Dr. Roberts Blog


Digital takeover: 5 stats that reinforce back-to-school exams

"Each year when school starts, we see an increase in kids complaining of symptoms synonymous with eye strain."

Summer vacation likely wasn't a break from electronic devices for many kids, but as school gets back in session, it's blue light—not sunlight—that will sparkle in students' eyes. And that's all the more reason for a back-to-school eye exam.

This year's AOA Ready-for-School public awareness campaign has circulated nationwide since July, promoting the necessity of such exams and pairing it with results from recent AOA surveys that show a stark contrast between parents' and kids' perceptions of digital device use.

"Each year when school starts, we see an increase in kids complaining of symptoms synonymous with eye strain," stated Lori Roberts, O.D., chair of the AOA's New Technology Committee, in the campaign. "Essentially, they're going from being home over the summer with a minimal amount of time spent using their devices back to a classroom full of technology, and their time on devices often doubles, leading to a strain on the eyes."

Digital devices take a toll
The Ready-for-School campaign includes materials that give recommendations for avoiding digital eye strain, including the 20-20-20 rule while using screens: Take a 20-second break every 20 minutes and fixate vision on something 20 feet away.

But do parents, and for that matter students, know these recommendations? According to results of the AOA's 2014 American Eye-Q and a children's omnibus survey, the integration of technology into the classroom gives more of a reason for children to get an eye exam, because:

  1. Kids are digitally connected longer than parents think. Eighty-three percent of children report using an electronic device more than 3 hours daily, while only 40 percent of parents think their kids exceed that mark; furthermore, 42 percent of kids report 5 hours of use or more versus only 10 percent of parents that think the same thing;

  2. All that time can cause eye problems. Eighty percent of children report their eyes have burned, itched, felt tired or had blurry vision after using an electronic device;

  3. Kids aren't taking appropriate breaks. Students aren't following the 20-20-20 rule—14 percent report taking a visual break from their device every 20 minutes. A third of kids report taking breaks every few hours or not at all;

  4. Most learning happens visually. An estimated 75 to 90 percent of all classroom learning happens through visual pathways—nearly all tasks a child performs depend on good vision;

  5. More could be done to get kids in the exam chair. Almost a third of parents report a child should be 3 years or older before visiting the eye doctor for his or her first comprehensive eye exam, while another 28 percent report they don't know when their child should first be seen.

The AOA recommends every child be seen by an optometrist soon after 6 months of age and before the age of 3, and as a result of the pediatric essential health benefit in the Affordable Care Act, children are now covered for yearly comprehensive eye exams through age 18.


Ocular migraines- A migraine may be described as a throbbing head pain accompanied at times by nausea/vomiting, mood changes, fatigue or photophobia. They are typically unilateral (although it may occur behind both eyes or across entire front of head). Some patients report a preceding "visual aura" with visual disturbances such as flashing, zig-zagging lights, blurred vision or a visual field defect lasting 15-50 minutes which may appear as tunnel vision. Neurologic deficits may also accompany the migraine such as paralysis, numbness, or tingling.

Most unilateral migraine headaches change side, if the migraine always stays on same side make sure to mention this to your physician as another cause may be at fault.

Migraines with typical aura have fully reversible visual or unilateral sensory symptoms. Symptoms develop gradually and last between 5 and 60 minutes. No motor symptoms will present.

Precipitating factors include: Birth control/hormonal pills, puberty, pregnancy, menopause, foods w/tyramine or phenylalanine (aged cheese, wine, chocolate, cashews), nitrates or nitrites, monosodium glutamate, alcohol, fatigue, stress or bright lights.

Management- Ocular & neurologic examinations, for atypical or complicated migraines- a CT scan or MRI are often indicated

Avoid precipitating agents and report to your PCP or neurologist for pharmacologic management.  


Cataracts Some statistics- - In the US, about 50% of those between the ages 65 and 74, and 70% of those over age 75 have a cataract. - Women>Men. - 1/10,000 babies are born with congenital cataracts (often related to the mother having an infectious disease or alcohol/drug abuse during pregnancy) Causes and Risk Factors- - Aging is the primary risk factor for cataracts. Other factors determine overall risk for and severity of the condition. When cataracts occur in younger patients, they are usually caused by a chronic medical condition, eye trauma, or prescription drug. - Medical conditions such as diabetes, myotonic dystrophy, or Wilson's disease increase the risk for cataracts, regardless of age. Slowly progressing cortical cataracts (spoke-like peripheral opacities) are common in diabetics. Diabetic patients or those who take high doses of steroids are more at risk for subcapsular cataracts (cataracts that form on the capsule behind the lens). - Certain drugs can stimulate cataract development. These include the following: Amiodarone (heart medication) Chlorpromazine (sedative) Corticosteroids (e.g., prednisone- used to treat inflammation in many acute and chronic illnesses) Lovastatin (cholesterol-lowering drug) Phenytoin (antiseizure drug- used to treat epilepsy) - Fetal exposure to infection, radiation, steroids, alcohol, and other substances of abuse during pregnancy are risk factors for congenital cataracts. - Smoking and alcohol abuse increase the risk for cataracts. Individuals who smoke 20 or more cigarettes a day have twice the risk of nonsmokers for developing cataracts. Long-term alcohol abuse leads to vitamin deficiencies that may lead to development of the condition. - Deficiencies in vitamins C and E, selenium, beta carotene, and lycopene may be linked to cataract development. These antioxidants protect the body from free radicals that cause damage to cell walls and other cell structures, as well as the genetic material within cells. - African Americans may be at higher risk for cataracts, possibly because of this group's higher risk for some chronic conditions (e.g., diabetes) that increase the risk for cataracts. - Prolonged exposure to sunlight, specifically ultraviolet B (UVB), is a risk factor for cataracts. The longer the exposure, the greater the risk. However, even a low level of exposure increases risk. - An eye injury may increase the risk for a cataract. - Eye disease (e.g., uveitis) or infection can lead to cataracts. A tumor can also cause changes that may lead to the development of cataracts. Common symptoms of cataracts include: Blurry vision, colors appear faded, frequent changes in prescription, poor night vision, seeing a halo around lights, sensitivity to bright sunlight or headlight glare at night


Dry eye syndrome can result when one or more of the eye’s layers fail to produce the right quantity or balance of tears. This condition has a multitude of causes but generally can stem from the following factors:

Age: As Americans age, eyes naturally become drier. Consequently, the majority of people older than 65 experience some symptoms of dry eye.

Gender: Women are more likely to develop dry eye with hormonal changes during pregnancy, while using oral contraceptives and following menopause.

Medications: Decongestants, antihistamines and antidepressants are among numerous medications that can reduce tear production.

Medical Conditions: Health issues associated with arthritis, diabetes, Sjögren’s syndrome and thyroid problems can produce dry eye symptoms.

Environment: Dry climates and exposure to wind and smoke may trigger dry eye. It’s also important to blink regularly, especially if you work at a computer for long periods of time.

Eyewear/Surgery: In some cases, long-term wearing of contact lenses may cause dry eye (or make eyes less comfortable if they are dry), and previous eye surgery, such as LASIK, may lead to a temporary decrease in tear production.

Cosmetics: When the lid margin is coated with heavy makeup, it can block the openings of the oily glands, which help lubricate the eye.

Treatment for dry eye syndrome varies depending on the severity. Some people can use artificial tears or similar eye drops or ointments that simulate the action of tears, but most will require medication prescribed by their optometrist. There are also oral capsules that can help the eyes maintain tear production and guard against future tear loss. The SCOPA and the AOA recommends consulting an eye doctor to diagnose the condition and discuss the proper treatment to help ease the discomfort. According to eye doctors, some over-the-counter eye drops will actually have an adverse effect on dry eye symptoms.

Additionally, consumers can help alleviate symptoms of dry eye by following a more holistic approach, such as:

Eating fish or taking a nutritional supplement that contains polyunsaturated fatty acids.

Increasing humidity in your home and/or office.

Blinking more frequently, especially when reading or staring at a computer screen, as well as lowering the computer screen to at or below eye level.

Wearing sunglasses with wraparound frames to reduce exposure to wind and sun.

Drinking plenty of water to avoid dehydration.

Nutrition plays a big role in a person’s overall health, including vision.  Eating healthy by adding the benefits of omega-3 fatty acids found in fish and nutritional supplements can play a role in preventing or easing the discomfort of dry eye.

Several new studies have confirmed the correlation between fatty acids and an improvement in dry eye syndrome. Salmon, tuna, herring, mackerel and other cold-water fish are rich in omega-3 fatty acids and can help reduce inflammation, enhance tear production and support the eye’s oily outer layer as well as provide health benefits for your cardiovascular, immune and nervous systems.


Take important steps offered by the American Optometric Association in safeguarding your child's eye sight while using computers or other devices. In an age of ever growing use of technology by children, specifically LCD flat screens, children are at risk for some of the same sight issues as adults, as well as some unique to children. Today, kids are spending countless hours on social media sites like Facebook and texting, and, of course, gaming. With all this screen face time comes an ever-increasing chance of eyestrain and fatigue. Kids, unlike adults, have a different perspective about using technology and can sit staring at screens big and small for hours, ignoring the signs of eye fatigue and strain in order to continue participating in an activity, which they find entertaining. The problem with continuous game play is that it can cause eye-focusing problems, which involves the eyes focusing and re-focusing. More specifically, being able to smoothly re-focus from one object to another even after a child has stopped playing for some time. Other eye situations kids are more likely to tolerate are dry eyes from infrequent blinking, screen glare, and near and far sightedness. Another consideration is a child's viewing angle, for an adult a comfortable screen-viewing angle is about 15 degrees. However, for a child sitting in adult chairs, the angle is much greater, which can make viewing the screen more difficult for a child. To help your child safeguard their sight and have a more pleasurable time while using the family computer, the American Optometric Association offers some simple common sense steps you can take. The AOA suggests an eye exam as a good first step in determining if there are any underlying eye conditions, which may be contributing to eyestrain, such as the need for glasses. Also, building in break times, as mentioned kids will continue to do what they are doing if it is entertaining, and forget to give their eyes a much needed rest. Getting them away from the screen every hour is a good rule in helping to reduce eye-refocusing problems. To reiterate, adjustment to the sitting position and angle of the viewing screen can reduce eyestrain. In addition, removing sources of screen glare such as lamps placed behind the screen also help. Moreover, moving the screen away from bright windows and reducing light levels in the room. Another point to remember is today kids are using screens more at school and passing these helpful ideas on to your kid's teacher may earn you a gold star!

Prevent Diabetes: Keep Your Eyes Healthy

In the United States, diabetes is responsible for eight percent of legal blindness. It is the leading cause of new cases of blindness in adults 20-74 years of age. On average, 18,000 people with diabetes will lose their sight this year. In fact, 17 million Americans have diabetes and one-third does not even realize they have it.

November is National Diabetes Month and the SC Optometric Physicians Association is encouraging SC citizens to take the necessary steps to protect their health and vision. A comprehensive eye examination is the only method for accurately diagnosing diabetic eye disease, cataracts or glaucoma.

“It is extremely urgent to contact your local optometrist if you are experiencing blurred or double vision, headaches when reading, pain in your eyes, or a loss of peripheral vision,” explains Lori Roberts Donovan, O.D. “Because a diagnosis of diabetes can also bring with it the possibility of irreversible vision loss or total blindness, your optometrist can serve as the first line of detection.”

Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye. If you have diabetic retinopathy, at first you may notice no changes to your vision. However, over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.

Fortunately, help is available for people with diabetic retinopathy. If needed, laser and other surgical treatments can be used to reduce its progression and risk of vision loss. Early treatment is important because once damage has occurred, the effects can be permanent. Individuals with diabetes can reduce their risk of blindness 95 percent by taking prescribed medications as instructed, following a healthy diet regimen, exercising regularly, controlling high blood pressure and scheduling an annual eye examination.

New Survey Data Reveals Parents’ Concerns about Eye and Vision Health as More Classrooms Go High-Tech
3D Imaging and Digital Devices Require Optimal Visual Capabilities and Eye Health


Classrooms around the country are becoming increasingly high-tech, and teachers are incorporating 3D imaging, digital devices and the latest computer applications into their daily curriculum. While these devices can greatly enhance learning, they also increase the importance of proper eye and vision care.

According to the American Optometric Association’s (AOA) 2011 American Eye-Q ® survey, parents have some concern about the effects of the evolving technology. Fifty-three percent of respondents with children 18 or younger believe 3D viewing is harmful to a child’s vision or eyes and 29 percent of parents feel very concerned that their child may damage their eyes due to prolonged use of computers or hand-held electronic devices.

“Today’s classroom technology is extremely visual, making it critical for students to maintain excellent eye health,” said Dr. Lori Roberts Donovan, optometrist and the South Carolina Optometric Physicians Association President. “Binocular vision, focusing abilities as well as nearsightedness and farsightedness should be checked by an eye doctor yearly, particularly as students head back to school.”

Three-dimensional imaging is a technology that is quickly making its way into the classroom, allowing for virtual tours of museums or views from inside the human heart. But not everyone can see in 3D and some children experience problems. Ten percent of survey respondents report their child experienced headaches; seven percent indicated nausea and six percent said their kids felt dizzy after using 3D technology. Furthermore, the SCOPA and the AOA estimates anywhere from three to nine million people have problems with binocular vision, prohibiting them from viewing 3D images.

“Quite simply, people who have even a small vision misalignment or those who don’t have equal vision in both eyes may not be able to see 3D images properly,” said Dr.Lori. ”Watching images in 3D can unmask issues such as lazy eye, convergence insufficiency, poor focusing skills and other visual problems students might not have previously known existed."

Undetected visual problems that affect the ability to see in 3D can also have an impact on students’ future careers. The 3D@Home Consortium, in partnership with the AOA, has developed a list of professions where 3D vision, tools and design are, or will be, used frequently to complete tasks or projects. The list includes professions ranging from astronomers to surgeons, engineers to forensic scientists.

According to a new report from the AOA, research on the learning benefits of using 3D in the classroom is still in its infancy, but early findings indicate that focus, attention span, retention, classroom behavior, and achievement gains are all seeing improvement. The report, “3D in the Classroom – An AOA Report” was developed in collaboration with educators, vision researchers and specialist advisors from across the 3D industry. It’s designed for teachers, students and parents and explains the optimal uses of 3D in the classroom.

The use of 3D imagery in schools compounds the already high usage of computer technology in today’s classroom. State-of-the-art computer labs are now mainstream at many schools; students often use laptops, tablets and other digital devices throughout the school day. According to the AOA’s American Eye-Q® survey, 62 percent of parents estimate their child spends one to four hours using a computer, video game, mp3 player or hand-held electronic device each day.

Unfortunately, prolonged use of these technologies can cause eye strain, headaches, fatigue, burning or tired eyes, loss of focus, blurred vision, double vision or head and neck pain. The SCOPA and the AOA calls this condition computer vision syndrome (CVS). CVS occurs when eye or vision problems related to near work are experienced during or related to using digital devices.

“The continued popularity and use of computers and digital devices in the classroom certainly poses a number of challenges to the visual system,” said Dr.Lori. “Many of these issues can be solved with good ergonomics and yearly, comprehensive eye exams by an optometrist.”

Students can help avoid CVS by practicing the 20-20-20 rule. At least every 20 minutes, take a 20-second break and view something 20 feet away. Studies show that people need to rest their eyes to keep them moist. Plus, staring off into the distance helps the eyes from locking into a close-up position. The SCOPA and the AOA further recommends that students take a 15-minute break for every two hours spent on computers or other digital devices.

Early detection and treatment are key in correcting vision problems and helping students see clearly. For more information on 3D vision, or to download a copy of “3D in the Classroom – An AOA Report,” visit www.3deyehealth.org. To find an optometrist in your area, or for additional information on children’s vision and the importance of back-to-school eye exams, please visit www.sceyedoctors.com or www.aoa.org.

About the American Eye-Q® survey:

The sixth annual American Eye-Q® survey was created and commissioned in conjunction with Penn, Schoen & Berland Associates (PSB). From May 19 – 23, 2011, using an online methodology, PSB interviewed 1,000 Americans 18 years and older who embodied a nationally representative sample of U.S. general population. (Margin of error at 95 percent confidence level)

About the American Optometric Association (AOA):

The American Optometric Association represents approximately 36,000 doctors of optometry, optometry students and paraoptometric assistants and technicians. Optometrists serve patients in nearly 6,500 communities across the country, and in 3,500 of those communities are the only eye doctors.  Doctors of optometry provide two-thirds of all primary eye care in the United States.

American Optometric Association doctors of optometry are highly qualified, trained doctors on the frontline of eye and vision care who examine, diagnose, treat and manage diseases and disorders of the eye. In addition to providing eye and vision care, optometrists play a major role in a patient’s overall health and well-being by detecting systemic diseases such as diabetes and hypertension.

Prior to optometry school, optometrists typically complete four years of undergraduate study, culminating in a bachelor’s degree. Required undergraduate coursework for pre-optometry students is extensive and covers a wide variety of advanced health, science and mathematics. Optometry school consists of four years of post-graduate, doctoral study concentrating on both the eye and systemic health. In addition to their formal training, doctors of optometry must undergo annual continuing education to stay current on the latest standards of care. For more information, visit www.aoa.org



March is Save Your Vision Month: Healthy Vision for Adults of All Ages It's important to take proactive steps to protect eyesight, such as quitting smoking, eating food rich in key nutrients and protecting eyes from UV rays. In addition to following healthy habits like eating right and exercising, patients should be knowledgeable about any eye diseases that run in their family and should discuss them with their optometrist. The most important step to take during the "golden" years is to visit an optometrist regularly to check for the onset of diseases such as age-related macular degeneration, cataracts and glaucoma. Many of these conditions have no early symptoms, developing painlessly and can be quite advanced before noticeable vision changes occur. Also, depending on family history and risk factors, the doctor may recommend patients in their 60s and beyond have vision checkups more than once a year.

In addition to taking the necessary steps to protect your vision, doctors of optometry encourage individuals to consider eye and vision care as an integral part of their regular health care routine.

· Eye exams on a yearly basis are the best defense against irreversible vision loss and can provide an optometrist with insight into a person's overall health and wellness.
· Adults should have eye exams annually, or as recommended by an eye doctor. Children should have their first eye assessment between six to 12 months of age, then again at age three and again before starting school.
· An adult's eyesight can change rapidly and frequently, particularly as one ages. Having one's vision examined on a regular, timely basis is important to maintaining overall health and can lead to early detection of various systemic diseases including elevated cholesterol, diabetes and hypertension.

A person's lifestyle can also have an effect on their eye health and vision. It's important to take the proper measures at any age to help ensure healthy, comfortable vision.

· Computer vision syndrome is a condition caused by prolonged use of a computer screen and can cause problems such as dry eye, eyestrain, headaches, neck and/or backaches, light sensitivity and fatigue.
o Americans should also pay attention to how long they use electronic devices. The AOA recommends that all Americans practice the 20-20-20 rule (every 20 minutes, take a 20-second break and look at something 20 feet away).
o Many of the symptoms are temporary and will improve after ceasing computer work. However, some individuals may continue to experience visual problems, such as blurred distance vision, even after computer work has stopped.
o Pre-existing, uncorrected vision problems like farsightedness and astigmatism, inadequate eye focusing or eye coordination abilities, and age-related eye issues also contribute to CVS.
· Watching 3-D programming can unmask issues such as lazy eye, convergence insufficiency, poor focusing skills and other visual problems consumers might not have previously known existed. o Signs that may indicate a potential problem include:
- Eyestrain or headaches during or after viewing
- Nausea or dizziness during or after viewing
- Lack of vividness when viewing 3-D images
- General discomfort and avoidance of 3-D viewing



November is National Diabetes Awareness Month.  The importance of a comprehensive eye exam on a yearly basis is critical for diabetics.  In 2009, only half of South Carolinians with Diabetes had an eye exam.

According to recent studies, diabetes is responsible for eight percent of blindness in the nation, making it the leading cause of new cases of blindness in adults 20-74 years of age.  Each year, over 12,000 people lose their sight because of diabetes.

Diabetic Retinopathy often has no early warning signs, so changes in vision may not be noticed.  Therefore early detection is critical for maintaining healthy vision.  Several factors influence whether someone with diabetes develops diabetic retinopathy.  These include controlling blood sugar and blood pressure levels, the length of time with diabetes, race and family history.  If left untreated, diabetic retinopathy can lead to blindness.