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January/February 2019 Newsletter


School Health Week in the first week of March is an opportunity to highlight the fact that "healthy kids learn better". Awareness is raised regarding healthy eating, healthy lifestyle habits, good oral health, as well as the importance of hearing and vision as the gateways to learning. While it is important to draw attention to these areas in school-going children and their parents, awareness and detection of problems should begin long before children start school. It is a well-known fact that early identification of problems leads to early treatment and usually a more positive long-term outcome. Healthy eyes and good vision are crucial to a child's overall development. 


Several eye conditions can affect children, and these can be detected at various stages of the child's development. Both the American Academy of Ophthalmology and the American Academy of Pediatrics recommend certain ages and milestones at which children should have their vision checked. 
Newborns, particularly high-risk and premature babies, should be examined for possible congenital eye problems such as retinopathy of prematurity and infantile cataracts. Congenital glaucoma is a rare condition which may be inherited. If there is a family history of genetic conditions which may affect the eyes, these should be discussed with an eye care specialist. 
Between 6 and 12 months of age, children should have their first comprehensive eye examination. During the first year, problems with misalignment of the eyes, squinting and difficulty following a moving object with the eyes may be detected. 
At 3 to 3 and a half years of age children should have their first acuity test. This should be followed up by an examination before the child enters school to check acuity and eye alignment. From then on children who need to wear glasses should be rechecked annually for changes to their vision and prescription, and all children should be examined every two years. 


Amblyopia ("lazy eye") is poor vision in an eye that may appear to be normal. Two common causes are crossed eyes and a difference in the refractive error (shortsightedness or farsightedness) between the two eyes. If untreated, amblyopia can cause irreversible visual loss in the affected eye because the brain eventually ignores signals coming from that eye. Amblyopia is best treated as early as possible, ideally before a child is 8 years old. 
Strabismus is a misalignment of the eyes. They may turn in, out, up, or down. If the same eye is chronically misaligned, amblyopia may develop in that eye. With early detection, vision can be restored by patching the properly aligned eye, which forces the misaligned eye to work. Surgery or specially designed glasses are other treatment options which may help the eyes to align. 
Refractive errors indicate that the shape of the eye doesn't refract or bend light effectively so that images appear blurred. Refractive errors can cause amblyopia. Shortsightedness or myopia (poor distance vision) is the most common refractive error in school-age children. Farsightedness or hyperopia affects vision for close work. Astigmatism is imperfect curvature of the front surface of the eye, which leads to blurred vision. Most of these errors can be managed with corrective lenses. Correcting children's vision early can lead to better school performance and psychosocial health, according to reports from parents, teachers, and children themselves. 


Parents need to be aware of the signs that may indicate a visual problem. These include constant rubbing of the eyes, chronic eye redness, tearing, extreme light sensitivity, poor focusing and difficulty following a moving object with the eyes, abnormal alignment or movement of the eyes, a white instead of black pupil. School-age children may experience recurrent headaches particularly after reading or close work, difficulty reading the board from the middle or back of the classroom, problems seeing distant objects, and frequent squinting. They may close one eye in order to see better, sit too close to the TV or hold books too close to the face when reading. Frequently losing the place while reading, confusing similar letters or reversing letters, numbers or words beyond a certain age could be an indication of an eye movement or visual perceptual problem. If detected early, most of these problems can be corrected. 


Children and babies of all ages can wear glasses and contact lenses. Your optometrist will guide you with regard to the most appropriate vision correction and the most suitable frames and lenses. Within certain parameters, let children choose their own frames; this will help them adjust to wearing glasses and being responsible for their care. Plastic frames are best for children under the age of 2 years. If older children prefer metal frames, those with spring hinges are more durable. Polycarbonate lenses are shatterproof and more resistant to impact damage, particularly if the child is very active, but they do tend to scratch more easily than plastic lenses. Children with more severe problems may need special high-index lenses which are thinner and lighter than regular plastic lenses. 
Older children may want to wear contact lenses for cosmetic reasons or comfort while playing sport. Seek the advice of your optometrist. Take into account the maturity and level of responsibility of the child. To wear contact lenses, the child will need to know how to insert and remove the lenses and follow the cleaning and care instructions of the optometrist. 


Limit screen time on phones, tablets and TV. By providing visually stimulating toys such as puzzles, building blocks, drawing and painting materials, visual development is enhanced. Hang mobiles and moving toys above the baby's pram or cot to encourage focusing and tracking of movement. 
Encourage outdoor activities to get children into the habit of a healthy lifestyle in natural light. Being indoors the child is usually doing close work, reading or on the computer. Outdoors the eyes are required to change focus from near to distance vision and to track objects such as a moving ball. 
Proper nutrition is vital for the protection and growth of any body part and the eyes are no exception. The daily diet should be filled with fruits, vegetables, nuts, fish and eggs. Nutrients such as vitamin C, zinc, vitamin E, and omega-3 fatty acids are vital for eye health. 
Schedule regular health and eye check-ups to ensure detection and treatment of problems as early as possible for the best possible outcome.



Contact lenses are worn by millions of people around the world, enhancing their lives in many ways. As with any medical device using them correctly is important, but with the numerous myths surrounding their use it becomes difficult to separate fact from fiction. Seeking accurate information goes a long way towards debunking some of the myths, and when in doubt consult your optometrist for guidance. 


Modern materials used in the manufacture of contact lenses nourish and allow oxygen to reach the cornea and other structures so that wearers are not even aware of wearing them. There may be some discomfort at first, but after an adjustment period they will be comfortable and non-intrusive. 


Like any new skill that needs to be mastered, learning to insert and remove contact lenses requires patience. The guidance of your optometrist and his or her staff will help. 


It is essential to care for your contact lenses properly, but contact lenses are easy to clean and maintain. Follow the method recommended by your optometrist to avoid any problems. If you choose to wear daily disposable lenses, then no cleaning or special storage methods are required at all. 


This is a dangerous myth! Contact lens solution is sterilised. Water and saliva, on the other hand, can contain bacteria which could cause infections if they infiltrate the cornea. A less serious issue is that when contact lenses are rinsed in water, they feel less comfortable and are harder to handle. Always use the contact lens solution recommended by your optometrist. 


Contact lenses don't directly cause problems; rather, the incorrect handling of them does. Contact lenses are no different from any other items that require close attention to hygiene and a careful cleaning routine. 


Contact lenses have an expiry date for a reason – to protect your eyes! They are made from materials that degrade after a certain time, so that over-wearing them may result in less clarity of vision or other eye problems. Wearing lenses over their daily wear limit may lead to eye irritation, corneal abrasions or ulcers. Check the packaging for the expiry date to be sure that your contact lenses have not expired. 


It is not possible for contact lenses to get stuck behind your eye. The eye has a thin membrane that covers the white section of the eye and connects to the inside of the eyelids. Because of this, there's no room for a contact lens to slip backwards and get lost at the back of the eye. If you find that your lens has slipped further upward than normal, keep blinking until it slides back into place. 


While there is no age limit to wearing contact lenses, there is some truth behind this statement. As some people get older, their eyes produce fewer tears, making contact lens wear less comfortable. However, there are solutions to this problem, such as wearing lenses for shorter periods of time or using artificial tears prescribed by the optometrist. Older people may also lose the manual dexterity required to put in and remove their lenses. It is sometimes believed that if people need bifocals, they can't wear contact lenses, but there are now a variety of available options, including bifocal and multifocal lenses. Your optometrist will prescribe the lenses that best suit your needs. 


There is no rule regarding the age at which children can wear contact lenses. If a child is mature and responsible enough to follow care and cleaning of the lenses, and can handle insertion and removal of the lenses, it should be fine. The decision is usually made at the discretion of the optometrist after discussion with the parents. Children's prescriptions tend to change fairly frequently due to growth. 


Due to the extra tears, vision may become cloudy if you cry with contact lenses, but there are no eye health risks. Be careful when wiping away tears and try not to rub your eyes which may dislodge the lenses. 


The health of the cornea depends on oxygen which it absorbs from the air when we are awake. Once we are asleep, the oxygen flow is reduced and the contact lenses over the cornea block the flow further, potentially leading to problems. While people sometimes fall asleep with their lenses in by mistake, it is best to remove the lenses before going to sleep. 


You don't have to give up wearing makeup because you wear contact lenses, but certain guidelines are advised. Ensure that the contact lenses do not come into direct contact with cosmetic products by removing the lenses before removing makeup. Some cosmetic companies market products specifically for contact lens wearers; alternatively, use hypoallergenic products. 


Swimming while wearing contact lenses carries the same risks as rinsing them with water. Even saltwater and chlorinated pools may contain bacteria and organisms that may lead to infections. Contact lenses will also naturally absorb any water around them, which could change their shape. This will make them uncomfortable to wear, often causing your vision to become distorted and blurry. If you must swim with your contacts lenses, wear waterproof goggles. After swimming, remove and clean your contact lenses before wearing them again. 


Modern contact lenses are able to cater for a range of eye conditions. Advances in technology, modes of manufacture and materials means that almost anyone can wear contact lenses. Discuss this with your optometrist. 


With proper fitting, contact lenses sit comfortably on the surface of the eye and rarely fall out. If a lens dislodges, blinking a few times should move the lens back into position. Otherwise, wash your hands and gently massage your eyelid or move the lens back over your cornea with your finger. 


The harmful ultraviolet (UV) rays from the sun can be damaging to the eyes. UV absorbing contact lenses are not a substitute for UV blocking sunglasses as they do not completely cover the eye and the surrounding area. 


This is probably one of the most dangerous myths about contact lenses, particularly when it comes to novelty contact lenses worn for certain festivals or fancy dress parties. Contact lenses should be fitted by your optometrist according to your unique prescription and should not be worn by anyone else. Sharing contact lenses exposes the eyes to the risk of bacterial infections, which can put your vision at risk.



"I'll never forget the beautiful image of Earth as I looked from the Space Shuttle Discovery. If my glaucoma had not been caught in time, I never would have seen such a sight." These words by former astronaut John Glenn remind us that glaucoma, one of the leading causes of blindness, can be effectively managed if detected early. 
Glaucoma is a group of visual conditions which sometimes sneak up on individuals without presenting any symptoms, so that almost half of the people who have it are unaware of it. Peripheral vision loss is usually the first sign, with gradual loss of vision as there is progressive damage to the optic nerve which transmits visual information from the retina to the brain. John Glenn and others who are raising awareness around glaucoma stress the importance of regular eye examinations as early detection and treatment can slow down and even stop the progress of the disease. 
Glaucoma is generally associated with people over the age of 60, and subtle changes to vision may be ignored or put down to the aging process, but a visit to your optometrist will investigate and treat these visual changes. Glaucoma can occur in younger people and rarely even in infants. World-famous opera singer Andrea Bocelli was born with congenital glaucoma and went blind at the age of 12. 
"My first exposure to glaucoma was becoming aware of my grandmother using eyedrops every single day. When I questioned her, she explained that she had glaucoma and using the eye drops would prevent her from going blind. About 40 years later I received my own diagnosis of glaucoma." Family history is one of the risk factors for glaucoma. If you know of someone in your family who has glaucoma, schedule an appointment with your optometrist and inform him or her of this possible genetic link. "I have a brother and two sisters, and I make sure they get tested for glaucoma regularly," said one man with glaucoma. 
Aside from a family history, other risk factors for glaucoma include diabetes, a high degree of shortsightedness or farsightedness, trauma to the eye and ocular inflammation. Although glaucoma is usually due to increased pressure in the eyes, it is not associated with high blood pressure. 
While your optometrist's primary emphasis is on your visual health and the changes to the structure of your eyes, you as the patient are also concerned with how your vision affects your day to day activities. A comprehensive dilated eye examination is likely to include ophthalmoscopy (examination of the optic nerve), tonometry (measurement of intraocular pressure), pachymetry (measurement of corneal thickness), perimetry (visual field assessment), and gonioscopy (assessment of the angle between the cornea and the iris). 
These vision tests may not necessarily provide information about how you use your vision in going about your everyday life. Functional vision is a subjective experience that cannot be entirely measured by quantitative tests. Consider the following questions and discuss them with your optometrist. Do you accomplish less because of your vision? Have you noticed a change in your vision? Do you have trouble going down steps in dim light or at night? Do you have difficulty choosing and matching your clothes? Do you have trouble grocery shopping? Making phone calls? Taking medications? Are there any blurred or distorted areas in your vision? Are you affected by glare? Do you have difficulty seeing things on the periphery of your visual field? Do you have trouble driving at night? 
A woman with glaucoma remarked: "What I've found through my experience with glaucoma is that once it's diagnosed it becomes a life-long maintenance program to protect your remaining vision." When you have glaucoma, you may receive eye drops, pills or other treatment. It is essential to follow the instructions on how and when to use these, but healthy lifestyle habits are important, too, to maintain eye health. Regular exercise may help lower eye pressure and keep blood flowing to the nerves in your eye. Talk to your optometrist about the best exercise programme for you, as some activities can increase pressure. Enjoy a healthy, well-rounded diet, including nutrient-rich foods and antioxidants. 
This won't prevent your glaucoma from getting worse, but it is key to keeping your body and eyes healthy. Some medications can cause side effects, and others may have negative interactions with each other. Let your optometrist know what medications you are taking. Cut back on or give up smoking. Smoking raises your blood pressure and eye inflammation, which can increase your risk of diabetes and cataracts. Both are risk factors for glaucoma. Watch your caffeine intake as an excess of caffeine can raise your eye pressure. Don't forget to wear sunglasses outside whatever the season. When you have glaucoma, your eyes can be very sensitive to glare. Don't rub your eyes, although glaucoma and the medicine you take might make your eyes feel itchy. 
Understand your condition. It is often difficult to accept the diagnosis of glaucoma because most types of glaucoma progress very slowly, often without symptoms. Educate yourself as much as possible about the disease. The better informed you are of your condition, the easier it will be to manage. Ask questions and discuss your concerns with your optometrist. 

Sight Lost Really Is Hindsight!

While vision loss can occur with glaucoma, going completely blind is not common. It remains vitally important, especially for people over 40 years of age or in high-risk groups, to get regular, dilated eye examinations. Glaucoma is a chronic disease. It is your responsibility to make sure that you follow up on your optometrist's advice and guidance and play an active role in the treatment process. 





Most people don't see well in the dark but some people have considerably more difficulty with it than others. Night blindness (nyctalopia) does not mean that one cannot see at all at night, but rather that vision is poorer at night. Night vision and day vision are naturally different. At night the eyes are essentially colour blind, seeing mostly black, white and grey. Visual acuity is reduced at night, the central field of vision is less clear, and moving objects are easier to see than objects that are stationary. 


There are several common signs of night blindness, the main one obviously being difficulty seeing in the dark, but different degrees of difficulty exist. Driving at night can be challenging due to street lights, road signs and the intermittent headlights of oncoming cars. The eyes may adjust slowly to light changes, particularly when moving from a brightly lit environment into a dark area such as a movie theatre or restaurant, or even walking from room to room at home. People with night blindness often have trouble seeing stars on a clear night. More specific symptoms may include blurred vision at night, particularly with close work such as reading or sewing, haloes around lights, and sensitivity to light or glare. 


While all night blindness symptoms are related to poor lighting situations, there is a range of specific causes which may be easily treated or could be untreatable. Some of the eye conditions which can contribute to night blindness include shortsightedness, astigmatism, cataracts, glaucoma, retinitis pigmentosa and conditions related to diabetes. Certain prescription medications may cause night blindness. One of the side effects of glaucoma medication is a narrowing of the pupils, limiting the amount of light that enters the eyes. Although not common, nutritional deficiencies can lead to a number of vision problems including night blindness. Vitamin A plays a crucial role in the effective functioning of the rods, cells in the retina responsible for perception of light, so reduced levels of vitamin A may affect the ability to see in poor lighting. 


The effects of night blindness may simply be frustrating or may significantly impact daily life activities such as reading or driving at night. A consultation with your optometrist and a complete eye examination will determine the cause and treatment. A detailed case history will include questions such as the symptoms and severity of the night blindness, other eye or vision conditions, family history of visual problems, general health, medications, diet and lifestyle. During the eye examination your optometrist will look for visual changes and signs of disease. The assessment may include visual acuity, pupil light reflex, colour vision, visual field and an examination of the retina. 


There is a variety of treatment options depending on the underlying cause. A new prescription or lens coating for your glasses may be all that is necessary for better vision in low light. In some cases, having cataracts removed can help reduce night blindness. Medications, changes to medication, dietary supplements or increasing vitamin A intake may be helpful. Foods rich in antioxidants and vitamin A include leafy green vegetables, milk, eggs, carrots, pumpkin and sweet potatoes. Night blindness is not treatable if caused by a birth defect or certain eye conditions. 


It is recommended that people with severe night blindness do not drive at night. However, there are strategies to deal with the less severe difficulty of night driving. Decreasing speed gives the driver more time to spot and react to potential hazards. Dim the lights on the dashboard of the car, use bright headlights when possible and set the rearview mirror to reduce the headlight glare from behind. To avoid being blinded by oncoming headlights, look to the edge of the pavement and shift the gaze between the road, rearview mirror and side mirrors. Turn your head for increased peripheral vision. 
Difficulties in being able to see at night are common. Yet rather than doing something about it, many people try to learn to live with it. The problem with that is, as well as being annoying and debilitating, night vision deterioration can be dangerous, particularly when it comes to driving. Scheduling regular check ups with your optometrist will help to detect and treat visual problems early and track their progress over time.



Of course, the primary aim of wearing glasses is clear vision, but over recent years glasses have become a fashion must-have. In fact, it has been reported that in certain age groups people are wearing frames with blank lenses simply to make a fashion statement. Most of us are unable to have a variety of frames to accessorise different outfits for different occasions, and the selection of a suitable frame can be an overwhelming experience. Where to start? After checking with your optometrist what type of frame will best accommodate the lenses for your specific vision problem, follow the guidelines that will help narrow down your choice. Choose a frame which accentuates your best features, complements the shape and colouring of your face, and makes you feel confident and comfortable. 


While everyone's face is unique, there are basically seven face shapes. Many faces do not fit clearly into only one specific type but have features that resemble two or even more types. To determine the shape of your face, brush your hair away from your face and look straight ahead into a mirror. Look at the outline of your face from your hairline down to your jawline. Determine if your face is more angular or soft. In many ways, this is more important than the exact shape of your face when it comes to choosing glasses. Choose frames that complement the shape of your face. In general, frames add the most visual interest when they are in contrast with your natural features. 
The round face has full cheeks with forehead and jaw of similar width. Soft, round faces look best with frames that have hard angles, like square or rectangular frames which tend to make the face look longer and break up the softness of the face. 
Square faces have strong, wide foreheads and equally strong, wide chins. They are also proportionate in the length and width of the face. Rectangular faces are very similar in shape to square, but with a longer length than width. Square and rectangular faces look best with round or oval frames that balance the hard lines of the face. To minimise the appearance of a very heavy jawline, look for a thin delicate frame in a colour similar to your skintone, so that you don't add more bulk to your face. The glasses should be slightly wider than the cheekbones to fit the face properly. 
Oblong and oval faces are similar, too: they are both proportional, with a slightly narrower forehead and jaw, but an oval face has a more pointed chin. Oblong faces look best with round or curved frames, which emphasise the width rather than the length of the face. Frames with the upper and lower rims of the frame equal in shape break up the length of the face. Oval faces look good in any type of frame, so choose something that fits your personality and enhances your features. 
Triangular faces tend to have a narrow forehead and a wide, strong, often angular jaw. The best choice for this shape would be frames that emphasise the top half of the face, like half-rimmed glasses or cat-eye glasses, or two-toned frames with darker tops and lighter bottoms. Balance the look by ensuring that the frames are slightly wider than the jaw. 
The heart-shaped face is almost like an upside-down triangle, with a wide forehead that narrows to a pointed chin. A heart shaped face can be long and graceful or more rounded, but both tend to have high, angled cheekbones. Frames that are wider at the bottom or have some kind of detail on the lower half would suit this face shape. 
As well as the shape of the face there may be certain facial features that should be taken into consideration when choosing frames. For large noses, select a frame with a low or wide bridge over the nose to minimise the size of the nose. If the hair line is receding, choose a dark frame with a strong horizontal line rather than a clear frame which will elongate the forehead further. 


Depending on your skin, eye and hair colour, different coloured frames will bring out your best features. There are three basic categories of skin tone – fair, medium and dark, or cool, neutral and warm. 
If you have a cool skin tone (characterised by blue eyes and pale skin), a frame in a cool colour will complement your colouring best. Avoid bright colours which will contrast too highly with your skin tone, resulting in a washed out look. Cool colours include silver and jewel tones like amethyst, ruby, emerald and sapphire. Alternatively, opt for brown, black or tortoiseshell frames. 
For a medium or neutral skin tone, choose solid colours such as blue, green and even pink, which will make a bold statement. If you prefer a more subtle look, warm-coloured frames, such as gold and earth tones like beige, orange, yellow, and mustard would be best. 
For those with a darker skin tone, lighter colours are recommended so that the frame is not lost against the skin. These include white, tan, and gold. 


Glasses should be in the right proportion to the rest of the face and should be in the correct position so as not to distract from your appearance. As a general rule, the top of your glasses frame should follow the line of your eyebrows. Avoid having too much eyebrow above or below the frames. The eyes should sit at the centre of each frame. 


Your personal sense of style and personality can be expressed in the glasses you choose, so instead of sticking strictly to the guidelines, decide which elements work for you and which you feel comfortable with. Also, be careful to choose a model that will not bend or break easily. Follow the example of actor Daniel Radcliffe, who made round glasses "cool" as Harry Potter in the popular movie series. His character started out as a round faced young boy who eventually grew into a more square-jawed young man. He was able to pull off the round framed glasses both ways!




So we finally emerge from Januworry and everybody stops thinking about money. Until we get into February and the month is all about... yup, money. 
I mean, think about it... 
You've just recovered from the admin of September tax season, and bam! It's tax time again in Feb. One day everyone's talking about how Joburg was fuller than usual over December. Next day all they can talk about is provisional tax. 
And when they're not talking tax, they're talking budget speech. No matter who you talk to, everyone's got an opinion about the budget speech. It's all about what "he'll" say and what "he'll" do about the biggest problems in our country. We worry about how much will be allocated to service delivery. But we also worry about (let's face it) how much tax we'll have to pay on a bottle of wine or... (cue scary music) ...a box of cigarettes. 
And then there's the petrol price. We all have that friend who's convinced it's a bad thing whether petrol goes up or comes down. If petrol goes up, we won't afford to buy anything anymore, because the price of everything will go up. If petrol goes down, it's "ja but just wait... just wait. It's only coming down so it can go up later in the year. And you betta be ready for that." 
Not to mention: "I'm doing it, hey. This year I'm selling my car. It's just not worth it. Hello Uber." 
I kinda feel like budget speech time is like the Academy Awards – that other big thing that happens in February. Because we all talk about it, we buy into the hype, we make predictions, we hope it goes a certain way. And when it's all over, we can't shake that feeling that the wrong movie won. 
But let's not be negative about it. We gotta hope this year will be a good one. We just do. Sure we'll probably complain about it anyway, but still we find ourselves hoping for the best. 
And if you really want to put a happy face on the situation, just remind yourself that February is also the month of love, the time to put on those rose-coloured spectacles. The cynic might say it's all about money once again, because we're forced to show how much we care by how much we spend. But don't listen to that cynic. It's also a time to be nice, and to tell other people they're nice. Does it really have to be more complicated than that? 
On that sentimental note, you'll have to excuse me. I gotta start looking for my tax documents.

March/April 2019 Newsletter
November/December 2018 Newsletter


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