Well Vision Services

When you visit Mt. Tam Optometric Center for a comprehensive eye exam, we will check your binocular vision, determine your visual needs, and then provide you with an accurate prescription for your glasses. We will also provide a thorough assessment of your overall eye health and screen for eye disease. To achieve this in a thorough and expedient manner, we utilize some of the newest technologies. Check out our section on Featured Equipment.

A Complete Eye Exam

Regardless of your age or physical health, Dr. Lassa Frank encourages you to have regular eye exams.

During a complete eye exam at our San Anselmo office, your eye doctor will not only determine your prescription for eyeglasses or contact lenses, but will also check your eyes for common eye diseases, assess how your eyes work together as a team and evaluate your eyes as an indicator of your overall health.

A comprehensive eye exam includes a number of tests and procedures to examine and evaluate the health of your eyes and the quality of your vision. These tests range from simple ones, like having you read an eye chart, to complex tests, such as using a high-powered lens to examine the health of the tissues inside of your eyes.

Eyecare experts recommend you have a complete eye exam every one to three years, depending on your age, risk factors, and physical condition.

Children. Some experts estimate that approximately 5% to 10% of pre-schoolers and 25% of school-aged children have vision problems. According to the American Optometric Association (AOA), all children should have their eyes examined at 6 months of age, at age 3 and again at the start of school. Children without vision problems or risk factors for eye or vision problems should then continue to have their eyes examined at least every two years throughout school.

Children with existing vision problems or risk factors should have their eyes examined more frequently. Common risk factors for vision problems include:

• premature birth
• developmental delays
• turned or crossed eyes
• family history of eye disease
• history of eye injury
• other physical illness or disease

The AOA recommends that children who wear eyeglasses or contact lenses should have their eyes examined at least every 12 months or according to their eye doctor’s instructions.

Adults. The AOA also recommends an annual eye exam for any adult who wears eyeglasses or contacts. If you don’t normally need vision correction, you still need an eye exam every two to three years up to the age of 40, depending on your rate of visual change and overall health. Doctors often recommend more frequent examinations for adults with diabetes, high blood pressure and other disorders, because many diseases can have an impact on vision and eye health.

If you are over 40, it’s a good idea to have your eyes examined every one to two years to check for common age-related eye problems such as presbyopia, cataracts and macular degeneration.

Because the risk of eye disease continues to increase with advancing age, everyone over the age of 60 should be examined annually.

After Mt Tam Optometric Center evaluates your visual needs, vision, and the health of the front part of your eye, we will:

• Discuss all contact lens options open to you
• Recommend the most suitable contact lens and wearing modality for your needs
• Put trial lenses on your eyes so you can see what they’re like

Then, you are able to make an informed decision on your goal of wearing contact lenses. We fit all types of contact lenses including:

• soft spherical lenses
• soft toric lenses
• gas permeable spherical lenses
• gas permeable front surface toric lenses
• gas permeable bitoric lenses
• multi-focal soft and gas permeable lenses
• the new Synergeyes hybrid lens
• lenses for keratoconus
• lenses for corneal transplant patients.

We are pleased to accept all hard to fit patients.

The most popular wearing modalities in our practice are dailies, lenses that you wear for a day and dispose of, or 30day/30 night lenses that most people wear for a month straight. Dailies are great for those patients who don’t plan to wear their lenses much more than two to three times per week. For patients who want to wear their contacts more, the 30 day/ 30night lenses tend to be more cost efficient. Although they are designed and marketed for extended wear, there is no law that says you can’t remove them nightly. Having said that there is a lot to be said for simplicity and this is closest thing we can do to LASIK, short of actually doing LASIK on you.

Our contact lens fitting fee covers the initial fitting of the contact lenses, training (including insertion, removal and care of the lenses), and all follow-up visits up to three months. More importantly, all trial lenses used during the fitting period are included. The fitting fee tends to be a onetime charge. Normal prescription changes are taken care of as part of the normal six month contact lens checks. The only time you would ever be charged another fitting fee is if you changed modality (distance to mono-vision, soft to hard lenses, sphere to astigmatic lenses, etc.). In these cases we usually just charge you the difference between what we originally charged you and what we would have charged if we were fitting you from scratch.

Give us a call at 415.453.8906 or request an appointment online.

While the screenings that are done at pediatricians and at schools are excellent, they are just screenings. During a comprehensive pediatric exam at Mt Tam Optometric Center we look at three things specifically.

First, we look at how the eyes and the visual system are developing to make sure the child is on track.

Secondly, we look at the health of both the front part of the eye as well as the inside.

Last of all, and most importantly, we look for the causes of or development of Amblyopia. Amblyopia is a condition where if a child has either a misalignment of the eyes (lazy eye in an extreme case), or if there is a large discrepancy in prescription between the two eyes, the child as a survival technique will effectively turn off one of the eyes. The result is that the child doesn’t develop the neuro connections between that eye and the brain resulting in an adult sitting in our chair who can’t see as well with one eye, even if they are perfectly corrected. If this had been caught and corrected early in life, the child would grow up with equal vision in both eyes. This in turn would improve depth perception, reading skills, and in general less eye strain for all visual tasks.

It is for these reasons that it is so important to provide your children with professional eye care.

Give us a call at 415.453.8906 or request an appointment online.

Eye Exams For Infants, Pre-Schoolers and School Age Kids

Mt Tam Optometric Center provides InfantSee to the residents of San Anselmo, CA! Vision disorders are the most prevalent handicapping condition during childhood. Despite this, studies show that only about 31 percent of children between ages 6 and 16 years are likely to have had a comprehensive eye and vision examination within the past year, while below the age of 6, only about 14 percent are likely to have had an eye and vision examination. Early detection and treatment are essential to preventing vision conditions that have the potential to cause permanent loss of vision. This is such an important issue that the American Optometry Association has designed the InfantSee program, which offer a free comprehensive eye exams for infants up to one year old. We are proud participants of this program, and we welcome your infants for their first eye exam!

When Should My Child Have an Eye Exam?

We strongly urge parents to schedule comprehensive eye exams for children at ages 6-12 months, 3 years, and before entry into elementary school. After kids start school, a comprehensive exam every year is recommended. These are times when children’s eyes are developing quickly, and vision problems are more likely to arise in growing kids.

What Eye or Vision Problems Can Occur at These Ages?

Infantile Esotropia

Infants between 6 months and 12 months old are the most likely to develop inward eye turns (cross-eyed), or infantile esotropia. This condition prevents the eyes from working together as a team, and from developing good depth perception.

Amblyopia

If there is a large enough difference in the vision between the two eyes, the brain will learn to ignore the more blurry eye (amblyopia). If this is not detected and treated, the visual centers of the brain will not develop properly for the blurry eye. We also want to identify neurological disorders (e.g., nystagmus, ptosis) or congenitalmalformations (e.g., congenital cataract) that could permanently affect vision. It is important to diagnose these eye problems as early as possible to begin treatment before vision loss is permanent.

Accommodative Esotropia

When children reach 3 years old, they become susceptible to new vision problems. This is because their eyes have grown so quickly since infancy. It is the size and shape of their eyes that determine whether their vision is normal, or if they will need glasses (nearsightedness, farsightedness or astigmatism). This age is the most likely for kids to develop a new eye turn related to the need for glasses (accommodative esotropia). If left untreated, this can cause a permanent loss of vision in the turned eye due to amblyopia. Treatment us usually simply to wear glasses to correct farsightedness. This stops the eye turn, and allows the visual parts of the child’s brain to develop normally.

Why is it Important for School-Aged Kids to Have Eye Exams?

Vision problems generally are not the directcause of learning disorders; however, they can interfere with children’s abilities to perform to their potential. Prevention of vision problems that can affect development, learning and quality of life.

For example, research has shown that “in the population of all school age students, 25% suffer from undiagnosed vision problems.”

The problem is even worse with kids at risk. It is estimated that 70% of juvenile offenders have undiagnosed vision problems. “Recidivism was reduced from 45% to 16% when wards received on-site optometric vision therapy at the Regional Youth Education Facility in San Bernardino, California. ” (California Department of Youth Authority – 1989). This study emphasizes the importance identifying and treating vision problems early on in a child’s school life.

Don’t School Vision Screenings Already Catch Kids with Vision Problems?

We believe that school-based screenings are important, and identify many vision problems in kids. However, the vision problems that cause the greatest problems in school are not detected in school vision screenings. For example, kids with pretty high amounts offarsightedness can see the 20/20 line on the vision chart, and pass the vision screening with flying colors. But, studies show that uncorrected farsightedness is related to poor reading progress and its correction with glasses or contact lenses results in improved performance. In contrast, the kids that can’t see the 20/20 line and fail vision screenings are usually nearsighted, or have astigmatism. Studies show that these kids have average to above average reading abilities. Studies also show that kids with farsightedness have statistically lower achievement test scores in school. As a result, school-based vision screenings don’t catch many kids with vision-related learning problems. We urge regular eye exams to catch farsightedness and correct it to prevent any obstacles to your child’s great performance in school.

Another vision problem not detected in vision screenings is convergence insufficiency. This is the inability to easily turn the eyes inward to keep a near object clear, and to avoid double vision. Strong convergence is important for reading and doing any type of desk work at school. Untreated convergence insufficiency can result in poor school performance, headaches, eyestrain, or avoidance of near work. Convergence insufficiency affects about 2-5% of the population. The rate is 3 times higher in kids diagnosed with ADHD. In fact, some kids with convergence insufficiency are misdiagnosed with ADHD.Convergence insufficiency can usually be treated with special eye exercises. After this treatment, your child can concentrate on the task of learning, instead of the task of holding their eyes in place to learn. Regular eye exams are essential to catch convergence insufficiency and correct it.

As a community service, Mt Tam Optometric Center provides free student vision evaluations when referred by pediatricians or school nurses. The purpose of these visits is to determine in questionable situations if in fact there really is a vision or binocular vision problem and if so, what further testing is required. The visit does not determine a final prescription and does not provide an overall ocular health checks. A report will then be sent to the child’s physician or school nurse.

If your child’s physician or school nurse suspects a vision problem, or if they just aren’t sure, have them give us a call us at 415.453.8906 or contact us with the information listed on our School Nurse Referral page.

Binocularity refers to the eyes’ ability to complete tasks while working together as an efficient team. Symptoms of binocular vision problems may be noticed by patients or their parents, or we might spot one during a regular comprehensive exam. When indicated, we perform a thorough binocular vision evaluation.

At Mt Tam Optometric Center ,our binocular vision evaluation provides a specific diagnosis of your binocular vision problem. We will discuss our prognosis and management plan with you at the end of the examination. We prescribe corrective lenses (glasses or contact lenses), prisms, eye patching or vision therapy when indicated.

Mt Tam Optometric Center provides computer vision exams including a thorough review of your workstation, its physical layout, and your visual needs. We then review your prescription, the design of your glasses, and your binocular vision needs. Putting this all together we will review your glasses options such as:

• modification of your current prescription
• modification of the glasses design
• the use of prism to reduce eyestrain
• the use of tints or anti-reflection coatings to reduce eyestrain

We will also explore your other options to see where they may reduce your eyestrain while using your computer for prolonged periods. These may include:

• work station layout and design lighting
• the use of exercises to strengthen either your binocular vision or accommodative systems
• the use of contact lenses or LASIK to better fulfill your computer vision needs

Give us a call at 415.453.8906 or request an appointment online.

At Mt Tam Optometric Center our low vision exam is designed to bridge the gap between your visit to the medical specialist and functioning in the real world. We start by reviewing your physical findings, fine tuning your prescription, and determining what your visual needs are. We then walk you through your options, whether they are new glasses, contact lenses, magnification devices, or some combination thereof. We work closely with the Lighthouse organization to help you find solutions to those visual tasks that are so important in life, but are much more difficult or impossible to do now.

Low Vision Information

A person is considered to have low vision if their ability to perform basic daily tasks is affected by their ability to see. The term “Low Vision” usually means the best attainable visual acuity is somewhere around 20/50 or worse. Low vision can result in general cloudiness, central vision loss, peripheral vision loss, blurry areas, or blind spots causing a loss of some portion of the visual field.

A Low Vision Evaluation is an in-depth functional evaluation to determine if the current vision can be improved to do those things the person wants to do. The end result of the low vision evaluation will be to determine the lens power and device that is best suited to meet the patient’s needs. The low vision evaluation should explore the optical and non-optical systems that are currently available.

The Low Vision Exam

The low vision examination is quite different from the regular comprehensive exam. The goals of the low vision exam include assessing your functional needs, and the capabilities and limitations of your visual system. We assess the impact of ocular and systemic diseases on your vision. We prescribe low vision systems to maximize the use of your vision, tailored to your visual needs. We may also recommend further evaluation and treatment by vision rehabilitation professionals or make appropriate referrals for medical and surgical intervention.

Low Vision Exam Format

The Low Vision Examination begins with an extensive history. We want to know if you have problems with reading, functioning in the kitchen, glare problems, travel vision, the workplace, television viewing, and school requirements. We also include a careful review of your ocular and medical history.

We will make careful measurements of your visual acuity using low vision test charts, and then determine the best glasses or contact lens prescription for you. We may also test your depth perception, color vision, contrast sensitivity and curvature of the front of the eye.

If you have decreased acuity, we may recommend various telescopic systems which magnify distance vision. These may be spectacle mounted or handheld. We may also recommend filters to control glare. Various reading aids including strong reading eyewear, magnifiers, electronic magnifiers and even electronic reading machines may be recommended.

Eye health testing may includes an examination of the external and internal structures of your eyes. We will counsel you on how your condition will effect your vision and what you may do to enhance and protect your vision.

Give us a call at 415.453.8906 or request an appointment online.

What is Vision Therapy

The eyes have two muscle systems which must work together. One system aims at a target and the other focuses on the target. When these two systems are not coordinated they fatigue. The result can be eye strain, headaches, and blurred or double vision. Vision therapy eliminates these symptoms by bringing these muscle systems under voluntary control, and then re-educating the muscle systems to work more effectively.

“Here’s an analogy: When a person learns to ride a bicycle, the learning process is mentally demanding and physically exhausting. It feels awkward trying to coordinate arms, legs, handlebars, and pedals while staying balanced!

However, over time with patience and success, riding a bike becomes more and more natural. What was difficult becomes nearly automatic and you don’t tire as easily. Through practice, you’ve learned new physical and mental skills; what was initially demanding is now easy and even fun! And once you’ve learned, you’ll always know how to ride a bike. This is what vision therapy is about— automating the reflexes. This is accomplished through specialized eye exercises. Eye exercises can improve how your eye muscles work and relieve your symptoms.

The Home Vision Therapy System (HTS)

We now offer the latest technology in helping treat your focusing and reading problems. The HTS system is a computer-based series of eye exercises that you perform either at home or at work on any computer that has internet access.

Many students and adults have 20/20 vision, yet they may have a muscle problem. When the eye muscles are not used properly, they fatigue, which can lead to eye strain, headaches, blurred vision, skipping lines when reading, even double vision.

Our eyes were never intended for spending long periods of time on close work – such as reading or at a computer. Eyestrain is caused by the visual demands of modern living. HTS re-educates your eye muscles to work more effectively.

For more information feel free to call us at Mt Tam Optometric Center!