,,FACT ,,& ,,FIC;N ,,( ,,H1L?Y ,,VI.N
       ,EYE ,C>E = ,ADULTS & ,*N

      ,,CLYDE ,K4 ,,KIT*51 ,M4,D4

      ,PUBLI%$ 0,PRAEG] ,PUBLI%]S1
          ,WE/PORT1 ,3NECTICUT
  ,COPY"R ^C #BJJG 0,CLYDE ,K4 ,KIT*5
  ,FUR!R REPRODUC;N OR 4TRIBU;N 9 O!R
  ?AN A SPECIALIZ$ =MAT IS PROHIBIT$4
             ,TRANSCRIP;N (
       ,,ISBN-#AJ3 #J-BGE-IICDE-J
     ,,ISBN-#AC3 #IGH-J-BGE-IICDE-J

         ,TRANSCRIB$1 #BJJH1 BY
              ,C>OL ,/UD]
          ,"EGRE5 ,BRL ,S]VICE
 ,WA%+TON ,TALK+ ,BOOK @& ,BRL ,LIBR>Y
           ,S1TTLE1 ,WA%+TON


             ,9 #E ,VOLUMES
               ,VOLUME #A
      ,BRL ,PAGES P#A-P#AJ & #A-IB
    ,PR9T ,PAGES ;I-;XIV & #A-C#CF   P#A
          ,! ,PRAEG] ,S]IES ON
        ,3TEMPOR>Y ,H1L? & ,LIV+
      ,JULIE ,SILV]1 ,S]IES ,$ITOR

             ,REC5T ,TITLES

..,A ,GUIDE 6,GETT+ ! ,BE/ ,H1L? ,C>E =
  ,YR .,* ,ROY ,B5>O*1 ,M4,D4
..,DEF5D+ & ,P>5T+ ,*N ,:O ,LE>N ,DI6]-
  5TLY3 ,LESSONS F ,$ISON'S .,"M ,SCOTT
  ,TEEL
..,ORD9>Y ,MIRACLES3 ,LE>N+ F ,BR1/
  ,C.ER .,SURVIVORS ,S4 ,DAVID ,NA?AN-
  SON1 ,M4,D4

 ,? BOOK IS = G5]AL 9=M,N ONLY4 ,NO BOOK
C "E SUB/ITUTE =! JUDG;T (A M$ICAL PRO-
FES.NAL4 ,IF Y H WORRIES OR 3C]NS1 3TACT
YR DOCTOR4
  ,"S (! "NS & DETAILS ( 9DIVIDUALS DIS-
CUSS$ 9 ? BOOK H BE5 *ANG$ 6PROTECT !
PATI5TS' ID5TITIES4 ,"S (! /ORIES MAY 2
-POSITES ( PATI5T 9T]AC;NS CR1T$ = IL-
LU/RATIVE PURPOSES4
                                     P#B
          ,,SPECIAL ,,SYMBOLS
         ,,US$ ,,9 ,,? ,,VOLUME

@& 7#D1 #ABCDF7 AMP]S& SYMBOL
^C 7#DE1 #AD7 COPY"R SYMBOL
_/ 7#DEF1 #CD7 SLA%
,' 7#F1 #C7 TRANSCRIB]'S NOTE SYMBOL

    ,MA!MATICAL ,SYMBOL
@+ 7#D1 #CDF7 PLUS SIGN














                                     P#C
         ,,TRANSCRIB]'S ,,NOTES

  ,! ILLU/R,NS 9 ? BOOK >E ALL S*EMATIC
CROSS-SEC;NS (! EYE OR "PS (! EYE4 ,!Y
>E N NUMB]$ OR O!RWISE ID5TIFI$4 ,CAP;NS
6! ILLU/R,NS >E BRLD ": !Y APPE> 9 PR9T4
  ,]RORS 9 SPELL+1 PUNCTU,N1 GRAMM>1 &
SYNTAX H1 =! MO/ "P1 BE5 TRANSCRIB$ Z !Y
APPE> 9 PR9T4















                                     P#D
                ,,3T5TS

               ,VOLUME #A
                                   ,PAGE
,S]IES ,=E^W 0,JULIE ,SILV] """""""" ;IX
,AC"KL$GE;TS """"""""""""""""""""""" ;XI
,9TRODUC;N """"""""""""""""""""""" ;XIII

                ,"P ,I4
               ,! ,BASICS """"""""""" #A
#A4 ,ANATOMY3 ,EYE ,/RUCTURE &
    ,FUNC;N """"""""""""""""""""""""" #C
#B4 ,EYE ,DEVELOP;T & ,3G5ITAL ,EYE
    ,PRO#MS """"""""""""""""""""""""" #I
  ,3G5ITAL ,EYE ,PRO#MS """""""""""" #AA
#C4 ,VI.N ,TE/+ & ,PRO#M ,TR1T;T """ #AD
  ,USE ( ,DILAT+ ,EYE ,DROPS """"""" #AI
  ,EXAM9,N (! ,EYES """"""""""""""" A#BJ
#D4 ,EYE ,GLASSES 7,SPECTACLES7 &
    ,3TACT ,L5SES """""""""""""""""" #BE
  ,3TACT ,L5SES """""""""""""""""""" #BH
#E4 ,VISUAL ,ACU;Y """"""""""""""""" #CD


                                     P#E
               ,VOLUME #B

               ,"P ,,II4
           ,-MON ,EYE ,PRO#MS """""" #CG
#F4 ,"EY"D ,MALADIES """"""""""""""" #CI
  ,! ,R$ ,EYE """""""""""""""""""""" #CI
  ,=EIGN ,BODY ,S5S,N 78,"S?+ 9 !
      ,EYE07 """""""""""""""""""""" B#DA
  ,H]PETIC ,OCUL> ,41SE """""""""""" #DD
  ,LACRIMAL ,4ORD]S """"""""""""""" A#DE
  ,SPOTS 9 ,VI.N """""""""""""""""" A#DG
  ,LUMPS & ,BUMPS (! ,EYES """""""" A#DI
  ,EYELID ,4ORD]S """"""""""""""""" B#EJ
  ,IT*Y ,EYES """"""""""""""""""""" A#EC
#G4 ,/RABISMUS 7,CROSS-,EY$ &
    ,WALL-,EY$7 """""""""""""""""""" #EE

               ,"P ,,III4
        ,AGE-RELAT$ ,EYE ,PRO#MS
    7,GETT+ ,OLD ,A9'T = ,SISSIES7   #FA
#H4 ,PRESBYOPIA """""""""""""""""""" #FC
  ,*OICES ( ,BIFOCALS1 ,TRIFOCALS1
      ,ETC4 """"""""""""""""""""""" B#FI

                                     P#F
  ,3TACT ,L5SES Z AN ,ALT]NATIVE 9
      ,PRESBYOPIA """"""""""""""""" B#GA
#I4 ,CAT>ACTS """""""""""""""""""""" #GD

               ,VOLUME #C
#AJ4 ,GLAUCOMA """"""""""""""""""""" #HJ
#AA4 ,MACUL> ,DEG5],N """""""""""""" #HG

       ,"P ,,IV4 ,SPECIAL ,3SID],NS  #IC
#AB4 ,VISUAL ,AIDS """"""""""""""""" #IE
#AC4 ,DIABETES """"""""""""""""""""" #IG
#AD4 ,NEUROLOGIC ,3DI;NS ,A6ECT+
    ,VI.N """""""""""""""""""""""""" #II
  ,CAUSES ( ,SU45 ,VI.N ,LOSS """""" #II
  ,O!R ,NEUROLOGICAL ,PRO#MS """"" A#AJA
#AE4 ,HI/ORY & ,CURR5T ,DEVELOP;TS
    9 ,REFRACTIVE ,SURG]Y """"""""" #AJH
  ,REFRACTIVE ,SURG]Y ,HI/ORY """"" #AJH
  ,TYPES ( ,REFRACTIVE ,SURG]Y """ B#AAJ
  ,PRESBYOPIA ,SURG]Y """""""""""" B#AAE

               ,VOLUME #D
#AF4 ,"S ,UNUSUAL ,EYE ,PRO#MS &
    ,EYE ,9JURIES """"""""""""""""" #ABC
                                     P#G
  ,EYE ,PRO#MS """""""""""""""""""" #ABC
  ,EYE ,9JURIES """"""""""""""""""" #ABG
#AG4 ,?+S 6,"K AB ,EYE ,SURG]Y """" #ACD
  ,CAT>ACT ,SURG]Y """""""""""""""" #ACD
  ,GLAUCOMA ,SURG]Y """"""""""""""" #ACF
  ,RET9AL ,DETA*;T ,SURG]Y """""""" #ACH
  ,/RABISMUS ,SURG]Y """""""""""""" #ADJ
  ,CORN1L ,TRANSPLANT """"""""""""" #ADA
  ,ENUCLE,N """"""""""""""""""""""" #ADB

                ,"P ,V4
             ,3SUM] ,9=M,N """""""" #ADE
#AH4 ,DEF9I;NS ( ,C>EGIV]S """""""" #ADG
  ,C>EGIV]S """"""""""""""""""""""" #ADG
#AI4 ,M ,?+S ,Y ,NE$ 6"K """""""""" #AEB
  ,-MON ,EYE ,DROP ,M$IC,NS """"""" #AEB
  ,:O ,PAYS & ,H[ """"""""""""""""" #AEH
#BJ4 ,EYE ,C>E--,! ,WAY ,X ,0 &!
    ,WAY ,X ,W ,2 """"""""""""""""" #AFJ
  ,ORIG9 (! ,OPH?ALMOLOGI/ """""""" #AFJ
  ,! ,ORIG9 ( AN ,OPTOMETRI/ """""" #AFC
  ,9T]AC;N ( ,OPH?ALMOLOGY & ,OP-
      TOMETRY """"""""""""""""""""" #AFD

                                     P#H
  ,! ,WAY ,?+S ,C ,2 7,Z ,I ,SEE
      ,X7 """"""""""""""""""""""""" #AFF

               ,VOLUME #E
,GLOSS>Y """""""""""""""""""""""""" #AGA
,9DEX """"""""""""""""""""""""""""" #AHA


















                                     P#I
























                                    P#AJ
              ,S]IES ,=E^W        ;I-;IX

,OV] ! PA/ HUNDR$ YE>S1 "! H BE5 9CR$I#
M$ICAL BR1K-"?S T H PREV5T$ OR CUR$ ILL-
;S 9 BILLIONS ( P & HELP$ _M M IMPROVE
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FEW (! MO/ IMPORTANT TW5TIE?-C5TURY DIS-
COV]IES 9CLUDE ANTIBIOTICS1 ORGAN TRANS-
PLANTS1 & VA39ES4 ,! TW5TY-F/ C5TURY HAS
ALR H]ALD$ IMPORTANT NEW TR1T;TS 9CLUD+
S* ?+S Z A VA39E 6PREV5T HUMAN PAPILLO-
MAVIRUS F 9FECT+ & POT5TI,Y L1D+ 6C]VI-
CAL C.ER 9 WOM54 ,POLIO IS ON ! V]GE (
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                                      #A
H1L? C>E4                           A;IX
    ,S]IES ,$ITOR ,JULIE ,SILV]1 ,M4,D4
    ,ASSI/ANT ,PROFESSOR
    ,H>V>D ,M$ICAL ,S*OOL
    ,DE"P;T ( ,PHYSICAL ,M$IC9E & ,REHA-
        BILIT,N


















                                      #B
              ,AC"KL$GE;TS        ;X-;XI

,I WD L 6AC"KL$GE ! HELP ( ,DR4 ,JULIE
,SILV]1 MY ,S]IES ,$ITOR1 & ,DE2IE ,C>-
VALKO1 MY ,ACQUISI;NS ,$ITOR1 :O MADE
:AT SEEM$ L UNSCALA# B>RI]S 2COME M L
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  ,AL1 ,I WD L 6%[ APPRECI,N = MY OPH-
?ALMOLOGY TRA9+ AT ! ,UNIV]S;Y ( ,I[A1
"U ! TUTELAGE ( PROFESSORS ,DR4 ,A4 ,E4
,BRALEY1 ,DR4 ,FR$ ,BLODI1 ,DR4 ,P4 ,J4
,LE9FELD]1 ,DR4 ,H]MAN ,BURIAN1 ,DR4
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  ,9SPIR,NAL L1D]%IP HAS BE5 4PLAY$ BY
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,I[A1 & :O 5T]$ ACADEMICS :ILE ,I W5T
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ET1 ^: 5C\RAGE;T & SUPPORT MADE ? BOOK
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OV] ! PA/ S"EAL YE>S4               A;XI























                                      #D
               ,9TRODUC;N     ;XII-;XIII

,E "D1 -;TS >E MADE 9 NEWSPR9T1 & ON RA-
DIO OR TELEVI.N AB EYE C>E1 F PROMO;NAL
PIT*ES 6DESCRIP;NS ( NEW 4COV]IES4 ,AN
EYE SURGEON ADV]TISES 8 S]VICES1 (T5 9
MULTIPLE (FICES1 Z A SPECIALI/ 9 COR-
RECT+ NE>SI<T$;S1 F>SI<T$;S1 A/IGMATISM1
CAT>ACTS1 PRESBYOPIA1 & K]ATOCONUS4 ,I
WOND] H[ _M P "K :AT ^! 3DI;NS >E & :Y
SURG]Y WD 2 9VOLV$4 ,OV] ! RADIO1 "! >E
/ATE;TS AB "S"O1 FREQU5TLY ! NEWSMAN HMF
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V]TIS$ ON RADIO & 0 A# 6/OP WE>+ H]
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ADV]TISE;T /ATES T SPECIAL OV]-!-C.T]
EYE DROPS C REDUCE SYMPTOMS ( CAT>ACT4
,A WELL-"KN RADIO NEWSMAN REPORTS T A
LADY :O US$ ! VITAM9S HE PROMOTES 0 A#
6REGA9 H] VI.N4 ,!N A T5NIS BU4Y ASKS ME
AB 8 N9ETY-F\R-YE>-OLD "F-IN-LAW1 :O
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9TRAOCUL> L5S IMPLANT :5 8 CAT>ACT    #E
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GLASSES4 ,? IS 9 SPITE (! FACT T HE HAS
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POCKET1 S9CE ? NEW PROC$URE IS N COV]$
0,M$IC>E4 ,ALL ^! ?+S HELP EMPHASIZE !
NE$ =A BOOK L M9E1 : IS WRITT5 F A PA-
TI5T'S VIEWPO9T ( 2+ A# 6"U/& 5 AB _!
EYES S Z N 6BE 3FUS$ OR UNDES]V$LY SWAY$
0S* /ATE;TS4
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6PROVIDE GD EYE C>E = _! *N1 & !MVS1 :5
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USU,Y GLASSES4 ,! NEWS & ADV]TISE;TS
CURR5TLY >E FULL ( 8NEW 4COV]IES0 & TE*-
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                                      #F
8IMPROVE VI.N10 USU,Y BY 8LAS]40    ;XIV
,X W 2 HELP;L 6"U/& H[ ! EYE "WS S Z 6N
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  ,MY PLAN IS 6GIVE "S BASIC 9=M,N 9 A
WAY S T P C N ONLY $UCATE !MVS1 B >E AL
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PRES5T+ ! FACTS Z !Y >E1 ,I AL 4CUSS >1S
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LY1 ? W /IMULATE 4CUS.N1 "U/&+1 &!    #G
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  ,ULTIMATELY1 ,I HOPE 6PRES5T AN 5C\R-
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9 EYE C>E & EXCITE;T AB FUTURE POT5TIAL4
,M* ( :AT ,I H 6SAY IS BAS$ ON :AT ,I H
LE>N$ Z AN OPH?ALMOLOGI/ OV] A P]IOD (
=TY-FIVE YE>S4 ,"S ( :AT ,I H 6SAY IS
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"E1 MY PR9CIPLES ( TR1T;T C 2 3SID]$
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IS N A TEXTBOOK1 & IF FUR!R 9=M,N IS DE-
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(! 9=M,N 9CLUD$ 9 ? BOOK IS BAS$ ON H[
,I WD EXPLA9 ?+S 6MY PATI5TS1 (F ! TOP (
MY H1D 7SPONTANE\S71 & /RAI<T F ! %\LD]
7FACTUAL74





                                      #H
                ,,"P ,I             #A-C
              ,,! ,,BASICS

                   #A
   ,ANATOMY3 ,EYE ,/RUCTURE & ,FUNC;N

      ,ILLU/R,N3 ,"PS (! EYE4 ,COPY"R ^C
    #AIHC ,/EPH5 ,F4 ,GORDON4 ,' ,! IL-
    LU/R,N ID5TIFIES ! "PS ( AN EYE IN-
    CLUD+ !3 RET9A1 *OROID1 VITRE\S1
    OPTIC N]VE1 MACULA1 SCL]A1 3JUNCTI-
    VA1 CORNEA1 IRIS1 CILI>Y BODY &
    L5S4 ,'

,62G9 6"U/& ! EYE1 "O MI<T MAKE A SIMPLE
ANATOMICAL -P>ISON 6A CAM]A & XS "PS4 ,!
EYE ( C\RSE IS RELATIVELY R.D & FILL$ )
FLUIDS4 ,X GR[S AL;G )! RE/ (! BODY &
R1*ES FULL SIZE AB ! SAME "T Z ! RE/ (!
BODY 2COMES FULLY DEVELOP$4 ,IF ( AV]AGE
SIZE1 L MO/1 ! EYE IS 8EMMETROPIC10 & IS
L A CAM]A ALR 9 FOCUS = 4T.E1 OR 89F9;Y0
9 MA? T]MS4 ,AN EYE L;G] ?AN AV]AGE WD 2
8NE>SI<T$10 OR 8MYOPIC10 & IS 9 FOCUS AT
A CLOS] 4T.E4 ,! M1SURE;TS 9          #I
OPTICAL T]MS >E 9 8DIOPT]S0 & 9 !    A#C
METRIC SY/EM4 ,= EXAMPLE1 A #C DIOPT]
NE>SI<T$ EYE IS 9 FOCUS AT #A_/C MET]1
XS F> PO9T4
--------------------------------------#D
,FOCUS+1 OR A3OMMOD,N1 9 ! EYE IS AN AU-
TOMATIC F1TURE1 Z 9 A PO9T-&-%OOT CAM]A1
: C AUTOMATIC,Y ADJU/ XS FOCUS Z RE-
QUIR$4 ,AT #A_/C MET]1 AN EMMETROPIC
EYE1 L A CAM]A ALR 9 FOCUS = 4T.E1 WD H
6*ANGE XS FOCUS AUTOMATIC,Y1 0#C DIOP-
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FOCUS AUTOMATIC,Y #C DIOPT]S 6SEE = DIS-
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8*ALK BO>D0 9 S*OOL4 ,! EYE _C 8UNFOCUS0
9 A WAY 6IMPROVE 4T.E VI.N =! NE>SI<T$4
,IF A P]SON IS #C DIOPT]S NE>SI<T$1
#A_/C MET] IS ! F> PO9T1 & ANY?+ CLOS]
?AN #A_/C MET] REQUIRES FOCUS+1 B ANY?+
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BLURR$4                              A#D
  ,0! WAY1 ! SIZE (! EYE IS N S OBVI\S
6O!RS4 ,WE E/IMATE ? SIZE 0H[ WIDE !
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6! EYELIDS 2+ UNUSU,Y WIDE OP51 OR DUE
6UPP] LID RETRAC;N1 &! EYE MAY AL 2COME
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6CORRECT VI.N 0! NE>SI<T$ P]SON ) ANA-
TOMIC,Y L>G] EYES MAKE ! EYES APPE>
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,! SIDE (! FACE LAT]AL 6! EYE APPE>S IN-
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$GE4 ,! F>SI<T$ P]SON'S PROFILE IS   #AA
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  ,H[ DOES ! EYE *ANGE XS FOCUS8 ,X IS
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IS RELATIVELY RIGID & _C *ANGE XS SIZE
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IS ! CORNEA4 ,2H ! CORNEA IS ! PUPIL =M+
IRIS TISSUE1 ! COLOR$ "P (! EYE Z SE5 F
! FRONT4 ,2H ! PUPIL IS ! L5S (! EYE1 :
BR+S ?+S 96FOCUS1 L ! L5S (A CAM]A4 ,!
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CAUSES CAT>ACT4 ,LOSS ( FOCUS+ ABIL;Y Z
WE AGE IS1 9 !ORY1 A S\RCE ( 3TROV]SY4
,H["E1 MO/ AGREE T X IS .N DUE 6! W1K5+
( \R 8FOCUS+ MUSCLES40 ,! ,HELMHOLZ !ORY
IS ! MO/ A3EPT$1 & ? SU7E/S T FOCUS+
TAKES PLACE 0M1NS (! ZONULES1 : >E GUY
WIRES HOLD+ ! L5S 9 PLACE & 3NECT$ >.D !
CIRCUMF];E (
--------------------------------------#E
! EYE 6! CILI>Y BODY1 A MUSCUL>      #AB
TISSUE LOCAT$ 2H ! PUPIL4 ,:5 !      A#E
FOCUS+ MUSCLES (! CILI>Y BODY "W1 !Y AC-
TU,Y MAKE ! ZONUL> 3NECT+ WIRES RELAX1 &
? ALL[S ! L5S 6R.D UP & 2COME M MAGNIFY+
02COM+ ?ICK] 9 ! C5T]4 ,:5 ! L5S 2COMES
M RIGID1 X _C R.D UP Z WELL )! CILI>Y
MUSCLE EF=T4 ,:5 ! CILI>Y MUSCLES RELAX1
! ZONULES 2COME TI<T] & RETURN ! L5S 6!
NORMAL %APE AT RE/4 ,! NE>SI<T$ EYE RE-
MA9S NE>SI<T$4 ,! L5S (! EYE _C 2COME
?9N] ?AN USUAL2 X _C 8UNFOCUS40
  ,! CORNEA IS ! CLE>1 R.D$ FRONT "P (!
EYE4 ,IF WE ?9K (! EYE Z A BALL1 S* Z A
T5NIS BALL1 !N ! CORNEA IS L A CLE>
BLI/] ON ! FRONT SURFACE4 ,S9CE X IS
TRANSP>5T1 X _C 2 SE5 )! NAK$ EYE1 UN.S
A P]SON IS VIEW$ F ! SIDE4 ,!N ! CLE>
BULGE C 2 SE5 9 PROFILE4 ,? IS AN UNUSU-
AL TISSUE1 S9CE X HAS NO BLOOD VESSELS4
,! CORNEA EXT]N,Y RCVS NUTRI;N F TE>S &!
AQUE\S FLUID BA?+ XS 9T]NAL SURFACE4
,N"E!.S1 :5 H1L?Y1 X TRANSMITS LI<T Z
CLE>LY Z GLASS4 ,IF 41S$ OR SC>R$1 X MAY
2 9VAD$ 0BLOOD VESSELS & !N 2COME OPAQUE
L ! 8:ITE0 (! EYE1 ! SCL]A4 ,SC>S    #AC
OR OPACITIES (! CORNEA MAY MAKE      B#E
VI.N SIMIL> 6LOOK+ "? A DIRTY W9D[4 ,AL?
! CORNEA CD 2 -P>$ 6! L5S COV] 9 A CAM-
]A1 ! HUMAN CORNEA HAS A M* GRT] FUNC;N4
,2+ R.D$ 9 CURVATURE1 X ACTU,Y PLAYS AN
IMPORTANT ROLE 9 FOCUS+ LI<T 6! BACK (!
EYE--! RET9A--AN AV]AGE ( #BD MILLIMET]S
AWAY4 ,H["E1 UNLIKE ! L5S (! EYE1 ! COR-
NEA _C *ANGE %APE 6FOCUS ! EYE4 ,N"E!.S1
! CURVATURE (! CORNEA C 2 SURGIC,Y
*ANG$1 & T IS ! BASIS ( MO/ 8REFRACTIVE
SURG]Y40 ,! CORNEA IS AL ! ONLY "P (!
EYE T C 2 TRANSPLANT$1 Z 9 A CORN1L
TRANSPLANT SURG]Y P]=M$ = CORN1L 9JURY
OR 41SE4
  ,IF ! CORNEA IS \ ( R.D1 M FOOTBALL
%AP$ ?AN BASKETBALL SPH]IC,Y %AP$1 WE
SP1K ( A/IGMATISM4 ,S9CE MO/ ( U >E N
P]FECT1 MO/ ( U H "S A/IGMATISM4 ,? IS
NO BIG D1L 9 MO/ CASES1 N 9ITI,Y E6ECT+
! NE$ = GLASSES UN.S A3OMPANI$ 0SIGNIFI-
CANT NE>SI<T$;S OR F>SI<T$;S4 ,H["E1 A
HI<] DEGREE ( A/IGMATISM C 2 AN IMPOR-
TANT FACTOR 9 CORRECT+ VI.N 6AN A3EPTA#
DEGREE4 ,WE SP1K ( F>SI<T$1          #AD
NE>SI<T$1 & MIX$ A/IGMATISM1 ON !    C#E
BASIS ( XS E6ECT 9 A4I;N 6! BASIC 8RE-
FRACTIVE ]ROR40 ,AL?1 TE*NIC,Y1 A/IGMA-
TISM MAKES VI.N IMP]FECT AT ANY 4T.E1
M9OR DEGREES ( A/IGMATISM MAY N 2 M* (A
FACTOR 9 NE$+ GLASSES1 UNTIL "O DEVELOPS
PRESBYOPIA1 ! AGE-RELAT$ NE$ = R1D+
GLASSES4 ,Y C E/IMATE ! DEGREE ( A/IGMA-
TISM 9 P]SONS 0HOLD+ _! GLASSES 9 FRONT
(A V]TICAL OR HORIZONTAL L9E & ROTAT+ !
L5S4 ,IF ! L9E /AYS /RAI<T1 !N "! IS LL
OR NO A/IGMATISM CORREC;N1 B IF ! L9E
B5DS X IS DUE 6A/IGMATISM CORREC;N 9 !
GLASSES4
  ,:5 LI<T /RIKES ! CORNEA1 ! MO/ =W>D
\TW>D "P (! EYE1 X IS !N TRANSMITT$ "? !
8PUPIL40 ,ACTU,Y1 ! PUPIL IS J A BLACK-
--------------------------------------#F
LOOK+1 R.D SPACE =M$ 0! COLOR$ "P (!
EYE1 ! IRIS4 ,! PUPIL FUNC;NS L AN AP]-
TURE1 9 A CAM]A1 2COM+ L>G] 9 REDUC$
LI<T 6LET M LI<T IN1 & SMALL] 9 B"R LI<T
S Z 6PROTECT ! DELICATE 9T]IOR (! EYE F
8OV]EXPOSURE40 ,! PUPIL HAS NO FOCUS+
E6ECT1 X J 3TROLS H[ M* LI<T GETT+   #AE
6! BACK (! EYE4 ,! SIZE (! PUPIL     A#F
MAY V>Y AM;G 9DIVIDUALS1 & / 2 NORMAL4
  ,NORM,Y1 PUPILS >E ( EQUAL SIZE1 ) "S
EXCEP;NS4 ,DI6];E 9 SIZE MAY 2 3G5ITAL1
B IF ACQUIR$1 X %D 2 REPORT$ Z "S?+ (
POSSI# SIGNIFIC.E NEUROLOGIC,Y4 ,NORM,Y1
! PUPIL %D 2 A# 6PROMPTLY *ANGE SIZE--=
EXAMPLE1 62COME SMALL] :5 EXPOS$ 6B"R
LI<T4 ,:5 "Y1 \R PUPILS >E L>G] ON AV]-
AGE1 B 2COME SMALL] ) AGE4 ,_! SIZE MAY
2 A6ECT$ 0M$IC,NS1 S* Z PILOC>P9E1 US$ =
TR1T+ GLAUCOMA "S"TS1 & : MAKES ! PUPIL
SMALL1 OR 8MIOTIC40 ,"S"TS P ) SMALL
7MIOTIC7 PUPILS H BETT] VI.N ?AN EXPECT$
)\T GLASSES1 = BO? NE> & 4TANT OBJECTS1
2C (! 8P9HOLE E6ECT40 ,H["E1 L>G] PUPILS
C 2 A SIGN ( DRUG USE1 & "S?+ POLICE (-
FIC]S LOOK =--= EXAMPLE1 AT A TRA6IC
/OP4
  ,Z M5;N$1 ! PUPIL IS =M$ 0! IRIS1 OR !
8COLOR$ "P0 (! EYE4 ,9 REGULAT+ ! PUPIL
SIZE1 OR AP]TURE1 ! IRIS AL S]VES Z A
8BLACK\T DRAPE0 6PROTECT ! 9T]IOR (! EYE
F OV]EXPOSURE 6LI<T4 ,! MUSCLES 9 ! IRIS
3TROL ! PUPIL SIZE4 ,VIEW$ "? A      #AF
MICROSCOPE1 CALL$ A SLIT LAMP1 !     B#F
FRONT (! IRIS APPE>S DIAPHAN\S & IRREGU-
L> ON ! SURFACE4 ,3TR>Y 6POPUL> OP9ION1
"! >E NO S* ?+S Z GRE51 HAZEL1 OR BLUE
EYES4 ,-POS$ ( TWO LAY]S1 ! IRIS HAS A
D5SE1 BLACK-PIG;T$ 8BLACK\T DRAPE0 ON XS
PO/]IOR2 ? LAY] IS ! SAME 9 ALL RACES4
,X IS ! FRONT LAY] T GIVES ! IMPRES.N (
V>I\S EYE COLORS4 ,! FRONT LAY] IS IR-
REGUL> ON ! SURFACE & MAY V>Y F PURELY
:ITE 6%ADES ( BR[N4 ,:ITE SUP]FICI,Y SU-
P]IMPOS$ ONTO BLACK GIVES ! APPE>.E (
BLUE EYES3 ! :IT] ! FRONT LAY]1 ! BLU] !
EYE APPE>S4 ,V>I\S %ADES ( BR[N >E DET]-
M9$ 0H[ M* BR[N PIG;T IS SPR9KL$ ON !
FRONT SURFACE (! IRIS4 ,A LI<T DU/+ (
BR[N PIG;T C GIVE A YELL[I% APPE>.E1 & ?
YELL[ PLUS BLUE YIELDS ! GRE5 APPE>.E4
  ,! IDEA T ! COLOR (! EYE *ANGES DEP5D+
ON :AT Y WE> 9 CLO?+ IS "!=E N TRUE4
,9/1D1 ! EYE COLOR *ANGES DEP5D+ ON !
SIZE (! PUPIL4 ,9 B"R LI<T1 ! PUPIL IS
SMALL1 & :AT PIG;T IS ON ! FRONT SURFACE
IS R SCATT]$ & SPR1D \1 MAK+ ! EYE COLOR
LI<T]1 LOOK+ L1 B N"E Q RE,Y1        #AG
8GRE50 OR 8HAZEL40 ,:5 L>G]1 ! PU-   C#F
PIL SIZE CAUSES ! PIG;T 6BE -PRESS$ TGR1
MAK+ ! EYE COLOR D>K]4 ,( C\RSE1 ! D5SE
PIG;T (! FRONT SURFACE RESULTS 9 D>K
BR[N EYES4 ,ALB9OS1 :O LACK PIG;T 9 ALL
TISSUES1 ( C\RSE H BLUE EYES1 &! ALB9ISM
MAY 2 LIMIT$ 6! EYES1 Z 9 OCUL> ALB9ISM4
,MY?S AB ! IMPORT.E ( EYE COLOR %ADES H
L$ 6V>I\S CLAIMS1 9CLUD+ A PSEUDOSCI;E
CALL$ 8IRIDOLOGY10 : IS "S?+ SIMIL> TO
R1D+ "O'S PALMS4
--------------------------------------#G
  ,! L5S (! EYE IS A BICONVEX 7?ICK 9 !
MI4LE & TAP]$ AT ! $GES7 PROTE9-LAY]$
GEL T IS OPTIC,Y CLE> 9 Y\?4 ,X 2COMES M
RIGID 9 3SI/5CY & LESS CLE> ) AGE4 ,?
RIGID;Y APP>5TLY RESULTS 9 FOCUS+ PRO#MS
( AN AGE-RELAT$ NATURE1 CALL$ PRESBYO-
PIA1 & 9 ADV.ED DEGREE1 CAT>ACT =M,N4 ,A
CAT>ACT IS A CL\D+ (! NORMAL L5S T OB-
/RUCTS ! AM.T ( LI<T PASS+ ON 6BE FOCUS$
ON ! RET9A 7-P>A# 6! FILM 9 A CAM]A71
L9+ ! BACK (! EYE4 ,! OPAC;Y (! L5S MAY
2 NUCLE> 7C5TRAL71 CORTICAL 7P]IPH]AL71
OR PO/]IOR SUBCAPSUL> 7S* Z OPAC;Y   #AH
PA9T$ ON ! BACK (! L5S74 ,V>I,NS (   A#G
PROCESS O3UR1 B X C 2 SD T WE ALL DEVEL-
OP CAT>ACTS1 IF WE LIVE L;G 5\<4 ,"S WD
H 6BE WELL OV] #AJJ 2F !Y MI<T NE$ CATA-
RACT SURG]Y4 ,( C\RSE1 _M DIE 2F HAV+
NOTA# PRO#MS F CAT>ACTS4 ,H["E1 "! IS AL
NO S* ?+ Z 2+ TOO OLD = CAT>ACT SURG]Y1
IF NE$$4 ,& S9CE ! AGE EXPECTANCY ( \R
POPUL,N IS 9CR1S+1 CAT>ACT SURG]Y IS1 &
%D 3T9UE 6BE1 ! MO/ -MON SURG]Y P]=M$ 9
! ,UNIT$ ,/ATES4 ,B FE> N3 CAT>ACT SUR-
G]Y W 2 F.D 6BE N S BAD2 9 FACT X IS M*
EASI] 6TOL]ATE ?AN MO/ SURGICAL PROCE-
DURES4 ,:5 P]=M$ ONCE TRULY NE$$1 X C 2
MO/ REW>D+ 6BO? PATI5T & OPH?ALMOLOGI/4
,CAT>ACT SURG]Y W 2 4CUSS$ 9 M DETAIL
LAT]4
  ,2H ! L5S IS A RELATIVELY L>GE CAV;Y1
! CORE (! EYE1 FILL$ )! VITRE\S FLUID4
,? IS A ?ICK1 CLE> GEL MADE UP MA9LY (
WAT]4 ,XS FUNC;N1 O!R ?AN FILL+ UP SPACE
& PROVID+ NUTRI;N P]H1 IS L>GELY UN"KN
AF XS ROLE 9 DEVELOP+ ! 3G5ITAL EYE
/RUCTURE4 ,S9CE CLE>1 X OPTIC,Y TRANS-
MITS LI<T VIA ! PUPIL & L5S ONTO !   #AI
RET9A4 ,X C 2 REPLAC$ )A WAT]LIKE    B#G
FLUID1 :5 NEC 9 SURG]Y1 S* Z :5 REMOV+ A
HEMORRHAGE F ! VITRE\S4 ,OPACITIES MAY
=M 9 ? FLUID1 & >E CALL$ FLOAT]S1 S9CE
!Y MOVE >.D 9 ! ?ICK GEL4
  ,! RET9A IS A ?9 LAY] ( N]VE TISSUE
L9+ ! 9SIDE (! BACK TWO-?IRDS (! EYE1 L
WALLPAP]4 ,X IS -P>A# 6! FILM 9 A CAM]A1
) EXCEP;NS4 ,UNLIKE CAM]A FILM1 ! RET9A
HAS V>Y+ S5SITIV;Y4 ,X IS MADE UP (
CELLS CALL$ RODS & C"OS1 : >E SPECIALIZ$
9 FUNC;N4 ,! SMALL >EA 9 ! C5T] (! BACK
(! EYE1 ": LI<T IS FOCUS$1 IS CALL$ !
MACULA4 ,X O3UPIES ! BACK APEX (! EYE1
": LI<T IS BR"\ 96FOCUS4 ,X IS -POS$ (
#AJJ P]C5T C"OS1 : SPECIALIZE 9 R1D+ VI-
.N1 COLOR & =M VI.N4 ,! P]C5TAGE ( C"OS
GRADU,Y DIM9I%ES 9 >1S (! RET9A M P]IPH-
]AL F ! MACULA1 MIX+ ) CELLS CALL$ RODS1
UNTIL1 9 ! P]IPH]AL RET9A1 "! >E MA9LY
RODS4 ,! ROD CELLS >E IMPORTANT = NI<T
VI.N1 MO;N S5S,N1 & P]IPH]AL VI.N4 ,RET-
9AL 41SES 9VOLV+ ! MACULA &! P]IPH]AL
RET9A W 2 4CUSS$ LAT] 9 ? BOOK4
  ,! OPTIC N]VE1 ! SECOND CRANIAL    #BJ
N]VE1 5T]S ! BACK (! EYE1 T[>D !     C#G
NOSE F ! MACULA1 Z A DIRECT EXT5.N (!
BRA94 ,N]VE FIB]S F ! RET9A BUN* UP &
TRAVEL AL;G ! OPTIC N]VE1 GIV+ VISUAL
IMPULSES 6! BRA94 ,! BRA9 IS 8S SM>T0 T
X REV]SES UPSIDE-D[N IMAGES RESULT+
--------------------------------------#H
F ! CAM]ALIKE EYE 96"R-SIDE-UP IMAGES4
,! LEFT SIDE (! BRA9 SEES ?+S 6! "R1 &!
"R SIDE (! BRA9 SEES "EY?+ 6! LEFT4
,GLAUCOMA A6ECTS ! OPTIC N]VE1 Z D O!R
41SES S* Z OPTIC NEURITIS4 ,L BRA9 TIS-
SUE1 X MAY N RECOV] F A PROL;G$ LACK (
OXYG51 : C O3UR SL[LY 9 41SES S* Z DIA-
BETES1 OR F A SU45 BLOCKAGE 9 ! CIRCUL,N
(! C5TRAL RET9AL >T]Y OR VE94








                                     #BA
                   #B                 #I
       ,EYE ,DEVELOP;T & ,3G5ITAL
              ,EYE ,PRO#MS

,WE >E N BORN ) #BJ_/BJ VI.N4 ,HE>+
ABIL;Y PROBABLY PREC$ES VI.N 6A3.T =!
APP>5T P>5TAL RECOGNI;N F ! BABY B$4 ,BY
AGE ?REE MON?S1 9FANTS C FIXATE ON &
FOLL[ A P5LI<T OR FOLL[ ! P>5TS >.D !
ROOM ) _! EYES4 ,VI.N LEVELS POSSI# 2C (
! MACUL> POR;N (! RET9A--T IS1 6BE A# TO
SEE COLORS & SMALL OBJECTS Z LL Z NEWS-
PR9T--USU,Y TAKE SIX MON?S 6DEVELOP4
,UN=TUNATELY1 "! >E SITU,NS T MAY DELAY
OR PREV5T NORMAL VI.N DEVELOP;T1 S* Z 2+
CROSS-EY$1 HAV+ 3G5ITAL CAT>ACTS1 3G5I-
TAL GLAUCOMA1 NY/AGMUS 7DANC+ EYES71 SE-
V]E MYOPIA 7NE>SI<T$;S71 OR O!R BIR?
ANOMALY4
  ,Z M5;N$1 2G9N+ 9 *ILDHOOD1 "! >E IM-
P]FEC;NS 9 ! UNAID$ VISUAL P]=M.E (!
EYES4 ,MO/ EYES >E F>SI<T$ 9 *ILDHOOD1
2C !Y >E N FULLY GR[N & "!=E SMALL] ?AN
! AV]AGE R1*$ 0AN ADULT4 ,-P5SAT+ = ?1 !
"Y H TREM5D\S P[]S ( A3OMMOD,N1 S    #BB
FOCUS+ IS N A PRO#M AT ANY 4T.E =    A#I
MO/ *N4 ,"S >E BORN NE>SI<T$1 73G5ITAL
MYOPIA71 & C 2 EXPECT$ 62COME M NE>SI<T$
) GR[?4 ,AL? NE>SI<T$;S 7MYOPIA7 IS USU-
,Y 3SID]$ J A V>I,N ( NORMAL VI.N1 ^? :O
>E 3G5IT,Y MYOPIC MAY 2 S 6S* A SEV]E
DEGREE Z 6H DEG5]ATIVE PRO#MS LAT]4
,S9CE EYES *ANGE ) GR[?1 ! ORIG9,Y F>-
SI<T$ *N T5D 62COME LESS F>SI<T$1 ) MO/
EV5TU,Y R1*+ RELATIVE EMMETROPIA1 9 2+
A# 6FOCUS = 4T.E )\T EF=T4 ,"S *ANGE 5
62COME MYOPIC OR NE>SI<T$1 & ? 3DI;N C 2
EXPECT$ 6BE PROGRESSIVE "?\T GR[?1 & AL
EV5TU,Y /ABILIZ+4 ,! "Y] ! ONSET ( NE>-
SI<T$;S1 ! M RAPID PROGRESS4
  ,ALL *N %D 2 SCRE5$ VISU,Y 2F K9D]G>-
T54 ,^? ^: P>5TS H SPECIAL EYE PRO#MS1
S* Z 2+ CROSS-EY$ OR HAV+ A 8LAZY EYE10
%D 2 SCRE5$ 0AGE ?REE4 ,AL 2 W>N$ T A
H]$IT>Y EYE PRO#M MAY SKIP A G5],N1 S T
IF ANY GR&P>5TS H A HI/ORY (A LAZY EYE1
! RULE / APPLIES = E>LY SCRE5+4 ,A PRE-
S*OOL * :O IS A LL NE>SI<T$1 MAY N NE$
GLASSES1 B C 2 EXPECT$ 62COME M
                                     #BC
NE>SI<T$ ) GR[?4 ,S 9 A YE> OR S1    #AJ
! * MAY NE$ GLASSES1 & ? IS GD 6"K S Z
6AVOID PRO#MS 9 S*OOL4 ,P>5TS :O >E AL
NE>SI<T$ MAY N 2 S SURPRIS$1 HAV+ G"O "?
! SAME /AGES DUR+ S*OOL-AGE DEVELOP;T4
,"S P>5TS1 ESPECI,Y ^? :O DID N NE$
GLASSES 9 S*OOL1 >E SURPRIS$ AT1 & "S"TS
9T]E/$ IN1 ANY?+ T C PREV5T ! USUAL MY-
OPIC DEVELOP;T4 ,N R1LIZ+ T "! >E NO EX-
]CISES 6MAKE ! EYE SMALL]1 S* P>5TS >E
EASILY 9FLU;ED 0FALSE CLAIMS AB EYE EX]-
CISES OR O!R ID1S T MAY /OP ! PROGRES.N
( MYOPIA4 ,( C\RSE1 REFRACTIVE SURG]Y IS
N USU,Y PRACTICAL =! "Y4 ,Z RESE>*$ AT !
,MAYO ,CL9IC1 ! MO/ SU3ESS;L TR1T;T TO
LIMIT ! DEVELOP;T ( MYOPIA T ,I "K AB1
IS ! USE ( ATROP9E4 ,ATROP9E P>ALYZES
FOCUS+ & HAS 6BE US$ = YE>S DUR+ GR[?4
,DUR+ ? "T ! * M/ WE> BIFOCALS S Z 6BE
A# 6R1D4 ,9 G5]AL1 ? HAS N BE5 A V POPU-
L> TR1T;T4 ,A NEW EXP]I;TAL M$IC9E1
CALL$ PIR5ZEP9E1 HAS BE5 TRI$1 B X HAS N
YET BE5 PROV5 6BE E6ECTIVE = LIMIT+ MY-
OPIC DEVELOP;T4
  ,"P (! MIS"U/&+ AB NE>SI<T$;S IS   #BD
! IDEA T ! MYOPIC OR NE>SI<T$ EYE   A#AJ
IS 8W1K40 ,?1 ( C\RSE1 IS N TRUE4 ,EYES
>E N 8W1K0 OR 8/R;G40 ,!Y >E ( AV]AGE
SIZE1 L>G]1 OR SMALL]4 ,& S9CE :5 HAS 2+
BI7] ?AN AV]AGE M1NT W1K;S8 ,! R1SON = ?
IS L>GELY G5ETIC1 & N 5VIRON;TAL4 ,P D N
2COME NE>SI<T$ F R1D+ TOO M*1 R1D+ 9
POOR LI<T1 OR WE>+ _! GLASSES TOO M*4
  ,! AV]AGE * HAS NO PRO#M A3EPT+ GLASS-
ES1 ?\< _! P>5TS MAY 2 A S\RCE ( RESIS-
T.E4 ,? A3EPT.E IS ESPECI,Y TRUE IF ! *
IS "Y1 :5 !Y >E Q ADAPTA#4 ,! BLURR$
4T.E VI.N ( *N MAY R SN1K UP ON !M4 ,_!
F/ CLUE MAY 2 PRO#MS SEE+ ?+S AT !
8BO>D0 T O!R CLASSMATES C SEE4 ,N "K+
:AT IS 8NORMAL10 ! NE>SI<T$ * IS (T5
AMAZ$ 6SEE L1VES ON TREES1 & O!R ?+S !Y
DID N "K !Y 7 MISS+1 :5 !Y GET _! F/
GLASSES4 ,A3EPT.E ( GLASSES MAY 2 N S
GD1 IF ! F/ EXP]I;E IS LAT]1 L 9 JUNIOR
HI< OR HI< S*OOL4 ,A NEGATIVE ATTITUDE
MAY O3UR DUE TO 8PRESUM$0 PE] REAC;N1 &!
*OICE ( 3TACT L5SES MAY 2 REQUE/$ 0! /U-
D5T1 9/1D ( GLASSES4 ,H["E1 ! F/ GLASSES
>E USU,Y N TOO /R;G1 & 3TACT L5SES   #BE
>E = ^? :O NE$ /R;G]1 FULL-"T       B#AJ
GLASSES1 9 G5]AL4 ,ANO!R FACTOR IS T AN
IMMATURE ATTITUDE T[>D GLASSES MAY AL
MAKE 3TACT L5SES AN EXP5SIVE ALT]NATIVE1
IF !Y >E N WORN4 ,MY APPROA* IS 6ALW TO
9SI/ ON GLASSES Z ! F/ ALT]NATIVE4 ,!N1
IF ! *N DEMON/RATE T !Y RE,Y L SEE+ Z
WELL Z !Y D ) GLASSES1 B WD R N WE>
GLASSES1 !Y MAY SWIT* 63TACT L5SES1 USU-
,Y AT ! NEXT ANNUAL EXAM4 ,"! IS NO AGE
LIMIT1 B AGE ?IRTE5 OR S IS A PRACTICAL
"T 62G9 3TACT L5SES4 ,GIRLS >E BETT] ?AN
BOYS1 2C ( DEXT];Y1 ATTITUDE1 & G5]AL
MOTIV,N4 ,H["E1 WE AL H S"EAL SU3ESS;L
PATI5TS "Y] ?AN ?IRTE51 USU,Y GIRLS4 ,9
G5]AL1 "! SEEMS 6BE A WIDE RANGE ( MA-
TUR;Y 9 *N1 RELATIVE 63TACT L5S WE>4
-------------------------------------#AA
         ,3G5ITAL ,EYE ,PRO#MS

  ,BABIES D N 9ITI,Y SEE WELL4 ,!Y D N
SEE WELL 5 6FIXATE & FOLL[1 S* Z 6A P5-
LI<T1 UNTIL AGE ?REE MON?S4 ,!Y _C SEE
COLOR WELL OR 8R1D0 UNTIL AGE SIX MON?S1
:5 _! MACULAS DEVELOP4 ,F T PO9T !   #BF
BABY'S VI.N IS RELATIVELY GD1 UN-   A#AA
.S -PLICAT$ 03G5ITAL ABNORMAL;Y4 ,^! AB-
NORMALITIES MAY 9CLUDE CAT>ACTS1 GLAUCO-
MA1 NY/AGMUS1 DEG5]ATIVE MYOPIA1 /RABIS-
MUS1 & AMBLYOPIA4
  ,3G5ITAL CAT>ACTS >E =TUNATELY R>E4
,IF !Y >E MILD1 ( C\RSE1 NO SURG]Y IS
NE$$1 & "! >E R1SONS 6PO/P"O SURG]Y Z
L;G Z POSSI#4 ,AL1 6BE 3SID]$1 H["E1 IS
! FACT T ! VISUAL RESULT MAY 2 DIM9I%$1
IF ! EYE HAS N"E _H A *.E 6SEE NORM,Y4
,D5SE CAT>ACTS AT BIR? CR1TE SPECIAL
PRO#MS4 ,IF ! CAT>ACT ONLY 9VOLVES "O
EYE1 OR AT L1/ IS WORSE 9 "O EYE1 !N "!
IS AT L1/ GD PROGNOSIS = VI.N )! O!R
EYE1 B ! *.ES (! EYE ) CAT>ACT SEE+ WELL
>E Q POOR1 EV5 AF CAT>ACT SURG]Y4 ,CATA-
RACT SURG]Y 9 *N HAS ALW BE5 M DI6ICULT
9 WAYS1 B -PLICAT+ ! GD RESULT IS ! /ATE
( APHAKIA 7NO L5S PRES5T74 ,?US EXTREME
ANISOMETROPIA 7"O EYE 2+ DI6]5T F ! O!R7
RESULT$1 M1N+ T ! EYE OP]AT$ ON IS N[ Q
F>SI<T$ 7APHAKIK7 & C N *ANGE FOCUS4 ,"U
^! CIRCUM/.ES1 AMBLYOPIA 7POOR VI.N DE-
VELOP;T7 IS V LIKELY1 EV5 )          #BG
TR1T;T1 9CLUD+ GLASSES1 3TACT       B#AA
L5SES1 OR PAT*+4 ,AL? ORIG9,Y *N 7 N
3SID]$ C&IDATES = 9TRAOCUL> L5S IMPLANT
) CAT>ACT SURG]Y1 ! L;G-T]M RESULTS >E
N[ GD 5 6N 3TRA9DICATE 9TRAOCUL> L5S IM-
PLANTS =! TR1T;T ( 3G5ITAL CAT>ACTS4
,POT5TI,Y1 0REDUC+ ANISOMETROPIA 7DI6];E
2T EYES71 "! IS A BETT] *.E ( DECR1S+
AMBLYOPIA 0UTILIZ+ 9TRAOCUL> IMPLANTS1 B
! PRO#M IS / DI6ICULT 6OV]COME4 ,= EXAM-
PLE1 DOES ! BRA9 "K ! DI6];E 2T 9PUT F A
PSEUDOPHAKIK EYE & T F A 8NORMAL0 EYE8
  ,MYOPIA C 2 PRES5T AT BIR?1 & :5 ( HI<
DEGREE1 X C 2 PROGRESSIVE & 8DEG5]ATIVE0
& -PLICAT$ 0MACUL> DAMAGE4 ,Y C ?9K (!
PRO#M Z AN EYE S BIG1 T 8/RET* M>KS0 OC-
CUR1 & ^! C A6ECT ! C5TRAL OR MACUL> VI-
.N4 ,RET9AL DETA*;TS >E AL M LIKELY 2C (
! /RET*+ E6ECT ON ! RET9A4 ,^! PATI5TS
MAY N ONLY NE$ /R;G GLASSES1 B MAY N 2
CAPA# ( NORMAL VI.N1 EV5 ) 3TACT L5SES
OR 9TRAOCUL> SURG]Y4 ,=TUNATELY1 ? DE-
GREE ( PRO#M IS UNUSUAL4 ,X IS 9T]E/+ TO
"U/& T ! -PLIC,NS ( AN EXTRA L>GE EYE1
EV5 IF VISU,Y IMPROV$ 0REFRACTIVE    #BH
SURG]Y1 / L1VE ! EYE /RUCTUR,Y M    C#AA
SUSCEPTI# 6L;G-T]M -PLIC,NS S* Z RET9AL
DETA*;T1 2C (! /RET*+ E6ECT ON ! RET9A4
  ,3G5ITAL GLAUCOMA1 ?\< R>E1 IS USU,Y
F> ADV.ED 2F 4COV]Y4 ,! F/ SIGN1 UN=TU-
NATELY1 MAY 2 5L>GE;T (! 9FANT'S EYE4
,S9CE ! WALL (! EYE IS RELATIVELY ELA/IC
DUR+ 9FANCY1 ! EYE MAY LIT],Y /RET* Z A
RESULT ( 9CR1S$ 9TRAOCUL> PRESSURE4 ,Z
EXPECT$1 0? "T X IS USU,Y
-------------------------------------#AB
TOO LATE 6PRES]VE VI.N1 S9CE ! DELICATE
OPTIC N]VE W ALR H BE5 SEV]ELY DAMAG$4
  ,NY/AGMUS1 J]KY MOVE;TS (! EYES T PRE-
V5T GD VI.N1 IS "O (! M -MON NEUROLOGI-
CAL PRO#MS PRES5T AT BIR?4 ,"! >E DI6]5T
TYPES ( NY/AGMUS1 V>Y+ F LAT5T 7"S"TS71
63/ANT1 OR EV5 VOLUNT>Y4 ,3/ANT NY/AGMUS
IS USU,Y ASSOCIAT$ ) SUBNORMAL VI.N4 ,!
EYES USU,Y H HORIZONTAL1 J]KY MOVE;TS1 B
NY/AGMUS MAY 2 V]TICAL OR TOR.NAL 7ROTA-
RY74 ,"S P C VOLUNT>ILY MOVE _! EYES 9 A
NY/AGMIC FA%ION1 & ?\< !Y MAY 2 A S\RCE
( 5T]TA9;T AT "PIES1 !Y >E N USU,Y VISU-
,Y H&ICAPP$4 ,LAT5T NY/AGMUS M1NS    #BI
T ORD9>ILY "! IS NO NY/AGMUS1 B     A#AB
CIRCUM/.ES MAY BR+ X \--! MO/ USUAL 2+
:5 "O EYE IS COV]$1 S* Z 9 ! C\RSE ( AN
EYE EXAM9,N4 ,= ^! P1 WE NE$ 6USE WAYS (
EXAM9+ ! EYES )\T COV]+ "O EYE4 ,A H1D
TURN MAY DEVELOP1 IF ? ALL[S ! * 6USE !
EYES TGR 9 ? POSI;N ( L1/ NY/AGMUS1 &
BE/ VI.N4 ,! DEGREE ( NY/AGMUS C V>Y1 Z
WELL Z ! LIMIT,N ( VI.N4 ,! VI.N MAY 2
GD 5 6GET A * "? PRIM>Y1 & (T5 SECOND>Y1
S*OOL 9 REGUL> CLASSES4 ,L[-VI.N PRO-
GRAMS >E AVAILA# 9 _M S*OOLS4 ,9 GRADE
S*OOL1 ! PR9T 9 BOOKS IS (T5 L>GE 5 6AL-
L[ A * ) SUBNORMAL VI.N 6MANAGE4 ,"! MAY
2 O!R EYE PRO#MS1 S* Z OPTIC N]VE 41SE1
B ! * IS O!RWISE USU,Y NORMAL NEUROLOGI-
C,Y4
  ,/RABISMUS IS ! MO/ -MON (! 3G5ITAL
PRO#MS1 B IS N ALW EVID5T F BIR?4 ,!
WOR/ -PLIC,N IS AMBLYOPIA1 7POOR VI.N
DEVELOP;T71 OR LAZY EYE1 : IS USU,Y AS-
SOCIAT$ ) ESOTROPIA1 ! CROSS+ OR 9W>D
TURN+ ( "O EYE4 ,EXOTROPIA1 OR \TW>D-
TURN+ ( "O EYE1 9 E>LY *ILDHOOD MAY H M
S]I\S NEUROLOGICAL SIGNIFIC.E1       #CJ
S9CE ! /RAY+ (A BL EYE IS EXPECT$   B#AB
6BE 9W>D 7CROSS$7 9 *ILDHOOD4 ,I RECALL
SU7E/+ 6P>5TS ( AN 9FANT ) EXOTROPIA T A
NEUROLOGIC PRO#M MAY 2 PRES5T1 & UN=TU-
NATELY ,I 0 CORRECT1 HE _H A BRA9 TUMOR4
,TR1T;T W 2 4CUSS$ ) V>I\S TYPES ( /RA-
BISMUS 9 *APT] SEV54
  ,ANISOMETROPIA IS A 3DI;N 9 : "O EYE
IS DI6]5T F ! O!R1 = EXAMPLE1 "O EYE MAY
2 F>SI<T$1 &! O!R MAY H A/IGMATISM OR
NE>SI<T$;S4 ,NEXT 62+ CROSS-EY$1 ? IS !
SECOND-MO/ -MON CAUSE ( AMBLYOPIA 7LAZY
EYE74 ,9 A WAY1 ^! ANISOMETROPIC *N >E
WORSE (F ?AN 2+ CROSS-EY$1 2C _! P>5TS
>E USU,Y UNAW>E ( ANY EYE PRO#M UNTIL
9ITIAL VI.N SCRE5+1 USU,Y AF ! * HAS
/>T$ S*OOL4 ,0? "T1 TR1T;T IS (T5 TOO
LATE4 ,( PRIME IMPORT IS A FAMILY HI/ORY
( LAZY EYE AM;G SIBL+S1 P>5TS1 GR&P>5TS1
AUNTS1 & UNCLES4 ,ANY S* HI/ORY %D AL]T
P>5TS 6HAV+ _! * EXAM9$ AT L1/ 0AGE
?REE4 ,AF T1 ! RESULT ( TR1T;T MAY 2
POOR1 ":AS E>LY TR1T;T ( AMBLYOPIA C RE-
SULT 9 NORMAL VI.N4 ,IF 9ITIAT$ E>LY1
PAT*+1 GLASSES1 OR EYE DROPS MAY     #CA
HELP DEVELOP VI.N4 ,APP>5TLY1 !     C#AB
NATURAL ?+ =! EYES 6D IS 6PICK ! EYE T
SEES BE/ )\T GLASSES & 6PREF]5TI,Y FOCUS
) ? EYE = BE/ VI.N4 ,! EYES APP>5TLY FO-
CUS
-------------------------------------#AC
EQU,Y1 S T IF "O EYE SEES WELL ) M9IMAL
FOCUS+1 ? EYE IS 9 FOCUS &! O!R MAY 2
LEFT BLURR$4 ,"!=E1 VI.N 9 ! BLURR$ EYE
DOES N DEVELOP FULLY4 ,3TR>Y 6POPUL>
MY?S1 ! 8W1K EYE0 DOES N 2COME 8/R;G]0
%D "S?+ HAPP5 6! GD EYE4
  ,RET9OPA?Y ( PREMATUR;Y 7,,ROP7 IS A
-PLIC,N = EXTREMELY SMALL1 PREMATURE BA-
BIES1 S* Z ^? LESS ?AN TWO P.DS AT BIR?1
B 0 M -MON 9 YE>S PA/1 :5 UNREGULAT$
AM.TS ( OXYG5 7 GIV5 69CUBATOR BABIES4
,! SEV];Y C V>Y1 B TR1T;T IS USU,Y NEC
6PRES]VE A DEGREE ( USE;L VI.N4





                                     #CB
                   #C                #AD
      ,VI.N ,TE/+ & ,PRO#M ,TR1T;T

,VI.N TE/+ C 2G9 ) VI.N SCRE5+4 ,S* VI.N
SCRE5+ C 2 P]=M$ 0NONPROFES.NAL P]SON-
NEL1 = PRES*OOL OR REGUL> S*OOL PURPOS-
ES1 Z L;G Z X IS "U/OOD T S* SCRE5+ DOES
N REPLACE A PROFES.NAL EYE EXAM9,N4 ,A
PRES*OOL * C LE>N 6D ! 8ILLIT]ATE ;,E
GAME10 USU,Y AF R1*+ AGE ?REE4 ,? TE/
9VOLVES AN EYE *>T -POS$ 5TIRELY (! LR
;,E1 TURN$ 9 DI6]5T DIREC;NS1 &1 L A
REGUL> 8,SNELL50 EYE *>T1 >RANG$ 9 R[S (
SMALL] & 9CR1S+ DI6ICULTY4 ,"S"O :O C'T
R1D ,5GLI%1 OR A SMALL *1 C LE>N 6PO9T :
WAY ! 8F+]S0 PO9T ON ! LR ;,E4 ,A DI6];E
9 P]=M.E 2T EYES WD SU7E/ ! NE$ =A PRO-
FES.NAL EXAM 6RULE \ NE$ = GLASSES OR
AMBLYOPIA4 ,SCRE5+ TE/S UTILIZ+ ! USUAL
,SNELL5 *>TS C AL 2 P]=M$ LAT] ONCE (
S*OOL AGE1 & >E LIKELY 6BE M A3URATE 9
4COV]Y ( VI.N PRO#M4 ,FAILURE1 ( C\RSE1
WD SU7E/ ! NE$ =A PROFES.NAL EXAM1 EV5
?\< ! SCRE5+ TE/S MAY / 2 9A3URATE4
,PASS+ ! VI.N SCRE5 IS REASSUR+ &    #CC
SU7E/S NO SIGNIFICANT 4T.E VI.N     A#AD
PRO#M OR S]I\S A/IGMATISM4 ,H["E1 ^!
TE/S _C DETECT R1D+ PRO#MS1 ! HI/ORY ( :
SU7E/S ! NE$ = SEE+ AN EYE DOCTOR4 ,C]-
TA9LY1 A FAMILY HI/ORY ( EYE PRO#MS1 IN-
CLUD+ ! NE$ = GLASSES1 IS HELP;L 9 DET]-
M9+ ! NE$ =A PROFES.NAL EXAM4
  ,MOD]N SCRE5+ TE/S N[ 9CLUDE PHOTO-
SCRE5+ & PHOTOREFRACTORS1 NEW TE*NOLO-
GIES T MAY "W WELL ) SMALL *N1 B ^: CUR-
R5T AVAILABIL;Y MAY MAKE !M IMPRACTICAL
= L>GE-SCALE SCRE5+ ( *N4 ,G5],Y1 ,I FA-
VOR S*OOL EYE-SCRE5+ EXAMS1 & WI% T !Y 2
M UNIV]S,Y AVAILA#4 ,Z ! ,N,NAL ,9/ITUTE
( ,H1L? 7,,NIH7 REC5TLY 9F]R$1 TRA9$ LAY
P]SONNEL C Q E6ECTIVELY P]=M PRES*OOL
SCRE5+ EXAMS4 ,H["E1 "! IS "S 3TROV]SY Z
REG>DS ! NE$ = LEGISLAT$ PROFES.NAL EYE
EXAMS1 : >E PROPOS$ 0"S4 ,UN=TUNATELY1
^? :O PROPOSE ^! EXAMS >E (T5 LIKELY TO
OV]DIAGNOSE & OV]PRESCRIBE GLASSES1 Z
/UDIES %[4 ,"O /UDY %[$ T #CD P]C5T (
PROFES.N,Y SCRE5$ *N1 Z WD 2 ! CASE VIA
=C$ LEGISL,N1 7 GIV5
                                     #CD
GLASSES1 ":AS ONLY #C P]C5T ( ?      #AE
SAME TE/ GR\P _H GLASSES RECOMM5D$ 0A
P$IATRIC OPH?ALMOLOGI/4 ,H["E1 ,I AGREE
T OV]REF]RAL = EYE EXAMS--= EXAMPLE1 (
*N :O >E N P]=M+ ! SCRE5+ TE/ 6_! CAPA-
BIL;Y--IS PREF]A# 6OV]LOOK+ *N :O NE$
ATT5;N4
  ,R1D+ 4ABILITIES1 ( AT L1/ "S DEGREE1
>E V -MON AM;G "Y S*OOL*N4 ,? CR1TES
3C]N AM;G P>5TS & T1*]S1 B PRO#MATIC,Y1
^! 3DI;NS >E FREQU5TLY OV]EMPHASIZ$ &
OV]DIAGNOS$4 ,X IS TOO EASY 6BLAME LACK
( P]=M.E ON "S SPECIAL PRO#M T REQUIRES
SPECIAL TR1T;T4 ,= EXAMPLE1 ! T]M 8DYS-
LEXIA0 IS GRTLY OV]US$1 ":AS X IS RE,Y A
Q R>E 3DI;N ":BY R1D+ MAY P]SI/ Z A
PRO#M "?\T LIFE4 ,MO/ R1D+ & LE>N+ 4A-
BILITIES RESPOND 6PATI;E & SPECIAL ATT5-
;N & D N REQUIRE ! TYPE ATT5;N NE$$ =
TRUE DYSLEXIA4 ,9 O!R ^WS1 EXTRA S*OOL+
9 R1D+ SKILL W USU,Y HELP MO/ *N :O >E
9ITI,Y SL[ 6LE>N1 & _M *N >E WR;GLY LA-
BEL$ Z REQUIR+ SPECIALI/ ATT5;N4 ,DYS-
LEXIA & ATT5;N DEFICIT 4ORD] 7,,ADD7 >E
BO? T]MS T >E (T5 OV]US$1 B X IS     #CE
"U/&A# H[ P>5TS & T1*]S >E QK TO    A#AE
R1* = ANY HELP AVAILA# =A *4 ,UN=TUNATE-
LY1 "S WEIRD =MS ( TR1T;T H SURFAC$1 S*
Z EYE EX]CISES1 CREEP+ & CRAWL+ ME?ODS1
& R$-T9T$ GLASSES4 ,ANO!R !ORY HAS SUG-
GE/$ T A * ) CROSS-DOM9.E1 = EXAMPLE A *
:O FIXATES )! LEFT EYE1 ?\< "R-H&$1 MAY
H RESULTANT R1D+ PRO#MS4 ,H["E1 /UDIES (
^? )\T R1D+ PRO#MS WD %[ ! SAME 9CID;E (
CROSS-DOM9.E4 ,C]TA9LY ! PAT*+ 9 ATTEMPT
6*ANGE ! DOM9.E IS FRUIT.S4 ,S9CE "! IS
A V GD PROGNOSIS = IMPROVE;T ( ALL R1D+
4ORD]S ) ANY SPECIAL ATT5;N 6! PRO#M1
APP>5T IMPROVE;T IS (T5 FALSELY TAK5 Z A
SIGN T S* ?+S Z EYE EX]CISES DES]VE CR$-
IT =! IMPROVE;T4 ,Z = GLASSES1 X IS
PROBABLY BE/ 6]ROR ON ! SIDE ( TR1T;T 9
8BORD]L9E0 9DIC,NS R ?AN IGNORE ANY POS-
SI# HELP =! * )A R1D+ 4ORD]4 ,B1 9 MO/
CASES1 X IS AN OV]SIMPLIFIC,N1 & USU,Y A
FALSE DIAGNOSIS1 6BLAME R1D+ & LE>N+
4ORD]S Z DUE 6EYE ABNORMAL;Y4
  ,:AT AB SPORTS1 & 9DIC,N = GLASSES OR
O!R TR1T;T 9 A?LETICS8 ,"Y P 9VOLV$ 9
A?LETICS NE$ "S GUID.E4 ,VISUAL      #CF
NE$S V>Y P] SPORT4 ,= EXAMPLE1 A    B#AE
BOY :O IS #A DIOPT] NE>SI<T$ MAY P]=M
,,OK )\T GLASSES 9 SO3]1 FOOTBALL1 &
BASKETBALL4 ,B 9 BASEBALL1 ": HE HAS TO
SEE 6HIT ! FA/-MOV+ SMALL] BALL1 OR 9
T5NIS1 ESPECI,Y AT NI<T1 ": HE HAS 6PLAY
"U LI<TS1 ! GLASSES MAY WELL 2 APPRECI-
AT$4 ,! M NE>SI<T$ * MAY NE$ GLASSES =
ALL SPORTS4 ,! F>SI<T$ * OR ^? ) MOD]ATE
A/IGMATISM MAY P]=M WELL )\T GLASSES 9
MO/ SPORTS4 ,ASK YR EYE DOCTOR IF X IS
RE,Y NEC = ? * 6WE> ! GLASSES 9 SPORTS8
,ANO!R PRO#M1 ( C\RSE1 IS T ! GLASSES
MAY GET 9 ! WAY1 FALL (F1 OR GET BROK54
,SPECIAL SPORTS GLASSES FRAMES >E HELP-
;L1 & :5 ! * 2COMES OLD 5\<1 3TACT L5SES
MAY 2 SUB/ITUT$4 ,2C ( RUMORS ( SUP] VI-
.N 9 A?LETES1 S* Z ,T$ ,WILLIAMS1 "! MAY
2 (F]S
-------------------------------------#AF
( SPECIAL EX]CISES OR GLASSES 6GIVE SUP]
VI.N4 ,ACTU,Y1 _M P >E A# 6SEE BETT] ?AN
#BJ_/BJ ) OR )\T GLASSES1 & ? CAPABIL;Y
_C 2 TAU<T OR IMPROV$ ^U ONCE EYE MATUR-
;Y IS R1*$4 ,I 2LIEVE T C]TA9        #CG
A?LETES H ! GIFT ( SUP] 3C5TR,N1    A#AF
AL;G ) GD EYE-H& COORD9,N1 & ? RESULTS 9
_! APP>5T VISUAL EXCELL;E4 ,I D\BT T ?
COORD9,N C 2 TAU<T1 B ,I AM SURE 3C5TR,N
C 2 IMPROV$ ) EXP]I;E4
  ,AM;G ! LATE/ PRACTICES1 5C\RAG$ 0PRO-
FES.NAL BASEBALL PLAY]S1 IS ! WE>+ (
COLOR$ 3TACT L5SES 7R$7 & UTILIZ+ A TE*-
NIQUE ( WAT*+ T5NIS BALLS ) NUMB]S PA9T$
ON !M4 ,03C5TRAT+ ON SEE+ ! NUMB]S1 "S"O
A# 6HIT ! BALL CD 2 EXPECT$ 6P]=M BETT]
9 BASEBALL OR T5NIS4 ,R ?AN CLAIM SUP]
VI.N1 ,I ?9K ? IS AN EXAMPLE ( LE>N+ TO
9CR1SE 3C5TR,N4
  ,! DETEC;N ( AMBLYOPIA1 OR LAZY EYE1
IS "O (! MA9 R1SONS = VI.N SCRE5+ 9 PRE-
S*OOL *N4 ,! AMBLYOPIC EYE IS /RUCTUR,Y
NORMAL1 B DOES N SEE WELL EV5 ) GLASSES4
,P (T5 MISTAK5LY REF] 6A LAZY EYE Z "O T
DOES N APPE> /RAI<T & SEEMS 6W&]4 ,!
EYE'S TURN+ 9W>D T[>D ! NOSE IS ESOTRO-
PIA 7CROSS-EY$7 & TURN+ \TW>D IS EXOTRO-
PIA 7WALLEY$74 ,! MO/ -MON CAUSE ( AM-
BLYOPIA IS 2+ CROSS-EY$1 & IF "O EYE IS
NOT$ 6BE ALW ! "O CROSS$1 !N ? "O    #CH
DOES N SEE WELL4 ,! SECOND-MO/      B#AF
-MON CAUSE ( AMBLYOPIA IS ANISOMETROPIA1
9 : "O EYE T 8NE$S GLASSES0 IS SIGNIFI-
CANTLY DI6]5T F ! BETT] EYE4 ,9 A WAY1 !
CROSS-EY$ * IS M =TUNATE 9 ! TR1T;T (
AMBLYOPIA1 2C ! P>5TS C SEE SU7E/IVE EV-
ID;E T ! *'S EYES >E N NORMAL4 ,9 ANISO-
METROPIA1 TOO (T5 ! PRO#M IS N 4COV]$
UNTIL ! * IS 9 S*OOL & TOO OLD 6BE TR1T$
SU3ESS;LLY4 ,AMBLYOPIA C 2 MILD1 OR S
BAD Z 6BE LEG,Y BL1 ) NO HOPE ( "E SEE+
BETT] )! 8BAD EYE40 ,! 8SITE0 ( AMBLYO-
PIA IS 9 ! BRA91 N ! EYE1 & ? HAS BE5
EXP]I;T,Y PROV$ 9 ANIMALS 6BE 9COMPLETE
DEVELOP;T (! LAT]AL G5ICULATE BODY4 ,!
EYE LOOKS P]FECTLY NORMAL ANATOMIC,Y1
EV5 ) C>E;L EXAM9,N4 ,APP>5TLY1 9 ORD]
6AVOID D\# VI.N1 ! BRA9 SUPPRESSES1 OR
TURNS (F1 ! C5TRAL POR;N ( VI.N4 ,? M1NS
T1 3TR>Y 6! CLOS+ ( "O EYE1 ! P]IPH]AL
VI.N IS RETA9$1 S T P ) AMBLYOPIA C H 5
SIDE VI.N 6FUNC;N WELL :ILE DRIV+ A C> &
9 MO/ SPORTS1 RETA9+ A =M ( B9OCUL> VI-
.N4 ,B IF "S?+ "E HAPP5$ 6_! GD EYE1 !
SECOND-BE/ EYE WD N"E IMPROVE =      #CI
R1D+ &= ?+S T REQUIRE GD VI.N4 ,9   C#AF
E>LY *ILDHOOD1 ! BRA9 IS RELATIVELY
FLEXI# & A# 6IGNORE ! C5TRAL VI.N 9 "O
EYE S Z 6AVOID 3FU.N1 Z MI<T 2 CAUS$ BY
D\# VI.N4 ,! EYE MO/ P]FECT 9 FOCUS IS
USU,Y *OS5 2C X IS ! EASIE/ 6USE4 ,!
EYES D N APP>5TLY FOCUS SEP>ATELY1 S IF
#B DIOPT]S ( FOCUS+ IS REQUIR$ 9 "O EYE1
& #E DIOPT]S 9 ! O!R EYE1 ! LESS] AM.T (
FOCUS+ IS *OS51 : L1VES ! M F>SI<T$ EYE
\ ( FOCUS DUE 6ANISOMETROPIA4 ,X IS 9T]-
E/+ T IF BO? EYES NE$ GLASSES R BADLY1
VI.N DEVELOP;T SEEMS 6TAKE PLACE EQU,Y
WELL1 & VI.N MAY 2 RELATIVELY NORMAL
ONCE
-------------------------------------#AG
GLASSES >E PRESCRIB$1 EV5 :5 "O IS OLD]4
,H["E1 9 "S CASES1 IF A SIGNIFICANT UN-
CORRECT$ REFRACTIVE ]ROR IS PRES5T UNTIL
ADULT LIFE1 BO? EYES MAY N SEE P]FECTLY
WELL1 EV5 ) CORRECTIVE GLASSES4
  ,! TR1T;T ( AMBLYOPIA AM.TS 6=C+ ! *
6USE ! NONPREF]R$ EYE4 ,? AM.TS 6COV]+ !
8GD EYE10 USU,Y 0AN ADHESIVE EYE PAT*4
,! SOON] ! TR1T;T IS 2GUN1 ! BETT]   #DJ
! EXPECT$ RESULT4 ,_M NEWBORNS H    A#AG
RELATIVELY W&]+ & NONFOCUS+ EYES4 ,BA-
BIES D N USU,Y FIXATE WELL1 S* Z 6A LI<T
OR OBJECT1 UNTIL AB ?REE MON?S OLD1 &
VI.N IS Q IMMATURE UNTIL SIX MON?S OLD4
,S IF ! BABY'S EYES >E ALW CROSS$ OR N
/RAI<T1 A PROFES.NAL EYE EXAM IS 9DICAT-
$4 ,H["E1 IF ! EYES ONLY "S"TS DON'T
LOOK /RAI<T1 X IS ,,OK 6WAIT4 ,B IF !
BABY IS SIX MON?S OLD1 &A P>5T / ?9KS !
EYES LOOK CROSS$1 OR N /RAI<T1 EV5 IF J
"S"TS1 !N X IS N TOO SOON 6GET ! BABY
EXAM9$4 ,AT S* AN E>LY AGE1 PAT*+ MAY N
TAKE L;G 6HELP4 ,& WE DON'T H 6WAIT UN-
TIL ! * "KS ! ALPHABET 63FIRM SU3ESS4 ,!
ABIL;Y 6FIXATE & HOLD FIX,N ) EA* EYE1
ON A DOCTOR'S P5LI<T = EXAMPLE1 HELPS
DEMON/RATE T BETT] VI.N HAS DEVELOP$4
  ,PAT*+ MAY SEEM CRUEL 6"S P>5TS1 & !Y
MAY N 2 GD AB 5=C+ ! RULE ( PAT*+ ALL !
WAK+ H\RS4 ,"S *N >E M DI6ICULT 6D1L )
?AN O!RS4 ,PRO#MS 9 PAT*+ %D 2 4CUSS$ )!
EYE DOCTOR S ! DOCTOR IS N S SURPRIS$ :5
X DOESN'T SEEM 6BE "W+4 ,M$ICAL PAT*+
MAY 2 D"O US+ ATROP9E EYE DROPS TO   #DA
DILATE ! GD EYE S T XS TEMPOR>Y     B#AG
LACK ( FOCUS+ ABIL;Y MAKES X SEEM UNDE-
SIRA# 6USE -P>$ )! AMBLYOPIC EYE1 : C /
FOCUS NORM,Y4 ,? HAS 6BE C>E;LLY SUP]-
VIS$ 0! EYE DOCTOR1 B DOES N REQUIRE S
M* COOP],N4 ,REC5T /UDIES H %[N T X MAY
ONLY 2 NEC 6USE ATROP9E DROPS ON WEEK-
5DS1 ON *N ( UP 6AGE SEV54 ,H["E1 MO/
PAT*+ IS RELATIVELY UNSU3ESS;L 0! "T ! *
IS 9 K9D]G>T51 & X IS DEBATA# :E!R ? IS
DUE 6! FACT T X IS TOO LATE 7! BRA9'S 2+
IS TOO WELL DEVELOP$71 OR DUE 6A -B9,N (
LACK ( 5?USIASM (! *1 P>5TS1 & T1*]S4
,P]=M.E 9 S*OOL IS HELD Z SUPREME 9
GOAL1 & FAILURE (A * 6MEET EXPECT,NS 9
S*OOL MAY 2 BLAM$ ON ! PAT*+4
  ,:AT IS A GD RESULT (! TR1T;T ( AMBLY-
OPIA8 ,WELL1 ANY IMPROVE;T HELPS ASSURE
LESS H&ICAP %D "S?+ HAPP5 6! BETT] EYE4
,SU/A9$ VISUAL DEVELOP;T 9 *ILDHOOD M1NS
T ? VI.N W ALW 2 AVAILA# 9 ! NONPREF]R$
EYE1 NO MATT] : WAY ! EYE PO9TS1 L M"OY
9 ! BANK4 ,! 3TR>Y--T ! EYE MAY DEVELOP
VI.N LAT] IF NE$$--IS1 UN=TUNATELY1 N
TRUE4 ,! BE/ ! EYE W "E SEE IS :AT   #DB
X CD SEE ) CORRECTIVE GLASSES 9     C#AG
E>LY S*OOL AGE4 ,ANO!R R1SON 6TRY 6GET
NORMAL VI.N IS T 9 ! CASE (! CROSS-EY$ *
:O NE$S SURG]Y 6/RAI<T5 ! EYES1 ! ONLY
HOPE ( ATTA9+ NORMAL B9OCUL> VI.N IS 6H
EQU,Y GD VI.N 9 BO? EYES4 ,IF "O EYE IS
/ ! SECOND-BE/ EYE1 !N EV5 ?\< ! EYES >E
/RAI<T5$1 !Y W N 2 US$ WELL B9OCUL>LY4
,AL1 ! P]MAN;E (! SURGICAL RESULT IS AF-
FECT$1 S9CE
-------------------------------------#AH
B9OCUL>;Y HELPS HOLD ! EYES TGR Z A T1M4
,LACK ( B9OCUL>;Y MAY RESULT 9 EV5TUAL
RELATIVE FAILURE (! SURG]Y1 "S"TS RE-
SULT+ 9 ! NE$ = FUR!R SURG]Y = COSMETIC
R1SONS4
  ,B9OCUL> VI.N APP>5TLY DEVELOPS NORM,Y
2T AGE FIVE & N9E & C 2 DESCRIB$ Z /]E-
OPTIC VI.N4 ,9 O!R ^WS1 ! DEP? P]CEP;N
AVAILA# NORM,Y 6^? ) NORMAL /]EOPSIS WD
M1N T LACK ( ? WD MAKE ! #C-;,D GLASSES
UNHELP;L = #C-;,D MOVIES4 ,AL1 B9OCUL>S
WD N 2 Z USE;L4 ,H["E1 "! >E DEGREES (
B9OCUL> VI.N1 S T EV5 ^? ) AMBLYOPIA1 :O
8SUPPRESS0 VI.N 9 "O EYE 6AVOID      #DC
D\# VI.N1 D RETA9 P]IPH]AL VI.N1    A#AH
6ATTA9 A K9D ( GROSS B9OCUL>;Y4 ,?1 (
C\RSE1 MAKES A BIG DI6];E 9 SPORTS & C>
DRIV+4 ,"! >E AL MONOCUL> CLUES = JUDG+
4T.E1 S* Z 3V]G+ P>ALLEL L9ES SU7E/+
4T.E T >TI/S USE 9 PA9T+S4
  ,:AT IF ! TR1T;T ( AMBLYOPIA IS UNSUC-
CESS;L1 TOO LATE1 OR TOO LL8 ,WELL1 X IS
N ! 5D (! _W4 ,C]TA9LY1 X IS IMPORTANT
6TRY \R BE/ 6A*IEVE ! BE/ VI.N POSSI#4
,H["E1 IF WE ALL TRI$ \R BE/1 T IS Z GD
Z WE C D4 ,MO/ IMPORTANTLY1 Z L;G Z "O
EYE IS NORMAL 9 VI.N DEVELOP;T1 "! IS N
EXPECT$ 6BE ANY SIGNIFICANT H&ICAP 9
S*OOL OR ADULT P]=M.ES4 ,! GD EYE W N
WE> \1 & X IS "U NO GRT /RA9 TO 8D ! "W
( TWO EYES40 ,O!R ?AN P]H MAJOR L1GUE
BASEBALL1 ,I C'T ?9K ( ANY SPORT ": LACK
( #AJJ P]C5T DEP? P]CEP;N HAS BE5 A SIG-
NIFICANT H&ICAP4 ,I H P]SON,Y EXAM9$ A
,HALL ( ,FAME PRO BASKETBALL PLAY]1 &A
PROFES.NAL HOCKEY L1GUE GOALIE1 BO? (
:OM 7 ONLY US+ "O EYE4 ,AB ! ONLY JOB
RE/RIC;N IS ( 2COM+ AN A/RONAUT1 2C 9
8\T] SPACE0 ! LACK ( DEP? P]CEP;N    #DD
IS M (A PRO#M DUE 6LACK ( MONOCU-   B#AH
L> CLUES4 ,&= SURE1 *N ) AMBLYOPIA >E N
6BE 3SID]$ H&ICAPP$1 9 ANY WAY4 ,R1D+
4ORD]S >E N ANY M -MON ) AMBLYOPIA4 ,WE
EXPECT NORMAL S*OOL & A?LETIC P]=M.ES2
NO EXCUSES4 ,WE >E MA9LY 3C]N$ )! ACTIV-
ITIES T 9VOLVE 9CR1S$ DANG] ( EYE 9JURY1
S* Z 9 C]TA9 SPORTS4 ,"O C GET A DRIV]'S
LIC5SE1 EV5 IF ! 8BAD EYE0 SEES NO BETT]
?AN #BJ_/BJJ1 ) GLASSES4 ,A PRO#M CD EX-
I/ )! AMBLYOPIC P]SON ) ANISOMETROPIA1
IF VI.N C 2 "S:AT IMPROV$ ) GLASSES4 ,B
IF A P]SON IS N US$ 6WE>+ GLASSES 2C (
M>K$ DI6];E 2T ! EYES1 YR EYE DOCTOR C
FILL \ A MOTOR VEHICLE =M 6HELP1 0PO9T+
\ T ! GLASSES D N IMPROVE FUNC;N1 & MAY
ACTU,Y CAUSE VISUAL 3FU.N4
  ,COLOR BL;S IS N USU,Y ! *IEF -PLA9T T
L1DS 6AN EYE EXAM1 B IS "S?+ EASY 63FIRM
0TE/+4 ,ACTU,Y1 S* P >E N 8BL02 _! VI.N
IS USU,Y NORMAL1 B ! PRO#M IS 4CRIM9,N
2T %ADES ( COLORS1 USU,Y 9 ! R$-GRE5 >-
EA1 & N "PICUL>LY H&ICAPP+4 ,X IS A SEX-
L9K$ H]$IT>Y PRO#M 9 MO/ CASES & A6ECTS
AB #E P]C5T ( MALES 9 ! ,UNIT$       #DE
,/ATES ( ,AM]ICA4 ,! TRAIT IS       C#AH
TRANSMITT$ F _! "MS1 ! 8C>RI]0 (! G5E F
H] COLOR-BL "F4 ,= EXAMPLE1 ! SON (A
COLOR-BL MAN W N 2 COLOR BL1 OR EXT5D !
T5D5CY 6HIS *N4 ,ON ! O!R H&1 8 SI/]S W
EXT5D !
-------------------------------------#AI
COLOR-BL TRAIT 6ALL _! SONS4 ,"! >E FEW
LIMIT,NS1 Z A RESULT ( COLOR BL;S1 EX-
CEPT T "MS & WIVES M/ HELP PICK \ TIES1
& S =?4 ,H["E1 "! >E A FEW JOB LIMIT,NS1
Z 9 ELECTRICIANS1 = EXAMPLE4 ,FEMALE
COLOR BL;S IS R>E2 & :5 PRES5T1 X MAY 2
A3OMPANI$ ) REDUC$ VI.N4

      ,USE ,( ,DILAT+ ,EYE ,DROPS

  ,EYE DOCTORS USE EYE DROPS A LOT4 ,WE
USE DILAT+ EYE DROPS 6EXAM9E ! RET9A1 &
O!R EYE DROPS 6TR1T MO/ EYE 41SES4 ,P H
A NATURAL AV].N 6EYE DROPS1 B C LE>N TO
USE !M Z NE$$4 ,9 EYE EXAMS1 PUPIL-
DILAT+ DROPS >E US$ 6GET A BETT] LOOK (!
EYE'S 9T]IOR1 Z LOOK+ "? A W9D[ R ?AN A
KEYHOLE4                             #DF
  ,X US$ 6BE TRUE T "O CD TELL !    A#AI
DI6];E 2T AN OPH?ALMOLOGI/1 A M$ICAL EYE
DOCTOR1 & AN OPTOMETRI/1 0! FACT T !
OPH?ALMOLOGI/ ALW US$ DILAT+ EYE DROPS1
DUR+ AN EYE EXAM B ! OPTOMETRI/ DID N4
,N[1 OPTOMETRI/S1 TOO1 C USE EYE DROPS
DUR+ ! EXAM4 ,2C !Y DID N G 6M$ICAL
S*OOL1 OPTOMETRI/S 7 RE/RICT$1 & CD N
USE OR PRESCRIBE M$IC,N4 ,REC5T /ATE
LAWS H ALL[$ USE ( M$IC,NS1 V>Y+ 0/ATE1
B USE ( DIAGNO/IC M$IC,N S* Z DILAT+
EYEDROPS >E UNIV]S,Y APPROV$4
  ,9 *N1 ESPECI,Y "Y *N1 DILAT+ ! PUPILS
IS ESPECI,Y IMPORTANT 9 M1SUR+ ! EYES'
NE$ = GLASSES OBJECTIVELY 0A RET9OSCOPE4
,2C ( COOP],N LIMIT,NS ( *N1 OBJECTIVE
M1SURE;T OR E/IM,N ( NE$ = GLASSES IS
EXTREMELY IMPORTANT1 S9CE !Y MAY H PROB-
LEMS LOOK+ "? 9/RU;TS & MA9TA9+ ATT5;N4
,0US+ DILAT+ DROPS1 : RELAX ! FOCUS+ (!
EYE1 X IS USU,Y POSSI#1 IF ONLY BRIEFLY1
6E/IMATE OBJECTIVELY A "Y *'S NE$ =
GLASSES4 ,I H BE5 R\T9ELY US+ S* DROPS1
ESPECI,Y =! 9ITIAL EXAM1 9 ALL *N "U AGE
ELEV51 UN.S PRIOR EXAM HAS 9DICAT$   #DG
T ! * C D WELL )\T !M SUBJECTIVE-   B#AI
LY4 ,MY DOG1 ,BE>1 = EXAMPLE1 0 A# 6CO-
OP]ATE WELL 5\<3 T :ILE HE SAT / = ME1
,I 0 A# 6TELL ) RET9OSCOPY1 T HE DID N
8NE$ GLASSES40 ,H["E1 HE PROBABLY SAT M
/ ?AN MO/ "Y *N4 ,WELL1 ANYWAY1 KIDS D N
L EYE DROPS1 & X IS HELP;L IF ! P>5TS >E
PREP>$ = !M1 & SUPPORTIVE4 ,X IS PROBA-
BLY N A GD IDEA 6M5;N ! EYE DROPS 2F !
EXAM1 B X IS HELP;L IF ! P>5TS >E FIRM &
SUPPORTIVE :5 ! EYE DROPS >E US$4 ,I
USU,Y SAY1 8,NURSE ,NANCY IS GO+ 6PUT 9
"S MAGIC EYE DROPS10 & !N L1VE4 ,! KIDS
>E !N MAD AT ,NANCY1 & N ME4 ,:5 ,I RE-
TURN 6F9I% ! EXAM1 ,I C REASSURE1 8,NO M
EYE DROPS10 & PROCE$4
  ,A4I;NAL FACTORS AB *N EYE EXAMS IN-
CLUDE RELATIVE FREQU5T UNRELIABIL;Y ( _!
-PLA9TS4 ,NORMAL * 2HAVIOR HAS 6BE "U-
/OOD1 2F CRITICISM 9 ? 4CUS.N4 ,MO/ *N
:O -PLA9 ( TR\# SEE+ 6R1D1 OR HAV+ H1D-
A*ES1 USU,Y D N H EYE PRO#MS1 OR NE$
GLASSES4 ,ON ! 3TR>Y1 ^? :O D NE$ HELP D
N USU,Y -PLA94
                                     #DH
,^? :O NE$ GLASSES (T5 D N "K :AT    #BJ
IS NORMAL VI.N1 & PRO#MS C SN1K UP ON
!M1 ESPECI,Y ON ! NE>SI<T$ *4 ,TR\# SEE+
?+S ON ! 8BO>D0 C (T5 2 ! F/ 9DIC,N1 :5
! * NOTES T O!R *N _! AGE C SEE ! ?+S ON
! 8BO>D0 EASILY4 ,"S ( ^! NE>SI<T$ *N C
2 NOT$ TO 8SQU9T0 6SEE BETT]1 B EXCES-
SIVE BL9K+ (! EYES1 SQU9T+1 & C]TA9 FA-
CIAL EXPRES.NS >E (T5 J TRANSI5T MANN]-
ISMS1 & N NECESS>ILY A SIGN ( EYE 41SE
OR NE$ = GLASSES4 ,! IMPORTANT ?+ IS 6H
! * EXAM9$1 & N 2 SURPRIS$ IF GLASSES >E
N 9DICAT$4 ,"S"TS1 H["E1 X IS AL IMPOR-
TANT 6LI/5 63SI/5T -PLA9T1 9 SPITE (
8NORMAL0 F9D+S4 ,ONCE1 /UCK = AN ANSW]
6A BOY 9 8 E>LY TE5S1 ,I NOT$ T HE 0
TAK+ ACUTANE = 8 ACNE1 & LOOK$ UP ! M$I-
C9E 9 MY ,PHYSICIAN'S ,DESK ,REF];E4
,SURE 5\<1 ! DRUG C CAUSE VISUAL PRO#MS
& H1DA*ES1 : HE DESCRIB$4 ,8 "F1 :O AC-
-PANI$ ! BOY =A SECOND OP9ION1 0 Q REAS-
SUR$ 6"K T 8 SON 0 N MAL+]+1 S9CE HE
TRU/$ 9 8 SON S M*4 ,LAT]1 HE CALL$ &
TOLD ME T ! SYMPTOMS _H 4APPE>$ :5 ! M$-
IC9E 0 4CONT9U$1 : MADE ME Q         #DI
HAPPY1 TOO4                         A#BJ

           ,EXAM9,N (! ,EYES

   ,! F/ BASIC "P ( AN EYE EXAM9,N IS TO
*ECK VI.N4 ,IF VI.N IS ABNORMAL OR SUB-
NORMAL1 !N A R1SON M/ 2 F.D4 ,IF ! R1SON
IS T GLASSES >E NE$$ 6SEE BETT]1 !N ? IS
REASSUR+4 ,IF GLASSES _C CORRECT ! VI.N1
!N WE M/ SE>* = ANO!R R1SON4 ,H["E1 !
DEGREE ( ABNORMAL;Y IS ! V>I,N 2T BE/-
CORRECT$ VI.N & NORMAL VI.N1 N 0H[ POOR-
LY A P]SON SEES SUBJECTIVELY )\T GLASS-
ES4 ,S ? PO9T _C 2 OV]EMPHASIZ$3 ! BA-
SIC1 9ITIAL "P ( AN EYE EXAM9,N IS 6SEE
H[ WELL ! EYE C SEE4 ,"S"TS ! EYES >E S
OBVI\SLY 9FLAM$ OR 9JUR$ Z 69DICATE T !
VI.N W 2 WORSE ?AN USUAL1 B WE NE$ 6GET
AN IDEA ( H[ BAD ! PRO#M A6ECTS ! EYE1
ON ! BASIS ( H[ POOR ! VI.N HAS 2COME4
,WE C ALW *ECK = GLASSES :5 ! EYE IS
H1L?I]1 B WE C GET AN IDEA ( VI.N POT5-
TIAL ON 9ITIAL EXAM9,N4 ,POT5TIAL = BET-
T] VI.N C 2 E/IMAT$ 0:AT IS CALL$ A P9-
HOLE TE/4 ,A DISC FILL$ ) SMALL      #EJ
HOLES ALL[S A P]SON 6PEEK "? "O (   B#BJ
! HOLES1 & AN IMPROVE;T ON H[ F> D[N !Y
C SEE ON ! ,SNELL5 *>T SU7E/S EI T !Y
NE$ GLASSES OR _! PRES5T GLASSES >E N
CORRECT1 OR T POT5TIAL = BETT] VI.N IS
PRES5T 9 ! FACE (A CAT>ACT4 ,A R$ EYE
DUE TO 8P9K EYE0 USU,Y DOES N A6ECT VI-
.N1 ":AS A R$ EYE DUE 6GLAUCOMA OR IRI-
TIS MAY 2 ASSOCIAT$ ) DROP 9 VI.N4 ,MO/
VI.N TE/+1 H["E1 IS 9 ! C\RSE ( R\T9E
EYE EXAM9,N1 ":BY A P]SON MAY OR MAY N
-PLA9 ( VISUAL PRO#MS4
  ,! M1SURE;T ( VI.N & NE$ = GLASSES IS
BO? SUBJECTIVE & OBJECTIVE4 ,"! >E WAYS
6M1SURE VI.N POT5TIAL1 OBJECTIVELY1 OR !
NE$ = GLASSES1 OBJECTIVELY4 ,! MO/ -MON
IS ! RET9OSCOPE1 AN 9/RU;T US$ 0! EXAM9]
)! REFRACTOR 9/RU;T OR TRIAL L5SES 9
PLACE4 ,? IS
-------------------------------------#BA
ESPECI,Y HELP;L 9 *N & 9 ALL 9ITIAL EX-
AMS4 ,MOD]N 9/RU;T,N HAS RESULT$ 9 AUTO-
MATIC REFRACTORS1 MA*9ES T C RELATIVELY
A3URATELY M1SURE ! REFRACTIVE /ATE (!
EYE1 ! NE$ = GLASSES4 ,"S"TS ^!      #EA
NEW MA*9ES C SEEM 6%ORT5 EYE EX-    A#BA
AM9,N1 S T -M]CIAL 5T]PRISES1 @A LA ^?
AT MALLS1 C QKLY 8GR9D \0 YR NE$ =
GLASSES4 ,9 (FICE PRACTICE1 H["E1 EYE
DOCTORS H ALW "KN T "! IS ACTU,Y AN 8>T0
6REFRACT+1 & DET]M9+ :AT GLASSES A PA-
TI5T MAY REQUIRE4 ,! SUBJECTIVE "P (!
EXAM 9VOLVES ASK+ PATI5TS :AT !Y APPRE-
CIATE Z HELP;L 6SEE BE/ &! EXP]I;E 9 "K+
:AT RESPONSES >E RELIA#4 ,S ! OBJECTIVE
M1NS ( M1SUR+ VI.N IS HELP;L1 B ! SUB-
JECTIVE POR;N (! EXAM IS DEF9+ 9 T]MS (
DET]M9+ ! PRESCRIP;N = GLASSES1 IF NE$$4
  ,9CLUD$ 9 ! SUBJECTIVE 8>T0 ( REFRAC;N
IS ! ABIL;Y 6DETECT :5 A PATI5T RESPONSE
IS 9A3URATE OR 9CONSI/5T1 2C ( 9T5T1
MIS"U/&+1 OR 9CAPAC;Y4 ,9 *N1 ? IS IM-
PORTANT4 ,0! WAY1 IF A * DOES N D Z WELL
Z IS CAPA#1 OR ACTS Z IF "S?+ IS WR;G1
EV5 IF N S1 ? IS N Z S]I\S Z S* P]=M.E
:5 AN ADULT DOES S1 & IS BASIC,Y =GIVA#
9 AN EYE EXAM4 ,(T51 *N >E 9FLU;ED BY
PE]S4 ,9 CASES ": AN OBJECTIVE EXAM SUG-
GE/S NO NE$ = GLASSES B ! * SEEMS 6DEM-
ON/RATE SUBNORMAL VI.N1 TRICK]Y      #EB
(T5 "WS4 ,0US+ PATI;E & "S TRICK-   B#BA
]Y1 X IS (T5 POSSI# TO 8IMPROVE0 ! VI.N
6NORMAL ) W9D[-GLASS TYPE GLASSES1 M1N+
) LL OR NO?+ 9 ! REFRACTOR MA*9E4 ,? IS
CALL$ A 8TOO?PA/E0 REFRAC;N2 Y H TO
8SQUEEZE X \ ( !M40 ,"S"TS TRICK]Y
FAILS1 & 2C (A LACK ( OBJECTIVE SIGN (A
PRO#M1 ! * & P>5TS >E REASSUR$ T NO
TR1T;T IS NEC4 ,H["E1 ,I H LE>N$ 6SU7E/
FOLL[-UP EXAM 9 AT L1/ "O YE> 63FIRM ?+S
>E ,,OK1 ESPECI,Y 2C ( "O PATI5T4
  ,YE>S AGO1 :ILE "W+ 9 A L>GE MULTISPE-
CIALTY CL9IC1 ,I EXAM9$ A BOY :O 0 AB
TWELVE YE>S OLD4 ,8 "M REPORT$ T A WELL-
"KN OPH?ALMOLOGI/ 9 ! -MUN;Y _H EXAM9$ !
* "O OR TWO YE>S PREVI\SLY & _H 3CLUD$ T
! * 0 N ADMITT+ H[ WELL HE CD SEE4 ,9
O!R ^WS1 ! DOCTOR 0 SU7E/+ A =M ( 3V].N
HY/]IA 9 ! FACE (A NORMAL EYE EXAM4 ,2C
! BOY'S P$IATRICIAN 0 AL 9 MY CL9IC1 ,I
CD R1D ON ! *>T A SEQU;E ( EV5TS4 ,! BOY
0 REF]R$ 6A PSY*IATRI/1 :O 3CLUD$ T !
BOY _H A BAD REL,N%IP ) 8 "F4 ,! "F 0
DRAWN 96!RAPY 9 ORD] 6T1* HM H[ BETT] TO
RELATE 6HIS SON1 & 0 L$ 62LIEVE T    #EC
S* AN IMPROVE;T MAY HELP ! * EV5-   C#BA
TU,Y SEE BETT]4 ,9FLU;ED 0? 9=M,N1 ,I 0
9ITI,Y IMPRESS$ 0! BOY'S )DRAWN ATTITUDE
&! FACT HE DIV]T$ 8 GAZE :ILE TALK+1 S Z
6N LOOK ME 9 ! EYE4 ,OBJECTIVE EXAM9,N
SU7E/$ ! BOY DID N EV5 NE$ GLASSES1 &
SUBJECTIVELY ,I CD N GET HM 6ADMIT BETT]
?AN #BJ_/BJJ VI.N4 ,!N ,I LOOK$ 9SIDE 8
EYES1 AT 8 RET9A1 & PRACTIC,Y CRI$4 ,!
POOR BOY _H SIGNS ( MACUL> DEG5],N1 ,/>-
G>DT'S 41SE1 & 0 N"E GO+ 6SEE NORM,Y1 NO
MATT] H[ GD 8 REL,N%IP 2CAME ) 8 "F4 ,?
TYPE ( MACUL>
-------------------------------------#BB
41SE 9 *N 2COMES SYMPTOMATIC 2F SIGNS >E
EVID5T 9 ! EYE1 S ! PRIOR OPH?ALMOLOGI/
_H N BE5 GUILTY ( MISS+ ? DIAGNOSIS4 ,!
BOY1 H["E1 0 4TRAU<T :5 9=M$ T HE 0 N
GO+ 6SEE BETT]4 ,HE PREF]R$ ! IDEA T "S-
"D 8 VI.N WD IMPROVE1 T ! PRO#M 0 ALL
M5TAL1 & TEMPOR>Y4 ,LAT]1 ! FAMILY MOV$
6,MI*IGAN & AN EXP]T ON ,/>G>DT'S 41SE1
,DR4 ,H>OLD ,FALLS ,I 2LIEVE1 3FIRM$ MY
DIAGNOSIS4 ,! MO/ IMPORTANT LESSON ,I
LE>N$1 ?\<1 0 T IF ,I _C 2 SURE T    #ED
A *'S EYES >E PROBABLY NORMAL1 !N   A#BB
,I %D SU7E/ ANNUAL EXAMS UNTIL WE C DEM-
ON/RATE T ! * C TRULY SEE NORM,Y4 ,& ,I
H N"E SE5 ANO!R CASE ( ,/>G>DT'S 41SE4
  ,EXT]NAL EXAM9,N1 ( C\RSE1 IS IMPOR-
TANT 9 SCRE5+ = EYE 41SE4 ,! EYES >E
*ECK$ = ANOMALIES (! PUPILS1 EYELIDS1
EYE ALIGN;T1 SIGNS ( 9FLAMM,N1 OR P]IPH-
]AL VI.N LIMIT,N4 ,! 9TRAOCUL> PRESSURE
IS *ECK$ 6SCRE5 = GLAUCOMA4 ,MICROSCOPIC
EXAM9,N IS P]=M$ US+ A SLIT LAMP1 A MAG-
NIFY+ DEVICE T ALL[S EXAM9,N (! CORNEA1
ANT]IOR *AMB]1 & L5S1 (! EYE1 &! ANT]IOR
OR FRONT ?IRD (! EYE4 ,_M 41SES C ONLY 2
DIAGNOS$ )A SLIT LAMP1 S* Z IRITIS1 H]-
PES SIMPLEX CORN1L 9FEC;NS1 CORN1L ABRA-
.NS1 3TACT L5S -PLIC,NS1 CORN1L OPACI-
TIES & =EIGN BODIES1 TE> DUCT ANOMALIES1
OR IRRITAT+ EYELA%ES4 ,G5]AL DOCTORS
TRY+ 6TR1T ^! 3DI;NS1 >E USU,Y H&ICAPP$
0N HAV+ ! USE (A BIOMICROSCOPE1 ! SLIT
LAMP4 ,AN ATTA*;T 6? 9/RU;T C AL 2 US$ =
M1SUR+ 9TRAOCUL> PRESSURES4
  ,9T]NAL EXAM9,N 9VOLVES LOOK+ "? ! PU-
PIL1 L5S1 & VITRE\S CAV;Y 6! BACK    #EE
(! EYE1 ! RET9A4 ,? PROCESS IS      B#BB
CALL$ FUNDOSCOPY4 ,A DIRECT OPH?ALMO-
SCOPE1 OR "S"TS AN 9DIRECT OPH?ALMO-
SCOPE1 IS US$4 ,A CAT>ACT C OB/RUCT VIEW
(! RET9A1 Z C ANY OPAC;Y ( CORNEA OR !
VITRE\S CAV;Y4 ,! OPTIC N]VE IS EXAM9$ =
SIGNS ( ANOMALY1 9CLUD+ SU7E/IVE SIGNS (
GLAUCOMA4 ,! BLOOD VESSELS >.D ! OPTIC
N]VE >E SCANN$ = SIGNS ( N>R[+1 : >E
SU7E/IVE ( HYP]T5SIVE >T]IOSCL]OTIC DIS-
EASE4 ,SIGNS ( >T]IOL> N>R[+1 AL;G )A
HI/ORY ( HYP]T5.N 2+ TR1T$1 C 3FIRM !
NE$ = TR1T;T4 ,H["E1 IF ! ISSUE IS DE-
SCRIB$ Z 8BORD]L9E10 !N SIGNS ( >T]IOL>
N>R[+ SU7E/ T ! DIAGNOSIS %D ACTU,Y CON-
FIRM HYP]T5.N IS PRES5T1 5 6W>RANT TR1T-
;T4 ,ANY HEMORRHAGES OR EXUDATES 7$EMA
PAT*ES7 >E 6BE NOT$2 & !Y C 2 DUE 6DIA-
BETES1 HYP]T5.N1 OR O!R VASCUL> PRO#MS4
,SCRE5+ EXAMS = DIABETIC RET9OPA?Y >E
RECOMM5D$ ANNU,Y1 )! IDEA T VI.N ?R1T5$
0DIABETIC RET9OPA?Y MAY NE$ LAS] TR1T;T4
,"! >E _M RET9AL 41SES T C 2 DIAGNOS$ )A
DIRECT1 OR 9DIRECT1 OPH?ALMOSCOPE1 IN-
CLUD+ MACUL> DEG5],N1 RET9AL         #EF
DETA*;T1 RET9ITIS PIG;TOSA1 & O!R   C#BB
RET9AL DEG5],NS4
  ,DILAT+ ! PUPIL IS USE;L 6BETT] SEE
9SIDE ! EYE1 Z M5;N$4 ,PATI5TS T5D 6BE M
3C]N$ AB ? ?AN NEC & (T5 TRY 6TALK ! EYE
DOCTOR \ ( ? "P (! EXAM4 ,ACTU,Y1 DILAT+
! PUPIL MAKES 9T]NAL EXAM9,N M L LOOK+
"? A W9D[ 7L>GE PUPIL7 R ?AN A KEYHOLE
7SMALL PUPIL74 ,"S "Y PATI5TS ) NATUR,Y
L>GE
-------------------------------------#BC
PUPILS1 C 2 EXAM9$ )\T DILAT+ ! PUPILS1
B IF YR EYE DOCTOR SU7E/S DILAT+ !M1 YR
COOP],N IS SU7E/$4 ,Z A RESULT ( DILAT+1
VI.N C 2 BLURR$1 B N S BAD1 ESPECI,Y IF
Y H GLASSES T HELP4 ,R1D+ IS A BIT
BLURR$1 = AN H\R OR S1 B IF Y >E "Y1 OR
IF Y H BIFOCALS1 "! IS N M* (A PRO#M4
,IF ! BE/-CORRECT$ VI.N IS SUBNORMAL1 !N
A SE>* = CAUSE IS NE$$1 & DILAT+ ! PUPIL
IS Q IMPORTANT 9 ? SE>*4 ,& IF Y >E NE>-
SI<T$1 Y C REMOVE YR GLASSES 6R1D4 ,SUN-
GLASSES W 2 HELP;L = \TDOORS1 &! EYE
DOCTOR C PROVIDE TEMPOR>Y "OS4 ,P :O H
_H CAT>ACT SURG]Y SU/A9 NO VISUAL    #EG
BLURR+ F DIL,N1 S9CE _! FOCUS+      A#BC
ABIL;Y IS N ALT]$1 ?\< _! CU/OM>Y FEEL+S
( S5SITIV;Y 6LI<T MAY MAKE !M RELUCTANT
6H _! EYES DILAT$4 ,9 G5]AL1 IF YR PU-
PILS H N BE5 DILAT$ = YR EYE EXAM9,N1 !
EXAM MAY 2 9COMPLETE4
  ,NONR\T9E A4I;NAL EXAMS MAY 2 RECOM-
M5D$4 ,= EXAMPLE1 IF GLAUCOMA IS SUS-
PECT$ ON ! BASIS ( FAMILY HI/ORY1 9TRA-
OCUL> PRESSURES1 %ALL[ ANT]IOR *AMB]S1
OR CUPP+ (! OPTIC N]VES1 FUR!R TE/S MAY
2 9DICAT$1 S* Z A VISUAL FIELD OR ,,GDX
7RET9AL N]VE FIB] TE/+74 ,SUSPECT$ OP5-
ANGLE GLAUCOMA REQUIRES S* TE/S1 S9CE !
DIAGNOSIS IS (T5 -PLICAT$1 ESPECI,Y IF !
9TRAOCUL> T5.N IS N ELEVAT$4 ,! VISUAL
FIELD TE/ IS -PUT]IZ$1 & HELPS DETECT
E>LY LOSS ( VI.N DUE 6GLAUCOMA1 2F A PA-
TI5T WD USU,Y 2 AW>E (A PRO#M4 ,E>LY DI-
AGNOSIS1 ( C\RSE1 IS IMPORTANT 9 ORD] TO
AVOID FUR!R LOSS ( VI.N4 ,IF N>R[-ANGLE
POT5TIAL GLAUCOMA IS SUSPECT$1 !N ANO!R
TE/1 CALL$ GONIOSCOPY1 MAY 2 P]=M$4 ,?
TE/ MAY HELP TELL IF PROPHYLACTIC TR1T;T
= N>R[-ANGLE GLAUCOMA IS 9DICAT$4    #EH
,PHOTOGRAPHS MAY 2 SU7E/$ = AN      B#BC
EVALU,N ( POT5TIAL GLAUCOMA OR RET9AL
41SES1 S* Z MACUL> DEG5],N4 ,A RET9AL
SPECIALI/ (T5 EMPLOYS SPECIAL PHOTO-
GRAPHIC TE*NIQUES1 S* Z FLUORESCE9 ANGI-
OGRAPHY1 A TE/ T C 2 DEF9ITIVE 9 ! DIAG-
NOSIS ( DIABETIC RET9OPA?Y1 MACUL> DEG5-
],NS1 & O!R RET9AL 41SES4
  ,M$IC>E DOES N PAY = R\T9E EYE EXAMI-
N,NS &= R\T9E M$ICAL EXAMS 9 G5]AL4 ,!
"Q IS1 :AT IS R\T9E8 ,M$IC>E 3SID]S !
*ECK+ ( VI.N1 8REFRAC;N10 Z R\T9E & "!=E
D5IES PAY;T = AN EYE EXAM1 UN.S "! IS A
M$ICAL DIAGNOSIS S* Z CAT>ACT4 ,!N ! RE-
FRAC;N "P1 TE/+ ! VI.N1 IS 8C>V$ \10 &!
PATI5T M/ PAY = ? POR;N (! EXAM4 ,?
SEEMS ESPECI,Y UNFAIR :5 X IS RECOGNIZ$
T TE/+ ! VI.N IS S IMPORTANT 9 DETECT+ !
PRES;E OR SEV];Y ( EYE 41SE4 ,= EXAMPLE1
WE M1SURE CAT>ACTS 0H[ M* !Y REDUCE VI-
.N4 ,X IS AL DI6ICULT 6A3EPT = _M P1 2C
!Y H 2COME A3U/OM$ 6VI.N COV]AGE VIA UN-
ION M$ICAL PLANS4 ,S* PLANS >E S -MON T
ONCE P R1* ,M$IC>E AGE1 !Y _C "U/& :Y
EYE EXAMS & GLASSES >E N COV]$4      #EI
  ,GUIDEL9ES = R\T9E EYE EXAMS      C#BC
MAY 2 G5]ALIZ$4 ,PROBABLY ALL *N %D 2
EXAM9$ PRIOR 6K9D]G>T54 ,A FAMILY HI/ORY
( LAZY EYE WD SU7E/ EV5 E>LI] EXAM9,N1
AT AGE ?REE OR F\R4 ,ONCE A * %[S ! NE$
= GLASSES1 ANNUAL EXAMS >E USU,Y NE$$1
2C GLASSES TAKE Q
-------------------------------------#BD
A B1T+1 & GR[? MAY DEMON/RATE *ANGE 9 !
EYES &! NE$ = PRESCRIP;N ( GLASSES ANNU-
,Y4 ,X IS H>D 6MAKE RULES = H1L?Y "Y
ADULTS1 ESPECI,Y IF !Y D N NE$ GLASSES1
B 0AGE =TY1 "O %D 2 EXAM9$ AT L1/ E TWO
YE>S4 ,( C\RSE1 IF "O USES GLASSES1 !N
P]IODIC EXAMS SEEM OBVI\SLY NE$$4 ,! ON-
SET ( 41SES S* Z GLAUCOMA1 MACUL> DEG5]-
,N1 & CAT>ACT 9CR1SE 9 FREQU5CY SIGNIFI-
CANTLY 2Y AGE =TY4 ,P ) DIABETES NE$ AN-
NUAL EYE EXAMS1 S T E>LY TR1T;T C 2 9I-
TIAT$ IF NE$$4 ,3TACT L5S WE>]S AL NE$
ANNUAL EXAMS1 & WE FOLL[ CAT>ACT PROG-
RESS AT L1/ ONCE A YE>4 ,GLAUCOMA PA-
TI5TS' NE$ = EXAM1 ONCE !Y >E "U TR1T;T1
V>IES P] PATI5T & RESPONSE 6TR1T;T1 &)
BE/ 3TROL1 X IS USU,Y NO LESS ?AN    #FJ
ONCE YE>LY4                         A#BD























                                     #FA
                                    B#BD























                                     #FB
                   #D                #BE
      ,EYE ,GLASSES 7,SPECTACLES7
            & ,3TACT ,L5SES

      ,ILLU/R,N3 ,^! ILLU/R,NS %[ H[
    LI<T F F> AWAY 7M ?AN #BJ FEET7 IS
    FOCUS$ ONTO ! MACULA 9 ! 8NORMAL0
    EMMETROPIC EYE4 ,9 ! MYOPIC EYE1 !
    LI<T RAYS >E B5T 0! CORNEA & L5S 9
    FRONT (! MACULA1 9 AN EYE USU,Y L>G]
    ?AN AV]AGE4 ,A SPECTACLE L5S ?ICK]
    ON ! $GES WD SPR1D ! LI<T RAYS 5T]+
    ! EYE 5 6ALL[ FOCUS ON ! MACULA4 ,!
    F>SI<T$ EYE1 2+ SMALL] ?AN AV]AGE1
    NE$S A SPECTACLE L5S ?ICK] 9 ! C5T]
    6HELP B5D LI<T RAYS M S T !Y >E 9
    FOCUS ON ! MACULA4 ,COPY"R ^C #AIHC
    ,/EPH5 ,F4 ,GORDON4

,9 G5]AL1 Z ,I W PO9T \1 WE ALL NE$
GLASSES EV5TU,Y4 ,"S >E S %AK5 UP 0?
FACT T !Y SEEK O!R ALT]NATIVES4 ,I PLAN
64CUSS ALT]NATIVES1 B D N EXPECT ME TO
4C\RAGE ! NATURAL TRANSI;N ( NE$ =
GLASSES1 SPECTACLES IF Y WI%1 OR     #FC
MAY N WI%4                          A#BE
-------------------------------------#BF
  ,Z ,I M5;N$1 MO/ ( U >E RELATIVELY EM-
METROPIC1 M1N+ T WE SEE Q WELL AT ALL
4T.ES )\T GLASSES1 AT L1/ :ILE WE >E "Y
ADULTS & REPRES5T AB #DJ P]C5T (! ADULT
POPUL,N4 ,! NE>SI<T$ 7MYOPIC7 USU,Y 2G9
6NE$ GLASSES AT AN E>LY AGE4 ,! F>SI<T$
7HYP]OPIC7 *1 UN.S M ?AN #B OR #C DIOP-
T]S F>SI<T$1 FUNC;NS WELL 9 S*OOL & G5]-
,Y4 ,H["E1 !Y MAY DEMON/RATE A PRO#M
R1D+ E>LI] ?AN EMMETROPIC PRESBYOPES1
P]H 9 ! TW5TIES OR ?IRTIES4 ,PRESBYOPIA1
! PHYSIOLOGICAL LOSS ( FOCUS+ VI.N1 C 2
PREDICT$4 ,2T AGE =TY & =TY-FIVE1 ! AV]-
AGE EMMETROPE1 M1N+ MO/ ( U1 W NOTICE !
8>MS TOO %ORT0 PRO#M4 ,? /ATE;T1 (
C\RSE1 IS DUE 6! FACT T HOLD+ ?+S CLOS]1
Z WE US$ 6D Z *N 6SEE BETT]1 ACTU,Y
MAKES ?+S WORSE1 S9CE ! CLOS] WE HOLD
?+S1 ! M IS ! DEM& = FOCUS+4 ,AT AB AGE
=TY-FIVE1 ! MAXIMUM FOCUS+ ABIL;Y IS D[N
6AB #C.E DIOPT]S4 ,"!=E1 R1D+ AT #A_/D
MET] 7#AF 9*ES71 : DEM&S A #B.E-DIOPT]S
A3OMMOD,N1 IS M DI6ICULT4 ,X IS      #FD
NATURAL1 !N1 6HOLD ?+S F>!R AWAY1   A#BF
: REQUIRES LESS FOCUS+ EF=T4 ,AL1 GD
LI<T HELPS1 : EXPLA9S :Y P MOVE OV] 6!
W9D[ 6R1D4 ,WE REF] 6! NE$ = 8R1D+
GLASSES10 B ACTU,Y WE >E TALK+ AB SEE+
ANY SMALL OBJECT UP CLOSE1 Z 9 SEW+1 OR
"W+ ) SMALL SCREWS OR NAILS4
  ,! NE$ = HELP SEE+ AT NE> IS PREDICTA#
& -MON 6ALL1 B "S T]MS >E 3FUS+4 ,"S
SAY1 8,Y GET F>SI<T$ 9 YR =TIES40 ,N
TRUE4 ,WE ALL 2COME PRESBYOPIC1 & ? IS
A4$ 6"O'S ORIG9AL BASIC REFRACTIVE /AT-
US4 ,"!=E1 IF Y >E BASIC,Y NE>SI<T$1 Y
TOO 2COME PRESBYOPIC1 & :5 WE>+ YR 4T.E
GLASSES1 Y EV5TU,Y NOTICE T Y M/ HOLD
?+S F>!R AWAY 6R1D1 ) YR GLASSES ON4
,REMOV+ ! GLASSES MAKES ?+S SE5 BETT]1
DEP5D+ ON H[ NE>SI<T$ Y >E4 ,! SAME IS
TRUE = ^? WE>+ 3TACT L5SES3 CLOSE "W BE-
-ES DI6ICULT1 & REMOV+ 3TACT L5SES IS N
S 3V5I5T =! NE>SI<T$4
  ,:AT IS H>D 6"U/& =! EMMETROPE IS !
EV5TUAL NE$ = GLASSES1 :5 "EY?+ HAS
SEEM$ P]FECT4 ,H["E1 ! MO/ 4APPO9T$ P]-
SON IS ! F>SI<T$ "O4 ,2+             #FE
8F>SI<T$10 A P]SON MAY ?9K T ! M    B#BF
F>SI<T$ "O IS1 ! F>!R AWAY "O C SEE4
,WR;G4 ,! M F>SI<T$ "O IS1 ! M "O NE$S
6FOCUS1 EV5 = 4T.E1 & "!=E :5 PRESBYOPIC
LOSS ( FOCUS+ DEVELOPS1 MO/ ( ^! P H AL
LO/ 4T.E VI.N4 ,& 2C !Y US$ 6SEE S WELL
= 4T.E1 !Y H TR\# A3EPT+ ! FACT T !Y H
DEVELOP$ PRIM>ILY A R1D+ PRO#M1 B N[
SECOND>ILY AL A 4T.E PRO#M4 ,!Y MAY NOTE
FRS :O NE$$ GLASSES 9 S*OOL = NE>SI<T$-
;S1 B :O N[ C (T5 / SEE WELL UP CLOSE BY
TAK+ _! GLASSES (F4 ,H["E1 ! F>SI<T$ P]-
SON MAY R1* A PO9T ": GLASSES >E NE$$
FULL "T1 6SEE BO? NE> & 4T.E OBJECTS1 &
? MAY N SEEM FAIR4
  ,WE C PREDICT1 )9 LIMITS1 :5 !
PRESBYOPIA-DRIV5 NE$ = GLASSES W O3UR4
,DRUG/ORE1 OR OV]-!-C.T]1 GLASSES >E
AVAILA#1 S T WE C
-------------------------------------#BG
USE ! T]MS ( SPECTACLE P[] EXPECT,NS4 ,(
C\RSE1 ^! GLASSES ASSUME T BO? EYES >E !
SAME & T "! IS NO SIGNIFICANT NE$ =
A/IGMATISM CORREC;N4 ,H["E1 MO/ P D N
FIT ? CATEGORY4 ,^! GLASSES >E AL    #FF
MADE 6BE RELATIVELY 8"O SIZE FITS   A#BG
ALL10 S T ! 4T.E 2T PUPILS IS N S* Z TO
ALL[ = V>IA#S1 &! FRAME 9 G5]AL MAY N
FIT WELL4 ,2T AGES =TY & =TY-FIVE1 !
W1KE/ P[] ( @+ #A.JJ IS NE$$ 0! EMME-
TROPE OR A P]SON WE>+ 3TACT L5SES4 ,LAT-
]1 0AGE FIFTY1 A @+ #A.GE OR @+ #B.JJ
P[] W 2 NE$$4 ,0AGE SIXTY OR S1 A @+
#B.BE R1D+ P[]1 &! FULL P[] ( @+ #B.EJ1
M1N+ ! FULL P[] = SEE+ AT #A_/D MET]1 IS
EV5TU,Y NE$$4
  ,AN 9T]E/+ PO9T3 IF A P]SON F9DS T HE
OR %E C SEE WELL = 4T.E ) DRUG/ORE R1D+
GLASSES1 !N "S?+ IS OBVI\SLY WR;G1 "R8
,WELL1 ,I H BE5 9 3TACT ) TWO 8PROFES.N-
AL0 P REC5TLY1 :O USE DRUG/ORE R1D+
GLASSES = 4T.E4 ,! NURSE USES @+ #B.EJ1
USU,Y ! /R;GE/ AVAILA# = WAT*+ ,,TV1 &!
*IROPRACTOR USES @+ #A.GE1 = T5NIS4 ,!
NURSE 0 TOLD 0! ,,DMV T %E NE$$ 6WE> H]
@+ #B.EJ R1D]S = DRIV+ & /AT$ S ON H]
LIC5SE4 ,NEI "U/OOD ! IMPLIC,N ( ? PHE-
NOM5ON4 ,N[1 D Y8 ,X M1NS T BO? >E SIG-
NIFICANTLY F>SI<T$4 ,S1 Z A RULE1 IF P
NOTICE T !Y C SEE WELL = 4T.E )      #FG
DRUG/ORE R1D+ GLASSES1 !N !Y >E     B#BG
F>SI<T$ 5 6DEF9ITELY NE$ BIFOCALS1 OR
ANO!R ALT]NATIVE IF !Y >E 9T5T ON AVOID+
GLASSES4 ,! WOR/ -PLIC,N ( *OOS+ ! OV]-
!-C.T] R1D+ GLASSES IS T A P]SON'S SAT-
ISFAC;N MAY 2 9T]PRET$ 6M1N T ! EYE
PRO#M HAS BE5 SOLV$ & FUR!R EYE EXAM9,N
IS N NEC4 ,? IGNORES ! FACT T ! SAME
AGE-RELAT$ PRO#MS REV1L+ ! NE$ = HELP 9
R1D+ AL SIGNIFIES ! NE$ = SCRE5+ = EYE
41SES S* Z GLAUCOMA1 CAT>ACT1 MACUL> DE-
G5],N1 & O!R S* AGE-RELAT$ POT5TIAL
PRO#MS4
  ,^? :O >E 9T]E/$ 9 COSMETICS WD 2
LIKELY 9T]E/$ 9 ! NO-L9E BIFOCAL1 ! PRO-
GRESSIVE ADD4 ,S9CE "! IS NO OBVI\S L9E
SEP>AT+ ! 4T.E F ! R1D+ POR;N (! L5S1 !Y
LOOK L S+LE-VI.N GLASSES1 "!=E HID+ !
8/IGMA0 ( 2+ OLD 5 6NE$ BIFOCALS4 ,H["E1
IF !Y H BE5 US+ S+LE-VI.N DRUG/ORE
GLASSES1 ! PROGRESSIVES MAY 2 DI6ICULT
6D1L ) 2C ! R1D+ >EA IS RELATIVELY
SMALL]4 ,M ?AN ONCE1 HAV+ PRES5T$ ! BET-
T] *OICE ( BIFOCALS OV] S+LE-VI.N R1D+
GLASSES1 ,I H BE5 SURPRIS$ BY        #FH
PATI5TS' RESPONSE T !Y >E ALR US+   C#BG
BIFOCAL SUNGLASSES1 : !Y AL GOT AT !
DRUG/ORE4 ,ON ? SUBJECT1 X C 2 PO9T$ \ T
"O'S REGUL> BIFOCAL OR PROGRESSIVE L5SES
C H 8TRANSI;NS10 ! ABIL;Y 6D>K5 \TSIDE &
LI<T5 UP AG BACK 9SIDE1 A V GD OP;N = ^?
WANT+ 6SIMPLIFY ! NUMB] ( PAIRS ( GLASS-
ES4
  ,:5 9=M$ (! EV5TUAL NE$ = GLASSES1
DI6]5T & "S"TS EXTREME PATI5T REAC;NS
O3UR4 ,"O LADY1 :5 9=M$ (! IMP5D+ NE$ =
R1D+ GLASSES1 _H A REAC;N SIMIL> 6,&Y (
,LONDON1 A
-------------------------------------#BH
-IC-/RIP "*4 ,&Y /AT$ T HE 0 S SICK &
TIR$ ( R1D+ T DR9K+ IS BAD = YR H1L? T
HE 0 GO+ 6QUIT4 ,:5 ASK$ IF HE 0 !N GO+
6QUIT DR9K+1 HE SD NO1 HE 0 GO+ 6QUIT
R1D+4 ,MY PATI5T SD ! SAME4 ,IF %E 0 GO+
6NE$ GLASSES1 !N %E WD J QUIT R1D+4

             ,3TACT ,L5SES

  ,3TACT L5SES C 2 A SUB/ITUTE = GLASS-
ES1 B >E USU,Y WORN 0P :O NE$        #FI
RELATIVELY /R;G GLASSES4 7,I W      A#BH
USE ! T]MS 8/R;G0 & 8W1K10 2C P SEEM TO
"U/& ^! T]MS1 ?\< GLASSES & EYES >E N
/R;G OR W1K2 R1 !Y >E EI M P[];L OR LESS
P[];L 9 FOCUS+ P[]47 ,! NE>SI<T$ >E USU-
,Y ! F/ C&IDATES = 3TACT L5SES1 EV5 AT A
"Y AGE4 ,! M NE>SI<T$1 ! M MOTIVAT$--
GIRLS M ?AN BOYS = COSMETIC R1SONS1 B AL
BOYS = COSMETIC & SPORTS ACTIVITIES4 ,!
ORIG9AL 3TACT L5SES 7 8H>D0 L5SES1 RIGID
PLA/IC L5SES ^: SPH]IC;Y 7R.D;S7 AL COR-
RECT$ A/IGMATISM4 ,! SU3ESS RATE 0 RELA-
TIVELY UNPREDICTA# 2C !Y >E R UNCOM=TA#1
ESPECI,Y AT F/ DUR+ ! ADJU/;T PHASE4
,ONCE SU3ESS;L ) H>D 3TACT L5SES1 H["E1
PATI5TS MAY 2 N SATISFI$ )! RELATIVE
LACK ( %>P VI.N1 6: !Y >E A3U/OM$1 IF !Y
TRY S(T 3TACT L5SES4 ,N"E!.S1 S(T 3TACT
L5SES H TAK5 OV] ! MAJOR;Y (! 3TACT L5S
M>KET1 2C ( 9ITIAL & 3T9U$ -=T1 SATIS-
FACTORILY GD VI.N1 EASY REPLACE;T1 &
RELATIVE SAFETY4
  ,S(T L5SES FEEL BETT] F ! />T1 >E SAF]
H1L?WISE1 C 2 4POSA#1 >E USU,Y WORN ALL
"D L;G1 B C 2 "P-"T4 ,EXT5D$ WE>     #GJ
IS POSSI#1 B N 5C\RAG$ )\T SUP]-    B#BH
VI.N 7L1VE 9 PLACE "D & NI<T = TWO 6F\R
WEEKS74 ,"P-"T WE> IS USE;L = ^? :O WI%
6WE> 3TACT L5SES ONLY = SPECIAL O3A.NS
OR ACTIVITIES S* Z SPORTS4 ,S* P C SWIT*
BACK 6GLASSES & SEE WELL1 )\T ! 8SPECTA-
CLE BLUR0 ASSOCIAT$ ) H>D 3TACT L5S WE>4
,H>D 3TACT L5SES >E S RIGID T :5 WORN !Y
T5D 6R.D \ & MAKE ! CORNEA 2N 3=M 6!
%APE (! 3TACT L5S4 ,= ? R1SON1 !Y C COR-
RECT A/IGMATISM BETT]1 B ! CORNEA %APE1
HAV+ BE5 TEMPOR>ILY ALT]$1 IS DI6]5T 5 S
T GLASSES WORN AF REMOV+ ! 3TACTS D N
GIVE 3SI/5T VI.N4 ,? 8SPECTACLE BLUR0
M1NS T VI.N ) GLASSES W V>Y1 DEP5D+ ON
H[ L;G ! 3TACTS H BE5 (F4 ,"!=E1 "! IS
NO S* ?+ Z A P]FECT PAIR ( GLASSES 6WE>
TEMPOR>ILY = H>D 3TACT L5S WE>]S1 :5 N
WE>+ ! H>D 3TACT L5SES4 ,? CR1TES A BIT
(A PRO#M1 2C H>D 3TACT L5S WE>]S M/ RE-
MOVE !M AT B$"T & NE$ BACKUP GLASSES4
  ,? MOLD+ E6ECT ( H>D L5SES HAS AL RE-
SULT$ 9 A =M ( TR1T;T ( NE>SI<T$;S CALL$
8OR?OK]ATOLOGY10 ": H>D 3TACT L5SES >E
PURPOSELY FIT FLATT] ?AN ! NATURAL   #GA
CURVATURE (A PATI5T'S CORNEA1 &     C#BH
WORN L BRACES4 ,? FLATT5+ RESULTS 9 !
FEEL+ ( SEE+ BETT] )\T GLASSES
-------------------------------------#BI
= 4T.E ?AN USUAL1 =! NE>SI<T$ P]SON1 AF
REMOV+ ! 3TACT L5SES4 ,! LACK ( SU3ESS (
? TR1T;T IS DUE 6V>IA# & IMP]FECT VI.N1
) ONLY TEMPOR>Y RESULTS1 S9CE ! CORNEA
T5DS 6RETURN 6XS ORIG9AL %APE :5 ! 3TACT
L5SES >E N WORN4 ,S(T 3TACT L5SES1 S9CE
!Y 3=M 6! %APE (! CORNEA & >E PLIA#1
CAUSE M9IMAL SPECTACLE BLUR1 & ?US FOLL[
! BASIC PR9CIPLES ( 3TACT L5S FITT+3 N
6D ANY H>M OR *ANGE 6! CORNEA4 ,A PAIR (
GLASSES MAY 2 SATISFACTORY VISU,Y1 &!
PATI5T MAY SWIT* BACK & =? 2T 3TACTS &
GLASSES1 :5 S(T 3TACT L5SES >E *OS54
  ,Z M5;N$1 S(T 3TACT L5SES >E EASI] &
SAF] ?AN H>D 3TACT L5SES4 ,EYE DOCTORS
N[ FIT MA9LY S(T1 DAILY WE> 4POSA# 3TACT
L5SES1 M1N+ T ! L5SES >E REMOV$ AT B$"T
& REPLAC$ AB E TWO WEEKS4 ,! ORIG9AL S(T
3TACT L5SES 7 Q SU3ESS;L1 B DESIGN$ 6BE
WORN DAILY-WE>1 & REPLAC$ E FEW MON?S4
,! NATURAL TR5D 0 6TRY 6MAKE !       #GB
L5SES LA/ L;G]1 &A SYNDROME ( GI-   A#BI
ANT PAPILL>Y 3JUNCTIVITIS 7,,GPC7 DEVEL-
OP$4 ,AM;G ! SYMPTOMS 7 T ! EYE _H "S
IRRIT,N1 MATT]+1 BLURR$ VI.N1 &! 3TACT
L5S NE$$ 6BE REPLAC$ M (T54 ,!N1 :5 RE-
PLAC$1 ! NEW L5S DID N LA/ L;G 2F AG
DEMON/RAT+ ! SYMPTOMS4 ,EXAM9,N %[$
SIGNS ( AN ALL]GIC GIANT PAPILL>Y 3JUNC-
TIVITIS1 ":BY FLIPP+ OR EV].N (! UPP]
EYELID %[$ L>GE PAPILL>Y GR[?S1 S L>GE T
! PAPILLAE RU2$ ON ! SURFACE (! 3TACT
L5S S Z 6DE/ROY ! OPTICS & DRAG ! L5S
UPW>D1 Z IF AN ERAS] 0 GRA2+ ! L5S DUR+
BL9K+4 ,ID5TIFIC,N (! SYNDROME 0 9TEGRAL
9 ! DEVELOP;T ( 4POSA# S(T 3TACT L5SES4
,:5 L5SES 7 WORN DAILY & 4POS$ ( 9 TWO
WEEKS1 ! SYNDROME ( ,,GPC 2CAME R>ELY
SE51 & 0 RECOGNIZ$ Z AN ALL]GIC REAC;N
6! PROTE9 BUILDUP ON ! ORIG9AL S(T L5S-
ES4
  ,A/IGMATISM (A SIGNIFICANT DEGREE C AL
2 TR1T$ ) S(T 3TACTS1 CALL$ TORIC L5SES1
B ! FITT+ IS M -PLICAT$ & EXP5SIVE4 ,X
IS DI6ICULT 6OBTA9 Z GD VI.N ) TORIC S(T
3TACTS Z ) SPECTACLES OR H>D 3TACT   #GC
L5SES :5 D1L+ ) L>G] DEGREES (      B#BI
A/IGMATISM4 ,S9CE SPECI,Y MANUFACTUR$ TO
CR1TE AN A/IGMATIC CORREC;N1 ^! TORIC
L5SES H A L;G & %ORT AXIS ( CURVATURE TO
CORRECT ! A/IGMATISM1 L A PAIR ( SPECTA-
CLES4 ,H["E1 !Y M/ ROTATE 6ADJU/ 6! COR-
RECT AXIS :5 F/ 9S]T$ & MA9TA9 ? POSI;N
) BL9K+4 ,MANUFACTUR+ SPECIFIC,NS MAKE
!M M EXP5SIVE 6REPLACE1 & "!=E !Y >E N Z
4POSA# Z 3V5;NAL NONTORIC S(T 3TACT L5S-
ES4
  ,SAFETY FACTORS 9CLUDE ! FACT T S(T
3TACT L5SES >E M FLUID & OXYG5 P]MEA#4
,"!=E1 ! 8OV]WE> SYNDROME10 -MONLY SE5 )
H>D 3TACT L5SES1 IS RELATIVELY UNUSUAL )
S(T 3TACT L5SES4 ,! OV]WE> RESULTS F
LACK ( OXYG5 6! CORNEA T IS PROVID$ 0!
NORMAL TE>S LUBRICAT+ ! CORNEA4 ,! B>RI]
6^! OXYG5-PROVID+ TE>S IS CAUS$ 0! RELA-
TIVELY OXYG5-IMP]MEA# H>D PLA/IC H>D
L5SES1 OR EV5 8GAS-P]MEA#0 H>D L5SES1 :
7 DESIGN$ 6IMPROVE ON "S (! DANG] ( OV]-
WE>4
-------------------------------------#CJ
  ,CALLS 6! EYE DOCTOR 9 ! MI4LE (   #GD
! NI<T H BE5 "!=E REDUC$ )! RE-     A#CJ
PLACE;T ( H>D 3TACTS 0S(T 3TACT L5SES4
,TYPIC,Y ! H>D 3TACT L5S WE>]S1 USU,Y
FEMALES1 HAV+ WORN _! 3TACT L5SES EXTRA
L;G1 2C ( "S WEEK5D "PY OR SPECIAL EV5T1
& UNAW>E ( ANY PRO#M1 F9,Y REMOVES !
3TACTS & GOES 6B$4 ,(T5 AIR TRAVEL IS
9VOLV$4 ,AF AN 9T]VAL1 ! LACK ( OXYG5
DUE 6OV]WE> (! 3TACT L5SES CAUSES SWELL+
(! CORNEA & PA9 S BAD T PATI5TS >E AWAK-
5$ & SUSPECT "S M S]I\S PRO#M4 ,IF ! PA-
TI5TS C 2 MADE 6SLEEP1 ) HYPNOTIC OR AN
ANALGESIC1 ! PRO#M IS SELF-LIMIT$1 &
SPONTANE\SLY CORRECT$ 9 A MATT] ( H\RS4
,9 ? WAY1 ! 3TACT L5S OV]WE> SYNDROME IS
SIMIL> 6ACT9IC K]ATITIS 7>C WELD] BURN74
  ,S(T 3TACT L5S WE>]S H LESS *.E ( OV]-
WE>1 B X C O3UR1 ESPECI,Y ) EXT5D$ WE>
3TACTS WORN OV]NI<T4 ,= ? R1SON1 ,I N"E
SU7E/ EXT5D$ WE> 6A 2G9N]4 ,X IS TOO AP-
P1L+ 6! 8KLUTZY0 P]SON :O IS TOO CLUMSY
OR SC>$ 6H&LE ! L5S ANY M ?AN FELT NEC4
,WE WANT \R 2G9N+ 3TACT L5S WE>] 6BE
AW>E (! DICTUM T IF ! EYE HURTS )! 3TACT
L5S IN1 !N ! 3TACT L5S %D 2 REMOV$   #GE
Z ! F/ ALT]NATIVE1 & T PATI5TS >E   B#CJ
EXPECT$ 6BE 3FID5T T !Y C 9S]T & REMOVE
! 3TACT L5S ANY"T WANT$4 ,? AL M1NS N
?R[+ AWAY OLD GLASSES1 Z !Y MAY 2 NE$$ 9
S* AN EM]G5CY4 ,H["E1 HAV+ DEMON/RAT$
SU3ESS AT DAILY WE>1 EXT5D$ WE> ( S(T
3TACT L5SES MAY 2 Q SU3ESS;L 9 _M CASES4
,? ( C\RSE REQUIRES APPROVAL & SUP]VI.N
(! EYE DOCTOR1 S9CE SPECIAL L5SES >E DE-
SIGN$ = EXT5D$ WE>4
  ,"! >E "S O!R PRACTICAL ?+S 6"K AB
3TACT L5SES4 ,!Y >E M EXP5SIVE ?AN
GLASSES1 B MA9LY AT ! 2G9N+4 ,! FITT+ (
3TACT L5SES 9VOLVES TRIAL FITT+1 ESPE-
CI,Y ) S(T L5SES1 6DEMON/RATE ! RESULT+
VI.N & RELATIVE -=T1 & !N 9S];N & REMOV-
AL TRA9+4 ,USU,Y ? TAKES AB AN H\R1 B
"S"TS L;G]4 ,WE D N GIVE UP ON A PATI5T
:O TAKES M ?AN "O SES.N1 S9CE WE WANT !M
6FEEL 3FID5T4 ,!N "! >E FOLL[-UP VISITS
Z NE$$4 ,EV5TU,Y1 ANNUAL EXAMS >E M9IM,Y
REQUIR$4 ,H>D OR GAS-P]MEA# L5SES MAY
LA/ =A FEW YE>S4 ,4POSA# S(T L5SES NE$
6BE RESUPPLI$ USU,Y E SIX 6TWELVE MON?S4
,H["E1 ! CO/ ( REPLAC+ S(T 3TACT     #GF
L5SES MAY 2 LESS ?AN T ( REPLAC+    C#CJ
GLASSES 9 ! GR[+ *1 ^: PRESCRIP;N IS
*ANG+ ANNU,Y4
  ,CO/ FACTORS & 3SUM]S "RS ISSUES H RE-
SULT$ 9 ! FACT T EYE DOCTORS >E 8LEG,Y0
REQUIR$ 6GIVE 3TACT L5S PRESCRIP;NS 6_!
PATI5TS4 ,H["E1 "! >E "S OBVI\S FACTORS
6BE CL>IFI$4 ,IF ! PATI5T HAS N"E BE5
FITT$ ) 3TACT L5SES1 !N "! ..IS NO 3TACT
L5S .PRESCRIP;N4 ,! EYE DOCTOR C GUESS1
B UNTIL ! PATI5T HAS BE5 FIT SU3ESS;LLY
) 3TACT L5SES1 "! IS NO 3TACT L5S PRE-
SCRIP;N4 ,YE>S AGO1 OPTICAL %OPS T FITT$
& SOLD 3TACT L5SES 7 SATISFI$ )! PRE-
SCRIP;N = SPECTACLES & CD PROCE$ )! FIT-
T+ !MVS4 ,WE TOLD PATI5TS T IF !
-------------------------------------#CA
3TACT L5S SUPPLI] NE$$ M 9=M,N ?AN _!
GLASSES PRESCRIP;N1 !N 8Y >E 9 ! WR;G
PLACE40 ,CURR5TLY1 3TACT L5S 8SUPPLI]S10
S* Z DRUG/ORES OR MAIL ORD] -PANIES1
WANT 6M]ELY REPLACE ! 3TACT L5SES ) NO
RESPONSIBIL;Y1 L SELL+ A %IRT1 & ALL !Y
NE$ IS ! SIZE4 ,? IS EASI] 6D ) S(T CON-
TACT L5SES1 : >E MANUFACTUR$ 6BE (   #GG
ID5TICAL /&>DS4                     A#CA
  ,RIGID 3TACT L5SES >E M -PLICAT$1 & H
6BE 9DIVIDUALIZ$ 9 MANUFACTURE1 & X IS
DI6ICULT 6F9D A PLACE ": ^! L5SES C 2
REPLAC$ O!R ?AN 0! EYE DOCTOR4 ,S 4C.T
RETAIL]S >E HAPPY 6REPLACE S(T 3TACT
L5SES ONCE !Y H ! PRESCRIP;N4 ,EYE DOC-
TORS W GIVE ! PRESCRIP;N S T PATI5TS C
GET _! 3TACT L5SES ELSE":1 PROVID+ T !
PATI5T HAS BE5 SU3ESS;LLY FIT1 &! EYE
DOCTOR "KS :AT IS ! SU3ESS;L PRESCRIP;N4
,S(T 3TACT L5SES H ! PRESCRIP;N1 BR&1 &
SIZE PR9T$ ON ! 3TACT L5S PACKAGE1 9=M,N
NE$$ 0A NEW EYE DOCTOR :O IS EXPECT$ TO
GIVE A 8PRESCRIP;N0 = 3TACT L5SES4 ,H[-
"E1 3TACT L5SES OBTA9$ ELSE": >E N USU,Y
"U ! PRESUM$ RESPONSIBIL;Y (! EYE DOC-
TOR1 IF "! IS A PRO#M RELAT$ 6QUAL;Y (!
L5SES4 ,& REMEMB]1 IF Y H N BE5 SU3ESS-
;LLY FIT = 3TACT L5SES1 M1N+ T Y H PD AN
EYE DOCTOR 6SATISFACTORILY FIT Y1 !N D N
EXPECT AN EYE DOCTOR 6GIVE Y 8YR PRE-
SCRIP;N0 = 3TACT L5SES4 ,& IF Y >E HAV+
PRO#MS1 &A REFIT OR TRIAL ( ANO!R K9D (
3TACT L5S IS NE$$1 !N 2 PREP>$ TO    #GH
PAY = ? S]VICE4 ,ONCE ?+S >E AG     B#CA
SATISFACTORY 6BO? PATI5T & EYE DOCTOR1
!N ! DOCTOR W GIVE Y YR PRESCRIP;N4
  ,9 SPORTS1 3TACT L5SES C 2 A BIG IM-
PROVE;T OV] GLASSES4 ,P]IPH]AL VI.N IS
BETT]1 ESPECI,Y = ^? ) /R;G PRESCRIP;N
SPECTACLES1 &! *.E ( DAMAGE 6! GLASSES
IS ELIM9AT$4 ,H["E1 "S"TS ! 3TACT L5S
FALLS \4 ,:5"E Y SEE A BASKETBALL OR
FOOTBALL GAME /OPP$ 6LOOK =A 3TACT L5S1
H["E1 X USU,Y M1NS ! LOSS (A H>D 3TACT
L5S4 ,S(T 3TACT L5SES D N USU,Y FALL \
OR 2COME 4LODG$ ) TRAUMA4 ,9 "S SPORTS1
L WAT] POLO1 AN EXTRA L>GE S(T L5S C 2
FIT 6MAKE X EV5 M UNLIKELY T X W 2 DIS-
LODG$4 ,H["E1 S* A PATI5T WD PROBABLY H
REGUL> S(T 3TACT L5SES = USUAL WE>4 ,"S
URG5T C>E ?+S 6"K AB 3TACT L5S -PLIC,NS3

#A4 ,IF ! EYE IS R$ OR FEELS UNCOM=TA#1
  REMOVE ! 3TACT L5S4 ,A H>D 3TACT L5S
  MAY 2COME Q TI<T & DI6ICULT 6REMOVE4
  ,9 AN EM]G5CY1 X IS ALL "R 6TRY "S?+
  /ICKY1 S* Z COLD M>%MALL[ SUNDAE TOP-
  P+1 OR COLD MAPLE SYRUP4 ,A DAB    #GI
  ON ! F+] W 2 /ICKY 5 6AD"H 6!     C#CA
  3TACT L5S & HELP 6PULL X (F4 ,!N !
  /ICKY /UFF C 2 R9S$ CL1N F ! L5S 2F
  FUR!R USE4 ,A S(T 3TACT L5S IS USU,Y
  REMOV$ DI6]5TLY1 B X AL CD 2 REMOV$ BY
  S* A /ICKY SUB/.E1 ! DI6];E 2+ T ! L5S
  WD H 6BE ?R[N AWAY4 ,"O (! POT5TIAL
  PRO#MS1 ESPECI,Y 9 S(T 3TACT L5S WE>1
  IS ! FACT T ! L5S MAY H ALR -E (F1 &
  ATTEMPTS 6REMOVE A 3TACT L5S NO L;G]
-------------------------------------#CB
  9 PLACE MAY 2 IRRITAT+ 6! EYE4 ,"O %D
  2 A# 6TE/ ! VI.N1 & IF X IS FAIRLY
  NORMAL1 !N ! 3TACT L5S MAY / 2 9
  PLACE4 ,IF ! VI.N IS POOR1 SIMIL> 6:5
  ! L5S IS (F1 !N ! 3TACT L5S IS PROBA-
  BLY NO L;G] 9 PLACE4 ,0! WAY1 D N WOR-
  RY AB ! L5S GO+ 2H ! EYE2 X _C4 ,X MAY
  HIDE "U ! UPP] EYELID IF A H>D L5S1 B
  MO/ S(T L5SES >E L>GE 5 S T "! IS N 5
  ROOM 6HIDE "U ! LID4
#B4 ,IF "O OR BO? EYES >E *RONIC,Y R$1 N
  -=TA#1 & LI<T S5SITIVE1 !N :E!R "O
  WE>S H>D OR S(T 3TACT L5SES1 !Y %D N 2
  WORN1 & EXAM 0YR REGUL> EYE        #HJ
  DOCTOR IS 9DICAT$4                A#CB
#C4 ,APPE>.E (A :ITE SPOT ON ! CORNEA1
  OV] ! COLOR$1 IRIS "P (! EYE1 MAY 9DI-
  CATE A CORN1L IRRIT,N F 3TACT L5S WE>1
  H>D OR S(T4 ,"S"TS S* A PRO#M IS CALL$
  AN 8ULC]10 SIGNIFY+ A M S]I\S PRO#M1 B
  USU,Y ! PRO#M IS DUE 6LACK ( OXYG51 &
  C 2 TR1T$ )\T S]I\S SC>R+4 ,C]TA9LY X
  IS N "S?+ 6IGNORE4
#D4 ,OV]WE> (A 3TACT L5S RESULTS 9 OXYG5
  DEPRIV,N 6! CORNEA1 &! RESULTANT PA9
  IS (T5 )9 AN 9T]VAL (A FEW H\RS AF !
  L5S IS REMOV$1 & IS "!=E 3FUS+ AB !
  CAUSE4 ,A H>D OR GAS-P]MEA# L5S %D N 2
  WORN OV]NI<T1 = EXAMPLE1 & OV]WE> MAY
  RESULT F EV5 A LL 9CR1SE 9 WE> OV] R\-
  T9E1 OR A7RAVAT$ 0AIR TRAVEL1 OR B"R
  SUNLI<T1 Z 9 SUNBA?+4 ,USU,Y ! SYMP-
  TOMS >E GRTLY IMPROV$ 0"T & TOPICAL
  /]OID DROPS1 AF REMOV+ ! 3TACT L5S4
  ,S(T 3TACT L5SES >E SAF] 9 G5]AL Z TO
  OV]WE>1 B C]TA9LY1 SLEEP+ )A DAILY WE>
  3TACT L5S 9 PLACE1 OR WE>+ AN EXT5D$
  WE> 3TACT L5S TOO L;G1 C RESULT 9 DIS-
  -=T & BLURR$ VI.N1 AT L1/          #HA
  TEMPOR>ILY4                       B#CB
#E4 ,AIR TRAVEL =! 3TACT L5S WE>] C 2 A
  PRO#M4 ,) H>D L5SES ESPECI,Y1 ! "T 9
  AIR TRAVEL C L1D 6SYMPTOMS ( OV]WE>
  SOON] ?AN EXPECT$4 ,I SU7E/ T IF H>D
  3TACT L5S WE>]S >E EXPECT+ A NE$ 6WE>
  ! L5SES L;G] ?AN USUAL1 !Y TAKE A BR1K
  =A FEW H\RS DUR+ ! "D1 9 ORD] 6GET
  AWAY ) WE>+ ! L5SES UNTIL LAT] AT
  NI<T1 Z =A BIG "PY4 ,DRY;S C CR1TE A
  PRO#M EV5 =! S(T 3TACT L5S WE>]S1 S T
  LUBRICAT+ DROPS >E 9DICAT$4
#F4 ,YES1 Y C GET GRE5 S(T 3TACT L5SES1
  Z WELL Z O!R COLORS AVAILA# 6ALT] YR
  EYE COLOR4 ,^! >E EV5 AVAILA# 9 PRE-
  SCRIP;N P[]S4 ,H["E1 PLANO 7L5SES )\T
  PRESCRIP;N P[]7 COSMETIC 3TACT L5S WE>
  HAS BE5 RE/RICT$ LEG,Y 6AVOID 9DIS-
  CRIM9ATE WE> 0UNTRA9$ P]SONS1 &! TRAD+
  (F ( L5SES F "O P]SON 6ANO!R1 USU,Y A
  TE5AG]1 )! SUBSEQU5T RISK ( SPR1D+ EYE
  9FEC;N OR EYE 9JURY4 ,H>D 3TACT L5SES
  >E USU,Y T9T$ SLI<TLY 9 ORD] 6MAKE !M
  EASI] 6F9D & H&LE1 B N 5 6*ANGE EYE
  COLOR4 ,S9CE !Y >E SMALL]1 BLUE    #HB
  L5SES ON BR[N EYES WD LOOK        C#CB
  WEIRD4
#G4 ,REC5TLY "! HAS BE5 3C]N AB S"EAL
  CASES (A R>E FUNGUS 9FEC;N "KN Z FUS>-
  IUM K]ATITIS4 ,CO9CID5TAL 3NEC;N )A
  -MON 3TACT L5S CL1N+ SOLU;N RESULT$ 9
  ! -PANY'S )DRAW+ ! SOLU;N F 4TRIBU;N1
  ?\< 9=M,N 0 N -PLETE 5 6MAKE A C]TA9
  3NEC;N4 ,S* CASES CALL 6ATT5;N T "! IS
  POT5TIAL = 9FEC;N AM;G 3TACT L5S WE>-
  ]S1 & X IS ACTU,Y AMAZ+ T ! 9CID;E (
  9FEC;N IS S L[4 ,X IS RECOMM5D$ 6WA%
  H&S ) SOAP & WAT]
-------------------------------------#CC
  & !N DRY !M 2F H&L+ ! L5SES4 ,! L5SES
  %D 2 REGUL>LY CL1N$ 0RU2+ & R9S+1 RE-
  PLAC$ AT REGUL> RECOMM5D$ 9T]VALS1 &
  /OR$ 9 A CL1N1 DRY CASE T IS REPLAC$ E
  ?REE 6SIX MON?S4 ,AT L1/ "TS H *ANG$
  S9CE ! OLD-"TR H>D 3TACT L5S WE>]S
  FELT T "S ( _! [N SPIT PROVID$ ! BE/
  LUBRIC,N = 9S]T+ _! L5SES4


                                     #HC
                                    A#CC























                                     #HD
                   #E                #CD
             ,VISUAL ,ACU;Y

,2F WE GET M 96R1D+ GLASSES1 REFRACTIVE
SURG]Y1 EYE 41SE1 CAT>ACT SURG]Y1 & S
=?1 MAYBE WE %D TALK AB :AT WE >E TRY+
6PRES]VE3 GD VI.N4
  ,:AT IS NORMAL VI.N8 ,WE SP1K (
#BJ_/BJ Z ! /&>D4 ,:AT DOES T M1N8
,WELL1 9 A R BASIC S5SE1 X M1NS Y C SEE
AT #BJ FEET :AT Y %D SEE AT #BJ FEET4 ,9
METRIC T]MS1 "O C SEE AT #F MET]S :AT "O
%D SEE AT #F MET]S4 ,SIMIL>LY1 #BJ_/DJ
VI.N1 M1NS Y SEE AT #BJ FEET1 :AT Y %D 2
A# 6SEE AT #DJ FEET1 IF ?+S 7 NORMALIZ$4
,? IS ! LEVEL ( VI.N REQUIR$ 6OBTA9 A
DRIV]'S LIC5SE 9 MO/ /ATES2 9 O!R ^WS1 N
P]FECT1 B PRETTY GD VI.N4 ,!N "! IS !
REF];E 6UNCORRECT$ & CORRECT$ VI.N4 ,:AT
IS MO/ IMPORTANT IS H[ GD "O C SEE1 EV5
IF GLASSES >E REQUIR$1 Z 9 8CORRECT$ VI-
.N40 ,TOO (T51 EMPHASIS IS PLAC$ ON UN-
CORRECT$ VI.N1 OR H[ WELL "O SEES )\T
GLASSES4 ,? IS ": "! IS (T5 EXTREME 3FU-
.N Z 6:AT IS M1NT BY 8LEGAL BL;S40   #HE
,? /ATE;T IS FREQU5TLY US$ 9COR-    A#CD
RECTLY1 S* Z SAY+ "S"O 0 8LEG,Y BL0 2F
REFRACTIVE SURG]Y1 :5 ACTU,Y ? IS N TRUE
AT ALL4 ,%AME ON ANY EYE DOCTORS :O AD-
V]TISE ? WAY4 ,LEGAL BL;S M1NS #BJ_/BJJ
VI.N OR WORSE1 .EV5 .) GLASSES1 OR COR-
RECT$ VI.N4 ,_M NE>SI<T$ P _C SEE !
#BJ_/BJJ LRS ON ! EYE *>T )\T GLASSES1 B
) GLASSES !Y USU,Y SEE #BJ_/BJ4 ,& !Y C
(T5 SEE #BJ_/BJ UP CLOSE )\T GLASSES4
,LEGAL BL;S M1NS NO BETT] ?AN #BJ_/BJJ
VI.N EV5 ) CORREC;N 7GLASSES71 .AT .ANY
.4T.E4 ,TOO (T51 ! RESULT ( REFRACTIVE
OR CAT>ACT SURG]Y IS ADV]TIS$ 9 REF];E
6UNAID$ VI.N AT A 4T.E4 ,H["E1 A S-CALL$
GD RESULT ( UNCORRECT$ VI.N MAY ACTU,Y
RESULT 9 IMP]FECT VI.N ) BE/ CORREC;N4
,S A P]SON MAY 2 HAPPY 6SEE BETT] )\T
GLASSES1 B ! BE/ RESULT WD 2 AL NO LOSS
( VI.N ) BE/ CORREC;N4
  ,PASS+ A DRIV]'S LIC5SE VISUAL RE-
QUIRE;T IS ( UTMO/ IMPORT.E 6MO/ ADULTS4
,P AL D N WANT 6BE RE/RICT$ 6WE>+ GLASS-
ES = DRIV+4 ,MO/ NE>SI<T$ P]SONS EXPECT
6BE TOLD !Y NE$ GLASSES = DRIV+1 B   #HF
_M O!RS1 EI 2C !Y H N _H AN EYE     B#CD
EXAM1 OR 2C !Y
-------------------------------------#CE
US$ 6SEE WELL )\T GLASSES1 >E Q SURPRIS$
6BE TOLD !Y NE$ 6H GLASSES = DRIV+4 ,MY
ADVISE = ^? :O ?9K !Y C PASS IS 6G AH1D
& TAKE ! TE/ )\T GLASSES4 ,IF !Y PASS1
F9E4 ,B IF !Y FAIL1 !N PULL \ ! PRE-
SCRIP;N GLASSES & PASS4 ,!N1 ( C\RSE 2C
( BETT] VI.N ) GLASSES1 ! LIC5SE W SAY T
GLASSES M/ 2 WORN4 ,S !N Y BETT] GET US$
6WE>+ YR GLASSES1 S T IF Y >E "E PULL$
OV] 9 A TRA6IC /OP1 Y C AVOID A TICKET
0HAV+ YR GLASSES ON4 ,H["E1 IF Y FAIL
EV5 ) GLASSES & H BE5 TOLD 0YR EYE DOC-
TOR T Y %D PASS1 ASK =! =M = YR DOCTOR
6FILL \4 ,I RECALL "O PATI5T 6:OM ,I
TOLD ?1 & %E LAT] CALL$ SAY+ T ,I _H
TOLD H] 6CALL IF %E FAIL$ ! ,,DMV TE/4
,I SD1 8,S Y FLUNK$ ! EYE TE/10 & %E SD1
8,NO1 ,I FLUNK$ ! WRITT540 ,I _H 6TELL
H] ,I CD N D ANY?+ AB T4
  ,LOSS (A DRIV]'S LIC5SE IS (T5 EX-
TREMELY DEVA/AT+ 6! ELD]LY1 Z ,DR4 ,ROB-
]T ,LEV9E PO9TS \ 9 8 BOOK .,AG+     #HG
.) .,ATTITUDE4 ,! NUMB] ( P 3SID-   A#CE
]$ ELD]LY IS 9CR1S+ RAPIDLY & REPRES5TS
A L>GE P]C5TAGE (! POPUL,N 9 "S /ATES4
,"S /ATES MAKE TE/+ PROC$URES M FREQU5T
OR 9T5SE =! ELD]LY1 : MAY N SEEM FAIR1 B
!N PRO#MS T CD A6ECT SAFE DRIV+ >E IN-
CR1S+LY -MON Z WE GET OLD]1 & M* ( ? C 2
DUE 6POOR UNCORRECT$ OR CORRECT$ VI.N4
,LOSS (! DRIV]'S LIC5SE M1NS LOSS ( /AT-
US & 9DEP5D;E =! ELD]LY1 &= _M X SIGNI-
FIES ! 2G9N+ (! 5D4 ,"! IS A G5D] 7MA*O7
E6ECT 9 ? PRO#M1 2C X IS V DI6ICULT =A
HUSB& 6GIVE AWAY ! DRIV+ "RS 6HIS WIFE2
,I M1N HE HAS 6BE RE,Y SEE+ BADLY 2F HE
W GIVE UP ! :EEL4 ,B !N "! IS ! /ORY AB
! N9ETY-F\R-YE>-OLD MAN 9 ASSI/$ LIV+1
:O TELLS 8 BU4Y T HE IS GETT+ M>RI$4 ,8
FR "QS :Y 6GET M>RI$ AT 8 AGE3 8,IS ?
WOMAN R1L PRETTY80 8,NO1 %E IS N9ETY1 S
:AT WD Y GUESS80 8,WELL1 IS %E RI*80
8,NO1 %E DOESN'T H M* M"OY40 8,WELL !N1
C %E COOK80 8,NO1 %E C'T COOK WOR? A
LICK40 8,WELL !N1 :Y >E Y M>RY+ H]80
8,WELL1 %E C DRIVE1 & .AT .NI<T40
  ,"O-EY$ P >E NATUR,Y 3C]N$ AB      #HH
PASS+ A DRIV]'S TE/1 B USU,Y ONLY   B#CE
"O GD SEE+ EYE IS REQUIR$ =A LIC5SE4
,R\T9ELY1 ? M1NS T YR EYE DOCTOR W NE$
6FILL \ A =M /AT+ :Y Y ONLY SEE WELL )
"O EYE1 EV5 ) GLASSES4 ,IF ! WORSE EYE C
2 MADE 6SEE WELL ) GLASSES1 Y MAY 2 RE-
QUIR$ 6WE> GLASSES = DRIV+1 B YR EYE
DOCTOR C ASK = AN EXCEP;N IF X IS DET]-
M9$ T WE>+ ! GLASSES WD 2 3FUS+4 ,? MAY
2 TRUE IF A P]SON HAS ANISOMETROPIA1 A
M>K$ DI6];E 2T ! EYES1 ":BY WE>+ GLASSES
MAY N IMPROVE ! SECOND-BE/ EYE 6NORMAL1
& MAY CAUSE 3FU.N DUE 6DI6];E 9 IMAGE
SIZES4 ,ONCE ! EYE DOCTOR FILLS \ ! =M1
A P]SON MAY 2 REQUIR$ 6H ! =M FILL$ \ E
"T ! LIC5SE IS 6BE RENEW$1 & UN=TUNATELY
! LIC5SE MAY 2 ONLY = "O YE> AT A "T4
,MOTOR VEHICLE DE"P;T CL]KS D N "K M* AB
EYE 3DI;NS1 & MAY T5D 6BE 8(FICI\S0 AB
DETAILS 9VOLV+ =MS4 ,& LET'S FACE X1 !
=M !Y "W ) IS ANTIQUAT$ & UN"WA# 9 _M
CASES4
-------------------------------------#CF
  ,IS "! S* A ?+ Z SUP]NORMAL VI.N1 & H[
C X 2 OBTA9$8 ,WELL1 ! 9CID;E (      #HI
BETT] ?AN #BJ_/BJ VI.N IS Q HI<1    A#CF
) OR )\T GLASSES--#BJ_/AE OR EV5 #BJ_/AJ
VI.N IS N UNUSUAL4 ,! ABIL;Y 6SEE ? WELL
IS 9NATE1 B MAY REQUIRE GLASSES4 ,"! IS
NO TR1T;T 6IMPROVE VI.N4 ,A?LETES S* Z
,T$ ,WILLIAMS D N H SUP]NORMAL VI.N1 _!
VISUAL P]=M.ES PROBABLY 2+ BE/ EXPLA9$
0EXCEP;NAL 3C5TR,N ABIL;Y & EYE-H& COOR-
D9,N1 : >E P]H N T1*A#4 ,IF A P]SON IS
A# 6SEE NO BETT] ?AN #BJ_/BJ ) CORREC;N1
!N CAT>ACT OR REFRACTIVE SURG]Y _C EX-
PECT 6MAKE VI.N ANY BETT] ?AN T4 ,EX]-
CISES & ALT]NATIVE M$IC9ES MAY 2 ADV]-
TIS$ Z IMPROV+ VI.N4 ,C EX]CISES *ANGE !
%APE (! EYE1 OR MAKE AN EYE SEE BETT]
?AN X "E POT5TI,Y DID8 ,! ANSW] IS NO1 (
C\RSE N4
  ,EX]CISES _C *ANGE ! %APE (! EYE4 ,!Y
_C MAKE Y NO L;G] NE>SI<T$4 ,H["E1 !
IDEA ( IMPROV+ VI.N ) EX]CISES HAS HUNG
>.D =A L;G "T1 F/ POPUL>IZ$ 0,DR4 ,W4
,H4 ,BATES1 :O WROTE A BOOK 9 #AIBJ4
,?\< A /UDY REFUT$ 8 ANECDOTAL CLAIMS1
O!RS H P]SI/$ 9 8SELL+0 S* NO;NS = PR(-
IT4 ,M REC5TLY1 ! 8,SEE ,CLE>LY      #IJ
,ME?OD0 HAS ATTRACT$ M* ADV]TIS+    B#CF
ATT5;N1 & AL1 ,I "U/&1 ! ATT5;N ( ANTI-
FRAUD AC;N4
  ,FOCUS+ PRO#MS MAY SEEM 6BE "S?+ POS-
SIBLY HELP$ 0CORRECTIVE EX]CISES4 ,H["E1
! M1SURE ( R1D+ ABIL;Y IS Q SUBJECTIVE1
(T5 EV5 9 A TE/+ SITU,N1 MAK+ RESULTS (
?+S S* Z FOCUS+ TRA9+ DI6ICULT 6OBJEC-
TIVELY M1SURE4 ,C]TA9LY1 "O'S ABIL;Y TO
R1D ) OR )\T GLASSES IS A6ECT$ 0S* ?+S Z
LI<T+1 /ATE ( RE/1 SIZE ( PUPIL1 SIZE (
PR9T1 3TRA/ ( PR9T Z 9 S(T- V]SUS H>D-
COV] BOOKS1 & V>I,NS ( BLACK ON :ITE
PR9T ( V>I\S NEWSPAP]S4 ,"!=E1 IF Y H
R1D+ GLASSES1 X IS M OBJECTIVE 6RATE YR
VI.N ON ! BASIS ( H[ Y SEE )! CORRECTIVE
GLASSES1 R ?AN 2 3C]N$ AB APP>5T V>I,NS
( VI.N )\T GLASSES4 ,AL1 AC 6! BE/ 9=MA-
;N1 FOCUS+ PRO#MS >E N SECOND>Y TO 8W1K
MUSCLES10 B >E R DUE 6! 9CR1S+ RIGID;Y (
! NORMAL L5S (! EYE ) AGE1 MAK+ FOCUS+
EF=TS LESS SU3ESS;L4 ,"!=E1 EX]CISES EX-
PECT$ TO 8/R5G!N0 ! FOCUS+ MUSCLES (!
EYE >E N EXPECT$ 6HELP4
                                     #IA
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