Patient Mary’d pteryigum removal after cataract and previous lasik surgery. www.gulanivision.com

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Hemifacial spasm is a medical condition that affects the muscles of one side of the face and is evidenced by involuntary muscle contractions. These usually begin with twitching of her eye then can progress to the muscles of the same side of the face including the tongue.

As a retired physician I had the opportunity during witness these symptoms first-hand, by observing them in my wife, who, at age 67 is an otherwise excellent health. She began to complain about eye muscle twitching for several years; then developed extreme sensitivity to light (photophobia) about three years ago. She then developed grinding of her teeth, thrusting of her jaw forward and biting of her tongue.

She was evaluated at the University of Colorado Dental School, but no diagnosis was made. Finally an opthalmologist evaluated her and suggested that she had hemifacial spasm which was confirmed by a neurologist. She has subsequently been treated with the anticonvulsant medication, Dilantin. However, she has continued to have symptoms.

Her symptoms have included tingling out her tongue, forward jaw thrusting, slurring her words and biting her tongue and some involuntary contractions in her hands and arms, and can even develop pain and muscle spasm in her neck and shoulder.

For the past six months she has developed an exercise program which he believes has significantly reduced her symptoms. These are simple set of exercises which she performs three times a day, in the morning, sometime during the day, and at night.

These exercises a rather simple to perform: she opens her mouth, her eyes, and her hands as wide as possible, sticks her tongue out as far as possible, and performs deep abdominal breathing. She holds this pose for about 5 seconds and then relaxes. She performs this exercise 10 times; five times with the tongue protruding, and five times with the tongue relaxed (in its normal position).

Any symptoms she might have seemed resolved in a few hours. She believe this is increased range of motion for opening her jaw. She has stopped biting her tongue and slurring her words. She has less involuntary contractions involving her hands and arms (the yips).

Although she continues to take a Dilantin to control her symptoms, she sincerely believes that these exercises have dramatically improved her symptoms, and decrease their severity.

How these exercises work is explained by the nerve pathways which are stimulated in this manner. What she is doing is encouraging the normal pathways to function and showing her nervous system the correct way to operate and by repeating this process she is helping to defeat the abnormal nerve pathways which have developed.

This clever exercise program I believe is a worthwhile addition to the treatment of hemifacial spasm. It is certainly safer than the three currently prescribed methods of treatment, namely surgery, Botox injections, or medications.

We intend to share this information with the Hemifacial Spasm Association, for the benefit of their members and guests at their website at http://www.hfs-assn.org

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Black spots in the eye are pretty common and in most cases aren’t serious. They are otherwise known as floaters as they have the tendency to float around in and out of the field of vision. They are generally more noticeable when in a light environment (for example being outside in the sunshine) and when looking at light surfaces. The shape, behaviour and size of the floaters vary from person to person – some people have described them as being similar to roads on the map, whilst others compare them to a large number of small circular grains.

Whilst the cause of these black spots haven’t been proven despite many studies, scientists believe that the shadows or black spots that you see in your eyesight are caused by dead cells (including red and white blood cells) and small particles of vitreous protein that are dark enough to cast a shadow on the retina.

Seriousness of Black Spots in the Eye

In the majority of cases, floaters are nothing to be worried about and can be nothing more than a minor irritation. However, if you’ve suddenly experienced a rapid accumulation of black spots over a short period of time then some studies suggest that you may have more permanent damage such as a retina break or a haemorrhage in the vitreous body of the eye. In this case you seek the advice of an experienced ophthalmologist without delay.

In some instances the black floaters can be prominent enough to obscure the vision of an individual even to the point of disabling that person. Again, it is recommended that you seek professional advice regarding the condition just to make sure that you don’t a more serious underlying problem.

Options for Treatment

There are a number of things that you can do to remove the black spots from your vision. The most effective method is surgery however it is quite an invasive procedure, doesn’t come without risk, costs quite a lot of money and should be taken through private healthcare and requires substantial recovery time after the operation. I would only recommend that this option is considered if the black floaters are hampering your vision to the point of being a disability.

Natural means of removing floaters are being increasingly used and many people have reported good results from supplementation of various substances that are used within the eye to promote healing and the production of new tissue. The most successful results have been obtained by combining a series of eye exercises (usually following William Bates’ guidelines) with supplementation of substances like lutein.

In Summary

The large majority who suffer from black spots in the eye don’t have anything to worry about for the long term health of their eye or vision. If you’re starting to feel that your floaters are hampering your vision in certain situations then it’s certainly worth experimenting with natural ways to remove them as results can usually be attained within as little as a few weeks. More serious vision obscuring floaters that have appeared abruptly could well be a sign of an underlying retina break or haemorrhage and professional advice should be sought immediately.

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The ACRILISA multifocal lens is used to provide patients with both DISTANCE and NEAR correction following Cataract or Lens Replacement surgery. Also know as MULTILEX at Centre for Sight (multifocal lens exchange) this is an excellent option for those looking for vision correction. For the lens to work astigmatism must be eliminated and this video also demonstrates a “Limbal Relaxing Incision” or LRI at the end to accomplish this correction. At Centre for Sight (www.centreforsight.com) with the introduction of the Bausch and Lomb Stellaris machine, the incision size has now been reduced by almost 50% at 1.8mm — and a video demonstrating this will soon be available. Please visit Our web site www.lasik-eyes.co.uk for more procedure videos…

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The purpose of this article is to simply describe what you need to do to buy your first pair of glasses online. I will not recommend particular retailers, as you can find that info in several of my other articles and also check out the links on the right of this page. Purchasing eyewear online seems daunting at first. If you’re like me, purchasing and fitting prescription glasses always seemed like a complex procedure best left to professionals. The truth is, if you know your prescription and have your existing rx glasses handy, it is really quite simple to purchase glasses online.

The Seven Critical Numbers

First, find your current prescription. I keep mine in the health file in my filing cabinet. If you can’t find your prescription, visit wherever you last had your eyes examined and request a copy. Your optician, optometrist, or ophthalmologist is required by law to release your eyewear prescription to you. You now need to make note of a few critical pieces of information from your prescription (see example above–click to enlarge). Among other information, you should see three columns on your prescription–sphere, cylinder, and axis.

In the example above, these are abbreviated SPH. CYL. and AXIS. These three columns will have two rows, Right and Left. In the prescription above, this is simply abbreviated R and L. Many doctors instead use the latin abbreviations, which are OD and OS. OD means right eye and OS means left eye. Jot down a quick copy of the six numbers or simply keep your prescription handy. These six critical numbers define how your lens will be carved. Any online eyewear retailer will ask for the input of these six numbers.

In addition to these six numbers, there is one more critical number, the Pupillary Distance, or PD. This is a measure, in millimeters, of the space between your eyes. In the example prescription above, you’ll see the Pupillary Distance of the patient is 62. Jot down this number also, it is the seventh of your seven critical numbers.

A Final Measurement

A somewhat less critical number is your temple length. If you’re lucky, you’ll also see a temple length and bridge size in your prescription. If not, don’t sweat it, you can figure it out yourself. The temple length describes the length of the two bars that connect the glasses to your ears. It is measured from where the 90-degree curve from your lens structure to the side bars (temples) begins to the very end of the temple, including the curve. It is not measured from the flex point of the temples, because the “stub” between the flex point and lens structure is not a standard size.

Now, take out some measuring tape (preferably the type of tape used for fitting clothes and sewing, as it is very flexible) and measure an existing pair of glasses that fit comfortably. An average temple length for men is 135mm or 145mm. For women, 130mm to 140mm is standard. If your tape only has inches, measure to the nearest eighth or sixteenth and multiply that number by 25.4 to get the measurement in millimeters. Temple lengths are generally available in 5mm increments, such as 130, 135, 140, 145, etc. At most online eyeglasses stores, temple length is shown within a frame description and is not customizable. Therefore, you need to find a frame with an appropriate temple size. This sometimes varies if you are at a site specializing in designer glasses, where you have the option to input your own temple size.

Honestly, temple size is not a huge deal. I have one pair of glasses with 135mm temples and another with 140mm temples. Both pairs fit comfortably. If for some reason you can’t come up with a temple measurement, don’t let that stop you from making an eyewear purchase online. Instead, simply choose 140mm temples if you are a man and 135mm temples if you are a woman. Chances are, this length will fit comfortably.

What’s your Style?

Armed with your seven critical numbers and an idea on your temple length, start browsing the myriad of online retailers. Pick out some favorite frames and open the individual pages in separate tabs or windows of your web browser. Similar to trying on glasses at a standard retailer, you need to figure out if the frames you like are appropriate for your face. You might visit my post on the topic of face shape. If you have a nice oval face, you’re in luck, most any pair will look on you. If you have strong, angular features, a rounded or rimless pair will look god on you. If you have a very round face, choose a rectangular or hexagonal pair of glasses. If you just want a basic pair of professional glasses, go with titanium rimless.

Using your trusty measuring tape, you can compare other measurements of your existing glasses with what you are looking at online. The bridge measurement describes the distance between lenses, the height describes the distance from the lowest point on the front of the frame to the highest point, and the lens describes the distance between the end of the bridge and the beginning of the temple. Some retailers also offer free virtual try-on. This service, which I describe in will allow you to upload a picture and place a variety of frame types on your face.

Place your Order

So you’ve found the perfect pair of frames. Begin the checkout process. You should see boxes where you can enter your prescription information (the seven critical numbers). This will sometimes be in a table format similar to your prescription, or it may be a simple list. You’ll also have the option to choose from a variety of coatings and add-ons. If you will be wearing your glasses day-in and day-out, I recommend choosing the anti-scratch and anti-reflective coatings. These really do make a difference and ease night driving (anti-reflective) and the longevity of being able to see clearly through your lens (anti-scratch). You can add on the UV coating if you wish, though it isn’t critical. Photochromatic tinting (aka “transition lens”) is also an option. Personally, I prefer buying a separate pair of prescription sunglasses, but that is up to you.

If you only wear glasses occasionally (maybe as a supplement to contact lenses), or are just purchasing a pair of Rx sunglasses that won’t be worn every waking hour, you might choose to save money by skipping on the extras. If you are buying a pair for your accident-prone child, skimping on the extras might not be such a bad idea either. Avoid coatings and other add-ons will also allow you to get a great pair of prescription glasses for well under $40. After you’ve placed your order, you’ll typically wait about 2-to-3 weeks for your glasses to be custom carved and delivered. The finished product will typically include a hard case and a soft cloth for lens cleaning.

In this I show a video of the exact product received from a popular online eyewear retailer.

Side Note One: “Help, I don’t have a prescription!”

If it has been a long time since your eyes have been examined, or if you just can’t get a hold of your prescription, it’s time to go visit an optometrist. While your neighborhood optometrist may charge $100 or more for a simple examination, discount stores like Wal-Mart, or optometrists in working-class neighborhoods will often offer an eye exam for $40 or less. Grab your yellow pages and start making phone calls. Chances are, you’ll get the best price if you find an optometrist who has many customers without vision insurance.

Side Note Two: “How can it be so cheap?”

The price difference between online eyewear and glasses bought from a traditional retailer, or even Wal-Mart or Costco, is startling. An identical pair of titanium frames might cost $60 online and $220 at Wal-Mart. How can this be? What about the quality? I will categorically state that the quality of glasses received from the majority of online retailers is equal to or exceeds the quality found at your neighborhood eyewear shop or optometrist. The price differential comes from a number of factors, including the relative obscurity of online eyewear purchases, the fact that highly paid optometrists do not spend one-on-one time with the eyewear purchaser, and the fact that insurance companies are typically not involved with online eyewear purchases, thereby discouraging inflated prices.

Give it a try. I guarantee you’ll be satisfied with your online eyewear purchase if you follow the steps outlined in this article.

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Jesse had Lasik surgery with Dr.Gulani 6 years agao and is still maintaining his 20/20 vision. He has referred a number of friends and navy pilots and they are all seeing 20/20 too. Recently he brought in his wife for her surgery too with Dr.Gulani. www.gulanivision.com

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When lasik goes bad, there is no Plan B. Your eyes are your most precious sense—you need them to drive, work, play, read…When you have lasik complications, you can only escape the trashed vision by sleeping, and that’s only if you are able to sleep after you figure out what has happened to your eyes. See lasikflap.com and lasikdisaster.com for more information.

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