Ophthalmic Optics can have some complicated equations.  We we see patients, there are times when a contact lens for astigmatism does not perform the way we predict.  We perform a measurement of the blur called an over-refraction and mathematically combine the result with the prescription to predict the next lens power that would work.  Before this utility was developed, we would have to do the math by hand or set up lenses together and use a machine called a lensometer to predict the next lens.  X-Cyl does the math for us so a doctor can just enter the variables and click on the answer.  It became wildly popular because it was faster, more accurate and free.  We wrote the software as a fun project and to help other doctors.

We wrote another program called ImageRx.  This calculator helps doctors design lenses that are equal in magnification.  Some prescriptions can generate headaches, eyestrain and double vision if the powers before each eye vary by too much.  To minimize the difference, we can vary the design of the lens such as the power, the fitting distance, the thickness and the curvature and refractive index to achieve an equal magnification.  This involved even more difficult calculations than what X-Cyl solves.  Before ImageRx, most doctors would would rely on nomograms.  ImageRx streamlines the design process and ensures mathematical accuracy to allow the eye care professional to try differing variables to solve their design challenge.

Both software have been updated to run on 32 or 64 bit operating systems.  They have been tested to run on Windows XP, Windows Vista and Windows 7.  Both are free and can be downloaded from our practice website.

Click on the icon to download.

X-Cyl Toric Crossed Cylinder Calculator
(version 1.20)

Updated for 32 or 64 bit Windows use, New tooltips and a clear button for faster, easier use.

ImageRx Anisekonic Lens Design Calculator
(version 1.20)

Updated for 32 or 64 bit Windows use, Calculate both lenses together now for easier use.

1. Check to see if the lens is inside-out or if it is correct.
2. Place the lens on the tip of the index finger of your right hand.
3. Pull up the upper eyelid with your left hand.
4. Pull the lower lid down using the middle finger of the right hand.
5. Look upwards, and place the lens on the white part of the eye.  Release the upper lid and blink.  The lens should center automatically.
6. Using the opposite hands place the other lens on the eye.

WEAR SCHEDULE
Your eyes require an adaptation period to adjust to contact lens wear.  Usually, the doctor will prescribe a wear schedule of 4 hours on the first day and increasing by 2 hours per day of wear (e.g. 4, 6, 8, etc. hrs).  Do not wear your lenses more than 12 hours until you have had your first progress exam.  At that time your doctor will let you know how long you should wear your lenses.  Be sure to wear your contact lenses to your progress exams unless you are having problems wearing them continuously.  Bring your glasses and contact lens case also.

REMOVAL OF LENS
Before removing your lenses, wash and rinse your hands  thoroughly.  Have your contact lens solutions and storage case opened and ready to receive the lens.

1. Look upwards and pull the lower lid down.
2. Using the right index finger, slide the lens onto the white part of the eye.
3. Press the lens gently between the thumb and index finger, and remove the lens from your eye.
4. Clean  and rinse the lens and place it in the storage case.

CLEAN
Daily cleaning of your lenses is necessary to remove tear residues, mucous films, lipid coatings and other foreign substances that accumulate on the lens surfaces.  Clean your lenses every evening after you have removed your lenses for the final time.

1. Wash your hands before handling.
2. Place the lens in the palm of your hand and place 1 drop of the prescribed daily cleaner or multipurpose solution on the lens and 1 drop on your hand by the lens.  Rub the lens with a small amount of pressure in a side-to-side and back-and-forth motion (do not go in a circular motion).  Clean each side for 25 seconds in this manner, invert the lens and repeat for the other side.  Instead of cleaning, disposable lens wearers should rub the lens with the multipurpose solution they are prescribed.

RINSE
After the cleaning process, place the lens in your free hand and rinse the soapy hand with tap water.

1. Place the lens in the palm of your hand and squirt the prescribed saline or multipurpose solution to the lens for several seconds.  Drain the excess solution and repeat 1 or 2 more times.

DISINFECTION
The disinfection cycle keeps your lenses free from harmful bacteria and other germs.  Disinfecting the lenses regularly reduces the possibility of contamination or eye infection.  This procedure is performed in addition to your daily cleaning procedure.

1. After cleaning and rinsing your lenses fill the storage well with the prescribed disinfecting or multipurpose solution to the fill line.  Place each lens in its appropriate well and close the cap.  Allow the lenses to sit overnight.  THE MINIMUM TIME FOR DISINFECTION IS SIX HOURS in most cases.
2. Rinse with the prescribed saline solution prior to lens insertion.  Discard the remaining solution from the container and wash the case so it is clean for the next use.

NOTE:
a)  AOSEPT systems utilize a catalytic disk to neutralize the disinfection solution.  These disks must be replaced each 3 months or 100 uses whichever comes first.

ENZYME
The enzyme procedure is designed to remove the protein buildup from your contact lenses which the daily cleaning solution does not remove.  Enzyme cleaning keeps your lenses cleaner, makes them more comfortable to wear and keeps the oxygen transmission at its highest level.  This procedure is performed in addition to your daily cleaning procedure.
Enzyme your lenses as recommended each week.  This is done just after daily cleaning and before you disinfect for the night.  Add one enzyme tablet to the contact lens solution in the appropriate container.  Allow to sit up to 2 hours and then use the daily cleaner again for maximum cleaning effect.

CARE TIPS

1. Use only the solutions that have been prescribed for you.  Other solutions may cause discomfort or damage your lenses.
2. Occasionally, contact lens wearers substitute sterile saline solution for the prescribed multipurpose solution thinking they are the same but cheaper.  Multipurpose solutions disinfect, clean and act as a rinsing-storage solution.  Sterile saline has no cleaning or disinfection properties.  This can result in eye infections and serious damage to the eye.  Always disinfect the lenses when stored overnight or longer.
3. Clean your lenses in the palm of your hand in the proper motion.  Lenses can tear if they are cleaned in a circular motion or between your fingers.
4. Keep your lenses wet at all times.  When you are not wearing your lenses, store them in your contact lens case with the prescribed saline solution.  Should the lens dry out on a countertop, do not touch it.  Wet the area with several drops of saline solution and wait 30 minutes before attempting to handle the lens.   Clean and inspect the lenses for damage before wearing.
5. Follow the wear schedule which was prescribed to you.  Do not sleep in your lenses unless your doctor approves the lenses for extended wear.  (If you should accidentally take a short nap wearing your lenses; remove, wet, and re-insert them as long as no discomfort is involved.)
6. If your lens becomes uncomfortable when it is inserted, remove the lens immediately.  Rinse the lens with saline solution and re-insert.  If the discomfort persists, remove the lens and call our office.
7. Inspect and clean your contact lens case often.
8. Blink often to keep your lenses wet.  Apply only prescribed wetting drops if dryness persists.  Never apply any medication to the eye with contact lenses in place unless approved by the doctor.
9. When in doubt about procedures, solutions or symptoms, do not hesitate to call our office!

Cataract Surgery is Done with Lasers
Never – almost. Yes, experimental research but nothing practical yet developed. Nearly 100% of cataract surgeries are still performed with traditional microsurgical techniques. Lasers can be used after cataract surgery to clear up cloudy membranes. This is where the confusion may often lie.

All Red Eyes are Infections
It has been our experience in our office that most red eyes are due to allergies or dry eye.We see more viral than bacterial etiological causes. This is why your eye doctor can’t just call in some antibiotic. Antibiotics fight bacteria and do not kill viri or decrease allergies.

Refractive Surgery Forever Removes the Need for Eyeglasses
People may assume no more visits are required to the eye doctor after refractive surgery. In fact people need MORE FREQUENT eye care after eye surgery. Refractive surgery today has a better than ever chance of eliminating your refractive error. One condition it can not cure however is Presbyopia. Presbyopia is the natural loss of focusing ability which first shows symptoms past the age of 40. Increasing working distance, eyestrain, blurred near vision are its symptoms. Presbyopia is not treatable except for corrective lenses.

Contact Lenses can be Welded to the Eye if you Weld with Them In
Nope. Contact lenses actually have been found to protect the eye from severe injury. Less trauma has been observed following foreign bodies and chemical splash/burns to the eye. A contact lens has been found to act as a protective shield for the cornea often taking the brunt of damage.

Stronger Glasses can Fix Every Vision Problem
“All I need is a pair of glasses that will work.” is a complaint often heard by eye doctors from patients seeking second opinions due to eye and vision conditions which have deteriorated their ability to see. Neurological problems can interfere with vision. Post-concussion syndrome frequently complicates vision problems. Cataracts interfere with a person’s ability to see. Retinal diseases like macular degeneration often cause a desire for a patient to ask the doctor for stronger glasses. Sometimes they are prescribed, but often special low vision magnifiers, electronic magnification aids and other special aids are needed.

Poor Night Vision is Infrequent
This is actually our most common complaint that we hear of. Small refractive errors is #1 cause. At night the pupil dilates which causes the eye to become more sensitive to changes in an eyewear prescription. Cataracts, macular degeneration, optic nerve disease and contact lens overwear can decrease night vision as well. Nicotine has been shown to decrease the ability to dark adapt. Dirty car windshields can create a phenonema known as the Mandelbaum effect. The focusing system draws inward creating an artificial form of near-sightedness. Night myopia is a similar phenonema which can occur as well despite perfectly clear windshields. Rainy weather decreases your ability to see to drive at night. Wet roads decrease the amount of light reflected back to you from your headlights and increase the amount of light from oncoming cars. Often no detectable problems are found. Aging is a frequent cause of night vision problems. The retina takes longer to recharge its photoreceptor chemicals as we mature. Retintitis Pigmentosa, a traditional cause of night blindness is another retinal disorder which has classically been associated with poor night vision is actually very uncommon.

Eyeballs are Removed During Surgery
Rarely, surgeons usually work around them. The muscles and the optic nerve are of a fixed length. Removing the eye risks avulsing (tearing) of the optic nerve.

“I’m Legally Blind Without my Glasses”
By it’s definition legal blindness is 20/200 in the better eye with correction (glasses or contact lenses) or less than a 20 degree visual field in the better eye. To say you are legally blind without glasses is not in keeping with the true definition.

These Lenses are Scratch-Proof
No lens yet developed is truly scratch-proof. There is always some material which can scratch a lens. A diamond can be scratched by another diamond. Lenses instead should be termed scratch-resistant. A plastic lens with a scratch-resistant lens is more durable than a lens without the coating. Glass to this date remains the most scratch-resistant material – more durable than plastic with a scratch-resistant coating.

1. Place the lens, concave side up, on the tip of the index finger of your right hand and place a drop of the prescribed conditioning solution on the lens.
2. Bend your head down so that your eyes will be looking down and your lens will be moving in an upward direction when being inserted.
3. Place the middle finger of your left hand on the upper eyelid by the eyelashes and pull the upper lid up.
4. Place the middle finger of your right hand by the lashes of the lower eyelid an pull the lower lid down.
5. Slowly bring the lens toward the cornea of your eye.  Look straight through the lens as it comes towards your eye.
6. Gently place the lens on your cornea, release your lower and then your upper eyelid, straighten your head and blink several times.
7. Repeat for the other eye.

WEAR SCHEDULE
Your eyes require an adaptation period to adjust to contact lens wear.  Usually, the doctor will prescribe a wearing schedule of 2 hours on the first day and increasing by 1 hour per day of wear (e.g. 2, 3, 4, etc. hrs).  Do not wear your lenses more than 12 hours until you have had your first progress exam.  At that time your doctor will let you know how long you should wear your lenses.  Be sure to wear your contact lenses to your progress exams unless you are having serious problems wearing them continuously.  Bring your glasses and contact lens case also.

REMOVAL OF LENS
Before removing your lenses, wash and rinse your hands  thoroughly.  Have your contact lens solutions and storage case opened and ready to receive the lens.  Removal is simpler if the lens is correctly centered on your cornea.  There are two effective ways to remove your lens.

Two Finger Method

1. Place a towel or your hand, palm up, under your eye to catch the lens.
2. Place the tip of the forefinger of one hand centered on the edge of your upper lid and the forefinger of the other hand centered on the edge of your lower lid.
3. Press the lid edge inward and then together.  The lens should be wedged out of your eye onto your hand or towel.
4. The lens may come out but remain on your eyelid or hand or be decentered into the white part of your eye.  If the latter occurs, recenter the lens onto your cornea before repeating the removal procedure.

Blink Method

1. Seat yourself at a table covered with a clean towel and lean over until you are looking down at the surface.
2. Place your index finger at the outer junction of your upper and lower lids, stretch the skin outward and slightly upward.  (Do not allow your upper lid to slide over the lens.)
3. Blink briskly.  The lens will be pinched by the pressure of your eyelids and the lens will pop out onto the clean surface of the towel, or you may catch the lens in the palm of your hand.

Clean  and rinse the lens and place it in the storage case.

CLEAN
Daily cleaning of your lenses is necessary to remove tear residues, mucous films, lipid coatings and other foreign substances that accumulate on the lens surfaces.  Clean your lenses every evening after you have removed your lenses for the final time.

1. Wash your hands before handling.
2. Put the lens in the palm of your hand and place 1 drop of the prescribed daily cleaner on the lens and 1 drop on your hand by the lens.  Rub the lens with a small amount of pressure in a side-to-side and back-and-forth motion (do not go in a circular motion).  Clean each side for 20 seconds in this manner. A cotton-tipped applicator often helps to clean the concave surface.
3. Place the lens in the palm of your hand and thoroughly rinse the lens with fresh tap water.

DISINFECTION / STORAGE
The disinfection cycle keeps your lenses free from harmful bacteria and other germs.  Disinfecting the lenses regularly reduces the possibility of contamination or eye infection.  This procedure is performed in addition to your daily cleaning procedure.

1. After cleaning and rinsing your lenses fill the storage well with a fresh supply of the prescribed disinfecting/conditioning solution.  Place each lens in its appropriate well and close the cap.  Allow the lenses to sit overnight.  THE MINIMUM TIME FOR DISINFECTION IS FOUR HOURS for most solutions.
2. If desired, reapply fresh conditioning solution prior to lens insertion.  Discard the remaining solution from the container and wash and air dry the case so it is clean for the next use.

ENZYME

The enzyme procedure is designed to remove the protein buildup from your contact lenses which the daily cleaning solution does not remove.  Enzyme cleaning keeps your lenses cleaner, makes them more comfortable to wear and keeps the oxygen transmission at its highest level.  This procedure is performed in addition to your daily cleaning procedure and will  be needed only if your doctor mentions it.

Enzyme your lenses  once or more each week.  This is done just after daily cleaning and before you disinfect for the night.  Add one enzyme tablet to the contact lens solution in the appropriate container.  Allow to sit for 2 hours or more for maximum effect.  Daily clean them again, rinse and disinfect for the next days use.

RECENTERING A LENS

In rare instances, or due to improper performance of insertion or removal techniques, your lenses may decenter onto the white part of the eye.  Because of the anatomy of the eye, the lens cannot go “behind” the eye.

1. Locate the lens by using a mirror and pulling the lids away with your fingers to identify its position.  Combine large head and eye movements to locate difficult to find lenses.  Your fingers may also be useful in feeling for the lens.
2. When located, massage the lens gently back towards the cornea, looking in the direction of the lens  until it slips back into position.  If the first method doesn’t work, try pulling the lids apart and rolling the eyes in a circular motion to recenter the lens.

CARE TIPS

1. Use only the solutions that have been prescribed for you.  Other solutions may cause discomfort or damage to your lenses.
2. Clean your lenses in the palm of your hand in the proper motion.
3. Keep your lenses wet at all times.  When you are not wearing your lenses, store them in your contact lens case with the prescribed soaking/conditioning solution.
4. Follow the wear schedule which was prescribed to you.  Do not sleep in your lenses unless your doctor approves the lenses for extended wear.  (If you should accidentally take a short nap wearing your lenses; remove, wet, and re-insert them as long as no discomfort is involved.)
5. If your lens becomes uncomfortable when it is inserted, remove the lens immediately.  Rinse the lens with wetting solution and re-insert.  If the discomfort persists, remove the lens and call our office.
6. Clean your contact lens case often.  Scrub your case weekly using your daily cleaner and a clean toothbrush.  Rinse the case well with hot tap water and allow it to air dry before further use.
7. Blink often to keep your lenses wet.  Apply only prescribed wetting drops if dryness persists.  Never apply any medication to the eye with contact lenses in place unless your doctor says it would be safe.  The drugs can ruin the lenses and irritate your eye.
8. When in doubt about procedures, solutions or symptoms, do not hesitate to call our office!  Our courteous staff will always be willing to help you