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What Exactly is an Eye Chart?

If there’s one aspect of optometry that everyone recognizes, it’s the traditional eye chart, with its rows of big letters on top, which gradually become smaller the farther down you go. This chart is usually known as the Snellen chart.

Yet how much do you really know about this eye chart? Are all eye charts the same? How are these eye charts used? And when were they invented?

Here’s everything you need to know about eye charts and more!

What is an Eye Chart?

An eye chart is one of the tools your eye doctor uses to assess your eyesight. Based on how well you can see various letters on the chart, your optometrist will determine whether you have myopia (nearsightedness), hyperopia (farsightedness), presbyopia (age-related farsightedness) or astigmatism, and will measure the prescription that will give you the clearest, most comfortable vision.

Are All Eye Charts The Same?

There are a number of variations to the standard Snellen eye chart. The one an eye doctor uses depends on the personal needs and abilities of the patient. For example, eye doctors will use charts with pictures or patterns for younger children who may not have learned to read or identify letters and numbers.

There are also certain charts that specifically measure distance vision, while others are better for measuring near vision.

History of the Snellen Eye Chart

The Snellen eye chart was developed by Dutch eye doctor Hermann Snellen in the 1860s. Before this standardized eye chart was developed, each eye doctor had their own chart that they preferred to use.

Having so many different eye charts made it impossible to standardize the vision correction available to patients. Eyeglass makers didn’t receive the defined measurements they needed to accurately design, manufacture and measure the optical prescriptions their patients needed.

For the first time, the Snellen eye chart allowed a person to provide a standardized prescription from any eye care provider they chose to any eyeglass maker, and get the same optical lenses to accurately correct their vision.

How The Snellen Chart Is Used in Eye Exams

The standard Snellen chart displays 11 rows of capital letters, with the first row consisting of a single large letter. The farther down the chart you go, the smaller the letters become.

Your eye doctor will ask you to look through a phoropter – an instrument used to test individual lenses on each eye during an eye exam – and look at the Snellen chart placed 20 feet away. Your eye doctor will prescribe the lenses that provide you with the clearest and most comfortable vision.

In many offices, where 20 feet of space may not be available, you’ll be asked to view the chart through a mirror. This provides the same visual experience as if you were standing 20 feet away.

If you have 20/20 vision, it means you can see what an average person can see on an eye chart from a distance of 20 feet. On the other hand, if you have 20/40 vision, it means you can only see clearly from 20 feet away what a person with perfect vision can see clearly from 40 feet away.

If you have 20/200 vision, the legal definition of blindness, this means what a person with perfect vision can see from 200 feet away, you can see from 20 feet away.

Does 20/20 Visual Acuity Mean Perfect Vision?

No. While eye chart tests identify refractive errors, they can’t detect signs of visual skill deficiencies or diseases such as glaucoma, cataracts or macular degeneration. These are diagnosed using advanced equipment as part of a comprehensive eye exam with your local eye doctor. Early diagnosis and treatment of eye conditions are essential to ensuring long-term vision and eye health.

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Q&A With Your Local Optometrist

How do you keep your eyes healthy?

You only have one set of eyes – don’t take them for granted!

Make sure to implement the following habits for healthy eyes (and body). These include:

  • Eating a balanced diet rich in fiber, fruits and vegetables
  • Drinking plenty of water to hydrate your body and eyes
  • Not smoking, and avoiding 2nd-hand smoke
  • Wearing sunglasses to protect your eyes from ultraviolet (UV) rays
  • Maintaining normal BMI with regular exercise
  • Regular visits to your eye doctor as recommended

What health conditions can an eye exam detect?

A comprehensive eye exam can often detect certain underlying diseases that can threaten your sight and eye health, such as diabetes, high blood pressure, high cholesterol, tumors, autoimmune conditions and thyroid disorders. This is why having your eyes checked regularly is key. The earlier the diagnosis and treatment, the better the outcome and the higher your quality of life.

The Link Between Dry Eyes and Depression

The Link Between Dry Eyes and Depression 640×350Depression is a serious illness that impacts a person’s mood and emotional well-being. It creeps into all areas of a person’s life, and can become life-threatening if left untreated.

Not only does depression impact mental health; it can manifest as physical symptoms, too, like insomnia, chronic pain and inflammation, weight loss or gain and heart problems, among others. These physical problems can worsen depressive thoughts — sometimes leading to a vicious cycle.

Interestingly, many patients with depression also suffer from severe dry eye symptoms. The question is, how are these two conditions related?

What is Dry Eye Syndrome?

Dry eye syndrome, also known as dry eye disease, is a chronic condition that results from inadequate lubrication of the eyes. Ocular hydration is crucial when it comes to keeping your eyes healthy and your vision clear. Your tears are responsible for maintaining this necessary hydration, and in healthy eyes fulfill their unique mission each time you blink.

Your tear film is made up of three layers, consisting of oil, water and mucus. If any of these layers become compromised, inadequate tear quality or insufficient tear quantity can result and lead to a host of uncomfortable dry eye symptoms.

The most common dry eye symptoms include:

  • Dry eyes
  • Red or irritated eyes
  • Itchy eyes
  • Gritty eyes
  • Light sensitivity
  • Blurry vision

Can Depression Cause Dry Eye (or Vice-Versa)?

This is what researchers are trying to find out.

In a March 2022 study published in JAMA Ophthalmology, researchers examined the link between depression and severe dry eye symptoms. The study followed 535 dry eye patients for an entire year.

After a year, the patients who tested positive for depression had more severe dry eye symptoms than the patients who didn’t have depression. Their symptoms were measured based on the Ocular Surface Disease Index (OSDI), Brief Ocular Discomfort Index and composite dry eye disease sign score.

Additionally, severe depression was associated with more severe dry eye symptoms at baseline, six months, and one year.

The study concluded that depression was associated with more severe dry eye symptoms, which suggests that among patients with moderate to severe dry eye syndrome, those with depression may be likely to have more severe dry eye symptoms.

The researchers said further research is needed to learn exactly why people with depression have more severe dry eye symptoms than those without depression.

Could the sometimes debilitating symptoms of dry eye syndrome actually cause depression and anxiety?

A 2016 dry eye study published in Nature concluded that chronic discomfort and pain from dry eye symptoms can negatively affect the cognitive processes, sleep, mood and mental health. The researchers urged eye doctors to be aware of the higher incidence of dry eye syndrome in people with depression, whatever the underlying cause.

Can Antidepressants Cause Dry Eye Symptoms?

Yes. Antidepressants have been shown to increase dryness in the body, including the eyes. These medications work by blocking signals between nerve cells, which can result in insufficient tear production and dry eye syndrome.

If you’re taking an antidepressant, be sure to inform your eye doctor during your consultation.

How We Can Help

At Dry Eye Services at Family Optical in Winnipeg, we recognize that some of our patients that come in with dry eye symptoms may be suffering from depression.

We’ll diagnose the cause of your dry eye symptoms and offer the most effective dry eye treatments to give you the relief you’re searching for.

Contact us today to schedule a dry eye assessment and take the first step towards regaining your quality of life.

Frequently Asked Questions with Dr. Dale Mulhall

Q: Who is affected by dry eye syndrome?

  • A: While dry eye syndrome is most common in adults over 50, it can occur at any age. The following factors can increase your risk of dry eye:
    – Aging
    – Hormonal changes
    – Medical conditions such as Sjogren’s syndrome and rheumatoid arthritis
    – Prolonged screen time
    – Living in a dry, dusty or windy environment
    – Eye allergies
    – Blepharitis or meibomian gland dysfunction
    – Certain medications, such as decongestants, antihistamines, antidepressants, hormone replacement therapy
    – Vitamin A deficiency

Q: How can you reduce your risk of dry eye?

  • A: While some dry eye risk factors can’t be avoided completely, making some lifestyle changes can help. Practice these recommended tips:
    – Use a humidifier to add moisture to the air
    – Wear wraparound sunglasses outdoors to protect your eyes from harsh winds
    – Take frequent screen breaks and blink often while using your digital device.
    – Quit smoking
    – Use lubricating eye drops
    – Consume a healthy diet including omega 3 and drink plenty of water.
    – Have regular eye exams

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Bloodshot Eyes – Should You Be Concerned?

You wake up in the morning ready to start your day, only to discover that your eyes are bloodshot. That might not be surprising if you stayed up late to finish a project, had too many drinks at a party or spent time in a smoke-filled room.

But bloodshot eyes can also signal an underlying eye problem. If your eyes appear red or bloodshot, make an appointment with an eye doctor for a comprehensive eye exam to determine the cause and to receive effective treatment.

Why Do I Have Bloodshot Eyes?

When blood rushes to the front of the eye, the tiny red blood vessels on the white of the eye dilate and become visible. This makes the eyes appear red and irritated.

So why do these blood vessels dilate, causing your eyes to look bloodshot?

Bloodshot eyes tend to be caused by:

  • Dry eyes
  • Irritants such as smoke, pollen and perfume
  • Lack of sleep
  • Excessive alcohol consumption
  • Spending too much time in front of the computer

Bloodshot eyes due to lifestyle and environmental irritants may disappear on their own, or you can try to relieve them with over-the-counter eye drops or liquid tears. Lifestyle changes, such as getting more sleep, cutting down on alcohol intake and limiting screen time can often be helpful. If allergies are the culprit, oral antihistamines and antihistamine eye drops may relieve symptoms.

At other times, underlying problems requiring prompt medical attention can cause your eye’s blood vessels to dilate. The following are some of these medical conditions:


You’ve probably heard of “pink eye.” It’s another name for infectious conjunctivitis – an infection of the conjunctiva, the thin membrane covering the eyelid and the front surface of the eye.

There are two types of infectious conjunctivitis – bacterial and viral.

If your child has conjunctivitis, they’re not alone. About 12% of kids get bacterial conjunctivitis every year. This highly contagious condition affects children and adults. In addition to reddish eyes, the following symptoms are associated with conjunctivitis:

  • Bacterial conjunctivitis – irritated eyes, swollen eyelids, eye discharge, crusty eyelids and excessive tearing
  • Viral conjunctivitis – cold or flu-like symptoms, runny nose, fever, itchy eyes, excessive tearing

If you or your child are experiencing these symptoms, it’s important to schedule a prompt appointment with an eye doctor, who can diagnose whether the conjunctivitis is viral, bacterial or due to allergies.

Depending on the diagnosis, your eye doctor will prescribe antibiotic eye drops or creams to treat bacterial conjunctivitis. The viral form may run its course after a few days, but cold compresses and non-prescription eye drops may provide relief.

Dry Eye Syndrome

If your eyes are chronically bloodshot you may have dry eye syndrome (DES). Signs of DES include:

  • Dry, irritated eyes
  • Burning or stinging eyes
  • Discharge from the eyes
  • Light sensitivity
  • A feeling you have something stuck in your eyes
  • Blurred vision
  • Watery eyes

Dry eye syndrome is most commonly caused by a blockage of the tiny meibomian glands in the eyelids. These glands secrete oil that keeps eye moisture from evaporating too quickly. Without the oil, tears dry fast, leaving your eyes feeling dry, itchy and with a bloodshot appearance.

Too much screen time, aging, certain medications such as antihistamines, and medical conditions such as Sjogren’s syndrome can cause dry eye syndrome.

In addition to any medications or in-office treatments your eye doctor recommends, make sure to get plenty of hydration, take frequent breaks from digital screens and use a humidifier in your home.


In addition to bloodshot eyes, if you also experience blurred vision, see floaters or your eyes feel painful, you may have an eye inflammation called uveitis. The causes of uveitis include:

  • Autoimmune or inflammatory condition
  • Infection
  • Medication side effects
  • Cancer (in rare cases)

Unfortunately, uveitis symptoms can often be mistaken for something less serious. That’s the reason it’s important to get an eye exam if your eyes are bloodshot. Left untreated, uveitis can lead to serious conditions such as retinal scarring, cataracts and vision loss.

Depending on the cause and severity, your eye doctor may treat uveitis with prescription eye drops, steroid pills, injections or eye implants.

Eye Injury

It’s vital that all eye injuries receive immediate eye care from an eye doctor.

Even a minor eye injury can cause a big red blotch to form on the white part of the eye (sclera). The cause is a broken blood vessel or a subconjunctival hemorrhage.

Although the appearance of this blood looks severe, and can make the entire white part of the eye appear bright red, a subconjunctival hemorrhage is usually painless and doesn’t cause vision loss. Any time you notice excessive blood on the eye following an eye injury, schedule an appointment with an eye doctor to assess the health of your eye.


In rare cases, bloodshot eyes may signal the presence of glaucoma – a leading cause of vision loss and blindness.

While some types of glaucoma don’t show symptoms in the early phases, bloodshot eyes can indicate the type of glaucoma that requires immediate medical care. This disease causes damage to the optic nerve due to excessive pressure within the eye. When this pressure suddenly rises, the eye’s blood vessels become dilated and visible, making the eye appear red.

If you have bloodshot eyes and/or have the following risk factors for glaucoma, immediately schedule an appointment with your eye doctor.

  • Family history of glaucoma
  • Aged 60+
  • African American, Asian or Hispanic
  • Diabetes
  • High blood pressure

Bloodshot Eyes Won’t Go Away?

Talk to Us Any time you notice bloodshot eyes or blood on the front of the eye, don’t wait. Schedule your eye exam with Dr. Dale Mulhall at Family Optical in Winnipeg today.

Q&A With Your Local Optometrist

Can I get bloodshot eyes after LASIK surgery?

LASIK surgery is highly effective minimally invasive laser eye surgery that can correct refractive errors, but like all surgical procedures, it can have side effects. Your eyes may be bloodshot or you could see halos from a few days to three weeks after surgery. Additionally, you may experience other dry eye symptoms. Eye drops and liquid tears can alleviate these symptoms, but if you have any concerns about your eyes following LASIK surgery contact your eye surgeon.

What Should I Expect from a Glaucoma Exam?

If you have a family history and/or other risk factors for glaucoma, and if your eyes look bloodshot, consider scheduling a glaucoma exam. Your eye doctor may perform the following tests:

  • Tonometry – eye pressure test
  • Gonioscopy – to see how fluid is draining out of your eye
  • Vision field test – to examine the functioning of the optic nerve
  • Dilated pupil exam – to detect any damage to the optic nerve
  • Retinal photo or OCT – digital examination of the retina and optic nerve health

Coping with Low Vision? 5 Ways to Make Your Home Safer

Man with Low Vision on SofaIf you’ve been diagnosed with low vision, you may be worried about banging into the furniture or falling down the stairs. These simple modifications will help you stay safe at home, even with limited vision.

What is Low Vision?

Low Vision refers to significant visual impairment that can’t be fully corrected with conventional glasses, contact lenses, medication or eye surgery. The condition impacts nearly 250 million people worldwide, and 7% of all people over age 65. The most common symptoms of low vision are:

  • Blurred vision
  • Blind spots
  • Tunnel vision
  • Poor night vision

The condition is often the result of eye diseases such as glaucoma, macular degeneration and diabetic retinopathy. Low vision can also result from congenital conditions, eye injuries and stroke.

Although vision loss can’t be reversed, adjustments in your home can help you remain active, independent and safe.

5 Ways Low Vision Patients Can Stay Safe at Home

Get [Organized]

It’s time to organize your home. Remove things you don’t need and anything that can impede your mobility around the house.

  • Get rid of loose area rugs
  • Make sure your carpet is completely fastened to the floor
  • Use zip ties and other fasteners to keep long cords out of the way
  • Confine small stools or tiny tables to areas where you don’t walk

Become a master [organizer]. Be sure to put kitchen utensils, tools and other items in separate drawers and containers. Organize clothing in your closet by color, coats from light to heavy and shoes by season.

Label Everything

Having a place for everything is key. Once you’ve decided where everything should be, the next step is labeling your belongings. Use large letters and dark ink against light-colored paper, or brightly colored labels to differentiate between items.

Go for Contrast

Using contrasting colors is an easy way to make items stand out. If your couch is dark, place light-colored pillows at each end so you can see where to sit. Place fluorescent strips on dark stairs or dark strips on light stairs so you can step safely.

Lighten Up

Lighting your home properly can make a huge difference in your ability to see things and live safely, especially in places like the kitchen. You can add more brightness by:

  • Installing lighting in closets and under cabinets
  • Choosing bulbs with higher wattage
  • Using lights during the day to reduce glare
  • Try different types of lighting to see what helps you maximize your vision

Use Low Vision Aids and Devices

Your Low Vision Optometrist may prescribe low vision glasses and devices to enable you to see better and by helping you maximize your remaining vision. These include:

  • Telescopes – hand-held, spectacle-mounted and clip-on
  • Magnifiers – hand-held and standing
  • Non-optical visual aids – devices that increase light and enhance contrast
  • Computer-based aids – use software and large screens
  • Mobile phone applications – allow easier communication

Discuss this with your eye doctor to see which types of visual aids are best for you. Many people with low vision use several types of visual aids for specific activities — for instance, magnifiers for reading and additional lighting for preparing food.

Make the most of the internet with voice search features. This is particularly helpful if you quickly need emergency numbers or need to locate other information.

Smart technology has revolutionized life for people with low vision. Voice-activated features let you turn lights on and off, open and close your garage doors and contact emergency services immediately.

Talk to Us for Assistance with Low Vision

Need answers for living safely and comfortably at home with low vision? We’ll advise you on how to maintain your independence and recommend the best visual aids for your individual lifestyle and needs. We’ll help you maximize your remaining vision so you can continue to do the things you love. Schedule an appointment with Dr. Colleen Mulhall at The Low Vision Center at Family Optical in Winnipeg today.

Our practice serves patients from Winnipeg, Grande Pointe, Lorette, and Oak Bluff , Manitoba and surrounding communities.

Frequently Asked Questions with Dr. Dale Mulhall


Q: What is the difference between low vision and legal blindness?

  • A: Legal blindness is a legal term that refers to corrected visual acuity of 20/200 or less in the better eye or a visual field of 20 degrees or less. A person with low vision is someone who has permanent vision loss and cannot do those tasks they wish to do.

Q: Who is at risk for low vision?

  • A: People with the highest risk for low vision are typically over 65 and have a family history of AMD. For some reason, AMD affects women more than me, and Caucasians/Asians more than African Americans. Similarly, diabetic retinopathy and glaucoma also cause vision loss and tend to be more prevalent among African Americans.

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5 Ways to Prevent Dry Eyes During Air Travel

Dry Eye Air Travel Tips 640×350While traveling can be taxing on the entire body, the eyes are especially vulnerable — particularly when wearing a mask to protect from COVID. When traveling by plane, the dry air can cause your eyes to become red, parched and irritated. While you can’t control all variables during your travels, eye specialists have discovered a number of ways to reduce the chances of experiencing the unpleasant symptoms of “travelers’ dry eye.”

Here are five suggestions for preventing dry eye from affecting your vision.

Drink plenty of water. If your body isn’t properly hydrated, it will have a tougher time increasing tear production in a dry atmosphere. Humidity levels on planes are typically below 20%, which is lower than the Sahara Desert! Keep your eyes moist and comfortable by drinking plenty of water before, during and after your flight.

Wear your glasses. Since contact lenses remove moisture from your eye’s surface tear film, they can contribute to dry eye. Wearing your glasses can help keep your eyes moist.

Wear a sleep mask. Even when your eyelids are closed, your eyes might lose moisture, which happens frequently when you sleep. On a plane, a sleep mask can help prevent additional dryness.

Use hydrating eye drops. When you’re in a dry environment, a good hydrating eye drop can provide a brief respite.

Make sure your face mask fits snugly. When a person’s breath rises upward it can dry out their eyes. A face mask that fits securely around the bridge of the nose can prevent air from reaching the eyes.

Is dry eye making you miserable, especially when traveling? Put an end to the discomfort and struggle by contacting Dry Eye Services at Family Optical. Our dedicated eye doctors will get to the bottom of your dry eye and provide effective, lasting treatment.

Our practice serves patients from Winnipeg, Grande Pointe, Lorette, and Oak Bluff , Manitoba and surrounding communities.

Frequently Asked Questions with Dr. Dale Mulhall

Q: Can dry eye be cured?

  • A: In some cases, yes. A range of successful treatment options can help manage dry eye for long-term relief. Your eye doctor can also provide in-office treatments for more advanced forms of dry eye disease.

Q: What type of treatments are available for dry eye?

  • A: Depending on the cause of the dry eye, treatment options include:
    – Lubricants
    – Punctal plugs
    – Topical steroids
    – Warm compresses
    – Protective eyewear
    – Intense pulse light
    – Switching to medications that don’t cause dry eye symptoms

Looking for dry eye treatment? Contact Dry Eye Services at Family Optical today!

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Dating With Low Vision

elderly couple dating with low visionFor people with low vision, the logistics of dating can sometimes feel overwhelming. Your visual needs can change the dynamics of how the date goes, where you feel comfortable going, and what you feel comfortable doing. For many, it’s enough to give up on the idea altogether. But don’t throw up your hands in frustration just yet!

At The Low Vision Center at Family Optical in Winnipeg, we want to assure you that with a little bit of planning, dating can be a great experience, even with low vision.

Here are some of our top tips on how to make it work:

1. Play an active role in setting up the date.

It’s not always easy figuring out where to go on a date. This is especially true when you have special visual considerations that factor into your options. Make sure to take an active role in choosing a place and activity you feel comfortable with.

If you’re going out to dinner, consider restaurants in your area that offer good lighting, menus in large print or braille, and which may have special experience and/or accommodations for people with vision difficulties.

If you and your date would like to enjoy a movie together, look for theaters that offer audio descriptions so that you can enjoy the movie too.

2. Pick a place you can reach by public transit or within walking distance.

It’s always best to choose a place you can get to on your own. This is especially important if you’re just meeting someone for the first time and you’re not sure how the date will go. Choosing a place that you can easily walk to or is serviced by public transportation will give you the freedom to leave when you want to.

3. Be prepared to have a conversation about your visual impairment – if you want to.

There are always conversations to be had when you’re meeting someone for the first time. The question is, when do you bring them up and how much do you say at first? Having a conversation about your visual impairment is no different.

Your low vision may have already influenced your choice of date spot and the activities you’ve planned, so don’t be surprised if your date asks questions.

Whether you want to discuss your low vision on a first date is entirely up to you. Do what feels comfortable.

4. Don’t forget about traditional places to meet people.

Your whole life shouldn’t be defined by your vision disability, and your dating life is no exception. If you enjoy reading, join a book club. Love to exercise? Join a gym or even a cycling club – tandem biking is fun. If you’re religious, attend services at your local church, synagogue, mosque. If you enjoy giving back to your community, find local opportunities to volunteer. These are great places to find like-minded people for friendship and, with a little luck, romance. Shared interests and values are a great way to build a meaningful relationship.

5. Be yourself.

In the end, the biggest advice anyone can give is the oldest in the book. Just be yourself!

Our practice serves patients from Winnipeg, Grande Pointe, Lorette, and Oak Bluff , Manitoba and surrounding communities.


Frequently Asked Questions with Dr. Dale Mulhall

Q: What is low vision?

Low vision is defined as fully corrected vision (with glasses/contacts/surgery) that is still insufficient to do what you want to do.

There are many causes of low vision, including glaucoma, cataracts and macular degeneration, stroke and eye injuries. Patients with these conditions need two eye doctors. The medical eye doctor treats the medical condition. Low vision optometrists prescribe low vision glasses and aids to help with the vision loss condition. Low vision aids, such as telescope and microscope glasses, E-Scoop glasses, prism glasses and magnifiers make the most of the remaining vision and help maintain independence and quality of life.

Q: What is a low vision exam?

A: A low vision exam evaluates your level of vision, as well as the tasks you wish to do and can no longer engage in due to your limited vision. The low vision exam goes above and beyond the usual comprehensive eye exam performed by your eye doctor and concentrates on your visual needs.

Your eye doctor will ask you questions about your family history, your eye health and your general health. You’ll also be asked if you have difficulty with vision for daily tasks such as driving, reading or pouring yourself a cup of coffee.

All of this information will allow your eye doctor to accurately assess your level of vision loss and how it is affecting your daily life. With this information, they will be able to advise you on the proper steps you can take, and low vision glasses and aids you can use to maintain your independence and make the most of your remaining vision.


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    4 Signs You Have a Visual Contrast Sensitivity Problem

    elderly couple with low vision glasses sitting outside

    Contrast sensitivity allows you to tell the difference between the foreground and background. It’s a crucial aspect of your visual function, particularly in low-light situations.

    Common scenarios which require contract sensitivity include driving at night, in the rain or fog, or reading a newspaper, where the writing is printed on a gray background. The inability to distinguish objects clearly is not simply an inconvenience; it can lead to car accidents or falls that may cause injury.

    Reduced visual contrast sensitivity is often a symptom of a more serious eye condition, such as cataracts, glaucoma or macular degeneration. This is why it’s important—especially for those over 50—to undergo an annual eye exam. Your low vision eye doctor will measure how well you can tell the difference between light and dark by using a specific chart where the characters fade from black to gray gradually. If symptoms are present, your The Low Vision Center at Family Optical low vision eye doctor will provide you with treatment options, such as visual aids and devices to help you improve contrast sensitivity.


    4 Signs of Visual Contrast Sensitivity Problems

    The onset of this condition is often gradual and people may not notice a change in vision as it progresses. The following are common signs of reduced visual contrast sensitivity:

    1. Reading Difficulties

    People with reduced visual contrast sensitivity may be able to read normally if the letters are dark and the background is light, or vice-versa. However, if the letters and the background are of a similar color or level of brightness or faintness, people with reduced visual contrast sensitivity may struggle to read the text.

    2. Problems Differentiating Between Objects

    As with reading, poor visual contrast sensitivity doesn’t affect the ability to see objects, except when these objects are the same or similar colors as their surroundings. For instance, it may be difficult to locate black gloves in a black purse or see a white bird flying in a cloudy sky.

    3. Tripping Over Curbs or Steps

    People with contrast sensitivity difficulties may start realizing they have a problem if they keep tripping over curbs or steps because they don’t see them clearly. Steps and curbs are often the same shade as the surrounding surface and may not be visible to people with this vision problem.

    4. Driving in Certain Conditions

    People with reduced visual contrast sensitivity may struggle to drive in certain conditions:

    • Low light
    • Rain
    • Glare
    • Fog

    Contrast sensitivity is essential for driving because it allows the driver to see road signs, pedestrians and road curves, and to distinguish between the road and the curb.

    Tests for Visual Contrast Sensitivity

    Even people with 20/20 vision can experience a noticeable decrease in their visual acuity if they are exposed to glare or if the letters on a chart are of a similar color to the background.

    The Pelli Robson test was designed specifically to determine if a patient has difficulties with contrast sensitivity. The test is similar to the Snellen test because it features horizontal lines of letters. However, in this test, instead of shrinking in size with each descending row, the letters show less contrast, appearing in ever weaker shades of gray against a white background.

    For instance, on the top row, the letters are black and the background is white. In subsequent rows, the letters are lighter gray until the contrast against the white background is very subtle on the bottom row.

    If you have difficulty distinguishing between objects and their backgrounds or seeing road signs and steps, schedule an eye exam with Dr. Colleen Mulhall at The Low Vision Center at Family Optical today.

    Frequently Asked Questions with Dr. Dale Mulhall

    Q: What Causes Reduced Visual Contrast Sensitivity?

    • A: Difficulties with visual contrast sensitivity tend to be a symptom of another ocular problem. Here are some common causes of the condition:
      • Glaucoma
      • Macular degeneration
      • Severe dry eye syndrome
      • Cataracts
      • Diabetes
      • Optic neuropathies
      • Eye infections or trauma

    Q: How Can Visual Contrast Sensitivity Be Improved?

    • A: If the eye doctor identifies a problem with contrast sensitivity, the main form of treatment is to treat the underlying condition, which in most cases improves the contrast sensitivity as well. If the condition remains, the doctor can discuss treatment using specialized glasses that can enhance the quality and amount of light that enters the eye.
      • Tinted lenses filter out glare, and the yellow tint can help the patient see contrasts more clearly, especially at night
      • Anti-reflective coatings eliminate reflections from the surfaces of the eyeglasses and greatly reduce glare
      • Photochromic lenses gradually become darker as the surroundings become lighter, and vice-versa, and act as both regular glasses and sunglasses when needed
      • Polarized lenses reduce reflected glare, such as off water, snow and windshields.

      Intraocular lenses, which replace the eye’s natural lens during cataract surgery, can enhance contrast sensitivity and reduce some of the vision problems caused by cataracts.


    Our practice serves patients from Winnipeg, Grande Pointe, Lorette, and Oak Bluff , Manitoba and surrounding communities.


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    Call our St. Anne's Rd Location 204-818-3033

    What’s The Link Between Dry Eye and Accutane (Acne Medication)

    Teen with severe acne wearing maskAccutane, generically called isotretinoin, is an oral medication that is widely prescribed to treat severe acne that hasn’t responded to other treatments.

    Although this drug often does a great job of reducing acne, it has several potential side effects that can affect many bodily systems, including the eyes.

    Isotretinoin and Dry Eyes

    Isotretinoin works by decreasing the size of the oil glands that secrete oil onto the skin. By reducing the production of the facial oils, the pores become less clogged and the amount of acne diminishes.

    As the medication travels through the bloodstream, it also penetrates the eyelids’ meibomian glands, which produce the oil for tears.

    These meibomian glands, which line the inner portion of the eyelids, play an important role in keeping the eyes hydrated and healthy by secreting oil to stabilize the tear film. When Accutane suppresses their function, the oil layer in the tear is inadequate, allowing excessive tear evaporation. As a result, the eyes dry out.

    A 2012 study published in JAMA Dermatology analyzed the ocular effects of isotretinoin and concluded that taking it places patients at a significantly higher risk of experiencing a range of adverse ocular effects.

    Common ocular conditions that were associated with this acne medication were dry eye syndrome, blepharitis, conjunctivitis, photosensitivity, contact lens intolerance and papilledema.

    The researchers found that the ocular conditions resulted from changes to the cornea, eyelids, retina and meibomian glands. Additionally, the drug was found in the tear film and caused increased ocular irritation.

    The good news is that these effects are often temporary, and resolve within a few months after completing treatment. One study, published in Optometry and Vision Science (2015), however, found that 1% of patients developed permanent meibomian gland dysfunction after taking isotretinoin.


    How a Dry Eye Optometrist Can Help

    Some dermatologists will refer their patients to an optometrist for a dry eye evaluation before prescribing isotretinoin to treat acne. If the patient already has signs of ocular surface disease or is taking other medications that interfere with tear production, the doctor may decide against prescribing isotretinoin.

    We can help by thoroughly assessing your ocular condition to help your dermatologist determine the best acne treatment for you, as well as help you manage your dry eye symptoms.

    If you or a loved one is currently taking or has taken isotretinoin and is experiencing symptoms of dry eye syndrome such as eye irritation or burning eyes, we can offer lasting treatment and solutions.

    To schedule your dry eye consultation or learn more about our services, call Dry Eye Services at Family Optical today.


    Frequently Asked Questions with Dr. Dale Mulhall

    Q: Should I use lubricating eye drops while taking acne medication like isotretinoin?

    • A: Lubricating eye drops may be an appropriate treatment for medication-induced dry eye syndrome However always consult with your optometrist before purchasing drops from the drugstore. The huge range of choices in your local pharmacy can be hard to navigate alone, and not all eye drops will be right for you. We can help guide you to the best eye drops for your condition.

    Q: What are the common symptoms of dry eye syndrome?

    • A: Common symptoms of dry eye syndrome include watery eyes, gritty eyes, burning or painful eyes, red and irritated eyes, mucus around the eyes, the inability to wear contact lenses, sensitivity to light and blurred vision. The frequency and severity of these symptoms can range greatly from patient to patient, and treatment will depend on the underlying cause of your symptoms.

    Our practice serves patients from Winnipeg, Grande Pointe, Lorette, and Oak Bluff , Manitoba and surrounding communities.

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    5 Reading Tips Following Retinal Detachment Surgery

    elderly woman reading with glassesRetinal detachment is a potentially sight-threatening condition that requires immediate attention. When the light-sensitive retina has slipped out of its position, surgery is required to reattach it. Recovery from surgery is lengthy and it may be weeks or months before vision is fully restored.

    Patients often wonder how soon they will be able to read following retinal detachment surgery. The answer will depend on the severity of the detachment and the outcome of the surgery. In some cases, additional surgery may be required.

    About Retinal Detachment Surgery

    There are three types of retinal detachment surgery:

    • Pneumatic retinopexy – injecting a gas bubble into the eye to push the retina back into place
    • Scleral buckling – placing a belt-like structure around the white of the eye
    • Vitrectomy – replacing the aqueous humor with silicone oil

    How Long Does It Take to Recover from Retinal Detachment Surgery?

    Every patient will recover from surgery at a different pace, but most patients can resume some of their regular activities between 2 and 4 weeks post-op. For some people, it can take several months.

    During this recovery period, it’s crucial to avoid doing things that require vigorous head movements. It will be a while before you will be able to:

    • Clean
    • Garden
    • Lift heavy objects
    • Engage in strenuous activities like a workout

    Reading Tips Following Retinal Surgery

    Vision in the affected eye or eyes is likely to be poor for weeks following surgery, making it difficult to read. Until the retina heals and holds its position, you may see bright spots or your vision could be blurry. However, reading or watching television won’t harm your eyes, and there is no reason not to try to read if you feel so inclined.

    The following are some tips for reading following retinal detachment surgery:

    1. Check Your Eyeglass Prescription

    When your eye surgeon feels your eye has recovered, they will recommend having an eye exam to determine whether your eyeglass prescription is still right for you. It is possible that surgery has altered your optical prescription, so having updated eyeglasses will help you see and read more clearly.

    2. Use Adequate Lighting

    The retina contains layers of nerves that are sensitive to light. You may need more light to see and read than you did before your retina detached. Add some extra lamps and use fluorescent and halogen bulbs that illuminate reading material more effectively than incandescent bulbs.

    3. Get Assistance from Screen Readers

    In the days and weeks following surgery, when you are not yet able to read from books or a computer, use a screen reader, which converts written text into auditory recordings.

    4. Find Large Print Books and Audiobooks

    Make reading easier by reading from books with large print, or bypass reading altogether by listening to audiobooks.

    5. Magnify Your Screen or Book

    A magnifying device will make letters in printed material larger and more accessible. Your low vision optometrist can recommend specific low vision glasses or devices that can enlarge text and graphics to the extent you require.

    Also, you may find it easier to read with the unaffected eye. Reading with only the good eye will not harm either eye, so do not be afraid to read that way until the reattachment heals.

    After surgery, patients want to resume their favorite activities, including reading, as quickly as possible. Your eye doctor will determine when your eyes and vision have recovered and you are ready to enjoy your daily activities based on your recovery from retinal detachment surgery. You will need some follow-up eye exams to ensure that your eyes are healing well and that your retina remains in position. To schedule an appointment, call us today.

    Our practice provides low vision management, aids and devices to patients from Winnipeg, Grande Pointe, Lorette, and Oak Bluff , Manitoba and surrounding communities.

    Frequently Asked Questions with Dr. Dale Mulhall

    Q: What Are the Risk Factors for Retinal Detachment?

    A: The following are risk factors for retinal detachment:

    • – A previous case of retinal detachment
    • – Cataract surgery
    • – Eye injury
    • – Severe near-sightedness (myopia)
    • – Diabetic retinopathy
    • – Posterior vitreous detachment – the vitreous humor becomes separated from the retina
    • – Retinoschisis – the retina separates into two layers

    Q: How Does an Optometrist Test for Retinal Detachment?

    • A: If an eye doctor thinks you may have retinal detachment, your eyes will be dilated so the optometrist can see the retina and the back of your eye. Eye drops will be placed into the eye to make the pupils wider. The eye doctor may press on the eyelids to check for retinal tears. In addition to the dilated eye exam, the optometrist may check your eye with ultrasound or an optical coherence tomography (OCT) examination to confirm whether the retinas are detached.

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    What’s the Difference Between Low Vision and Blindness?

    Elderly couple dancing

    Low vision doesn’t mean blindness. It simply means that a portion of your vision is impaired, and you can continue to enjoy a high degree of independence thanks to low vision tools and devices.

    What Is Low Vision?

    People often confuse the terms ‘visual impairment,’ ‘low vision,’ or ‘blindness’. Below we’ll untangle that and bring some clarity to each term:

    Visual impairment is a broad term that refers to any loss of vision. The following are some of the terms used to characterize different types of vision impairment:

    • Low vision is defined as fully corrected vision that is insufficient or interferes with your ability to do the things you want to be able to do. It has nothing to do with your visual acuity, field of view or other visual functions like dark adaptation or contrast sensitivity.
    • Legally blind refers to vision that is 20/200 or less in your better eye that cannot be corrected with standard glasses or contacts, or a visual field of 20 degrees or less. Certain conditions, like glaucoma, cataracts, diabetic retinopathy, and macular degeneration can cause one to be legally blind.
    • Total blindness is defined as the complete lack of form and light perception that often results due to a genetic condition, disease, or injury.
    • Partial vision refers to the capacity to see only a portion of your visual field, or to have good central vision but poor peripheral vision. A brain tumor, brain injury, or an eye condition are the most common causes.

    Does Low Vision Mean Blindness?

    No. Vision loss that cannot be corrected with glasses, contact lenses or surgery is known as low vision. However, because some vision remains, it is not considered to be blindness. A person with low vision may have blurred vision, blind spots or have poor night vision.

    Common Types of Low Vision

    Loss of central vision

    A blur or blind spot in the center of what you’re looking at occurs from a loss of central vision. This makes it difficult to read, recognize people and identify features at a distance. A person’s side (peripheral) vision is mostly unaffected by the loss of central vision.

    As long as the person has adequate side vision, mobility is still possible.

    Loss of peripheral (side) vision

    Peripheral vision loss leaves a person with remaining central vision, allowing them to see straight ahead, read, watch TV and recognize faces. This is referred to as tunnel vision and can be caused by glaucoma, a brain tumor or injury.

    Peripheral vision loss makes it difficult to differentiate objects on one or both sides, as well as items directly above and below eye level. Mobility is often hindered by a loss of peripheral vision.

    Blurred vision

    Blurred vision causes both near and far vision to be out of focus. When blurred vision is caused by refractive error, glasses, contact lenses and sometimes surgery can clear it up. However, certain conditions may cause blurred vision that cannot be corrected, such as macular degeneration, cataracts and diabetic edema.

    Reduced contrast sensitivity

    People with poor contrast sensitivity struggle to distinguish an object from other objects having the same background color/shade. For example, a person wearing gray clothing would be difficult to see on a cloudy day. Similarly, finding a blue wallet in a blue purse can be difficult for those with reduced contrast sensitivity. Others may find driving difficult even if their “acuity” is good because visual acuity is measured on high contrast charts. The most common eye diseases that cause contrast sensitivity loss include macular degeneration and cataracts.

    Glare/light sensitivity

    There are two types of glare: discomfort glare and disability glare.

    Patients with discomfort glare tend to feel discomfort in the presence of sunlight, incandescent lights, fluorescent lights, and halogen lights, like those used in car headlights. Glare can emanate from many sources, such as reflection from water, fresh snow or white sand.

    Those with disability glare cannot function in these lighting conditions, posing a danger of being in harm’s way.

    Both types of glare can be helped by a The Low Vision Center at Family Optical low vision eye doctor.

    Night blindness

    People with night blindness find it difficult to see outside at night or in dimly lit indoor settings.

    How Low Vision Devices Can Help

    People with low vision can often live and work independently thanks to a number of tools and devices that can greatly improve their quality of life.

    Our low vision optometrist prescribes all types of low vision glasses and devices, such as:

    • bioptic and full diameter telescope glasses
    • microscope glasses
    • prism glasses
    • and filters of all types
    • as well as a wide range of low vision aids ranging from hand-held magnifiers to electronic visual aids.

    Large-type books, magazines, and newspapers, as well as books on tape, talking wristwatches, self-threading needles and other products can also help those with low vision.

    Live your best life by contacting The Low Vision Center at Family Optical to book a low vision evaluation and to determine the optimal low vision devices for your needs and lifestyle.


    Frequently Asked Questions with Dr. Dale Mulhall

    Q: What is a low vision evaluation?

    • A: A low vision evaluation includes components that are not usually part of a standard eye exam. Your vision will be evaluated to assess the nature and level of vision loss and how it’s affecting your ability to do the things you want to do. The evaluation will help determine which types of low vision glasses and devices to prescribe for improved function, safety and independence.

    Q: What causes low vision?

    • A: Traumatic brain and eye injuries, as well as congenital conditions and issues of aging and uncorrected refractive errors, are all common causes of low vision. As you age, you’re more likely to develop various eye conditions, like cataracts, glaucoma, diabetes and age-related macular degeneration. When treated early, vision loss can be prevented or limited. However, left untreated, some of these conditions can eventually lead to severe vision loss or even total blindness.

    The Low Vision Center at Family Optical provides low vision management, aids and devices to patients from Winnipeg, Grande Pointe, Lorette, and Oak Bluff , Manitoba and surrounding communities.

    Book Online
    Call our St. Anne's Rd Location 204-818-3033

    Call Our Two Locations!