

Here comes Dr. Gooch blazing his own trail again, he just received his new custom tailored Schnuchel frames straight from Germany! He chose his shape, color, size and even has his own named engraved on the inside of his new glasses! Just one more reason that Southwest Vision stands out from the rest! Stop in and take a peek for yourself. Ask for your own pair of custom tailored eyewear from our own German artisan- Schnuchel!

Understanding the Difference Between Vision Plans and Medical Insurances

Today's health care environment has become more confusing and complex. Understanding your vision and medical benefits is not as easy as it once was. Our practice is providing this information to clarify many misconceptions about third party insurance and your vision. In order to understand the complexities of your coverage, it helps to understand that there are two distinct sides of vision care. The first is medical eye care which covers all testing, diagnosis, and treatment of eye disease. The second is routine vision for those with healthy eyes. Third party payers usually reflect that difference. As a general rule, medical insurance pays for medical eye care and Vision Plans deal with routine vision, the exception being that some medical plans will pay for routine eye care. What many consumers don't realize is that by virtue of the medical nature of eye care, MOST eye exams are covered under their regular medical insurance, and that you don't need separate "vision insurance" to be covered.

Many common vision plans ONLY cover the routine vision part of the overall eye health examination, i.e, VSP, Eyemed, Davis Vision, Spectera,etc. These plans are not really insurance in the traditional sense that they spread risk, but are much more marketing plans that drive patients to participating practices. By definition, it is impossible to "insure" routine things. The reality is, vision plans are a middle man, dressed up to look like insurance, that extract a profit from the routine business of eyecare. Since we also must profit from the routine business of eyecare to exist, the cost is passed on to consumers in ways that aren't immediately noticeable. Typically, the consumer pays the price of reduced quality, since providers who accept vision plans have to make up the dramatic discounts vision plans demand by increasing volume and playing games with their retail markups in their optical to remain profitable. Because we strongly believe we can offer higher quality care and better quality retail optical without the encumbrances of Vision Plans, we do not contract with third party"vision only" insurances. As non-participating providers, we will be happy to complete all the necessary forms, provide documentation and submit them on your behalf to the vision plan carrier for your reimbursement.


Understanding that are two distinct and important elements of every visit to our practice may help you understand the role of your medical insurance. Because many eye diseases that affect your vision will have little or no symptoms until the problem has become sight-threatening, all eye exams have a medical component. In fact, the most important goal of your visit today is to insure quality of life by providing you with a comprehensive, thorough medical examination of your visual system. Regular eye health examinations are critical to prevent debilitating eye disease, and can include the use of cutting edge technologies designed to take the guesswork out of disease detection. The second component of all comprehensive medical eye exams include a routine vision component to analyze and prescribe, if necessary, eyewear or contact lenses to correct your vision. Our insurance billing specialists will contact your insurance company before your visit is completed to verify your eligibility and coverage to maximize your insurance benefits.

Our doctors participate in the Medicare program and accept assignment on behalf of each eligible patient. The eye health examination is a fully covered service under the Medicare program when there is a medical condition, dry eye, cataracts, allergies, glaucoma, etc. However, as mandated by Federal law, the refraction part of the vision section of your exam is a non-covered benefit. There are many new Medicare Advantage plans with private insurance companies that we participate in.

Flex-spending, or Cafeteria plans are an option that your employer may offer which allow you to set aside pre-tax dollars to pay for your medical expenses such as eye exams, glasses or contact lenses. Please contact your employer to take advantage of this option.

Our billing staff are always available to contact your insurance company before your appointment is made to check your benefits for you. We are here to help you will all your insurance needs until your claim is completely processed.

--Barri

Changing a Young Life

Holy HANDSOMNESS! (Click for original post)

We just got Gabe's new glasses. At first, he didn't like the idea of having something "new" on his face. Thank goodness they are flexible (and thanks for not selling cheap stuff Paul, they are worth every penny) because they would already be broken. He took them off his face numerous times and as long as we don't talk about them a lot, he forgets that they are there.

What we've noticed: He is willing to sit further away from the T.V. which is HUGE! He used to always move closer until he was basically hugging the T.V. I seriously thought that it was just him being stubborn because Kierstyn wanted him out of her way or because he liked the idea of being close. I am watching him now move the glasses up and down as he looks to see which works better for him.

The first time we walked outside, he went to take some steps and was like, "whoa." They looked so different to him! Today he has kept them on much better! When we went to go get sissy from school, he was looking around and pointing at things far away and saying what they were. It was so cute! My husband and I both started crying last night when we were holding him on the bed with us. Why? Because we know that he can see and that his world will be so much better now! Paul,we can't thank you enough for what you've done for your sweet little nephew. You are amazing at what you do and make a real positive difference in peoples lives :)

- Amberlee Harder

NEWS: Got Eyelashes?

Lattise. We have long wondered, when are they going to start selling this stuff for the cosmetic side effect of eye-lash growth? Lumigan, Travatan, and Xalatan are three similar drugs that we use to control eye pressure in patients with Glaucoma. All three drugs have an interesting side effect--they stimulate eyelash growth. So much in fact, some of our patients on these drugs look like they are wearing big, fake eyelashes. I even have a few who come in regulary for a trim--the lashes get too long.

Often our patients will ask, "My friends wonder if they can come here and get this medicine for their eyelashes?" Well...the thought certainly makes me a little uneasy.

CLICK HERE FOR ARTICLE

Today's New York Times article raises many interesting questions. First, the Mascara market is 5 billion dollars a year. The drug company knows opportunity when it sees it. Second, who is going to prescribe this stuff? Will our glaucoma patients be tempted to bypass us and assume that their treatment is going OK without monitoring progress after their dermatologist Rx's the cosmetic version? (The cosmetic version is the same strength as the glaucoma med).

It will be interesting to see where this goes...

New Schnuchel frames handmade in Germany!

Southwest Vision is introducing their newest frame line-Schnuchel. This one of a kind tailor made eyewear is all handmade by a german artisan named Dr. Wolf Schnuchel. We are able to tailor your specific frame by choosing color, shape, size, etc. for a truly unique custom tailored look! These frames are classic, retro and unlike anything else you will see in this area. Our new president Barack Obama recently stopped into a NYC optical shop and left with two pairs!Stop in today and have a look for yourself! Schnuchel frames modeled by Greg.

Diabetes and the Ketogenic diet

News you can use, Click here.

Researchers report (at MedpageToday) the finding that a Ketogenic diet, (one high in fat, and low in Carbohydrates) is more effective in controlling blood glucose than the earlier low-glycemic diet espoused by the Atkins Diabetes Revolution.

The study had some flaws, but the findings are worth a look and raise interesting questions that contribute to our overall understanding.

As eye physicians, we are keenly interested in blood sugar control for diabetic patients. Strict blood sugar control delays or prevents the devastating retinopathy that goes with diabetes. As always, we recommend you take this information and apply it carefully, consulting your internist with all diet and excersize decisions you make that can affect your blood sugar.

INTRODUCING SILHOUETTE'S NEWEST EYE-CATCHING COLLECTION-ENVISO!

Silhouette has just relased their newest collection-Enviso! Enviso's unique temple design and bold colors offer something new and different in the world of rimless eyewear designs. Rimless designs have been in the limelight this year with the discovery of Sarah Palin. Her drilled rimless frames have been all over the media since her nomination for Vice president. Enviso frames are extremely light weight and with no screws to loosen or loose they are virtually maintenance-free! Stop in today and try on the latest Enviso styles! You won't be disappointed! Happy New Year from Southwest Vision.

NEWS: Blind Google Engineer develops Technology that may help those with vision and Improve Access for the Blind

Enjoy this link to the New York Times article about a Google Engineer who is blind with Glaucoma from the age of 14. I marvel how people without vision adapt to our very visual world. This is a great example of this adaptation, with practical application.

Regards,

Dr Gooch

Click here for Article

What our Patients say...

I cant praise this office and staff enough I have been going to Dr. Gooch for I think 4 years now and my experience has been completely a joy. Dr. Gooch along with the entire staff have always gone out of their ways to make me feel comfortable and assured I was receiving the best care possible. I have always recommended Dr Gooch to my friends and will continue to do so.

--Chris McArdle

Hyperopia (Farsightedness) Explained

After examining a two-year old nephew this week, I attempted to explain what it means to be farsighted to his worried mother. I've been in practice for nearly 12 years and I still struggle to explain hyperopia in lay terms. Its not that Hyperopia is complicated, but it is not as intuitively tidy as Myopia, or nearsightedness (where near things are clear and far things are blurry). Patients often exclaim, "Ah, Farsighted... so things far away are clear and things up close are blurry?" Well, sort of. Therein lies the problem with understanding Hyperopia. We collectively miss-apply the logic that so nicely fits nearsightedness, to farsightedness. And people often confuse presbyopia, or bifocal vision with farsightedness. Even a quick google search on the subject reveals very little for the lay person that isn't slightly off colored just enough to leave an element of confusion. This post is for you, Sis, so you'll grasp how your young son sees; and for me, as I work to conjure a solid explanation of Hyperopia.


The Normal Eye




First, to understand Hyperopia, you must understand how the normal eye functions. When viewing things in the distance (20 feet and beyond are optically equal), the normal eye is relaxed and focused. The light rays entering the eye are parallel, and the relaxed eye converges those parallel rays, bringing them into focus on the retina. When the eye shifts its gaze to anything inside 20 feet, the rays of light begin to diverge, or open up, which pushes the focal point to somewhere behind the normal relaxed eye. The eye then has to accommodate, or shift focus, to keep the near object in focus. This happens when an internal muscle called the cilliary body activates and changes the shape of the crystalline lens that sits behind your pupil. This accommodation pulls the long-focused rays back into focus on the retina. And it all happens faster, and more fluidly than you can perceive, without conscious effort on your part. The normal eye uses about 2.50 diopters of accommodative power to see things at the normal reading distance (approx 16 inches).


Hyperopia

Farsightedness is the condition where the natural relaxed eye focuses the normal parallel rays from the distance behind the eye. How the farsighted person sees is based on the complex interaction between the amount of farsightedness, the natural strength of the accommodative mechanism, the person's age, and the visual system's alignment mechanisms which keep the eyes on target (they happen to be tied to the focusing system). A young person with small to moderate amounts of Hyperopia can use their close focusing power to pull the distance into focus on the retina and see clearly. Near objects take an additional 2.50 diopters in focus power, and if they have the ability to do it, they can see close as well. Here are some examples of a small and a large amount of Hyperopia:

A person with +1.00 diopter Hyperopia needs 1.00 diopter of their close-focus power to see in the distance. Add another 2.50 of accommodation for close vision and they end up needing a total of 3.50 in close focusing power to see clearly at the reading distance.

A person with +7.50 diopters of Hyperopia needs 7.50 diopters of help to correct the distance (usually they can't contribute that much by themselves unless they are very young) and they need another 2.50 for near for a total of 10.00 diopters of focusing power.


Since the eye's close focusing power was not designed to remain constantly activated, just like your arms weren't designed to hold a bucket of water outstretched for long periods of time, uncorrected Hyperopes can get extra fatigued with the full time, extra-duty use of their close focusing power. Depending on the factors mentioned above, Hyperopes experience a range of symptoms from mild, imperceptible strain, to extreme fatigue, double vision, and completely blurry distance and near vision.


Correction

Hyperopia can be corrected with glasses, contacts, or surgery, using PLUS dioptric power. Unlike Myopic (nearsighted) corrections which are very exact and simple to derive, Hyperopic corrections depend on the practitioner's ability to measure the amount of Hyperopia and then integrate all the other complex factors involved like age, accommodative strength, eye alignment, and lifestyle needs. Generally, correcting Hyperopia relaxes the farsighted eye for focusing in the distance the way it was designed, so the eye can use the normal amount of close focusing power for reading.


Because Hyperopic eyes can contribute accommodation to the vision-equation, finding the amount of correction that makes his/her eyes comfortable can be a challenge, and that equation changes over time as the aging eye loses its natural accommodative ability. The older you get, the easier it becomes to find the right amount of correction because your accommodation interferes less. Sometimes younger eyes won't relax and accept plus powered lenses. Large amounts of Hyperopia are easier to correct because the visual benefit is so dramatic. Small to moderate amounts are tougher because the benefit is the delayed gratification of reduced fatigue--which benefit often comes at the end of the day, the end of the week, the end of the school year, etc. For the younger Hyperope, we don't always correct the full amount, but instead, the amount that makes the eyes most comfortable--especially for close work.


Children and Hyperopia

Hyperopia is the most missed eye condition at school and pediatrician screenings because small to moderate amounts don't usually blur the child's vision. Children's symptoms increase with age and amount of Hyperopia, but they often don't know that the discomfort they feel is abnormal and they get numb to it. Often, it plays out as near-task avoidance. If reading is uncomfortable or tiresome after extended periods, the child usually develops avoidance patterns, which can turn into habits, attitudes, labels, and a self perception that can often be difficult to correct as the child gets older. As a parent, you can watch for these avoidance patterns, afternoon headaches, or strange visual behavior like squinting, sideways looking, or looking closer than normal at books, TV, etc.


Some eye doctors use a blanket approach to correcting a child's hyperopia--relying strictly on numbers. It is very important to find a practitioner who is committed to using the more sophisticated approach of finding the correction that makes the farsighted child comfortable for near tasks (whether that amount is none, or something different from their full correction). If correction is needed, sometimes single vision lenses suffice, or sometimes it is more convenient to put it in the form of bifocals. These are all complexities that take time to sort through and you will do well to expect your doctor to explain and recommend what is best for your child.

Having your child examined before the age of two is the best way to make certain that problems aren't missed which can lead to poor school performance and delayed visual development. You did a wonderful service for your son by bringing him in early, Sis. Check this post about a little girl we took care of with farsightedness similar to your son: THE EYES HAVE IT.

Longears and Sourdough: The Eyes Have It

Longears and Sourdough: The Eyes Have It

The EYES Have It

"Mom! Look! There are cracks in the sky!"

The life of any Optometrist is filled with "which is better, one or two?" punctuated with an occasional save that is SO spectacular, that just one patient makes your whole career worth him or her alone. There are a handful of these and I can recount them all.Over the past two weeks, I met young Sara (HIPPA forbids me from giving her real name.) At the age of five, she had never seen her world. Her eyes were so far-sighted that she had never been in focus and her brain had never learned to see. Even at the exam when I put the proper lenses in front of her, she didn't know how to process the suddenly-focused detail--still only seeing 20/400.

Her mom has been back in our office a couple of times already, full of emotion, stunned at the change in her daughter. Yesterday, it was to share the "lightning" story. She is horrified that she used to berate her daughter for being so blind, never sensing that it was the truth. Now in focus, nature takes over and Sara's brain is learning to see things for the first time. Every day, Mom gets to see things for the first time through five year old Sara's eyes. What a gift!

Reposted from an August 2008 "Longears and Sourdough" blogspot post.