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6 Ways To Maintain Eye Health If You’re Over 50

Aging and certain lifestyle choices can affect your vision, especially if you’re in your 50’s and up. While it’s normal for your eyes and vision to change, there are certain actions you can take to protect your sight. 

6 Tips for 50+ Eye Health

  1. Eat Well

    A well-balanced diet helps maintain a healthy body including healthy eyes, and reduces your odds of developing some very serious eye diseases. Nutrients and nutritious foods, which help prevent vision loss include:

    • Vitamin A: Carrots, spinach, kale, egg yolks, dairy products
    • Vitamin C: Citrus fruits and juices, broccoli, potatoes, green peppers
    • Vitamin E: Whole grains, eggs, sunflower seeds, vegetable oils
    • Fatty Acids: Coldwater fish, such as mackerel, rainbow trout and salmon; corn oil, sunflower oil, flax and chia seeds
    • Lutein: Kale, spinach, broccoli, brussels sprouts, corn
    • Zinc: Poultry, meat, fish, dairy products, whole grains
  1. Quit Smoking

Smoking can significantly increase the chances of developing age-related macular degeneration and cataracts, as well as diabetic retinopathy in people with diabetes. So if you smoke, the sooner you quit, the better. 

  1. Exercise

Exercising for at least 20 minutes a day is great for your whole body, including your eyes, by increasing blood flow to the optic nerve and retina! It isn’t necessary to engage in strenuous exercise—in fact, a brisk walk will suffice. 

  1. Protect Your Eyes

Sunglasses

Protecting your eyes from ultraviolet rays with UV-blocking sunglasses can slow down the development of cataracts, prevent sun damage to your retina, and lower the risk of skin cancer near your eyes.

Protective eyewear

Another way to protect your eyes is to wear protective eyewear. If you play sports or work with materials such as wood, glass or metal, protective eyewear can shield your eyes from splinters and shards, as well as fast-moving objects like balls and hockey pucks.

  1. Give Your Eyes a Rest

If you spend a lot of time reading, driving or looking at digital devices, you may develop eye strain and eye fatigue. By implementing the 20-20-20 rule, especially during prolonged computer or smartphone use, you can give your eyes some much-needed rest. All you need to do is this: every 20 minutes look at something 20 feet away for at least 20 seconds. 

  1. Have Regular Eye Exams

And finally, a comprehensive eye exam is crucial, as it can detect eye conditions that don’t display any symptoms until vision loss has already occurred.

These conditions include:

    • Age-Related Macular Degeneration
    • Cataracts
    • Glaucoma
    • Diabetic Retinopathy

When detected early, treatment can often prevent permanent vision loss or even blindness. Less serious and more common, presbyopia or age-related farsightedness, develops with age, and simply updating your prescription for glasses or contact lenses at your routine eye checkup can keep you enjoying the arm’s-length activities you love.

Age-related vision changes can be challenging, both emotionally and physically. However, some of these can be mitigated by implementing the tips above. Schedule an eye exam with Dr. Hopkins & Associates in Niagara-on-the-Lake to check your eye health today! 

 

Q&A

How does aging affect your eyes?

Aging causes changes in every part of your body, including your eyes. As you age, the lens inside your eye begins to harden, which leads to presbyopia (age-related farsightedness). This makes it more difficult for your eyes to focus on near objects and tasks like reading. Other common age-related eye problems include:

  • Age-Related Macular Degeneration
  • Cataracts
  • Glaucoma
  • Diabetic Retinopathy
  • Dry Eyes
  • Floaters
  • Changes to Peripheral Vision

Can I do anything about my chances of vision loss?

It is estimated that half of all visual impairment and blindness can be prevented through early diagnosis and treatment. So make sure you get regular eye exams to ensure that all is in check. 

 

Why Does Bono Always Wear His Signature Shades?

Ever wonder why Bono always wears shades, even indoors? U2’s frontman doesn’t sport sunglasses simply as part of his image. Bono has had glaucoma—a build-up of pressure in the eyeball, which can damage the optic nerve and potentially lead to blindness if untreated—for over two decades now. 

The real reason he wears his trademark shades is due to this progressive, sight-robbing eye disease, to protect his sensitive eyes from light and glare. 

How Do Sunglasses Help People With Glaucoma?

People with glaucoma experience sensitivity to light (or photophobia) and glare, among other symptoms. When the sun is strong, those with this condition will be more affected by glare emanating from a variety of surfaces, like water, snow, sand or pavement, than the average person. Furthermore, certain glaucoma medications constrict the pupils, which can further contribute to acute sensitivity to glare and light, as well as redness and irritation.

That’s why people with glaucoma — and lots of people without glaucoma — feel best wearing sunglasses when outdoors on a sunny day, in a bright indoor space, or while driving in the early evening. 

Here’s How You Can Protect Your Eyes 

By wearing sunglasses that offer 100% UV protection, you can reduce your risk of developing sight robbing diseases, like cataracts and macular degeneration, and reduce glaucoma symptoms. Polarized lenses, in particular, can help with glare. With yearly comprehensive eye exams, early diagnosis and consistent treatment, you can prevent vision deterioration from glaucoma or similar sight-threatening eye diseases. Contact Dr. Hopkins & Associates in Niagara-on-the-Lake to book your eye doctor’s appointment today.

Q&A

Can glaucoma be cured?

While there is currently no cure for glaucoma, there are many effective treatment options available. Treatments that can help stop or slow the progression of glaucoma include eye drops, oral medications, as well as laser and surgical procedures. 

How can glaucoma vision loss be prevented?

The best way to avoid glaucoma-related eyesight deterioration is to undergo regular eye exams, as glaucoma can be detected and treated even in its early stages, which can prevent significant vision loss or blindness. That’s why routine eye exams that include glaucoma testing are so important.

How Sleep Apnea Affects The Eyes

Did you know that some eye conditions are associated with sleep apnea? According to the National Sleep Foundation, more than 18 million Americans have sleep apnea, and Health Canada reports similar prevalence. It’s a sleep disorder where people stop breathing — often multiple times per night — while sleeping.

If you have sleep apnea: it tends to take longer for your tears to be replenished, you’re more likely to have ocular irritation, you have a higher chance of developing floppy eyelids, and you’re at increased risk for glaucoma.

What Is Obstructive Sleep Apnea?

There are different types of sleep apnea. The most common one is obstructive sleep apnea (OSA). During OSA, your airway becomes partially blocked due to relaxed muscles in your nose and throat. This causes apnea (the absence of breathing) or hypopnea (abnormally shallow, slow breathing). It’s twice as common in men, and is more likely to affect people with obesity, hypertension, diabetes or heart disease. 

What are the common symptoms of sleep apnea?

Sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These temporary breathing lapses cause lower-quality sleep and affect the body’s oxygen supply, which can lead to potentially serious health consequences. 

While snoring is a common symptom, not everyone who snores has sleep apnea. Interrupted sleep can cause excessive daytime sleepiness, fatigue, irritability or depression, headaches in the morning, difficulty concentrating and thinking, and a sore throat.

Which Eye Conditions Are Associated With Sleep Apnea?

Glaucoma

Glaucoma occurs when increased pressure within the eye damages the optic nerve, which connects the eye to the brain, leading to vision loss and sometimes blindness. In some cases, it might be due to a drop in blood oxygen levels, which happens when you stop breathing. However, CPAP machines, one of the most common treatments for sleep apnea, can also cause glaucoma. 

So, people with sleep apnea — even if it’s being treated — need to get their eyes checked on a regular basis for glaucoma.

Floppy Eyelid Syndrome 

Floppy Eyelid Syndrome (FES) is an eye condition where a person has an unusually large and floppy upper eyelid. It can cause eye redness, irritation, discharge, or blurry vision — and over 90% of people with FES also have sleep apnea.

Non-Arteritic Anterior Ischemic Optic Neuropathy

Non-arteritic anterior ischemic optic neuropathy (NAION) is an eye condition that occurs when there is a loss of blood flow to the optic nerve. Patients typically complain of significant vision loss in one eye without any major pain. Approximately 70-80% of patients with NAION have been found to have OSA.

Retinal Vein Occlusion

Also referred to as an ‘eye stroke,’ retinal vein occlusion (RVO) is a blockage of the small veins that carry blood away from the retina. A recent study of 114 RVO patients found that sleep apnea was suspected in 74% of the patients that had previously been diagnosed with RVO. 

Other Eye Health Issues Associated With Sleep Apnea

Some other ocular conditions that are more common in patients with sleep apnea include: papilledema, keratoconus, and central serous chorioretinopathy. Furthermore, in addition to glaucoma mentioned above, CPAP machines are associated with dry eye syndrome and bacterial conjunctivitis.

Talk To Your Doc

Get eye exams regularly to rule out eye disorders and prevent potential vision loss, especially if you have been diagnosed with sleep apnea. At Dr. Hopkins & Associates in Niagara-on-the-Lake we encourage you to share your medical history with us so we can better diagnose and treat any eye conditions or ocular diseases you may have, and help you keep your eyes nice and healthy.

What You Should Know About Night Blindness

If you don’t see well while driving at night, there’s a chance you have night blindness. Night blindness, or nyctalopia, is the inability to see well at night or in dim lighting. It’s not considered an eye disease, but rather a symptom of an underlying problem.  

Our eye doctors can help diagnose, manage and treat your night blindness so that you can enjoy being out at night again. 

Here are 4 things you should know about night blindness:

Causes of Night Blindness 

The inability to see well at night can be the result of a condition such as:

Vitamin A Deficiency — Vitamin A helps keep your cornea, the layer at the front of your eye, clear; it’s also an important component of rhodopsin, a protein that enables you to see in low light conditions. Although uncommon in North America, deficiency of this vitamin can induce night blindness. 

Cataracts — A buildup of protein clouds the eye’s lens, leading to impaired vision, especially at night and in poor lighting conditions.

Diabetic Retinopathy — Damage to the eyes’ blood vessels and nerves can result in vision loss, including difficulty seeing at night.  

Glaucoma — This group of eye diseases is associated with pressure build-up in the eye that damages the optic nerve. Both glaucoma and the medications used to treat it can cause night blindness. 

Myopia — Also called nearsightedness, myopia makes distant objects appear blurry, and patients with it describe a starburst effect around lights at night.

Keratoconus — An irregularly shaped cornea causes blurred vision and may involve sensitivity to light and glare which tend to be worse at night.

Retinitis Pigmentosa (RP) — A progressive genetic eye disease which can be associated with other diseases, RP leads to night blindness and peripheral vision loss.

Usher Syndrome — This genetic condition causes both hearing loss and vision loss, including night blindness and RP, mentioned above.

Symptoms of Nyctalopia

Since night blindness is a symptom of some serious vision problems, it’s important to get your eyes checked regularly to ensure that everything is in good working order. Contact your eye doctor as soon as possible if you notice that you don’t see as well in dim light as you used to, such as when driving at night or when adjusting from being outdoors in the sunshine to being indoors. 

Symptoms of Night Blindness Include:

  • Reduced contrast sensitivity
  • Difficulty seeing people outdoors at night
  • Difficulty seeing in places with dim lighting, like a movie theater
  • Trouble adapting to the dark while driving
  • Excessive squinting at night 
  • Trouble adjusting from bright areas to darker ones 

Treatments for Night Blindness

Your eye doctor will want to diagnose the cause of your night blindness in order to treat it. For example, in the rare case of vitamin A deficiency, it can be treated with vitamin supplements and vitamin-A rich foods; myopia can be corrected with eyeglasses or contact lenses. Other conditions may require medications or surgery. 

If night blindness is caused by a birth defect, Usher syndrome, or retinitis pigmentosa, low vision aids and devices can help you make the most of your remaining vision. 

Prevention

While there is no proven way to prevent night blindness resulting from genetic conditions or birth defects, consuming healthy, nourishing foods and taking certain vitamin supplements may prevent or slow the onset of some eye conditions that cause night blindness. 

If you experience poor vision at night or in dim lighting, we can help. Contact Dr. Hopkins & Associates in Niagara-on-the-Lake to schedule your appointment today. 

6 Common Myths About Glaucoma

Glaucoma is an eye disease in which increased pressure causes progressive, permanent vision loss and even blindness. Unfortunately, many misconceptions about the disease can leave you misinformed. Below we sort fact from fiction by debunking 6 of the most common glaucoma myths.

Glaucoma Facts vs. Myths

MYTH 1: Glaucoma is a single disease

FACT 

Glaucoma is a group of eye diseases; the most common ones are open-angle glaucoma (OAG) and angle-closure glaucoma (ACG). 

In open-angle glaucoma, the drainage structure in your eye (called the trabecular meshwork) doesn’t allow the fluid inside the eye to flow out as it should, causing an increase in internal ocular pressure that damages the optic nerve. OAG develops slowly, and usually by the time people perceive symptoms, such as peripheral vision loss, they already have optic nerve damage. 

In angle-closure glaucoma, the eye doesn’t drain fluid as it should because the drainage channel between your iris and cornea becomes too narrow, causing increased eye pressure. This pressure damages the optic nerve, leading to vision loss. ACG can occur suddenly or gradually.

MYTH 2: Only the elderly suffer from glaucoma

FACT

Although it’s true that people over 60 are at a greater risk of developing open-angle glaucoma compared to people in their 40s, there are other types of glaucoma that can affect people aged 20 to 50 and even young infants (due to abnormal ocular development). 

In addition to age, those with a higher risk of developing glaucoma include:

  • African Americans and Hispanics 
  • Individuals with a family history of glaucoma 
  • Patients with cardiovascular disease, diabetes, or sickle cell anemia
  • Those who have previously sustained an eye injury
  • People taking steroid medications over the long term

MYTH 3: Glaucoma shows symptoms early on

FACT

The most common form of glaucoma, open-angle glaucoma, shows virtually no signs or symptoms until its later stages when vision loss sets in. Despite what people may think, the increased eye pressure causes no pain. And since peripheral vision is the first to go, you may not recognize vision loss until your vision has become significantly impaired. The only way to detect glaucoma is to undergo a comprehensive eye exam. 

MYTH 4: Nothing can be done once you have glaucoma

FACT 

While there’s currently no cure for glaucoma, many effective treatment options exist: eye drops, oral medications, as well as laser and surgical procedures that can help slow glaucoma progression. Each treatment option is used to get the fluid to flow properly out of the eye, reducing pressure inside the eye and decreasing damage to the optic nerve.

MYTH 5: Testing for glaucoma is painful

FACT 

Actually, testing for glaucoma is practically painless. One of the tests includes a non-contact device that blows a gentle puff of air into each eye to test the intraocular pressure. The sound of the puff may be startling, but it’s over in a second and is painless. With the Goldmann applanation tonometry test, an anesthetic eye drop is inserted into each eye, which may cause a stinging sensation for a few seconds. Your eye doctor will then use a blue light to quickly and gently touch the cornea to precisely measure intraocular pressure. The most accurate of all, however, are visual field testing and OCT (optical coherence tomography), non-invasive imaging, both of which are also painless.

MYTH 6: You can’t prevent glaucoma

FACT 

Regular eye exams are the only way to prevent glaucoma, as blindness or significant vision loss can be prevented if the disease is diagnosed and treated in the early stages. That’s why routine comprehensive eye exams which include glaucoma testing are so important.

Getting your eyes checked regularly can ensure that any existing eye problems are detected early enough to prevent or slow ocular damage. Contact Dr. Hopkins & Associates in Niagara-on-the-Lake to book your comprehensive eye exam today!

Does Obesity Impact Eye Health?

Nation-wide awareness about the vast dangers of obesity is at an all-time high, with TV shows like “The Biggest Loser” and health initiatives such as Michelle Obama’s “Let’s Move!” campaign shining a spotlight on the importance of fitness and good nutrition. However, despite the public’s knowledge of obesity’s effects on hypertension, stroke, and diabetes, many are not aware of how it damages eye health and vision.

Increasing evidence shows that people who are clinically obese have an elevated risk of developing serious eye diseases. It is widely known that expanding waistlines place people at a higher risk of getting diabetes, heart disease, and cancer — but researchers say the link between obesity and deteriorating vision is the “risk factor that no one talks about”. Professor Michael Belkin and Dr. Zohar Habot-Wilner, from the Goldschleger Eye Institute at the Sheba Medical Center, found a consistently strong correlation between obesity and the development of four major eye diseases that may cause blindness:

  • Age-related macular degeneration (AMD)
  • Cataracts
  • Glaucoma
  • Diabetic retinopathy

The researchers said that although the evidence was out there suggesting a link between obesity and these conditions, their study emphasizes the optometric risks of obesity which can help motivate people to shed those extra pounds.

How Obesity Contributes to Eye Disease

A Body Mass Index (BMI) of 25 is considered overweight and above 30 is regarded as obese. A high BMI is tied to several chronic systemic health conditions such as diabetes, cardiovascular disease, and stroke, among others. Recent research indicates that a handful of ocular diseases can now be added to that list.

Serious eye conditions such as diabetic retinopathy, glaucoma, and age-related macular degeneration are more common in individuals with obesity, as well as floppy eyelid syndrome, retinal vein occlusions, thyroid-related eye diseases, and stroke-related vision loss.

The connection between obesity and these eye diseases is likely due to the increased risk of peripheral artery disease. This occurs when the tiny blood vessels bringing oxygen to parts of your body like the feet, kidneys, and eyes become compromised.

Your eyes are particularly prone to damage from obesity because the blood vessels in the eyes (called arterioles) are easily blocked, since they’re extremely thin and small — as thin as ½ the width of a human hair!

Most people are not aware that obesity may increase the rate of developing cataracts, too. Cataracts result when the focusing lens in the eye becomes cloudy and requires surgery to be replaced. In addition to age, cataract development is associated with obesity, poor nutrition, gout, diabetes and high blood sugar levels, though the exact cause isn’t clear.

A Healthy Lifestyle Can Reduce Your Risk of Ocular Disease

Knowing about the risk of vision loss may give those with a high BMI the extra motivational boost they need to lose weight. The good news is that a few lifestyle changes can reduce the associated risks.

An active lifestyle and a balanced, nutritious diet lower obesity and improve overall physical and eye health. Give your body a boost by incorporating important nutrients, such as vitamins C and E, zeaxanthin, omega 3, zinc, and lutein, many of which are found in green leafy and dark orange vegetables, as they have been shown to reduce the onset, progression, and severity of certain eye diseases.

We Can Help Keep Your Eyes Healthy in Niagara-on-the-Lake

While a healthy diet and regular exercise greatly increase your chances of living a disease-free long life, they alone are not enough to ensure long term healthy eyesight. Regular eye exams with Dr. Hopkins can help prevent or detect the onset of ocular disease, and maintain vision that is clear and comfortable.

If you have any questions or concerns regarding your vision or eye health, don’t hesitate to call Dr. Hopkins & Associates — we’re here for you.

3 Ways Diabetes Can Affect Your Vision and Eyes

Did you know that people with diabetes are 20 times more likely to get eye diseases than those without it? There are three major eye conditions that diabetics are at risk for developing: cataracts, glaucoma, and diabetic retinopathy. To prevent these sight-threatening diseases, it’s important to control your blood sugar level and have your eyes checked at least once a year by an eye doctor.

But First, What Is Diabetes?

Diabetes is a disease that is associated with high blood glucose levels. Insulin, a hormone produced by the pancreas, helps our cells get energy from the sugars we eat. Diabetes develops when the body doesn’t produce or respond to insulin effectively, leaving too much sugar in the blood stream instead. Over time, diabetes can lead to potentially irreversible ocular damage and poor eyesight. However, by taking care of your blood sugar levels and your eyes, you can prevent vision loss.

Annual eye exams are recommended for everyone, but routine screenings are even more important for diabetics. Eye doctors may send diabetic eye health reports to a patient’s primary care physician or internist to adjust medication as needed to prevent complications.

What’s the Link Between Vision and Diabetes?

Blurred vision or fluctuating eyesight clarity is often one of the first noticeable signs that diabetes has begun to affect your eyes. Sometimes, fluid leaking into the eye causes the lens to swell and change shape. This, in turn, makes it difficult for the eyes to focus, resulting in fuzzy vision. Such symptoms can indicate that an eye disease is developing, or may simply be due to imbalanced blood sugar levels which can be rectified by getting your blood sugar back to healthy levels.

If you start to notice blurry vision, make an appointment with Dr. Hopkins as soon as possible.

The 3 Ways Diabetes Impacts Vision

Cataracts

While cataracts are extremely common and a part of the natural aging process, those with diabetes tend to develop cataracts earlier in life. Characterized by a clouding or fogging of the lens within the eye, cataracts impede light from entering the eye, causing blurred vision and glares. The best treatment is cataract surgery, which is very safe and effective.

Glaucoma

Glaucoma refers to a group of eye diseases characterized by optic nerve damage. Since it tends to impact peripheral vision first, glaucoma often goes unnoticed until significant damage has occurred. However, routine glaucoma screenings can detect warning signs; early treatment can prevent disease progression and vision loss.

Although there is no true cure for glaucoma, most glaucoma patients successfully manage it with special eye drops, medication, and on occasion, laser treatment or other surgery. The earlier glaucoma is diagnosed and managed, the better the outcome.

Diabetic Retinopathy

Diabetic retinopathy occurs when the small blood vessels on your retina (capillaries) become weakened and then balloon (microaneurysm) due to poorly controlled blood sugar levels. The resulting poor blood circulation in the back of the eye causes more abnormal blood vessels to grow, which also bleed or leak fluid, and can lead to scar tissue, retinal detachment and even blindness, over time.

Often there are no symptoms until the advanced stages of diabetic retinopathy, where patients may begin to see spots and missing patches in their vision. Retinopathy can be treated through surgery and eye injections, but the best way to prevent this disease from progressing is to regularly have your eyes screened.

The good news is that diabetic eye disease can often be prevented with early detection, proper management of your diabetes and regular diabetic eye exams. Contact Dr. Hopkins & Associates in Niagara-on-the-Lake to set up your eye doctor’s appointment today.

Dr. Kimberlee Robertson-Woods OD, BSc

  • McMaster University – Faculty of Health Sciences. Dr. Kim Robertson-Woods has been appointed to the rank of Assistant Clinical Professor
  • Department of Family Medicine Michael DeGroote School of Medicine
  • Ocular Nutrition Society Member
  • College of Optometrists in Vision Development (Canadian and International) Member

Dr. Kimberlee Robertson-Woods has provided optometric care in the Niagara region for over 20 years. She has shared space with Ophthalmologist Dr. George Beiko at the Niagara Health Centre, in St. Catharines. In earning her various degrees, Dr. Robertson-Woods attended university for over ten years. She initially enrolled in a general Arts and Science program at the University of Toronto. Prior to attending the University of Waterloo’s School of Optometry, she obtained her undergraduate science degree from the University of Guelph through the college of Physical and Engineering Sciences. She received her Doctor of Optometry Degree from the University of Waterloo and has received certification for the treatment and management of ocular disease. In addition, Dr. Robertson-Woods has received numerous academic awards and has been on the Dean’s Honor List every semester for both her Bachelor of Science and Doctor of Optometry Degrees. While in Waterloo, she was a teaching assistant for both the School of Optometry and the Department of Biology, teaching students and conducting labs for physical optics, embryology and histology. During her studies, Dr. Robertson-Woods completed two externships in ocular disease and therapeutics at Omega Tertiary Eye-Care Centres in Alabama. While there she participated in advanced aspects of therapeutic eye care, including Cataract, Glaucoma, Retinal and Extra-ocular muscle surgeries and management. She also studied at a surgery centre specializing in only vitreo-retinal surgical procedures, and has experience in ultrasonic imaging (A and B scans), intravenous fluorescein angiography and retinal tomography. She continually strives to learn and is currently working towards her Fellowship in Neuro-Sensory training, Developmental and Behavioral Optometry. Dr. Robertson-Woods has also acted as a consulting Optometrist at LASIK Centres of America, and has been an Associate with Dr. James Agate in Grimsby. Dr. Robertson-Woods is an active member of the Canadian Association of Optometrists, The Ontario Association of Optometrists, the College of Optometrists of Ontario, the Niagara Society of Optometrists, the Ocular Nutrition Society and the College of Optometrists in Vision Development. She has acted as a proctor for the Canadian Standard Assessment in Optometry through the Canadian Examiners in Optometry, for Optometrists to become licensed to practice in Canada. Dr. Robertson-Woods primary areas of interest are pathological states of the eye and ocular adnexa; pediatric optometry, developmental and behavioral optometry, visual rehabilitation, nutrition and sports training; and the ocular health concerns of the aging. Upon graduation, she was presented with the William Feinbloom Low Vision Award “in recognition of the graduating student who, by study, interest and performance, has demonstrated aptitude in the clinical care of Low Vision patients”. She enjoys educating the public through her clinics as well as through community based public speaking forums. Her office and her services were utilized as a rotation site to teach fourth year University of Waterloo Interns different aspects of primary eye care practice. She is involved in providing eye care for the Third World and has conducted and managed two eye care clinics in impoverished areas of Central America.

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