Author: hanneszwarts

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Blue Light Block Fad

As an Optometrist with 22 years of clinical experience, Hannes Zwarts is critical of anecdotal evidence when presented with novel treatment options for his patients.

A decade ago a prominent ophthalmic lens company launched a product claiming to block so called harmful light of a certain short wavelength emitted by digital devices. Accompanying the product information to optometrists was a research paper partially funded by the same company on research done 5 years before.

We noticed that all the lens companies followed the trend and had in some way or form a blue blocking lens available soon after. It didn’t take long before advertisements flooded all media platforms and we were inundated by requests for blue blocking lenses. Amidst this lens craze teachers started recommending blue block filters for all children and glasses were dished out left right and centre by optometrists, online vendors and and any retailer who could profit from it.

We practice in a predominantly farming community and Hannes candidly remarked on various occasions: “had blue light been that bad for you, all our farmers would have had eye problems being exposed to full spectrum light all day”. These comments often offended some colleagues, patients and representatives of the suppliers. Scientific evidence does elude to blue light playing a role in the sleep-wake cycle of an individual and blue light being potentially harmful in older individuals with a lack of certain macular pigment caretenoïds. We believe that these harmful effects can be mitigated by changing the display settings at night on these devices to “nigh mode” and taking supplements rich in lutein, zeaxanthin, and meso-zeaxanthin.

It comes as no surprise that Hannes was delighted when he learned of a scientific paper published in August 2023 discrediting most of the blue blocking therapeutic claims made by many suppliers in the past. At Hannes Zwarts Optometrists we will continue to pursue clinical excellence for our patients.

Disclaimer: The information above is solely the opinion of Hannes Zwarts Optometrists and is by no means intended to

discredit, disqualify or belittle the opinion of his colleagues, suppliers or patients.

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Floppy Eye Lid Syndrome. What?!

Frequently in our practice a patient presents with chronic redness, irritation and a discharge from one eye. “You snore at night and sleep on your right side.” patient answers,”How on earth do you know that?!”

What is Floppy Eye Lid Syndrome?

Floppy eyelid syndrome (FES) is considered a common and under-diagnosed eyelid syndrome. FES is characterized by a loose or “floppy” eyelid that easily contorts or everts without spontaneously returning to its normal shape. Typical presenting symptoms include tearing, irritation, photosensitivity, and foreign body sensation in the eye.

Who develops Floppy Eye Lid Synrome

Studies suggest that 98% of patients with FES are male and 57% of patients with FES suffer from Obstructive Sleep Apnea.

What is Sleep Apnea

This is when you stop breathing while asleep or have almost no airflow. It combines the Greek roots “a,” which means “not” and “pnea,” which refers to breathing. Combined, it means “breathless.” Sleep apnea is a potentially serious sleep disorder. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea.

The main types of sleep apnea are:

  • Obstructive sleep apnea (OSA), which is the more common form that occurs when throat muscles relax and block the flow of air into the lungs
  • Central sleep apnea (CSA), which occurs when the brain doesn’t send proper signals to the muscles that control breathing
  • Treatment-emergent central sleep apnea, also known as complex sleep apnea, which happens when someone has OSA — diagnosed with a sleep study — that converts to CSA when receiving therapy for OSA

Obstructive sleep apnea

Obstructive sleep apnea occurs when the muscles that support the soft tissues in your throat, such as your tongue and soft palate, temporarily relax. When these muscles relax, your airway is narrowed or closed, and breathing is momentarily cut off.

This causes excessive snoring and forces them to frequently awaken and turn to sleep on their stomach or side. As a result, their face is pressed onto the pillow, mechanically stretching and pulling open the eyelid, leading to chronic eye irritation and drooping of the eyelid(s).

How is Floppy Eye Lid Syndrome treated?

Regarding the eyes, patients can use metal shields to cover their eye(s) while sleeping to reduce the mechanical trauma. Medications can be tried to lessen the eye irritation, and there are surgeries which can be performed to tighten the eyelid and/or raise it to correct the drooping. However, unless the underlying obstructive sleep apnea is addressed, the condition will continue.

How does one get checked for Sleep Apnea?

You get booked for a sleep study, in a sleep lab or by a monitor at home. These studies determine if and how often your breathing pauses for a significant period of time while sleeping. Remarkably, people with obstructive sleep apnea may have hundreds of episodes each night in which they stop breathing for 15 seconds or longer.

Why is it important to diagnose and treat OSA?

Obstructive sleep apnea reduces oxygen flow to all parts of the body. This can lead to high blood pressure, heart failure, arrhythmias, and many other potentially fatal systemic diseases. In addition, the poor quality of sleep has effects on daytime performance at work and other activities. Management of the condition always starts with diet, exercise, and weight loss. Once diagnosed, it can be treated with continuous positive airway (CPAP) masks and/or mouth and nose pieces to prevent collapse of the airway while sleeping. Treated patients sleep more soundly, feel better, and are healthier. Often, once the sleep apnea is treated, the changes seen on the eyelids will slowly revert to normal without the need for surgery.

Patient seen before and after treatment of obstructive sleep apnea with CPAP device. Note the improvement in position and appearance of the right upper eyelid.

For further information Fourie and Associates can be contacted. Fourie & Associates Clinical Technology Group is a team of experienced technologists with advanced sleep facilities in Cape Town, Johannesburg and Pretoria. They help patients understand, diagnose and treat sleep disorders such as sleep apnea using latest technology and expert advice to combat fatigue and daytime sleepiness.

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Vera Wang Eyewear – Exciting new addition to our practice

The Vera Wang Eyewear Collection is characterized by a modern take on light, form and structure. Using innovative techniques, all handmade with the highest quality of craftsmanship.

In a recent interview with Vision2020 magazine, Vera Wang discusses life as a designer and reveals her newest role – starring in her eponymous Eyewear campaign for the first time.

Vera Wang has always had a passion for eyewear. “I’m a collector; I probably have over 1,000 pairs of frames. Maybe more,” says the fashion designer. If that surprises you—it shouldn’t. Wang studies eyewear and notices every minute detail, fine-tuning her designs until they exceed her very high standards. She has partnered with Kenmark Eyewear since her initial eyewear collection launched in 2001, and she still somehow manages to keep us on our toes. Twenty years later, the designer adds model to her long resume after starring in her eyewear campaign for the first time.

Wang began her career in the industry at Vogue, becoming one of the magazine’s youngest fashion editors. As an accessories editor for almost 17 years, she worked with and studied eyewear on a daily basis. “It really was not what it became—what it evolved to be. Over the last 50 years eyewear has changed so much,” says Wang. 

It is clear that Wang is not just in eyewear for the license. She knows it. She knows all of the players and has designed with some of the best in the industry. She brings her vision and style to life, but still prioritizes technicality and comfort.

What makes eyewear so important to you?

“I always joke, it’s such a little area of the face, but if people understood how much work goes into the width of the temple or the bridge,” says Wang. “Is there a bridge? How do the lenses attach, are they flat, are they curved?” Hinges are also an incredibly important design detail to her technically. “I mean if the hinges aren’t beautifully made and beautifully executed, no matter how good looking the eyewear is, no matter how flattering, no matter how cool, no matter how editorial—they just don’t work. If they don’t stay on your face, they don’t work.”

Mirrors line the tables of her eyewear meetings, and Wang tries on every single frame she designs. “I think it’s one of the most insane accessories,” she says. “It is so creative, so personal. For people to be able to transform themselves and enjoy their own creativity and experiment. I just think it’s such a fun thing.”

She believes eyewear is one of the most significant accessible accessories for both men and women of all ages. “It’s like a new hairdo, a new lipstick, a new eyeshadow. That is the cosmetic creativity of eyewear that I love so much. It changes the shape of your face.”

Wang wants to convey her belief that there are not any limitations in eyewear anymore, and she is amazed by how the industry evolves each season. “It is part of your wardrobe. It’s part of your life,” she says.

“It can be very whimsical, it can be very sophisticated, it can be just plain beautiful and mysterious like Jackie Kennedy was. I feel very lucky to be able to do eyewear, because I think it makes such a contribution creatively.”

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5 Tips for Managing Winter Dry Eye

Most of us suffer from Dry Eye Disease, especially in the cold winter months.

Winter weather means lower humidity, colder winds, and stuffy indoor heat. This combination can make for conditions that irritate your eyes. Moisture evaporates more quickly, so you may notice grittiness, irritation, and a stuck feeling.

The good news is that simple measures can help ease the discomfort of winter dry eye. Here at Hannes Zwarts Optometrists, we recommend the following:

1.    Add humidity

A humidifier added to your bedroom, living areas, and office can go a long way in restoring valuable moisture to heated air. Some in-house systems are available, too, but a portable machine to add humidity to the air where you spend the most time can effectively lubricate your eyes and reduce gritty dryness.

2.    Don’t sit in front of heat

When you’re in the car, direct the heat toward your body — not your face.  Even the defroster can bounce air off the windshield and contribute to eye dryness. Try defrosting before you start driving.

This goes for space heaters around your desk or favorite chair, too. And if you’re around an open fire, protect your eyes from overuse because smoke from a wood-burning fire accelerates the evaporation of tears from your eyes. Position yourself some distance from the flames.

3.    Protect your eyes from wind and cold

A good pair of sunglasses isn’t just for the beach. Your eyes get protection from the sun and drying winds of winter by wearing a quality pair of glasses with sun protection. We can help you find just the right pair. A hat with a visor can offer further protection.

4.    Drink water and other fluids

Stay hydrated to maintain moisture in your eyes. You may not feel as thirsty in winter, but drink plenty of fluids to keep your membranes moist. Water is a good choice, but other sources of fluid — such as fresh fruit, juice, and herbal tea — also help keep you hydrated.

5.    Manage screen time

Dry eyes, in winter and at other times, are exacerbated by excessive screen time. When you’re using your phone, computer, tablet, or other digital screen, take regular pauses.

Sitting in front of a screen causes you to blink less, which means fewer tears distribute over your eyeballs. Look away every 20 minutes as a good rule. When you do pause, gaze at something about 20 feet away for 20 seconds to encourage blinking. It’s easy to get wrapped up in what you’re doing and forget to take these breaks, so set a timer if you have trouble remembering on your own.

And, if at-home measures don’t work to reduce your discomfort or you experience dry eyes year-round, make an appointment at our practice for a more thorough evaluation of your dry eyes. We can offer hypochlorous products or punctal plugs to help control excess tear drainage. Feel free to contact the practice or schedule an appointment online to set up your consultation.

Source: veyep2000

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A new patching alternative for “lazy eye”

We now offer an alternative treatment to patching for amblyopia, also commonly referred to as “lazy eye”. Flicker Glass is developed by Eyetronix. Based in Silicon Valley, Eyetronix is focused on understanding real needs of the vision care community and developing practical and innovative electronic eyewear solutions.

Flicker Glass is designed to overcome many shortcomings of traditional “occlusion” treatments such as patching and atropine therapy. Standard occlusion, though rudimentary, can be effective in improving visual acuity – but only with high compliance starting from a young age. The discomfort, disruption, and social and psychological stigma associated with patching can make compliance difficult and cause undue burden and stress for the parent and child. Compliance with patching can also take a long commitment – two to six hours each day, often for half a year or longer.

Improvements with current therapies may be temporary, and monocular occlusion can introduce or exacerbate other visual challenges, such as problems with eye teaming, depth perception and effective hand-eye coordination – impacting quality of life. Visual acuity has historically been the standard measure of improvement with patching, but it is just one element of vision performance. From a patient care perspective, exploring ways to treat underlying suppression and improve stereopsis may have more meaningful benefits.

Eye care professionals are increasingly focusing on binocular therapy approaches. Eyetronix Flicker Glass is a simple, wearable tool for binocular therapy that integrates known principles of the visual system and flicker, combined with the clinical experience of practicing eye care professionals. 

Flicker Glass uses rapid alternating occlusion, at flicker frequencies shown in research to help break suppression. Instead of occluding to penalize one eye and forcing the signal from the other eye, the theory is that using flicker can gently stimulate the visual system and encourage both eyes to naturally work together, ultimately aiding in the restoration of binocular vision and depth perception.

Flicker Glass offers a novel, more natural, intuitive approach to binocular vision conditions.

Flicker Glass was created to help avoid the struggle and burden otherwise associated with current traditional therapies. It may be worn for just 1-2 hours a day, while enjoying regular home activities like reading, doing puzzles, watching TV, or playing video games. Flicker Glass does not require specific, repetitive exercises. With Flicker Glass, binocular therapy is less obtrusive and can fit with any lifestyle and schedule.

Using advanced liquid crystal technology, Flicker Glass delivers precisely controlled, rapid alternating occlusion at flicker rates shown in vision science research to effectively break suppression.

In contrast to current available treatments, Eyetronix Flicker Technology is based on research of sensory function in the visual pathway between the eyes and the brain. In normal binocular vision, both eyes focus on an … to create one stereoscopic (3D) image. When a disorder in binocular vision is present, however, a neurological problem causes the brain to favor one eye and suppress vision in the other.

Therefore, the key to breaking suppression is to “wake up” that sensory pathway and encourage the brain to accept visual sensory signals from both eyes. The Eyetronix Flicker Technology approach is to gently stimulate the visual system to break suppression and restore the normal binocular fusion process to perceive one 3D image.

In a recent clinical study conducted with Flicker Glass, results showed significant improvement in both visual acuity and stereopsis – even into older age ranges typically considered more challenging to treat. Study investigators were impressed with the remarkable levels of compliance, and patients and parents rated Flicker Glass highly on ease of use, comfort, and preference over traditional monocular therapies. From a quality of life perspective, reports of improved reading and sports performance supported the overall positive evaluation of this novel Flicker Glass experience.