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REFRACTIVE SURGERY


Shooters have been asking me over the years about refractive surgery.

My opinion is not to have it done, although each shooter I talk with has a buddy that has had the surgery and they "see great", go for it as long as you realize there is a risk. If you are serious about shooting consider these statements that are taken from refractive surgery manuals:

• Refractive surgery is an imprecise tool….until 20/20 can be guaranteed in 98% of the cases without serious residual farsightedness (overcorrection)….At this point it is like "reaching into a grab bag"

• The results cannot be guaranteed: there is no guarantee that you will completely eliminate reliance on eyeglasses and / or contact lenses.

• "It is possible that dependence on reading glasses may increase or reading glasses may be required at an earlier age."

• After surgery you may experience starburst-like images around lights, depth perception may be altered, and image size may appear slightly different, all of which may affect my ability to drive and judge distances. Additional side effects may include "double vision" and the possibility of my eyes not working well together after the surgery.

• There is a possibility of having glare (rings around lights), fluctuating vision, and ghost images...they do not always go away completely.

• It is possible to incur unforeseen complications as well as complications such as corneal vascularization, corneal ulcer formation, epithelial healing defects, endothelial cell loss, corneal thinning, irregular and lack of permanent corneal curve change, cataract formation, infection inside the eye, pain, blindness, and even loss of the eye.

• Ask the surgeon if they have had refractive surgery done on their eye(s).

• It is now being discovered that refractive surgery does not eliminate dry eye in contact lens wearers.

I discourage refractive surgery for marksman and people that need very precise visual acuity. I do and will continue to have a small number of patients each year having refractive surgery. If you would like to discuss this further please contact us.

Dr. Alan Toler O.D.
Doctor of Optometry
For more information on Laser eye surgery visit the FDA web site: http://www.fda.gov/CDRH/Lasik/


For the pistol shooters:
"Why you should focus on the Red Dot?"


Electronic dots do not have the ability to be focused like variable power scopes. As we get older it becomes harder to focus on the front sight. The same is true for electronic dot scopes. Although, the dot may appear to be at the same distance as the target it isn't. The dot is only a couple of inches in front of the scope. The exact distance is the reflected distance from the mirror coated front lens to the light emitting diode inside the scope. Reflections in mirrors work like this. If you stand three feet from a mirror, your reflection is six feet away. To verify this put a yard stick against your stomach and the mirror, how long is the yardstick between you and the mirror? Three feet long. How long is the yardstick in the reflection? Three feet long. Total six feet.

Although scores usually go up when switching to electronic dots, competitive shooters 36 years old and older would benefit even more by focusing on the dot. I am using the same understanding as focusing on the front sight. Every minute of error at the sights results in a larger error at the target. If you look at the target the dot is going to have some fuzz to it, because we know that the dot is right in front of the scope.

Custom Sight Picture (Patented) is the only method that allows a shooter To test at the range under all conditions and determine what lens will sharpen the dot or iron sights. Get those extra points today.



If you are not focusing on your red dot you are losing points.

Electronic dots can not be focused like variable power scopes. As we get older it becomes harder to focus on the front sight of iron sights. The same is true for electronic dot scopes. Although the dot may appear to be at the same distance as the target it isn't. The dot is only a couple of inches in front of the scope. The exact distance is the reflection distance from the mirror coated front lens to the light emitting diode inside the scope. Let me explain you r reflection. When standing three feet from a mirror, your reflection is six feet away. To verify this put a yardstick against your stomach and the mirror, how long is the yardstick between you and the mirror? Three feet long. How long is the yardstick in the reflection? Three feet long. Total six feet.

Scores usually go up when switching to electronic dots because of the illuminated red dot. I am using the same understanding as focusing on the front sight. Remember above how I stated that the red dot is only a few inches in front of the scope. Every little bit of fuzz on the dot can mean a minute of error at the sight that results in a larger error at the target.

Custom Sight Picture is the only method that allows a shooter to test at the range under all conditions and determine what lens will sharpen the dot or iron sights.


Tear Film Break-Up and Vision

The tear film is the first refractive surface of the eye. The refractive index difference between the curved surface of tear film and air contributes about two-thirds of the refractive power of the eye. When the tear film breaks up across the cornea, the optical quality of the eye suffers greatly. Researchers at Indiana University are investigating the impact of these optical effects on vision.

Frequently, disease, medication, or just plain wear and tear will render the eye’s lubrication system inefficient. Sometimes, the eye simply becomes unable to produce enough tears to lubricate the movement of the eyelid against the eye. Other times, the eye produces lubrication, but the eyelid is unable to distribute it properly.

Causes
Dry eye can evolve in a number of ways.
• Arthritis may cause a decrease in the body’s mucous membrane lubrication.
• Dermatological disorders may affect the glands which produce oil; thus, reducing the lubrication in the eye, resulting in the symptoms of dry eye.
• Diuretics, drugs which are designed to control hypertension by decreasing the amount of fluid in the body, causing corneal drying.
• Contact lens wear may disrupt the tear film, because the lids don’t spread mucous well in the area around the lens.
• A systemic disease called Sjoren Syndrome may inexplicably cause a glandular dysfunction. This results in a marked decrease in the secretions of the watery layer of the tears. This multi-organ disorder can occur in patients of any age and either sex, although it usually affects females. In addition to dry eye, patients with this disease will experience xerostomia (dry mouth), and connective tissue diseases such as rheumatoid arthritis

A Checklist of Dry Eye Risk Factors
The following patient characteristics usually translate into a higher risk for dry eye syndrome.
• fair complexion
• taking certain medications such as Claritin, Benadryl, or Allegra.
• acne Rosacea
• nocturnal lagophthalmos (eyes not totally closed while sleeping)
• contact lens wear
• contact lens intolerance
• heavy reading
• computer use
• lack of blinking
• menopausal females

Symptom Checklist
• dryness of the eye
• mucous discharge
• red eyes
• sandy or gritty feeling
• itching
• burning
• foreign body sensation
• tearing
• light sensitivity
• chronic infection of eye or lid
• "tired" eyes
• contact lens discomfort
• Have you ever had any of the following medical problems?
Glaucoma • Tuberculosis • High Blood Pressure • Thyroid disorder
Heart Disease • Diabetes • Arthritis • Asthma
Gout Lupus • Sjogrens Syndrome

Treatment
1. Eyelid hygiene: Make this part of your daily bathing. When rinsing your face take a few extra seconds to clean the eyelashes. The rubbing action will remove any matter on the lashes, e.g. eyelash dandruff. This will massage the tear glands to keep them supple, will express some fluid to keep the glands unclogged.
2. Improve general hydration. Drink those eight 8-oz. glasses of water a day.
3. Change eye care products(no-preserved products are preferred – available in contact lens solutions and in artificial tears).
4. Address possibility of systemic medication affecting tears and tear film.
5. Frequent replacement of contact lenses.
6. Blink rate should be 15 – 20 times per minute, about every 3-4 seconds. I realize that sometimes it takes 8 – 10 seconds to break the shot.

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