Lasik Vision

Red eyes and swollen eyelids upon awakening in the morning are common eye problems that many people suffer from with vague diagnoses usually of dry eyes or eye allergies. Sometimes just having the eyes dilate in the darkness can precipitate attacks of angle closure glaucoma in patients who have risk factors for this type of glaucoma. Frequently eye allergies are the cause, aggravated by a low level of tears in dry eyes. The lower level of tears means allergens your eyes are exposed to at night are not as diluted as a normal eye and they have a greater effect. Open windows in allergy season allow more pollen inside, and pets sleeping on pillows during the day can also add to the problems. Sleep apnea along with floppy eyelid syndrome can cause your eyes to be open and dehydrate while you sleep. A low-grade infection of the eyelid margins with staphylococcus bacteria is another common cause of swollen eyelids in the morning.   Many other conditions can cause red, swollen eyes in the morning. However, there are normal aging factors that predispose you to this condition that is found more frequently in women than men.

As you sleep at night the normal tear film is not being pumped out through the tear ducts and spread across the eyes by the wiper like motion that occurs with normal blinking. In the REM states of sleep you do have some blinking occurring, but overall the eye is a static environment while you sleep trapping bacteria on the surface of the eye. The eye has it’s own immune system that is ramped up at night to compensate for this increase in bacteria. The result is a state of mild inflammation is almost everybody. As the body ages and the eyes become dryer the relative concentration of bacteria and bacterial toxins increases making a more noticeable immune response.   With menopause, there is a drop in hormone levels in both men and women. The androgen hormone that is more commonly associated with men seems to be the largest factor in dry eyes in women. The incidence of dry eyes in women is at least 3-4 times more commonly reported  than in men and also increases with age.  

The eyelid anatomy contributes to eyelid swelling. There is a barrier to fatty tissue in the upper eyelid that degrades with age and fatty tissue enters into the lid causing it to droop all of the time. The eyelid tissue looses its elasticity with age and thins resulting in more susceptibility and visibility of swelling. Sleeping at night without blinking with the buildup of inflammation described above causes swelling in the adjacent eyelid tissue. Since you are lying down with a slight elevation to your head there is reduced drainage of fluid within the lymph system and fluid accumulates on the lower eyelid. This will reduce throughout the day if the cause is chronic low-grade inflammation overnight.  

The first step in treatment is a visit to your eye doctor to rule out any other more serious causes such as heart conditions, kidney problems, obstructive sleep apnea,glaucoma, or medication side effects. Your optometrist may find other causes as outlined above that need to be treated. After that, there are a few alternative therapies you can try to help.  

    1. Reduce alcohol and salt consumption as they contribute to water retention 

    2. Try some form of cool compresses in the morning for 5-10 minutes.

    3.  Exercise early in the morning to stimulate the circulation.

    4.  Be glad your vision is good and your eyes are essentially healthy!

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The purpose of this article is to simply describe what you need to do to buy your first pair of glasses online. I will not recommend particular retailers, as you can find that info in several of my other articles and also check out the links on the right of this page. Purchasing eyewear online seems daunting at first. If you’re like me, purchasing and fitting prescription glasses always seemed like a complex procedure best left to professionals. The truth is, if you know your prescription and have your existing rx glasses handy, it is really quite simple to purchase glasses online.

The Seven Critical Numbers

First, find your current prescription. I keep mine in the health file in my filing cabinet. If you can’t find your prescription, visit wherever you last had your eyes examined and request a copy. Your optician, optometrist, or ophthalmologist is required by law to release your eyewear prescription to you. You now need to make note of a few critical pieces of information from your prescription (see example above–click to enlarge). Among other information, you should see three columns on your prescription–sphere, cylinder, and axis.

In the example above, these are abbreviated SPH. CYL. and AXIS. These three columns will have two rows, Right and Left. In the prescription above, this is simply abbreviated R and L. Many doctors instead use the latin abbreviations, which are OD and OS. OD means right eye and OS means left eye. Jot down a quick copy of the six numbers or simply keep your prescription handy. These six critical numbers define how your lens will be carved. Any online eyewear retailer will ask for the input of these six numbers.

In addition to these six numbers, there is one more critical number, the Pupillary Distance, or PD. This is a measure, in millimeters, of the space between your eyes. In the example prescription above, you’ll see the Pupillary Distance of the patient is 62. Jot down this number also, it is the seventh of your seven critical numbers.

A Final Measurement

A somewhat less critical number is your temple length. If you’re lucky, you’ll also see a temple length and bridge size in your prescription. If not, don’t sweat it, you can figure it out yourself. The temple length describes the length of the two bars that connect the glasses to your ears. It is measured from where the 90-degree curve from your lens structure to the side bars (temples) begins to the very end of the temple, including the curve. It is not measured from the flex point of the temples, because the “stub” between the flex point and lens structure is not a standard size.

Now, take out some measuring tape (preferably the type of tape used for fitting clothes and sewing, as it is very flexible) and measure an existing pair of glasses that fit comfortably. An average temple length for men is 135mm or 145mm. For women, 130mm to 140mm is standard. If your tape only has inches, measure to the nearest eighth or sixteenth and multiply that number by 25.4 to get the measurement in millimeters. Temple lengths are generally available in 5mm increments, such as 130, 135, 140, 145, etc. At most online eyeglasses stores, temple length is shown within a frame description and is not customizable. Therefore, you need to find a frame with an appropriate temple size. This sometimes varies if you are at a site specializing in designer glasses, where you have the option to input your own temple size.

Honestly, temple size is not a huge deal. I have one pair of glasses with 135mm temples and another with 140mm temples. Both pairs fit comfortably. If for some reason you can’t come up with a temple measurement, don’t let that stop you from making an eyewear purchase online. Instead, simply choose 140mm temples if you are a man and 135mm temples if you are a woman. Chances are, this length will fit comfortably.

What’s your Style?

Armed with your seven critical numbers and an idea on your temple length, start browsing the myriad of online retailers. Pick out some favorite frames and open the individual pages in separate tabs or windows of your web browser. Similar to trying on glasses at a standard retailer, you need to figure out if the frames you like are appropriate for your face. You might visit my post on the topic of face shape. If you have a nice oval face, you’re in luck, most any pair will look on you. If you have strong, angular features, a rounded or rimless pair will look god on you. If you have a very round face, choose a rectangular or hexagonal pair of glasses. If you just want a basic pair of professional glasses, go with titanium rimless.

Using your trusty measuring tape, you can compare other measurements of your existing glasses with what you are looking at online. The bridge measurement describes the distance between lenses, the height describes the distance from the lowest point on the front of the frame to the highest point, and the lens describes the distance between the end of the bridge and the beginning of the temple. Some retailers also offer free virtual try-on. This service, which I describe in will allow you to upload a picture and place a variety of frame types on your face.

Place your Order

So you’ve found the perfect pair of frames. Begin the checkout process. You should see boxes where you can enter your prescription information (the seven critical numbers). This will sometimes be in a table format similar to your prescription, or it may be a simple list. You’ll also have the option to choose from a variety of coatings and add-ons. If you will be wearing your glasses day-in and day-out, I recommend choosing the anti-scratch and anti-reflective coatings. These really do make a difference and ease night driving (anti-reflective) and the longevity of being able to see clearly through your lens (anti-scratch). You can add on the UV coating if you wish, though it isn’t critical. Photochromatic tinting (aka “transition lens”) is also an option. Personally, I prefer buying a separate pair of prescription sunglasses, but that is up to you.

If you only wear glasses occasionally (maybe as a supplement to contact lenses), or are just purchasing a pair of Rx sunglasses that won’t be worn every waking hour, you might choose to save money by skipping on the extras. If you are buying a pair for your accident-prone child, skimping on the extras might not be such a bad idea either. Avoid coatings and other add-ons will also allow you to get a great pair of prescription glasses for well under $40. After you’ve placed your order, you’ll typically wait about 2-to-3 weeks for your glasses to be custom carved and delivered. The finished product will typically include a hard case and a soft cloth for lens cleaning.

In this I show a video of the exact product received from a popular online eyewear retailer.

Side Note One: “Help, I don’t have a prescription!”

If it has been a long time since your eyes have been examined, or if you just can’t get a hold of your prescription, it’s time to go visit an optometrist. While your neighborhood optometrist may charge $100 or more for a simple examination, discount stores like Wal-Mart, or optometrists in working-class neighborhoods will often offer an eye exam for $40 or less. Grab your yellow pages and start making phone calls. Chances are, you’ll get the best price if you find an optometrist who has many customers without vision insurance.

Side Note Two: “How can it be so cheap?”

The price difference between online eyewear and glasses bought from a traditional retailer, or even Wal-Mart or Costco, is startling. An identical pair of titanium frames might cost $60 online and $220 at Wal-Mart. How can this be? What about the quality? I will categorically state that the quality of glasses received from the majority of online retailers is equal to or exceeds the quality found at your neighborhood eyewear shop or optometrist. The price differential comes from a number of factors, including the relative obscurity of online eyewear purchases, the fact that highly paid optometrists do not spend one-on-one time with the eyewear purchaser, and the fact that insurance companies are typically not involved with online eyewear purchases, thereby discouraging inflated prices.

Give it a try. I guarantee you’ll be satisfied with your online eyewear purchase if you follow the steps outlined in this article.

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