Bright red eyes and a runny nose: this year’s must-have style accessory

May 12th, 2015

itchy eyes

Don’t you just love this time of year? The beautiful people of the world strolling languidly around with their long tanned legs coming out of their designer shorts and a pair of Ray Bans thrown on to finish it off.

Unfortunately, whilst I’ve got the Ray Bans (and I do indeed love them), they are largely to hide my bright red, itchy, inflamed eyes. I find acute uncontrolled seasonal allergic conjunctivitis is the ultimate accompaniment to my hairy, pasty and generally harried look. I just love hayfever… but at least there are a few things my fellow sufferers can do to try to manage our symptoms; hopefully with a little more success than me.

It always tickles me that we healthcare people like to assign complicated, intelligent-sounding technical terms to things that are indeed wholly obvious. I like to counsel my patients on allergen avoidance – people allergic to cats should not get a cat and people with nut allergies should maybe refrain from the satay.

Having said this, there are a couple of clever ways to avoid the immensely irritating little buggers that cause me to sneeze one hundred times a day and make me want to scratch my eyes out (pollen, not cats). You can press the button to recirculate the air in the car, you can put Vaseline around your nostrils in the morning to catch them on the way in, you can shower regularly and wear a hat so they don’t get stuck in your hair (pollen, not cats). Thankfully the truly massive pair of sunglasses that I hide behind happen to be trendy at the moment too (although possibly excessively trendy for me, giving me the deviant-chic look).

In terms of medications, there are smart combinations of medications that help. A heady cocktail of tablets, drops and sprays, which thankfully are safe, easy, cheap and readily available, can certainly make things more manageable. One of my favourite tips which I have been using more recently is to put my eye drops in the fridge to cool them down.

As I gently place one cool drop in my lower conjunctival sac, the resulting vasoconstriction inhibits histamine release but more importantly elicits a few seconds of unadulterated bliss as my eyes feel momentarily cool, calm and comfortable. Maybe it’s not ambling idly through Victoria Square in designer chinos, watching all the beautiful people and feeling an utter sense of belonging, but hey, you really do have to take a moment to savour in the little things in life.

“Andrew, have I got Kerry Katona’s ?”

May 12th, 2015

 

Keratonous

 

What is Keratoconus anyway?

I could write for about three days on what keratoconus is and how it affects people but in short, it is a condition which affects the cornea (the clear structure that lies over the pupil and iris). The cornea acts as the most powerful lens in the eye and consequently, the optical quality of this structure is crucial for good vision.

It is helpful to point out that the normal cornea is utterly incredible to begin with. It is the only living structure in the entire human body that is completely optically clear, the only structure in the entire human body which breaths for itself (from the air around us), and is the most sensitive structure in the entire human body with over 11,000 nerve endings per square millimetre.

I describe the cornea as being like steel reinforced concrete – it has a matrix gel (the concrete) and it has collagen fibres running through it (the steel reinforcement). It is the astounding regularity of the collagen fibres which gives the cornea its amazing optical clarity which is essential for visual function. Anything that causes these collagen fibres to become irregularly arranged causes the cornea to become cloudy. Just one example of this is the very clever pump which regulates the amount of water in the gel to maintain this regularity – to be honest, I find it incredible that it ever works to begin with!

Keratoconus is a condition where the collagen doesn’t work properly and the shape of the cornea becomes irregular resulting in reduced vision.

Do I have it?

Well, as it turns out, that’s a very good question. Keratoconus has a wide variety of different severities and presentations. There are a lot of people who are asymptomatic – they don’t have any problems at all and without specialist tests, neither they nor their optometrist would ever know.

The first tell-tale sign is often that the irregularity causes a prescription for glasses which changes more rapidly than usual or in an unusual way. But prescriptions for glasses often do this so in itself this doesn’t tell us what we need to know. The diagnosis can really only be made with analysis of the curvatures and thickness of the cornea using a number of specialist instruments and even then, there will be certain incidences where we miss it. There is a not very straightforward family link with keratoconus so if a family member has it, it is worth investigating.

What can be done?

Firstly it can be monitored – often it is not particularly progressive, so we do nothing more than watch it to see if it changes and talk to the patient about how they can manage symptoms and risk factors. Often the irregularity means that glasses do not give good vision and contact lenses are required.

There is a standing joke that the contact lenses we work so hard to design and fit aren’t really doing the work – it’s the tear lens created behind the contact lens, filling in the irregularity in the front surface of the cornea that corrects people’s vision. Designing the back surface of the lens is pretty tricky though – the keratoconic eye is a very very complex shape and all of them are different. And if I get it wrong, it can cause permanent scarring. To give you an idea, the lens which looks like a little clear bit of plastic less than a centimetre across, the back surface is designed, using over twenty different parameters, each of them accurate to five hundredths of a millimetre.

In order to get the very best performance possible, we use one of the widest ranges of contact lens manufacturers, types, materials and designs available anywhere in the UK – and there’s a reason for that. We have found the task isn’t easy and there is a lot to gain. Remember, many of our keratoconic patients can’t really see with glasses so contact lenses which give reliable crisp vision and all day comfort are very helpful.

Thankfully, there are loads of really innovative products and techniques available – and we are always scouring the journals for more. We use standard and specialist RGPs, piggy back with a range of different soft lenses, specialist soft lenses, corneosclerals and sclerals – we find that this gives us the best chance of getting a really good result for you.

More importantly, we stay hugely motivated to find the very best optical products for you. Regularly I find myself asking patients, “Yes, they are good, but are they good enough?” The question here is really whether the patient would like to put the time in to investigate other avenues. I joke that what we lack in skill, we make up for with pure tenacity!

Finally, we put it together with an aftercare package which enables you to pay monthly for everything we do. The aftercare means you can be sure you are looking after your eyes properly and investing in good eye health. Occasionally, the cornea becomes so irregular and thin that the care of a specialist is helpful, so we try to keep really good links with the local specialists who are at the top of the game .

If you would like to book a no-obligation appointment with us to discuss your keratoconus, give Ann/Ali a call on 02890 323 341 to book an appointment.

Get your kids ready for an active summer

March 16th, 2015

Little Girl Holding Basketball

 

If you think about it, kids have a pretty active lifestyle. That’s why we parents seem to spend most our lives running them to different clubs, sports and activities.

They do loads of sport, and even when they aren’t participating in formal sport, often they are outdoors at the park or on their bikes. Contact lenses provide crisp, comfortable vision without any frame to get in the way, slip down your nose or become damaged.

We routinely fit contact lenses from 8 years old where the child is good about other routine habits such as brushing teeth. Interestingly, young children are often better at looking after their lenses than teenagers, and good habits are often carried on into teenage years.

Contact lenses are ideal for sport as modern lenses stay in exactly the right place even during contact sports. They give better peripheral vision, improving awareness of new information throughout the visual field, such as movements of other participant or potential dangers.

Contact lenses are so incredibly thin and breathable nowadays that most wearers are not even aware that they have lenses on their eyes. We describe it as being like a layer of cling-film over the front of the eye.

Not only are contact lenses perfectly safe for kids, they have a role in protecting the eye from UV which causes cataract and age-related macular degeneration. 50% of UV damage done to the human eye throughout the lifetime, has happened by the age of 20. This is because children spend more time outdoors, they have bigger pupils, and their own natural lens inside the eye starts to filter out UV from that age.

Studies have shown recently, that full time correction of vision can reduce the progression of short-sightedness and one of the best ways to get kids to wear their glasses, is actually by fitting them with contact lenses!

Kids can wear daily disposable lenses, reusable lenses, tailor made gas permeable lenses and Orthokeratology lenses which are worn when sleeping, and taken out in the morning to leave good vision all day long.

They are generally really motivated to wear lenses as the lenses have such benefit to their lifestyle and for this reason, they usually find placing, removing and handling the lenses very easy, following the written instructions given as a matter of course.

Ongoing costs involve the lenses themselves, any solution necessary and ongoing care to make sure everything is working well, and are available from just £12/month. We can use any NHS entitlement towards costs and can even have the lenses delivered to your door.

Initially, we examine they eyes for suitability, take detailed measurements and discuss options both with the child as well as parents. We then order some lenses, which not only fit the eye perfectly, but also give good vision. The first lens placed on the eye sometimes feels like an eyelash, but often is completely comfortable.

Once a suitable lens is found, we take time to show how to place, remove and look after the lenses. Once they are working successfully with the lenses confidently, we go through dos and don’ts, what to expect, when to wear, tips from your appointment and recall schedule, which is all given in writing to take away. Our fitting fee for all of this for disposable lenses is £55.

OrthoK Contact Lenses

March 16th, 2015

Ortho K

Are you short-sighted? Contact lenses just not perfectly comfortable? Maybe they don’t sit perfectly when you’re cycling or get foreign bodies under them? OrthoK could be the perfect thing for you.

Tailor made gas permeable contact lenses, manufactured to an accuracy of hundreds of a millimetre, redistribute the cells on the front surface of the eye while you are sleeping, leaving crisp clear vision all day long. Just pop them in when you are brushing your teeth and in the morning, drive, work, play sport with the freedom from glasses or contact lenses.

It’s completely safe having had FDA approval in the US since 2002, and what’s more, unlike surgical options, completely reversible. It is suitable for patients with quite large prescription, correcting up to -6.00 diopters of short-sightedness, where glasses start to become thick and heavy. Studies show that it is as safe as disposable contact lens wear or possibly safer due to reduced wearing time.

Quite a number of recent studies have shown the technology to be effective in reducing the progression of myopia, a disease which is strongly linked to retinal detachment and glaucoma. The mechanism for this appears to be a change in the chemical messages sent to the eye, causing it to grow. For this reason, the technology may have added benefit when the short-sightedness is progressing quickly, often in early life.

FDA trials show fantastic success rates even with the first generation of lenses, with over 90% of patients vision being perfect for driving. Patient give this modality brilliant satisfaction scores in comparison to other forms of vision correction.

Fitting the lenses is quick and easy. The first appointment is an assessment for suitability, accurately measuring the contours of the eye and giving specification for precision engineering of the tailor-made lenses. Appointment two is for collection and an appointment is made for the next day. By appointment three, even after the first night, you will have clearer vision, so check the condition of the eyes and lenses, and take some more measurements. Appointment four – vision should be completely corrected within a few days, the final appointment being to make sure that both practitioner and patient are entirely happy, and to arrange an aftercare schedule, which is similar to conventional contact lenses.

One of the clever things about these lenses is that if you get up in the middle of the night, you will be able to see. The lenses will correct your vision whether you have them in or out. Lens costs include lenses, solution and aftercare, which will often come to about £30/month. There is a one off fitting fee of £195, which includes a £50 fee for the initial suitability assessment.

Local Optometrist gets Prestigious Award

November 12th, 2014

7/11/14

Mr Frank Petticrew FCOptom DipCLP

Mr Frank Petticrew FCOptom DipCLP

Belfast optometrist Frank Petticrew this week travelled to London to receive his award of Life Fellowship of the College of Optometrists for his worldwide contribution to complex contact lens fitting.

Frank (77) said, ‘I am humbled by the company I am in when being given this award, when hearing the contribution other recipients have made. This award is made all the more touching as it is recognition by our peers and colleagues.’

Frank’s son Andrew Petticrew who is now running the fourth generation family practice commented, ‘I watch with amusement at the mix of pride and embarrassment I see in my dad at getting Life Fellowship, which is a pretty big deal in the world of UK optometry. When hearing about the sheer volume of work my father has put into educating students, educating optometrists, developing contact lens technologies and most of all, helping his patients, I realise that he has done a lot of work that I wasn’t even aware of!’

At the presentation ceremony in Westminster Hall, Frank was asked to respond on behalf of the recipients, including the newly qualified optometrists from throughout the UK as well as further afield. He made a number of elegantly simple points including the importance of recognising that the new blood are the future of our profession and should be encouraged at every opportunity. He stressed that embracing technology, embracing education and to make time to talk to colleagues of a different generation is vital for development of our skills.

Frank continued, ‘The older members can learn from the younger members and the younger from the older. It is only sitting down together that we can all work together to improve the care we give our patients.’

With this award joining other from the Association of Optical Practitioners and the International Society of Contact Lens Specialists, Frank has shown us what community optometrists in Northern Ireland can achieve.

For more information please contact:
Andrew Petticrew
Work 02890323341
Mobile 07980282848
e-mail andrew@petticrewoptometrists.com

It’s time for you to see the optician…well, no it’s probably not.

October 21st, 2014

For some genius reason, at some stage in the dim and distant past, the great and good of our profession decided that we should no longer be called opticians.

Now, to put this in perspective, in eye care we have dispensing opticians, we used to have ophthalmic opticians, we have optometrists, orthoptists and ophthalmologists. The poor general public haven’t a notion who they are seeing – I have been called an optician, an ophthalmologist, an optimist, an optomeetryist and various other more insulting names too. I have to come clean and admit that I am indeed an optimist.

For most high street practices, even if they have the term optician above the door, it is an optometrist who you see in the consulting room. Interestingly, optician is not a protected term so anyone can call themselves an optician – I’m not sure why you would, but you could.

So, an optometrist is the person in the optician’s shop who is professionally qualified to examine your eye for disease, calculate your prescription and dispense your glasses. To book an appointment with me (an optometrist with a special interest in eye disease and medical contact lenses), call us on 02890323341 or e-mail us at info@petticrewoptometrists.com. We have great contacts with some fantastic local orthoptists and ophthalmologists too, if you need them too.

 

Andrew Petticrew.

Senior Optimist, Petticrew Optometrists.

 

Local Optometrist Eyes up a New Menu

October 15th, 2014

To mark National Eye Health Week 2014 which runs from 22-28th September, Belfast optometrist Andrew Petticrew talks about how to eat well to improve your eye health.

Andrew says, “People don’t always know that you can stack the odds in your favor regarding eye disease in later life, by making changes to your diet. The back of the eye has a number of very delicate structures which rely on a superb blood supply to maintain their function. Too little blood and they die, too much leakage from the blood vessels and they die too. And unfortunately, when the die, they aren’t regenerated.”

Thankfully, there is action we can take to keep these arteries, veins and capillaries healthy. Research has shown that eating just one portion of fish a week can reduce your risk by up to 40%, of developing age-related macular degeneration, the UK’s leading cause of blindness.1

Also, blueberries and grapes contain anthocyanins, which may help improve night vision. Green leafy vegetables such as spinach or kale are rich in carotenoids, especially lutein and zeaxathin. Lutein and zeaxanthin may help prevent age-related eye diseases such as macular degeneration and cataract. These carotenoids may also reduce discomfort from glare and enhance visual contrast.2

Andrew continued, “My advice to patients is to eat a rainbow every day. Eat a wide variety of different colours fruit and vegetables. The different pigments in the skins, provide different antioxidants which have been shown to slow the aging process in the eye. Of course, making sure your blood pressure is ok, your cholesterol is ok and that you get plenty of exercise. But if you can enjoy delicious food, and help your eyes at the same time, it’s a win-win.”

For more information and some interesting recipe suggestions, go to www.visionmatters.org.uk.

 

 

 

Cheap Glasses? They have a real cost.

August 7th, 2014

I got stung by a bee the other day…

I was flicking through Which Magazine in the bath this morning (not a pretty picture that one) and I stumbled upon an article entitled ‘The Real Cost of Cheap Glasses.’ The crux of the article is that it is completely impossible for the consumer to know if they are getting ripped off or not…and lots of people are.

Out of 36 pairs of glasses bought and tested, 10 were borderline and 15 failed, of which five were described as being dangerous – not that cheap if they cause you to crash the car or trip going up a step.

My late mum regularly used to mutter to herself, ‘price of everything and the value of nothing.’ What she was really commenting on was that people are very aware of the price of goods but are often completely blind to their value.

I feel entirely comfortable with cheap things being cheap and expensive things being good. Some cheap things may be good, but expensive things should always be good. One way to tell if a product is good is by the brand but this doesn’t work where the product is then tailored for you, like a pair of glasses.

I often see patients who have come to me for the first time having bought a really excellent frame with a really beautiful pair of lenses, where the sum total is zero. The prescription is rubbish, the lens type is inappropriate, the frame was fundamentally unsuitable for the patient or the lab has screwed it up.

I feel that trust is the important part of it all. It was actually a patient who pointed out to me that of course I would always make huge efforts to provide transparent, good quality, good value products and services because it is my name above the door – I simply have too much to lose if I don’t.

There is a reason why we are meticulously careful about our work – it’s so we can be truly proud of what we do. Patients often ask us to comment on the quality of products from our competitors, and it is indeed our job to know what they are doing and how much it costs.

The last pair I bought I actually came clean with their customer services department, telling them I was a qualified optometrist working as a mystery shopper – I returned their product so that they could initiate an investigation to find out how it could happen. Our standard answer at Petticrew Optometrists is, ‘We are extremely proud of what we do.’

The title of this post is stolen from a good buddy of mine whose favourite joke is, ’I got stung by a bee the other day…£10 for a pot of honey.’

Andrew Petticrew BSc(Hons) MCOptom

Optometrist