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Myopia Control and Kids

There are a growing number of children becoming myopic (nearsighted) every day. In fact, it is estimated that by the year 2020, 50% of the world’s population will be myopic. The Center for Disease Control (CDC) now recognizes this trend as a global epidemic and encourages eye care practitioners to address these changes. Although myopia may seem harmless and correctable with glasses and contact lenses, that is not always the case. Myopic individuals are at higher risk of sight threatening complications such as glaucoma, retinal detachments, macular degeneration and cataracts. The earlier in life children show signs of nearsightedness, the more likely they are to progress and experience these problems.

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What Causes Myopia?

The question is often asked, “why are we seeing a shift in more children developing nearsightedness?”. While there might be a genetic link, the answer is not all genetics like once thought. Myopic parents have children with a predisposition to nearsightedness but are not guaranteed this destiny. We know this as we see highly nearsighted parents with children that have varying degrees of myopia. It is believed that myopia development is a product of the environment around us. This has the largest effect on myopic development starting at the early grade school years through late teens. Children are spending more time indoors doing near work than they were 25 years ago. Between digital devices, studying, reading and videogames, children are putting more stress on their visual systems than in the past. Our eyes adapt to this added stress by becoming nearsighted. While the best treatment is to encourage children to spend more time outdoors, running around and getting dirty; more needs to be done as the increasing demand in near work is not going away.


Myopia Control Treatments

There are four main treatments for controlling myopia. The most effective treatment method is chosen based on the child’s current prescription and ability to use contact lenses, eye glasses or eye drops. Treatment is not designed to eliminate future nearsightedness, rather to slow its progression. For example, a child not treated with myopia control might have 8 diopters of myopia by the end of their teenage years. However, that same child treated may only have 4 diopters of myopia by the same time. This may result in a lifetime of fewer nearsighted related complications and eye diseases.

 

  • Orthokeratology (Ortho-K)

 

This involves using a rigid gas permeable contact lens to gently reshape the front surface of the eye while the child sleeps. The child then enjoys clear vision the next day free of contact lenses or glasses, while getting the full benefit of myopia control. Children as young as 5 are excellent candidates for ortho-k. Studies indicate that this method of myopia control yields, on average, a 50% reduction in myopia progression.

 

  • Atropine Eye Drops

 

Atropine drops have been used for many years to control myopia progression. They work by limiting the eyes ability to focus up close, which is one of the triggers for myopia progression. Studies suggest that atropine drops reduce myopic progression by upwards of 80%. However, this benefit is limited by the high rebound rate associated with atropine drops. Recent research has found that children using a diluted concentration of atropine drops have a lower likelihood of rebounding.

 

  • Multifocal Spectacles

 

Children wearing multifocal spectacles compared to single vision spectacles are less nearsighted in adulthood. Like other methods, multifocal eyeglasses work by limiting the amount of stress on the eye during near activities. This treatment results in the lowest reduction in nearsightedness compared to the other three methods.

 

  • Multifocal Soft Contact Lenses

 

Similar to ortho-k, multifocal soft contact lenses will slow myopia progression by around 50%. While there are many multifocal designs available, studies have found a specific design most effective in slowing myopic progression. The most successful lens design to control myopia is one that features a distance vision corrected zone in the center and a strong reading power outside the center zone.

It Starts with the Parents!

The best and most effective way to take advantage of myopia control is to detect nearsightedness early. Parents should schedule an annual eye examination for their child, even if they do not suspect problems. Children often do not complain of small changes in vision until it is negatively impacting their daily activities. Children undergoing myopia control treatment have less yearly prescription changes and more stable vision. Most importantly, by treating nearsightedness early, children are less likely to encounter future sight-threating vision complications later in life.

Please call today to schedule a consultation to see if myopia control is right for your child!

 

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Macular Degeneration

What is macular degeneration?

Age-related macular degeneration (AMD) is a condition that causes disruption to a small area of the retina called the macula. The macula is about 5 millimeters in size and is responsible for our central vision, allowing us to see fine detail. As the macula begins to degenerate in AMD, patients experience blurred or distorted central vision. AMD is the leading cause of blindness in people over 55 and impacts more than 10 million people in the United States.

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A properly functioning retina contains many layers that all work together to process light into clear vision. Beneath these retinal layers is another thin layer responsible for supplying nutrients and removing wastes from the retina, called the retinal pigment epithelium (RPE). In AMD, the RPE loses the ability to rid the retina of waste products, resulting in a buildup of deposits called drusen. It is important to know that, in most cases, patients with a few small drusen never progress to severe AMD and central vision loss. In patients with progressive AMD, drusen increase in size and number. This results in a lack of nutrients supplied to the retina.

Dry vs. Wet Macular Degeneration

As the nutrient supply to the retina weakens with AMD, blood vessels sprouted from the surrounding layers of the eye infiltrate the diseased macula. This is the eye’s attempt to provide nutrients to this undernourished area of retina. Unfortunately, these newly developed blood vessels are very fragile and often leak blood into the macula. If these new blood vessels grow and leak, it is called wet AMD (or exudative AMD). Wet AMD occurs in only 10% of all AMD cases. Vision loss caused by wet AMD often occurs much faster than dry AMD. Most cases of AMD are dry (or non-exudative AMD), meaning these blood vessels never develop. It is important for the doctor to make this distinction because the treatment and management for dry versus wet AMD is much different.

What are the risk factors for AMD?

  • Smoking
  • Having a family history
  • Obesity
  • A diet high in saturated fat
  • Age over 50
  • Caucasian ethnicity
  • Excessive exposure to UV light

What are the symptoms of AMD?

  • blurred central vision
  • distorted or wavy vision
  • difficulty reading
  • change in color vision

Are there treatments or preventative measures?

Unfortunately, there are no proven curative treatments available for patients with AMD. However, there are measures that can be taken to help combat and slow the progression of the disease. A specific formulation of antioxidants and vitamins, called the AREDS 2 formulation, has proven effective in helping patients with mild AMD. Studies found that taking these vitamins lowers the chances of mild AMD worsening to more advanced forms. For smokers, cessation is another important step to lower the risk of progression. In addition, sunglasses should be worn outside to protect the retina from excessive exposure to ultraviolet light.

For wet AMD, development and growth of new blood vessels can be managed with laser treatments, photodynamic therapy, and/or anti-VEGF injections. These treatments are very effective at halting further progression and sometimes result in improved vision.

Is there anything that can help me see better?

While there are currently no treatments to permanently reverse the vision loss caused by AMD, we do have access to rehabilitation services and low-vision devices that help optimize patients’ functional vision. These specialty devices include hand-held and video magnifiers, computer programs, large print books, and other ophthalmic devices.

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Diabetic Eye Care

It is important for any patients with diabetes (type 1, type 2, or latent autoimmune diabetes) to have annual eye exams as they are at an increased risk of developing many eye conditions and complications. Early detection of any potential problem will lower the risk of vision loss from diabetes. The doctors at Koetting Eye Center are trained using the latest technology to detect and monitor the earliest signs of diabetic eye disease.

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In what ways can diabetes affect one’s eyes?

  • Blurred vision: When uncontrolled, fluctuations in blood sugar can cause quick changes in glasses or contact lens prescriptions. This is because a higher concentration of sugar inside the natural lens of the eye causes swelling of the lens. It is important that eyeglasses and contact lenses are not prescribed in patients experiencing high fluctuations in blood sugar, as the prescription is likely to change once the blood sugar is controlled.
  • Cataracts : It is common for patients with diabetes to develop cataracts at a younger age than average. Symptoms include: blurred or cloudy vision, poor color contrast, glare, and difficulty driving at night.
  • Glaucoma: As blood vessels weaken from diabetes, new blood vessels may form in an effort to restore blood flow throughout the eye. In rare cases, these blood vessels will block the area that drains fluid from the eye, resulting in an increase in eye pressure. If left untreated, elevated eye pressure can damage the optic nerve and cause permanent vision loss.
  • Diabetic retinopathy

Diabetes is a condition that affects the small blood vessels in the body. Over time, the disease causes the walls of these blood vessels to weaken, eventually allowing fluid and blood to leak outside of the blood vessels. The retina is especially susceptible to this leaking because it has a high concentration of small blood vessels. Damage to the retina from diabetes is termed diabetic retinopathy and is a leading cause of blindness in adults. In most cases, this is completely preventable with close monitoring and tight blood sugar control. Early stages of diabetic retinopathy usually has no symptoms; which makes it so important for patients with diabetes to have annual exams. As diabetic retinopathy progresses, it can be divided into two categories: nonproliferative (NPDR) diabetic retinopathy and proliferative diabetic retinopathy (PDR).

Nonproliferative diabetic retinopathy is the earlier, less severe form of diabetic retinopathy. This occurs when the retinal blood vessel walls begin to break down and allow fluid or blood to leak into the retina. The location of the leaking blood vessels determines if the vision will be impacted. Fluid leaking in an area called the macula is termed diabetic macular edema. Diabetic macular edema is treatable using injectable medication and laser treatment, but the best outcomes come when detected early.

Proliferative diabetic retinopathy occurs when new, abnormal blood vessels grow in the retina. These blood vessels are brittle and cause many problems in the eye, including severe vision loss from leaking vessels and retinal detachments. Depending on the severity, PDR is usually reversible and vision loss is preventable with injectable medication and laser treatment.


Your role in reducing the risk of diabetic eye disease

Blood sugar control is the best way to prevent vision loss from diabetes. Diet, exercise, and medical management by an endocrinologist are the best ways to keep your blood sugar under control. It is imperative to schedule an annual eye exam with a thorough retinal examination. Ocular conditions associated with diabetes have a much better prognosis when detected early. Call us today to schedule your annual diabetic eye exam.

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Blue Light Protection

Could an eye exam help you get a good night's sleep?

If you are having trouble sleeping at night, blue light may be the culprit, and glasses or contact lenses could be the solution.

Today's digital technology is better and more convenient than ever. We love our computers, tablets and smart phones. Stuck waiting for an oil change? No problem. Scroll through Instagram or Facebook, play a game, catch up on email or even watch a movie. Our lives are full of modern conveniences that help with many things.

However, digital screens emit harmful blue light, and without proper protection, those conveniences could be costing you a restful night's sleep along with increasing your long-term risk to eye health complications. At Koetting Eye Center, we offer the latest cutting-edge technology in glasses and contact lenses to combat blue light. In fact, our practice was first in the St. Louis area to receive the new Oasys with Transitions soft contact lenses. And for those that wear glasses, we offer many lenses with built-in blue light protection.

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Get the Details!

Numerous studies have shown that individuals who are highly engaged in a digital lifestyle are experiencing more eye strain. We also know that too much blue light exposure can increase the aging process of the eye and result in acceleration of age-related eye conditions such as cataracts and macular degeneration. In addition to the blue light emitted from digital screens, the transition from incandescent overhead lighting to LED lighting adds to the bombardment of blue light.

To understand blue light and its effects on the eyes, it is helpful to look at a visible light spectrum of electromagnetic radiation. The spectrum is comprised of different wavelengths of light varying in length from 380-700 nanometers. Shorter wavelengths of light have higher energy and are more likely to cause damage to the eyes. Blue light, also referred to as high energy visible (HEV) light, contains the shortest wavelengths, ranging from 380-500 nanometers. This high-energy blue light is absorbed by the lens of the eye and the retina, which is why these structures are susceptible to damage.

Blue Light and Melatonin

One of the major concerns with blue light that is often over looked is its effect on our sleep cycle. Melatonin is a naturally occurring hormone in the human body that regulates our wake-sleep cycle, or circadian rhythm. Blue light emitted from the sun is important in controlling the levels of melatonin in our body throughout the day. During the day, blue light released from the sun suppress the amount of melatonin produced and keeps us feeling awake and alert. In the evening, when the sun is set, melatonin production increases, making us feel tired and ready for bed. This is when artificial blue light from digital devices and LED lights becomes a problem. Blue light exposure prior to sleep decreases our body’s production of melatonin, resulting in wakefulness and a delayed or disrupted sleep cycle. There are many physical and psychological implications of not getting a full night sleep. It is recommended to minimize blue light exposure a minimum of two hours before bed. Today, most digital devices have a blue filter mode you can program to turn on in the evening, as well as commercially available blue light blocking screens for computers. While these modifications help minimize blue light, they do not eliminate it.

Be Proactive, Not Reactive!

Digital devices and LED lighting are a big part of our lifestyle and will continue to be. In fact, unless you printed this article, you are most likely reading it on a digital screen and being exposed to blue light. The goal is not to eliminate all blue light as some blue light is an important part of our wake-sleep cycle. However, moderation is the key. With the advent of blue blocking glasses and contact lenses, we can now control blue light exposure throughout the day.

If you are experiencing side effects from blue light or are concerned about its long-term effects on your eyes, call today for an appointment. Our doctors can help guide you to the perfect solution to fit your lifestyle and provide you the very best protection from this very real threat.

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Advancements in Dry Eye Therapy

Over the last several years, researchers have learned significantly more about dry eyes.  Gone are the days where we are restricted to artifical tear drops to sooth symptoms of dryness.  What we know is that the old name "dry eye syndrome" is a vague explanation of symptoms for a more rooted problem.  The new approach is to first identify the source and individualize a treatment based on that.  

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Our tear film is made up of three main components which interact like layers of an onion: mucin, water, and oil. The inner most layer is made of mucin, which adheres the tears to the eye like puddy.  Just outside of that is the aqueous, or water, component that lubricates the surface of the eye. Lastly, and arguably the most important component, is oil.  Oil, or lipids, act like the shield that sits on the outer most layer of the tearfilm.  For better visualization think about oil floating on top of a body of water.  This oil provides a nice smooth surface for clear vision and protects the underlying aqueous layer from air.  Without a structurally sound lipid layer the water layer will quickly evaporate, directly exposing the eye to wind and irritating air particles.  

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What we have learned is that this vital oil is actually produced from glands within the eyelids, called meibomian glands.  These are modified versions of the same glands that produce oil on your skin.  These meibomian glands are prone to clogging and obstruction.  When these glands are not producing oil as they are intended to it is called Meibomian Gland Dysfuntion (MGD).  MGD is the leading cause of dry eyes and is found in about 85% of patients with dry eye symptoms.  MGD is a chronic, progressive condition that without intervention may continue to worsen until the glands become completely unfunctional.  

Once lost, these glands are very difficult to revive.  We use heat therapy in the form of warm compresses to melt the stagnant oil so that it may flow more freely.  Additionally, we emphasize the importance of complete blinks which promote the release of oils from the glands onto the surface of the eye.  For symptomatic relief artificial tears containing lipids are recommended as needed; although, it is important to know these will not help to improve gland function.  Omega-3 fatty acid supplements have been shown to reduce ocular surface inflammation which drives this chronic condition.  Antibacterial lid wipes and hypochlorus acid sprays work to eliminated any over population of unwanted microbes on the eyelids and clean the gland surfaces.  While these therapys help the glands function and may provide short-term relief of symptoms, they do not clear deep obstructions which leave the glands unfunctional. 

A new treatment, called the Lipiflow system, uses heat and pressure to clear blocked meibomian glands by applying heat directly to the glands on the inner eyelid surface. Heat rapidly and efficiently raises gland contents, liquifying any blockages making it easier to remove from the gland. Gentle pressure is applied to the outside of the lid from the base of the gland to the gland opening removing blockages and flushing dead cells from the gland.  During this process stagnant gland tissue may be removed from the glands. Maintaining normal meibomian gland health and function is critical to the long-term maintenance of ocular surface health and good vision.  The Lipiflow treatment is an in office procedure lasting about 12 minutes per eye.  This deep cleaning is repeated in most cases every one to three years.  We are pleased to offer this treatment option at Koetting Eye Center.  Please ask one of our doctors how the Lipiflow system can help you.  

Click here for a link to recent news story about the benefits of the Lipiflow.

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How to Dazzle in Your New Spectacles...aka...Guys Do Make Passes at Girls Who Wear Glasses

Once thought of as "bookish" or "nerdy", glasses have become a sought-after accessory for both young and old alike. Glasses can say a lot about your personality and fashion sense, and will instantly communicate a great deal of information about you. For instance, colorful or patterned glasses may indicate a fun-loving personality. Wooden or eco-friendly frames tell the world you care about nature and the environment. High end designer specs let everyone know you have got ultra-chic style to spare. A sporty frame in the colors of your favorite team will advertise your athletic interests.

Glasses can also make you more memorable. If you want to stand out in a crowd, choose distinctive eyewear. Play up and define your own unique style. Anyone can establish a signature look, not just artists and celebrities. Picture John Lennon, Buddy Holly or Jackie Kennedy.  I guarantee you can see their glasses in your mind right now.

If you want to stand out in a competitive world, uniquely styled glasses can make you more noticeable, and may help you to land that big account or even get the job over other equally qualified but less noticeable candidates.

No matter what you choose, if you wear your glasses with the right attitude and confidence, you will look stunning and heads will turn.  Here are a few insider tips for finding your perfect spectacle style:

Stay True to Yourself

If you are not one to follow the latest fashion trends in other aspects of your appearance, this may not be the time to start. Pick something classic or neutral in a shape that compliments your face. You want to be comfortable in your glasses and not feel like the glasses are "wearing" you. Any frame that looks good on you will always be in style. If square frames don't flatter you, give them a miss and opt for something that suits your face shape better. Generally, round faces will look great in wider or more elongated shapes with strong noticeable details. Square shaped faces are complimented by less angular, softer frame shapes. Oval faces tend to be fairly well-balanced so choose a style that's as wide as the broadest part of your face. If your face is heart or triangle shaped, choose something wider at the bottom than at the top. Of course all these rules can be thrown out the window if you find a frame that looks and feels great but doesn't fit the guidelines because if you love the look you will rock it naturally!  And, of course, you will get lots of compliments so be prepared for the extra attention!  

Conversely, if you already enjoy extra attention and love to wear the latest styles- Go for it! Choose something funky, sparkly, colorful or distinctive that you can make your own- and consider having multiple pairs in your wardrobe to fit your outfit, your mood, or the season. You wouldn't own just one pair of shoes or just one purse, why have only one eyewear option?

It Pays to Upgrade

Have you ever been excited to order new glasses and then been disappointed by the thickness of the lenses or the weight on your nose or glare on the lenses? Your Optician knows how to fix these problems and can offer suggestions on how to avoid them. They can help you with glasses that suit your lifestyle and they will also be able to help you by choosing thinner materials, non-glare coatings, and various treatments which will give you the best glasses you have ever worn. It may cost a little more, but it is money well spent. Your glasses are an investment and you use them every day. Consider options like Polarized or Transitions light adaptive lenses that will allow you to enjoy outdoor activities without squinting or damaging UV exposure. There are even new Transitions color lenses in jewel tones such as Sapphire, Amethyst, Emerald, and Amber. These fun new options offer the same reliable sun protection in cool new colors to compliment your style. Think about choosing hi-index lenses that will not only look thinner but give you a crisper, clearer, wider field of vision. Choose non-glare lenses that will help to relieve eyestrain caused by the glare from overhead lighting, headlights, and more. Additionally, non-glare coatings contain several components that will keep your lenses cleaner, keep them dry in the rain, and prevent them from scratching. Your Eyecare Professionals are a valuable resource. They study and learn about all the latest products to be able to enhance your lifestyle and help you to love your glasses!

Color Your World: On Tuesdays We Wear Pink
It's fun to have multiple frames in different colors. Change it up from day to day and match an outfit, mood or season. Perhaps wear a certain color during the Stanley Cup Playoffs (LGB!). Or choose a neutral tone that compliments both your wardrobe and your complexion. Either way, opt for a shade that works well with your skin tone.

There are two basic categories of skin tones, cold and warm. Most people will fall into one of these two categories, although 60% of the US population is reported to have cool skin tone. Not sure which you are? Look at the inside of your wrist. If the veins there appear blue, you are a cool skin tone. If they appear green, you are a wam skin tone.

 

                                         So, what should you look for when choosing a frame?

       Warm skin tones are complimented by: camel, khaki, gold, copper, peach, orange, coral, ivory, red, and blonde tortoise.

      Cool skin tones look best with: black, silver, brown, blue, grey, plum, magenta, pink, amber, and dark tortoise.

 

 

 

 

 

 

 Accentuate Your Best Features


Emphasize your strengths...

Use eyewear shapes to enhance your neatural beauty. Glasses will frame your eyes the same way artists frame great works of art. Cat eye frames will create a natural facelift by making eyes appear less droopy and highlighting and lifting cheekbones. Choose frames that compliment your eye color. For example, blue eyes will sparkle and shine when contrasted with a red or copper colored frame.

Also, consider your glasses when applying your makeup. Glasses may make your eyes appear a bit darker or in shadow, so use concealer to counteract that effect. Eyeshadow may appear darker as well, so an intense smoky eye may not be your best choice. Instead, highlight lashes with mascara, keep to lighter tones for eyeshadow, and don't forget to highlight your eyebrows.

Do wear makeup to your eye appointment when you try on frames. And style your hair the way you normally wear it. If you always wear a ponytail, wear a ponytail that day. If you always wear your hair down, wear it down. And if you always wear black brown or grey, do not pull out the one bright pink shirt you own and wear it to choose your glasses. This way, you will have a more accurate idea of how the glasses will compliment you and your wardrobe.

Confidence, Confidence, Confidence!

Whatever eyewear look you choose, own it. You will receive second glances and compliments when you hold your head up and smile. In fact, wearing glasses may actually make you more approachable. Several studies have shown that glasses wearers are perceived to be more intelligent, successful and trustworthy. Glasses also make you appear more human. They convey the message that no one is perfect which may help people open up to you.

As far as guys making passes at girls who wear glasses, remember the classic stereotype of romantic comedies where the girl-next-door flings off her glasses to reveal the sexy seductress lurking within.

Cue the lights and the music...

You've got this!

 

 

 

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"Beam Me Up, Scotty": 5 Reasons Why Light Adaptive Lenses are the Wave of the Future.

The future is here. We have yet to set foot on Mars, employ robot maids, pilot flying cars or teleport across space and time, but we are getting there. We carry smart phones in our pockets with microprocessors more powerful than entire roomfuls of past computers. We posess more knowledge about our bodies and our surroundings than ever before. And now, thanks to Transitions light adaptive technology, we can protect our eyes seamlessly, effortlessly, and look like rockstars while doing so.

Here are 5 reasons why light adaptive lenses are the wave of the future:

1) They protect your eyes.

Transitions lenses are constantly adjusting to changing light conditions, so even when they appear clear, they are working and adapting to give you the best possible continuous protection.Gen8 Blueprint We are under constant bombardment by UV rays from LED lighting, computers and digital devices, and the sun. UV rays are known to cause cataracts, macular degeneration, unsightly wrinkles, and skin cancer. Furthermore, the blue violet UV rays emitted by digital devices are especially damaging and can disrupt your sleep patterns by interfering with the melatonin production of the pineal gland. Mealtonin is the hormone which controls your daily sleep-wake cycles. We all have more than enough worries to keep us up at night- no need to let UV blue rob you of more sleep! Transitions light adaptive lenses protect your eyes from 100% of harmful UVA and UVB rays.

2) They fit your lifestyle.

Are you a minimalist? If you watch Marie Kondo on repeat and rock a capsule wardrobe of main-staple pieces, Transitions are a great option for you. They allow you to be crafty with your outfits and accessories. Wear one pair all day and all night. Rain or shine. No extra pairs to bog down your suitcase, pockets or purse. No wasting precious time in the morning trying to decide what glasses you need to bring for the day. One pair - all light conditions - covered. Choose a neutral frame with grey or brown Transitions Signature Colors lenses and you are set. You will no longer forget your sunglasses or not bother to put them on for a short trip outside. And fewer glasses to keep track of means they are less likely to get lost.

Conversely, if you love fashion and following trends and think more is always better, Transitions Style Colors Light Adaptive lenses can help you keep your style on point. Why not get 24/7 protection AND increase your style cred? Your accessories will pack twice the punch with new vibrant colors such as Emerald, Amethyst, Sapphire and Amber. You will look good and feel good with the perfect lenses for any occasion be it a hike in the woods, an evening concert, or cute selfies on insta- and they will always match your OOTD!

Or, opt for the new Style Mirrors with six cool mirror colors to choose from such as Silver, Gold, Red, Blue, Green and Pink!

3) Because you love your children.

Did you know that children receive THREE times the annual sun exposure as adults? They are outside playing at recess, gym class, in the yard, at the park, but they don't tend to wear sunwear. And even if they had sunglasses, they would likely struggle to keep track of them just like all the jackets and lunchboxes and assorted items that end up in the lost and found. Additonally, 1 in 4 kids spends more than 3 hours a day on digital devices. Transitions light adaptive lenses will keep their eyes safe both indoors and outdoors giving you valuable peace of mind. Now if only there were an invention to automatically brush their teeth, do their homework, make them eat healthy and clean their rooms!

4) It's Super-cool Tech.

Transitions light adaptive lenses are a lot more than just sun protection. They are highly innovative auto adjusting lenses. When Transitions lenses are exposed to light, trillions of photochromic molecules in the lens begin to change structure. This reaction is what causes the lenses to darken. These molecules are integrated into the surface of the lens and they constantly and smoothly recalibrate so the optimal amount of light reaches your eyes whether you're in bright sunlight, under cloud cover or indoors.

 And just in case you were thinking that glasses wearers are having all the fun, Acuvue Oasys contact lenses with Transitions were introduced earlier this year. Yes, contact lenses that will actually darken in the sun to make you more comfortable outdoors and give you superior UV protection in all light conditions. Ask us about a free trial pair so you can "see" for yourself.

5) Comfort.

When surveyed, 2 out of 3 people say they are bothered by light. Transitions light adaptive lenses keep eyes comfortable even in harsh light and they filter the light so your eyes don't have to work as hard. Damage from UV exposure is cumulative, building each time your eyes are exposed to the sun. Transitions light adaptive lenses block 100% of the sun's eye-damaging rays and help decrease painful discomforting glare as well as photophobia, migraines, and squinting.

Knowing these facts, doesn't it make sense to let your glasses work for you all day every day to make your life easier, safer, trendier and more comfortable? The future is here- don't get left behind!

 

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Building a Legacy in Eyecare: A Comprehensive History of the Koetting Eye Center

The Koetting Associates Eye Center has long been a St. Louis fixture. Many of our patients can recall coming to the Koetting Eye Center for as long as they can remember. But, did you know that the modern, cutting edge eyecare practice you know today actually dates back to the late 1800's and has had a history of innovation since its inception? Join us as we explore the long history and humble beginnings of one of the largest and most revolutionary eyecare practices in the St. Louis Area.

Our story begins South of St. Louis in Ste. Genevieve, MO in the year 1887. John Koetting, grandfather to Dr. Robert A. Koetting, owns a department store in town which features a watch and jewelry repair shop. He decides to open an optical department within the shop in order to offer more services to his clientele. Although small, this optical department will become the predecessor to what we know today as Koetting Eye Center. The original department store, now named Koetting Foodway still stands in Ste. Genevieve. It has offered other merchandise and services along the way, serving as a furniture store, silent movie theater, and funeral parlor, but it has been selling groceries exclusively since the 1950's.

To continue our story, we must move ahead to the year 1921 and pick up with John Koetting's son, Dr. Felix A. Koetting who has been inspired by working in his father's optical department to become an Optometrist. At this time, Optometry is a very new profession and Dr. Felix Koetting establishes his Optometric profession in South St. Louis. He is joined in practice by his son, Dr. Robert A. Koetting in 1947.

Dr. Robert Koetting, always a pioneer in his profession, makes the decision in 1961 to devote his practice exclusively to contact lenses. This is an extremely bold endeavor at this time , as contact lenses are uncomfortable and very few Optometrists know how to fit them. In fact, only 1% of the population is wearing contact lenses in 1961. His practice is called Eye Laboratory Inc, but in 1976 he moves to the University Club Towers and renames it The Koetting Associates. He specializes in hard-to-fit contact lenses and carries a large inventory of lenses so patients won't have to wait. His progressive decision pays off and his practice grows as he cares for tens of thousands of patients; not only gaining the trust of his patients but also that of other Doctors in the eyecare industry.

In the early days of contact lenses, a contact lens fitting was an extremely complicated and time-consuming endeavor. Many patients fit at that time recall that the process took an entire day and that Dr. Koetting and his technicians would take them out to lunch midway through the day. Dr. Koetting was fitting "hard" contact lenses and as in present day, had a lab on site so adjustments could be made. According to those patients, it was a long day, but it was life changing. They were able to see clearly without glasses for the first time they could remember.

Fast forward to 1982, and Dr. Carmen F. Castellano joins The Koetting Associates. Dr. Castellano works alongside Dr. Koetting until his retirement from seeing patients in 1986. He learns every aspect of the "Koetting Way" from philosophy to patient care and to this day he continues to safeguard the legacy of this revolutionary practice. LIke his predecessor, Dr. Carmen Castellano continues to push the boundaries of eyecare, recieving numerous awards and accolades for his contributions to optometry. He adds an eyewear dispensary to the practice in 1990 as well as further expanding into medical eyecare.

1999 brings the advent of LASIK surgery, and Dr. Castellano moves the practice very heavily into that area seeing upwards of 30 LASIK cases each month. This new wave of eyecare is the modern-day life-altering equivalent to the experience of Dr. Koetting's early contact lens patients, allowing them to see clearly without glasses or contact lenses.

In 2006, The Koetting Associates moves from the University Club Towers to our present day location at 2511 South Brentwood Boulevard and continues to be an integral part of the Brentwood community.

And, continuing the father-son tradition of The Koetting Associates, Dr. Carmen Castellano's son, Dr. Joseph C. Castellano joins the practice in June of 2011.

In August 2011, Dr. Robert Koetting passes away. Although he retired from seeing patients in 1986, Dr. Koetting remained active in the profession through writing, lecturing and consulting. He was an inventor, an expert on management practices, a popular speaker in his field, and he wrote over 350 articles and scientific papers and five books. His contributions to the eyecare industry are numerous and valuable. It is our honor and pleasure to carry on his legacy through the exemplary care of our patients.

Always moving forward and evolving, The Koetting Associates expands the practice into West County in 2016 by acquiring the practice of Dr. Gary DeLancey in Ellisville. This merger is an obvious decision for Dr. Carmen Castellano and Dr. Gary DeLancey, who have been friends and colleagues for many years and feel that the philosophy of the two practices and the quality of care provided make this a perfect match.

Also in 2016, the practice is joined by Dr. Nicholas A. Castellano. Dr. Nick is also one of Dr. Carmen Castellano's four sons thereby cementing the family legacy for at least this generation.

This year (2019) we added Dr. Jacob Pieper to our team in Brentwood bringing the total number of Doctors in our practice to five.

Additionally, in March of this year (2019), The Koetting Associates became known as Koetting Eye Center. You may or may not have noticed this change when calling in to our office or on our correspondence. We also updated our logo. It's a slightly different look but we will continue to strive to provide you and your family with the quality of care you have come to know and expect from Koetting. We aim to be the Ritz Carlton of eyecare in St. Louis, and we will continue to break boundaries and explore the latest technology for our patients both established and new.

 

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Navigating your Vision Insurance: Everything you ever wanted to know but were afraid to ask.

Insurance. It's not a very exciting topic, and you may feel your eyes glazing over as you begin to read this article, but it's important to have a basic understanding of your benefits. After all, you pay for them. Hopefully, this post will help you gain a little clarity when it comes to choosing and utilizing your vision benefits.

Routine Vision Insurance vs. Medical Insurance

What is the difference between routine and medical vision claims and does my medical insurance cover my eye exam?

The short answer is, that depends. If you wear glasses or contacts to correct your vision, but your eyes are otherwise healthy, your exam is considered to be a "routine" eye exam and is not covered by your medical plan. If you are being treated for a disease of the eye such as macular degeneration, glaucoma, have a condition like cataracts which requires surgery to correct, or if you have a systemic condition like diabetes which affects the eye and must be monitored, your medical insurance can be billed for your eye exam. Likewise, if you are taking certain medications that may affect your eyes, your exam may be covered by your medical plan. Another category which will fall under your medical insurance coverage is infections or injuries to the eyes including abraisions, foreign bodies or conjunctivitis. However, during an office visit to treat one of these issues, the doctor will not be performing a vision exam so this is truly a separate category.

All "routine" eye exams will fall under your "routine eyecare" or "vision" plan. There are many vision plans out there including VSP, Eyemed and Spectera just to name a few. Many employers will offer these plans in addition to your medical and dental coverage. It is always a good idea to opt into these plans as they are usually very affordable and most will cover an eye exam each year as well as provide a benefit for glasses or contact lenses. Not all vision plans will issue an ID card, however, so it's a good idea to gather some information about the name of your plan before your appointment. A quick call to your HR Department or visit to your benefits website will ensure that you have all the required knowledge to maximize the benefits to which you are entitled.

The good news is that all routine eye exams provide multiple tests and screenings for medical conditions and diseases of the eyes. If it is determined during your exam that you require further medical evaluation, our doctors will either continue your care using your medical plan or refer you to a specialist who will then bill your medical insurance for your care.

Some insurance plans such as Medicare do not cover the refractive portion of the eye exam. The refractive portion of the exam is the actual determination of the prescription for eyeglasses or contact lenses.That portion of the eye exam will be the patient's responsibility. Many Medicare Supplemental plans do offer routine eyecare however, and these options should be explored when selecting your Medicare plan. That way you can be sure you will have coverage in place for exams and glasses or contact lenses once you have retired.

Unfortunately, some companies do not offer vision insurance to their employees, and some people are self-employed with no access to group insurance benefits. For those individuals, there are standalone plans available at very reasonable rates which offer excellent coverage for the whole family. These same plans can be chosen to accompany Medicare as well. If  you would like more information on these plans, please ask one of our staff. We are happy to provide you with the phone numbers and websites to research and enroll in an individual plan.

If you decide you would rather just set aside your own funds for your eyecare, remember that eye exams, glasses and contact lenses are all qualified FSA and HSA expenses. You can easily estimate your usual yearly costs for these items and contribute those funds to your pretax spending accounts. Furthermore, if you do have vision insurance, your HSA and FSA dollars can be used to pay your copays.

 

How often can I have an eye exam?

Most vision plans will cover one routine eye exam per year. That will either be once per calendar year renewing January first every year, or once per year based on the previous date of service. When a plan is based on the date of service, you may be required to wait until after the date you were seen the previous year in order to receive coverage. Each plan is different, but all will fall under one of these two categories. Visits which address medical issues are not limited by the year so if you are being treated for a medical disease or condition of the eye, you can be seen as often as needed under your medical insurance to ensure proper treatment of your condition.

 

 

What about Glasses and Contact Lenses?

While some folks are fortunate enough to have coverage for two pairs of glasses per year or benefits for glasses AND contacts each year, the majority of plans will include one pair of glasses OR a specific allowance toward contact lenses. Most plans will allow these benefits every year, but some plans allow services only every other year.

It's also not uncommon for plans to allow either glasses lenses or contact lenses every year but a frame only every other year. The idea here is that glasses wearers can update the lenses in their frame in the off years. You can always purchase a new frame out of pocket if yours is worn out or if you would like a new look. There may also be discounts provided for additional pairs if you require more than one pair and your insurance covers only one.

It is worth mentioning that insurance will pay at a much higher rate of coverage for glasses than for contact lenses. About four times more. This goes back to antiquated ideas by insurance companies that contact lenses are a cosmetic option. We know that this idea is false and that contact lenses and glasses are equally valid and effective methods of vision correction, but the fact remains that insurance benefits are often greater for glasses. Therefore, in those years that you require both glasses and contact lenses, it will likely be more beneficial to use the insurance for the glasses and pay out of pocket for the contacts. Our team members will do their best to maximize your benefits and use them to your best advantage.

 

If I need my contacts to see, why aren't they considered "Medically Necessary"?

We get this question from time to time from those who read their policies and discover that medically necessary contacts are covered at a much higher rate by insurance than elective contacts. This is a valid question and it's quite understandable that this would be confusing. There are some conditions which are corrected much more effectively by contact lenses than by glasses. One is keratoconus. Keratoconus is a progressive eye disease in which the normally round cornea thins and begins to bulge into a cone-like shape. This shape causes distorted vision and progressive nearsightedness with irregular astigmatism to develop as well as glare and light sensitivity. As this disease progresses, regular glasses or contact lenses will not provide adequate vision correction, and specific custom contacts including hybrid and scleral lenses are required to give clear vision to these patients. Eventually these patients may progress to a point where the only corrective option is surgical, but contact lenses prescribed to treat keratoconus are considered to be medically necessary.

A second condition which qualifies contacts as medically necessary is anisometropia. This condition occurs when there is a large difference in prescription from one eye to the other creating an imbalance in vision. Because this condition decreases the eyes ability to work together, glasses may cause double vision, headaches and eyestrain. In order to minimize or even eliminate image size difference, contact lenses are usually the recommended solution thereby qualifying them for medically necessary coverage.

There are a few other conditions that can be considered for medically necessary contact lenses, but the general rule is that unless the patient meets the criteria for medically necessary coverage, all contacts are considered "elective".

 

We hope this helps to shed some light on the dark and mysterious subject of vision insurance. If your questions were not addressed here, just ask. Our team is always available to help you to understand and utilize your benefits to your very best advantage.

                                                                       

 

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What are Floaters?

A sudden onset of what we call floaters can be very unsettling to experience.  Floaters can mean several things, but most of the time it is a part of normal changes to the vitreous gel that fills the eye.  In less common cases, floaters may be a result of a retinal tear or detachment.  Because of this, an evaluation by a professional is always warranted in these cases. Read this article to learn what to look out for and when it is appropriate to seek help.

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Brentwood:

  2511 South Brentwood Blvd.
St. Louis, Missouri 63144

    (314) 863-0000


Ellisville:

 113 Old State Road Suite 101
Ellisville, Missouri 63021

    (636) 256-7800