Dr. Mitchell's Eyecare Blog

Contacts and climate

2012-02-20T06:27:00.001-08:00

The most frequent issue that we deal with here with our contact lens patients is dryness. Because of our dry climate, it can be difficult for many to be successful with contacts. This dryness can result in:

reduced vision with the contacts,
reduced comfort while wearing lenses,
red eyes
reduced wearing time.

Through our research efforts for the manufacturers, we have come up with ways to improve this situation. Through changes in care systems, lens designs and lens materials in most cases we can help. What we have primarily found is that contact lens related dryness is an individual issue, and in partnership with our patients we can come up with an individual solution. There is no easy fix, or a single change that can help everyone.

So, come on in for an evaluation, and you and the doctor can discuss your current situation.

New Year Resolutions for your Eyes

2012-01-07T11:08:00.000-08:00

Happy New Year! At this time of year, many of us make those resolutions. This year why not make your resolution about your eyes? Your eyes are one of the most important and most neglected part of upir body. Here are a few ideas:

If you are a contact lens wearer, make a resolution that you will take them out every night, change them on the FDA recommended replacement schedule, use only recommended disinfection solutions, change your case every 3 months, and make sure you have your annual eye exam.

If you are using over the counter readers as your only type of vision correction (or know someone who is), make a resolution to get your eyes (or theirs) examined. After all $10 reading glasses do not keep you from getting GLAUCOMA, MACULAR DEGENERATION, CATARACTS, or RETINAL HOLES and TEARS (all of which can have no symptoms whatsoever).

Even if you are good about making your annual eye exams, and have an updated pair of glasses, you can still make a healthy sight resolution by pledging to get yourself a pair of prescription sunglasses to protect your eyes from the damaging UV rays of the sun.

We only get one set of eyes, so whatever 2012 brings, be sure to make them a priority this year!

Thanks for a great year!

2011-12-29T05:41:00.001-08:00

I've been honored to be your eye doctor throughout 2011 and look forward to seeing you again in 2012. Thanks to all my patients for a great year!

End of the year...

2011-11-13T04:30:00.000-08:00

You might think it's too soon to think about, but the end of the year is right around the corner. In November and December it can be tough for our office to get you and your family scheduled for services before the end of the year-when either your insurance changes, or your flexible spending account dollars go away, or your benefits end, or your kids go back to school.

Here are some ways that you can help our office help you to get what you need:

1. Check with your insurance to see if you have any remaining benefits for the year. This is a great way to help pay for that extra pair of glasses, sunglasses or spare contact lenses. We can help you with this!

2. Schedule your appointments now for yourself and your family, especially for your kids back from school on break. We get really busy this time of year, and this will allow you to pick the best time for you in and around all the holidays. It will also allow our office to be sure that we can get everything you need done before the end of the year.

3. Check to see if you have any flexible spending account dollars left from your employer. Again, this is a great way to help pay for that extra pair of glasses, sunglasses or spare contact lenses.

Happy (early) Holidays!
Dr. M

Our remodel is done!

2011-10-24T07:55:00.000-07:00

We're all excited around here because our Reno office remodel is complete. We have a fresh new color on the walls, new carpeting, new office chairs and a much more efficient layout. We can provide even better personalized service to our patients. We have added some new frame lines as well: Bebe, Juicy Couture, and Tommy Bahama. And, we've expanded our selection of the very high quality Carrera line. Stop by and take a look!

Pardon our dust...

2011-09-09T16:43:00.001-07:00

We're in the midst of remodeling the reno office. It's exciting...or, more correctly overwhelming right now. A new color scheme, new floorcovering, updated eyeglass area, and a better office layout will enhance your visit and help us to care for you. It already looks great and we're not done! Stop by and see what we're up to.

Railroad Days!

2011-08-24T02:51:00.000-07:00

It was great to see all my friends at Railroad Days last weekend...from horseback during the parade! My horse and I had a great time, and it was so, so good to see that the event was well attended. I came around the corner at Gulling and Commercial and what a cool sight it was to see the parade route lined with people, 3 or 4 deep the whole way. And, it looked like way more vendors than last year with everyone out enjoying the beautiful day with a smile on their face supporting our community.

Thanks so much for all the volunteers for helping make all of the Railroad Days events come off so well. See y'all at the end of the trail!

Come on out to Portola!

2011-08-14T16:40:00.001-07:00

For those of you who live in Plumas County, California you know where to be next Saturday, August 20th...Railroad Days in Portola! And, if you live in Reno...it's just an hour long, beautiful drive to get to Portola. There are a whole host of events planned as you can see on the Railroad Days website. It's always lots of fun, and it looks like the weather will be great. I'll be in the parade on my horse Blackjack. I'll see you all from horseback Saturday!

Proper Use of Contact Lenses

2011-07-20T04:06:00.000-07:00

I fit a lot of contact lenses. Maybe it's because I am a clinical investigator for the contact lens companies, or maybe I just discuss them more with patients, but in any event, contact lenses and lens care is a large part of my practice. I've seen some pretty serious contact lens-related eye problems lately (in patients fit with lenses elsewhere) and I'd like to go over a couple of points to keep in mind for as long as a person wears contact lenses.

Every contact lens wearer needs an acceptable pair of glasses to use as a backup to their contacts. There are times that you either won't want to wear your lenses or can't wear your lenses.

Don't sleep in your lenses. I know, your lenses may be approved for overnight wear, but that doesn't mean that it's particularly safe to do that. Sleeping in lenses increases the risk of possibly serious infection and vision loss...even if you do it for one night.

Don't overwear your lenses. If your lenses are bothering you, or are uncomfortable, take them out. This is not an endurance event.

Replace your lenses on schedule. A clean lens gives much better vision and comfort.

Use the proper solution. We make specific recommendations on solutions for a reason. Call us if you want to try a different solution. The solutions are not all the same.

Keep your appointments with us. We make those appointments to be sure that your lenses fit properly, the vision is the best that it can be, and that your eyes are responding well to the lenses.

Most importantly, if you think that there is a problem, then remove your lenses and call the office. We can be reached anytime to talk with you.

While this is not a complete list of "do's and don'ts" I hope that it refreshes your mind so that you can continue to be a safe, healthy contact lens wearer with good vision.

--Dr. Mitchell

Insurance...our most common issue!

2011-06-20T10:17:00.000-07:00

What is the number one issue for patients and our office? Insurance

I was talking with a patient the other day about the most common issue that our patients have. The number one issue is insurance. I’m sure you’ve experienced it—not only at my office, but at any doctor’s office. I know, it seems like when you call, the only thing that doctor’s offices care about is what kind of insurance that you have! There is a reason for that. The reason is that insurance is the most difficult, time consuming and problematic issue in any healthcare office. My offices are no different.

It would probably surprise you to know just how much time I personally spend interacting with insurance companies. I literally spend several hours every day working on insurance authorizations, approvals for care, non-payment issues and the like. All of this is time that would be better spent taking care of my patients, but that’s the way it is today. I’m not alone in this. Check out this link: http://www.kevinmd.com/blog/2009/05/how-much-time-do-doctors-spend-on-paperwork.html. Based on information from this and other studies suggests that I actually spend less time than average. Any doctor that you see spends a large portion of time on insurance and billing issues.

Suffice to say that a system where your doctor has to spend significant time on “clerical” issues because they are so complex, is probably not working well. And, keep in mind that if there is even the slightest problem or issue with any insurer, the doctor will need to get involved. That’s why when there is a problem with your Medicare bill, I’ll have to look it over and often write to Medicare to get the issue resolved. This resolution through Medicare can take 9-12 months and sometimes longer.

In eyecare, we have the additional issue that most of the time the company that insures you for medical conditions is not the company that insures you for routine eye exams and glasses. This level of confusion is common in eyecare, and we’ve gotten pretty good about getting your information to clear this up for you in advance. But, remember, it is your insurance at the end of the day, and not ours. There is only so much that we can do to help.

You can help is with all this, though. Keep in mind that your insurance is a relationship between you and your insurance company. So, there is only so much that we can do to help you. You may need to contact the insurance company yourself to get the benefits that you are paying for.You may need to contact the insurance company to verify your own coverage. You may need to plan ahead to get services that you need if you know your insurance is going to change (Don't wait until the last day of your coverage to make an appointment). And, you may need to contact the insurance company to understand your coverage and what is and is not covered.

Ultraviolet light and the eye

2011-05-15T14:19:00.000-07:00

As we head into summer when we spend more time outdoors, it's time to think about sun exposure and the eye. More specifically, ultraviolet (UV) light exposure. Not only does ultraviolet light affect your skin (sunburn!), but it also affects your eyes. And those effects are not good.

Acute Exposure

When the eyes get a large exposure to UV, this results in a burn to the front surface, the cornea. Most commonly this occurs when welding (a welder's flash) or skiing or off of water (snow blindness). This usually resolves without problems to the vision, but it is quite painful. However, staring at the sun burns the retina, and this can cause serious vision loss.

Chronic Exposure

When you expose the eyes to UV light over years, there are several effects on the eye. The most prominent one is that the UV light can cause cataracts. We do not have convincing evidence that UV light causes macular degeneration.

Protect Yourself!

Wearing UV absorbing sunglasses that wrap around your eyes is your first step. Second, wear a hat with a brim. We make almost all of our glasses at the office with polycarbonate lenses that absorb UV on their own...even the clear lenses. Another choice is photochromic lenses (Transitions). These lenses absorb UV and get darker when light conditions increase.

We've put in some new sunglass lines in the office to help you protect your eyes, and look your best while doing it. Come on in to check them out!

Why have a yearly eye exam?

2011-04-08T03:26:00.000-07:00

I'm often asked by patients when they should come back for their next exam. People tend to put off things like eye exams, particularly if they are not having any problems. But, over the last month, I've seen a whole bunch of patients where if the person had kept up on their routine eye exams problems could have been prevented.

Here's a summary of what I saw:

several patients with macular degeneration who had noticed changes and had not seen an eye doctor in over a year,
several patients with chronic red eyes who had not seen an eye doctor in years,
several contact lens patients who had just been refilling their lens prescription from Canada and hadn't been able to see well for the last year,
several patients with broken glasses who had not had an eye exam in over 2 years,
several patients with diabetes who had never had eye exams. And, since diabetes is the leading cause of preventable vision loss in the US, this is a huge deal.

Maybe it was just a bad month for me, but this sort of thing bothers me. I know that things are tough, but for a basic service like eye exams, you just have to stay on top of it. This allows us to prevent vision loss and give you the best vision possible. You need to take responsibility for taking care of yourself by having routine eye care.

I do not want to see anyone lose any vision. Many eye disorders when found early can be effectively treated, and visual disability can be prevented. And for a disorder like glaucoma, the patient generally does not notice a change in vision themselves until it is too late.

So, here are Dr. Mitchell's tips for your routine care:

Have an eye exam once a year. If we find that everything is OK, then that is money well spent, and is good news. If we don't find anything, that does not mean that you wasted your money!
Follow the doctor's directions. If we say come back in a year, then that's when you should come back.
If you have a change in vision, or other eye change, call us. That's what we're here for and we'll usually be able to tell if you need to return sooner.
Glasses don't last forever. If you come in regularly for care, we'll look at your glasses and can let you know when they are on their last legs and need replacement. Or, we'll tell you that the glasses look good and don't necessarily need to be replaced.

So, if we haven't seen you in over a year, then call the office and schedule your appointment. We'd love to see you again!

Are you a snowbird?

2011-03-11T03:27:00.000-08:00

It's that time of year for us here at the office...the time when our patients that spend the winter in warmer areas return. While we here spent the winter in the mountains (and being a skiier-I'm not complaining!) dealing with snow and ice, it's good to see you all again. We enjoy hearing your stories about golfing in 80 degree weather while we're sliding on the ice. Welcome back! I want to pass along some healthcare ideas for you to consider as a part of your return.

Don't wait until late in the summer to start taking care of your health. While you're busy opening your home and reconnecting with your friends now is the time to have your routine healthcare needs met. Have a physical, have an eye exam and see your dentist. That way if we doctors need to take care of an issue we have enough time to arrange your care. It's far easier to get you taken care of now than it is if we're trying to deliver your care the week before you leave to go back to your other location.
It's never too soon to sit down and think about how you want to handle your healthcare in two or more locations. Talk to your doctors and see if there is a better way to coordinate your care. It's a good idea to have providers in both your locations that work together. That means coordinating medical records as well. We in healthcare have done this all before and are happy to arrange relationships with other providers to facilitate record sharing and coordination of care. It's way easier to do this in advance than when you're calling us with an issue from 1000 miles away!
Make sure that throughout your care with any provider that you maintain copies of your prescriptions. This can be a literal lifesaver during your travels.

Again, welcome back to the mountains!

The most common eye issues we see

2011-02-18T05:26:00.000-08:00

I was asked by a patient today what the most common eye issues that I see and deal with. Here are the top 5:

1. Dry eyes This is far and away the most common issue that we deal with in the office. In our dry climate, most of my patients have dry eyes to some extent. This affects vision and comfort. Our thinking about dry eyes and treatment of this disorder has changed recently and new prescription and non-prescription drops are available. I'm a clinical investigator primarily working on dry eye treatment and contact lens-related dry eye treatment.
2. Cataracts Our aging population (that's you, Baby Boomers...well, I'm one too...) has made this a common diagnosis in the office today. New surgery techniques and technology have made surgery for cataracts much improved. Many times, though, updating glasses or contact lenses is the right thing to do until the cataracts really interfere with your lifestyle.
3. Nearsightedness This is blurry vision at distance and affects all age groups. New thin, light eyeglass lenses with advanced optics allow for the most attractive lenses we've ever been able to create. New contact lenses allow for better vision and more comfortable wear. Not all contacts are the same-some work better than others and we can discuss your needs and issues and usually can make both vision and comfort better than in the past.
4. Presbyopia Again, the aging population's loss of focus at near makes this a common problem. New eyeglass lenses with lineless, progressive bifocals have revolutionized our treatment of this disorder. And, not all progressive lenses are equal-some work better than others, and a discussion of your visual needs allows us to prescribe the best lens design for you.
5. Contact lens problems With my work as a clinical researcher, I've become a referral source for other doctors in Reno and Portola. So, a large part of my day is spent taking care of people with contact lens related issues. We have wonderful success in improving patient vision in many patients where medical conditions make contacts the only way to correct vision.