Prism Correction

On our blog, we have covered diplopia before, also known as double vision. This occurs when someone sees two images of one object. Prism correction can help to align the two images so that a person only sees one image.

The reason some people have double vision, is because the light coming into the eye and hitting the retina is falling on different parts of the retina in each eye. In order to see one image, light would need to fall in the same place on the retina in each eye.

How Does Prism Glasses Fix Diplopia?

Prism glasses are incredibly cool and can fix someone’s vision if they are seeing double. The prism added to the glasses bends the light before it travels through the eye. It redirects the light to the right place on the retina in each eye which then triggers the brain to fuse the two images together to make one picture.

Can Prism Glasses Fix All Double Vision?

The short answer is no. The long answer is that there are a number of double vision causes that prism glasses can fix:

  • Eye muscle problems
  • Brain related issues
  • Nerve related problems

Unfortunately though, there are some causes that prism glasses cannot help to correct. Double vision can be a sign of a seiours health condition. It is so important to make sure to seek professional care if you are suffering from double vision. Especially if your double vision:

  • Happens for unknown reasons
  • Is a new development
  • is caused by eye misalignment

How do you know if you need Prism in your glasses?

Like most eye correction methods, your eye doctor will determine whether you will benefit from prism being added to your glasses. There are a few different tests that can be performed if your eye doctor decides they are necessary.

  • Hirschberg Test – In this test a pen light is aimed at the eyes, and the lights reflection should appear in the center of the pupil in each eye. If the reflection is off center in either eye, there may be an alignment issue.
  • Krimsky Test – This test is used to find the severity of a misalignment that has been identified. This test uses a pen light as well with the addition of prisms of different strengths. The different prisms are placed in front of the eye, and when a prism brings the reflection in each eye to the center, the correct prism measurement has been found.
  • Cover Test – There are three different types of cover tests. The cover/uncover test, the prism and alternate cover test, and the Maddox rod test. Each of these tests will help your eye doctor to determine what type of double vision you have.

Prism Correction in eyeglasses can help to correct diplopia, or double vision. Be sure to always bring up any eye issues with your eye doctor in your normal ey exams. This will help your eye doctor to decide the best course of action to diagnose and correct any vision problems you are having!

Eye Pressure

Something that doesn’t get a lot of attention is eye pressure, or Intraocular Pressure. This little discussed topic is actually an incredibly important part of your eye health.

Intraocular (eye) Pressure is the pressure inside your eyes. It is the measurement of fluid pressure in your aqueous humor. There is a certain amount of pressure that your eyes need in order for them to work and be healthy. If your eye pressure is high, it can lead to other eye issues like glaucoma. If left untreated over time, it can cause harm to your vision.

A look at what Eye Pressure is

Eye pressure is an important part of your eyes overall health. Your eyes are filled with fluid. There are two types of fluid in your eye.

  • The vitreous humor in the chamber at the back of your eye.
  • The aqueous humor the fills the area at the front of your eye. The aqueous humor is thinner than the vitreous humor.

Normally, your eyes will know how to regulate this on their own. As your eye makes new aqueous humor, it will remove the same amount.

Measuring Eye Pressure

The best way to get your eye pressure measured is during a regular eye exam. The test used to measure eye pressure is a tonometry test. This test measures the pressure inside of your eye by flattening your cornea. The more force needed to flatten your cornea, the higher your eye pressure is.

The air puff tonometry is the most common type of tonometry. You may have had this done in the past, it’s not particularly fun, but it is so important. If necessary another way to test this would be to numb your eye and press a tool against your cornea.

A normal and healthy amount of eye pressure to have is between 10mmHg and 20mmHg. (millimeters of mercury). Your eye doctor can determine if your eye pressure is normal with one of the two described tests.


There are many different things that can cause high eye pressure. Since your body knows to automatically adjust the pressure in your eye, if this pressure is off that means there is something wrong. Some things that can change your eye pressure faster than your body can regulate it are:

  • Trauma or eye injuries
  • Side effects of medications like corticosteroids
  • A blockage
  • Your eye producing too much aqueous humor

If you have high eye pressure you are risk of developing glaucoma and it can lead to damaging you vision.

Symptoms and Treatment

High eye pressure does not normally cause any kind of symptoms that you would notice in your day to day life. This is another good reason to have regular eye exams regardless of just your eyesight. We have covered many times just how important eye exams can be to your overall health.

High eye pressure isn’t going to cause any symptoms until it’s already damaged your optic nerve enough to affect your vision. You can discuss with your eye doctor at your next visit how often they recommend to get your eye pressure tested.

If you are diagnosed with high eye pressure there are a few different ways to treat it:

  • Laser treatment
  • Surgery
  • Medication like eye drops

Your eye doctor will recommend what they think will be best based of off their findings from your eye pressure test.

Bottom Line

As always we want to reiterate how important regular eye exams are to your overall health. There are a lot of issues that will be identified early if you have regular eye exams. Not only do you have a record of your previous eye health but your eye doctor will notice smaller changes from year to year since they regularly see you.

Your eye health is important and we want to make sure you are well equipped with the knowledge to keep them healthy for as long as possible!


Have you ever heard of keratoconus? We love to bring you information about common eye issues that everyone may face in their lifetime. Every now and then, we like to bring awareness to the lesser know eye issues that not as many people know about.

One that we wanted to bring attention to today is Keratoconus. This eye issue happens in approximately 2,000 people in the United States. It can begin usually in puberty and then progressing into the mid 30s. The condition may take up to 10 years to progress, or even longer.

What is Keratoconus?

This eye condition is when your cornea gets thinner and gradually bulges outward into a cone shape. The Cornea is the clear, dome front of your eye. If your cornea becomes coned shaped, it can cause a lot of issues for your vision.

This condition can affect one eye more than the other eye, so you may need a different prescription in one lens.

Symptoms of Keratoconus

  • Sudden worsening or clouding of vision
  • Blurred or distorted vision
  • Frequent changes in eyeglass prescriptions
  • Increased sensitivity to bright light and glare

What Causes Keratoconus?

There are not any known causes for keratoconus. It is thought that there are genetic and environment factors that can contribute to it. The statistics go up if your parent has the condition.

Things that can increase your chances of developing keratoconus:

  • Rubbing your eyes vigorously.
  • Having other conditions like retinitis pigments, Down syndrome, Ehlers-Danlos syndrome, Marfan syndrome, hay fever and asthma.
  • Having a family history of keratoconus.


Depending on the severity of the condition the treatment can range from prescription eye glasses to surgery.

In the early stages, the vision problems can be corrected with glasses or soft contact lenses. If the condition develops, you may need to be fitted with rigid, gas permeable contact lenses or other types of lenses like scleral lenses. If the condition continues to progress and get worse, you may need a cornea transplant.

There is a procedure called corneal collagen cross-linking that may stop or slow the progression of keratoconus, if caught early enough. This could also prevent the need for a future cornea transplant.

Low Vision Awareness

February is low vision awareness month, so we thought this was the perfect time to shed some light on the topic. According to the National Eye Institute millions of people in the US are living with a visual impairment.

Having a visual impairment can make things like every day activities hard to do.

What is Low Vision?

Low vision is when someone has uncorrectable, reduced vision. It means that their vision cannot be improved by wearing glasses or contacts.

According to the American Optometric Association, the criteria for low vision is 20/200 or worse. Most of us know that 20/20 vision is what we are shooting for each year at our eye exam.

For reference, 20/500 to 20/1000 is considered profound low vision and less than 20/1000 is considered near total low vision.

In the United States, anyone who has vision that cannot be corrected better than 20/200 in their best eye or who has 20 degrees or less of their visual field remaining is considered legally blind. So to be legally blind does always mean you cannot see anything.

What Causes Low Vision?

While low vision affects so many people in the world, there are many different things that can cause it. Some of the main things that can cause low vision we have talked about on our blogs in the past. They include:

  • Macular Degeneration – This affects the retina, causing blurred vision. If developed later in life can be caused by smoking and poor nutrition.
  • Cataracts – This is clouding of the lens inside the eye. The clouding keeps light from being able to reach the back of the eye which is needed for sight.
  • Glaucoma – This happens when there is increasing internal pressure in the eye because of issues with the flow or drainage of fluid within the eye. This pressure causes damage to the optic nerve.
  • Diabetic Retinopathy – This can happen to people with diabetes. The diabetes can cause blood vessels to develop tiny branches that leak and keep all of the nourishment from getting to the Retina.
  • Retinitis Pigmentosa – This is an inherited disease that causes vision impairment.
  • Amblyopia – This is when the visual system does not develop normally during childhood resulting in blurry vision that is not easily corrected.
  • Retinopathy of Prematurity – This affects newborns who are born prematurely and the high oxygen levels in incubators during the critical neonatal period can cause it.
  • Retinal Detachment – This is when the retina separates from is underlying layer.
  • Traumatic Brain Injury – any traumatic brain injury can affect the eye and result in long term vision impairment issues.

Common Types of Low vision

  • Loss of central vision
  • Blurred vision
  • Reduced Contract Sensitivity
  • Glare light sensitivity
  • Loss of peripheral vision
  • Night Blindness

Low Vision Rehabilitation

If you are suffering from low vision there are some things that eye doctors can do to help improve your quality of life. Some eye doctors specialize in low vision rehabilitation. This rehabilitation can help people with low vision get their independence back.

People with low vision can learn a variety of techniques to help them perform daily activites with their remaining vision. There are also government and private programs that offer educational counseling, occupational therapy and more.

Winter Eye Tips

We want to remind our customers about protecting their eyes, since this time of year winter eye safety usually not at the forefront of your mind.

It is normal during the summertime to remember to grab your sunglasses before you hit the beach or the pool. Did you know that it is just as, if not even more important to bring them along during the winter months?

Wear Your Shades

A winter eye safety survey was done by the American Optometric Association noted that 80% of Americans wear sunglasses in the summer, but less than a third wear them in the winter. This is primarily due to the colder temperatures and overcast skies much of the country sees this time of year. We want to remind you, that even when it’s cloudy 80% of the sun’s UV rays are still coming through and have the potential to harm your eyes.

While here in the Lowcountry, we don’t see much snow, many families plan vacations to go skiing, tubing or just enjoy a change of scenery. If you plan to head to a higher elevation, your eyes are not used to the strength of the UV rays the closer you get to the sun. Higher elevation equals higher UV rays and the potential for a disorder called photokeratitis (Snow Blindness). This is basically like a sunburn for your eyes, which sounds awful. Make sure to keep your sunglasses on while exploring!

Lasting effects of UV Rays

One main concern aside from snow blindness is that exposure to too much of the bad UV rays could cause cataracts later in life. The World Health Organization says  20% of cataracts may be the result of overexposure to UV radiation. Furthermore, the effect cataracts has on your long-term eyesight is not good! It can lead to total blindness. While this is a worst-case scenario, it’s still good to keep in mind anytime you are outside.  The UV rays are affecting your eyes so why not protect them??

If you are thinking you need a new pair of sunglasses to sport on your next winter vacation. Or maybe you just want to wear them around town to always keep your eyes protected. Come by our offices to find the right pair for you!

We offer many styles and brands that can be made into prescription if needed! You may even be able to get your sunglasses covered by your insurance provider.

Dry Eye

Another danger to your eyes in the winter time is dry eye. The air in the winter is drier than the other seasons. Plus, the use of heat in your home is also another way we dry out the air around us in the winter months. Both of these combined can cause a higher amount of people to suffer from dry eye during the winter months.

Some recommendations from the AAO to help keep your eyes from drying out are:

  • Protect your eyes in windy areas
  • Avoid cigarette smoke
  • Rest your eyes often and blink
  • Try artificial tears
  • Omega-3 fatty acid supplements
  • Warm compress over your eyes

We also have some great dry eye therapy we offer if your dry eye persists and is causing you a lot of discomfort.

Tricounty Eye Associates wants to make sure you are well prepared for what the winter months can bring. We also want to remind you that we have everything you need to keep your eyes safe!

Call or come by to check out our extensive sunglass collection and ask us about our dry eye therapy!

Back to Basics

We normally use this platform to discuss the many things that can go wrong with vision. The issues you may face as you age, or if you were born a certain way are important to know and understand.

We wanted to take a different approach today and dive into how your eye’s work and what should be happening if there are no vision correction issues.

Your eye is made up of so many different parts, but they are all vital to help you see clearly. We are going to divide up the eye into four parts:

  • The Eye Outside The Eyeball
  • The Front of the Eye
  • The Back of the Eye
  • The Surface of the Eye

The Eye Outside The Eyeball

There are two main sources of connection from your eye socket to your eye ball:

  • Extraocular Muscles -These are six muscles inside the eye socket (orbit) that move the eye up an down, side to side and route the eye.
  • Sclera – this is a layer of strong tissue that covers almost the entire surface of the eye ball and is what the extraocular muscles attach to on the eye.

Surface of the Eye

The surface of your eye is covered with a clear membrane. This clear membrane is called the Conjunctiva, which is the mucous layer and is the first layer of tear film. The next two layers are the watery layer and the oil layer. All these layers of tears help to protect your eyes and keep them lubricated.

The Front of the Eye

The cornea is a dome shape part of your eye that light focuses into the eye through. Behind the cornea is a fluid filled space called the anterior chamber. The eye is always producing this fluid called aqueous humor. This liquid helps to regulate eye pressure by filling and draining from this space.

Behind the anterior chamber is the Iris which is the colored part of the eye as well as the pupil. The pupil is the dark hold in the middle of the eye which will constrict and dilate to control the amount of light that reaches the back of the eye.

Directly behind the pupil is the lens of the eye. The lens is what focuses the light the iris and pupil let in on the back of the eye. The cornea and lens are both really important players in making sure to give us clear vision. 70% of the eye’s focusing power comes from the cornea and 30% comes from the lens.

The Back of the Eye

There is a cavity that lies between the lens and the back of the eye which is called the vitreous cavity. It is filled with a jelly like substance called vitreous humor.

Like we already mentioned, light is focused by the cornea and lens. It is then passed through the vitreous onto the retina. The retina is the light sensitive tissue that lines the back of the eye. There is a very small area of the retina called the macula that gives us our detailed and central vision. There is also another part of the retina that provides us with peripheral vision called the peripheral retina.

The retina has cells called photoreceptors that change light into energy that is transmitted to the brain. There are two different types of photoreceptors:

  • Rods – perceive black and white and enable night vision
  • Cones – perceive color and provide detail vision

The retina uses electrical impulses to send light through the optic nerve to the brain. The optic nerve then sends these impulses to the visual cortex which his the part of the brain that is responsible for sight.


The eye is the second most complex organ in the human body, only after the brain. There are so many working parts that all work together to give you your sight. It is no mystery why it helps to have a professional help you make sure your eyes are working in tip top shape!

TriCounty Eye Associates wants to be your eye care provider and we are here for anything and everything you might need regarding your eyes!

New Year’s Resolutions

It is that time of year again, where we reflect on the past year’s high’s and low’s and look to the future. It can feel like a new beginning and usually invigorates people to set goals. Some usual new year resolutions are exercise more and eat better. Did you know that both of those goals could also enhance your vision?


We all know that regular exercise is good for you, this of course, is not news. BUT did you know that in addition to keeping your heart and body healthy it may also help your eye health?

There is a study that has linked regular exercise to eye health. According to the American Academy of ophthalmology, exercise can help you guard against eye damage and help prevent serious diseases.

Some of the diseases that it could help prevent are:

  • Macular Degeneration (AMD) – This is a leading cause of vision loss for people over 50, and this happens when the small central portion of your retina wears down over time.
  • Glaucoma-this is a group of eye conditions that cause damage to the optic nerve, this is usually caused by abnormally high pressure in your eye.
  • Diabetic Retinopathy-this is damage caused to the blood vessels of the retina, as a result of diabetes.

Cardio exercise will increase the flow of blood to the optic nerve and the retina. The science behind the link is that exercise promotes healthy blood vessels in the eye. This means, that exercise boosts the resilience of your eyes to damages. Vision problems and eye disease can also be a byproduct of high blood pressure and high cholesterol. Regular exercise and a healthy diet can help to lower both your blood pressure and your cholesterol, which in turn help you prevent future eye problems.


Your overall health and eye health is all interconnected and being health conscious about your food and making sure to get your physical activity in can make such a difference. There are certain nutrients found in commons foods that are good for you eyes like Vitamins C and E, zinc, lutein, and omega-3 fatty acids.

Examples of foods that are good for you and your eyesight are:

  • Spinach/Kale/Collards
  • Salmon/Tuna
  • Eggs/nuts/beans
  • Oranges and citrus fruits

Just adding some of these to your weekly meals will help dramatically.

Eye Health

By taking steps towards a healthier lifestyle you are not only helping your waistline or your heart but your eye health as well. As we move towards a new year, and setting new goals, keep in mind how much your healthy habits will affect your whole body health.

In addition to exercise and healthy food, do not forget to schedule your eye exam with us here at TriCounty Eye Associates! A regular eye exam should always be a part of your healthy lifestyle.

Retinal Detachment Syndrome

One of our goal with these blogs is to inform our patients about the different type of issues they could face when it come to their eye health.

The human eye is so complex that it leaves a lot of room for issues to arise. One of those issues is Retinal Detachment. This conditions can result in permanent vision loss if not treated. One in ever 300 people are affected by this condition. The best way to keep from losing your vision with this condition is early detection.

What is the Retina?

The Retina is responsible for capturing images and transmitting them to the brain. It is a delicate tissue layer that is located at the back of the eye containing cells that are light-sensitive. The retina is anchored to the back of the key by the retinal pigment epithelium, which also serves as a filter and support system for the rods and cones.

Retinal Detachment

This condition is when the retina pulls away from the eye and essentially detaches. Trauma, surgery, and infections can all be events that lead to the retina detaching from the eye. The most significant factor that will cause detachment is age. As you age the fluid in our eyes shrink and can create a tiny tear in the retina. You are also at a higher risk of having retinal detachment if someone in your family has had it happen before.


There are some signs you can look for to give you time to reach out to your eye doctor. Usually pain is an indicator that there is something wrong. With Retinal Detachment, there is normally no pain related. Some things that will happen include:

  • An increase in the number of floaters you see
  • Sudden flashes of light
  • A shadow in your peripheral vision
  • Feeling of heaviness or pressure in one eye
  • Straight lines that appear to curve

What can you do about it?

Knowing the symptoms or signs can help you, but the biggest thing you can do is remember to get regular eye exams. Make sure to let your eye doctor know if you have any family history of retinal detachment as well as any of the above symptoms. Your eye doctor may be able to detect an issue early by being able to compare images of your retina year after year.

As always, we want to be a part of your entire eye health journey! Call us to make your next appointment!

Calling All FSA, HSA and HRA Holders

It’s that time of year again! Time to look at your Vision benefits and evaluate your health savings options to see if you need to use it before you lose it. We see it happen all the time, you contribute to your FSA or HSA all year long. Before you know it December rolls around and you need to use what you have saved. We also want to touch on HRA’s which your employer may be contributing to on your behalf.

Many employers offer different types of health savings accounts. While we know this time of year can be busy enough, we wanted to try to help weed through the different kinds of health savings.

Three Major Health Savings Options

HRA – Health Reimbursement Account

This type of account is an employer funded plan that reimburses employees for qualified medical expenses. Reimbursement dollars that employees receive are usually tax free. Your employer will decide how much they will put into the plan. Then, you as the employee can request reimbursement for medical expenses up to that amount. 

Each HRA plan is going to be set up differently depending on the employer. It’s important to discuss your options with your HR rep at work. They will be able to tell you exactly what the HRA funds can be used for so that you stay compliant.

FSA-Flexible Spending Account

This type of account is the type you want to plan carefully how much you save. This type of account can be used to help pay for copay deductibles and prescriptions. You don’t pay any taxes on this money so it can be helpful to contribute throughout the year if you can accurately estimate your family’s needs. This is the one to watch though, if you still have funds in there this late in the year, you want to make sure to use them.

HSA-Health Savings Account

This type of account also allows you to put in pretax dollars, but you don’t have to worry about losing the funds at the end of the year.

Whether you have an HSA or an FSA TriCounty Eye Associates could be the perfect use of those hard-earned dollars you put aside for health expenses. Maybe you or someone in your family needs new glasses or sunglasses? Maybe you just haven’t made the time yet this year to schedule your yearly appointment?

What is the difference between an HSA and FSA?

HSA – Health Savings Account 

  • You or your employer contribute pre tax dollars
  • Unused contributions roll over year after year
  • HSAs must accompany a high deductible health plan (individual or through employer
  • Withdrawals are allowed with 10% penalty
  • HSAs have higher contribution maximum than FSAs

FSA – Flexible Spending Account

  • Typically FSA funds must be used by the end of the plan or calendar year
  • Account cannot be used after you leave the employer
  • FSAs must accompany group insurance through employer
  • Withdrawals are not allowed

What Can you use your HSA or FSA funds on?

Your vision insurance is probably going to cover  one set of glasses or give you an allowance on what you can spend. If you contribute to a FSA or HSA you can use those funds to purchase the more expensive frames you want, or more than one pair of glasses to switch out your frames form time to time.  In general you can use your funds for:

  • Reading glasses
  • Progressives
  • Prescription blue light glasses 
  • Prescription anti-fatigue glasses
  • Prescription glasses
  • Prescription sunglasses

You can also choose to use your funds on contacts if they are medically necessary!

There are other things you can use the funds on as well aside form hardware. Other approved expenses would be eye exams, LASIK, copays and deductibles, eyeglass cleaning supplies and eye drops!  It is important to check with your individual FSA or HSA provider to make sure anything that might fall into a grey area is covered. 

What is NOT Eligible?

While there are so many things you can use these funds on there are still some things you shouldn’t use it on.

  • Non-prescription glasses
  • Non-prescription sunglasses
  • Non-prescription  contacts
  • Insurance premiums
  • How to use your funds

This is going to depend on your specific plan. Some proivders will send you a debit card that you can use on the approved expenses. Other plans will require you to pay out of pocket but get reimbursed so it is important to hang on to receipts. 

Vision Insurance Limitations

Another part of your insurance you want to be aware of is the Vision Plan you have. Depending on the type of plan you have you may be limited to a certain number of frames, lenses, contacts, or eye exams per year. Make sure you get it in during the calendar or plan the year your plan supports. You pay for these benefits so don’t let them go to waste!

Bottom Line

FSA and HSA accounts can be a great way for you to set aside pre-taxed funds to spend on health expenses throughout the year. When enrolling in your employers benefits, make sure to take a look at the average expenses your family has each year to determine how much to contribute to your plan. HRA’s are also great because its extra money your employer is giving you to help pay for medical expenses. Make sure to make the most of the benefits your employer offers!

Call us today to schedule your end-of-the-year appointment and make sure to utilize your vision benefits in every way possible.


We have talked about this new lens technology on our blog before. We thought it was worth another look considering the amazing benefits of these lenses. Keep reading to see if they will be a good fit for you!

What is Neurolens?

Neurolens are specifically designed lenses that use a contoured prism to realign your eyes and relieve pressure on the trigeminal nerve. These lenses are designed to help with digital eye strain and help with reading or doing work up close.

In today’s world, blue light is almost completely unavoidable. We all work or spend time on a laptop, smartphone or watching a television. Blue light has been proven to cause digital eyestrain. You can check out more about digital eye strain in our other blog here: PUT LINK HERE

How does Neurolens Work?

It has been found that there is a direct correlation between the trigeminal nerve and the eyes. The trigeminal nerve is the biggest nerve connected to the brain and responsible for neck and head sensations. Headaches, tension and eye strain are caused by misaligned eye’s that can put pressure on this nerve.

There is a specialized diagnostic that Neurolens uses to try to find any misalignment in the eyes and what the severity of the problem is. Once the measurement device measures where the gap between your eyes should be versus where it actually is, it can determine if you have a misalignment and how to fix it. It is a very quick and easy test.

Neurolens is the first to use a contoured prism that helps with misalignment at different distances.

Benefits of Neurolens

If you suffer from digital eye strain, this could be the best solution for you. The main symptoms of digital eye strain are:

  • Eye strain
  • Headache
  • Neck and shoulder tension or pain
  • Eye irritation
  • Dry Eyes

Neurolens has helped so many people already to relieve them of these symptoms.

Is Neurolens for you?

It is best to talk to your eye doctor about your options. If you spend a lot of time on a computer or struggle to read, and suffer from any of the above symptoms you could be a perfect candidate!

Next time you are in for an eye exam, ask us about it!

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