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Cataract surgery is one of the safest and most effective procedures available today, thanks to advances in surgical techniques. But a new study confirms the findings of earlier research: Men using Flomax to treat symptoms caused by enlarged prostate are 2 times more likely to experience complications during and immediately after cataract surgery.

About 3 out of 4 men are diagnosed with an enlarged prostate or benign prostatic hyperplasia (BPH) by the time they reach age 70. Flomax is one of the most commonly prescribed medications used for treatment. Flomax works by relaxing the muscles in the prostate and the bladder. That’s the most common use, but physicians also prescribe Flomax for some women experiencing urinary problems, relying on the same principle of relaxing the muscles in the bladder.

Flomax is part of a class of medications called alpha-blocker drugs. In addition to their effects on the prostate and bladder muscles, alpha blockers also keep the hormone norepinephrine from tightening the muscles in the walls of smaller arteries and veins. This causes those smaller blood vessels to remain open and relaxed.

That’s also the source of the problem for cataract surgery patients. Blood vessels that remain opened even when the body needs to close them off to heal the areas of the eyes affected by cataract surgery can lead to complications. The American Society of Cataract and Refractive Surgery (ASCRS) and the American Academy of Ophthalmology (AAO) both recommend that it’s best to undergo cataract surgery before beginning treatment with Flomax.

A 2005 study also found that men taking Flomax or other alpha-blockers before cataract surgery were more likely to experience complications during and immediately after the procedure.

The new study showed that 7.5 percent of the men who had taken Flomax in the 2 weeks before cataract surgery had a serious complication, compared with 2.7 percent of those who had not taken the drug. That makes it a 2.3 times greater risk.

Studies like this also make it especially important to disclose your full medical history as accurately as possible. Knowing that a patient is taking Flomax (or any other alpha blocker) — or even if he or she used it in the past — is very important before an eye surgeon performs cataract surgery. Our experienced eye doctors in Princeton and Hamilton, New Jersey can prepare for alpha-blocker patients differently by adjusting our surgical techniques in those cases, which can lead to much lower complication rates and optimal results.

If you’re being treated with Flomax and are planning on having cataract surgery, discuss your condition with the physician who prescribed the medication. You should never simply stop taking an alpha-blocker without talking to your doctor.



Most women approaching menopause begin thinking about hormone therapy to mitigate the most common symptoms that accompany “the change,” which can range from uncomfortable hot flashes to more serious conditions like osteoporosis. When women begin to look into hormone therapy, though, questions about the treatment’s potential risks emerge, which a clinical trial identified several years ago. Those health risks include heart disease, stroke, and even breast cancer.

Our eye doctors in the Hamilton Township and Princeton, N.J. areas say you can add cataracts to that list.

A study of more than 30,000 postmenopausal women in Sweden found that using hormone replacement therapy (HRT) may make it significantly more likely for women to need cataract surgery in the future, compared to women who never undergo HRT. A cataract is the thickening and clouding of the eye’s natural lens that can occur as men and women age.

There’s reason to be cautious about HRT. The essence of the study’s findings boils down to 2 important points:

1. The longer a woman used HRT, the greater her chances of developing cataracts.

2. Women who consumed more than 1 alcoholic drink per day while taking HRT had nearly double the risk of having cataracts, compared to women who didn’t drink or use HRT.

This is the first large study to reach these conclusions. Earlier studies exploring the potential link between HRT and cataracts performed in the U.S., Australia, and Europe yielded mixed results. There are some shortcomings to the Swedish study’s conclusion, though: The study didn’t identify the type of hormone replacement treatment being used (there are different types of HRT), offer details on the type of cataract the study’s subjects developed, or consider their exposure to sunlight (which is itself a risk factor for cataracts.)

Additionally, the Swedish participants nearly all had the same ethnic background, which could influence the outcome. As we mentioned in an earlier blog post about cataracts, certain ethnicities appear to have a higher risk for developing cataracts than the general population. If you have Scandinavian heritage, the findings may prove more relevant to you, but it’s hard to say because the study didn’t prove (or disprove) that the homogeneity of its participants was a factor.

In that same blog post, we outlined that there are simple things you can do to actually lower your risk of developing cataracts, such as wearing sunglasses that block UV rays and eating more foods rich in vitamin C. It’s also clear that women and men who don’t smoke are less likely to develop cataracts at a younger age. Those little changes to your habits and lifestyle can add up to healthier eyes.

Hormone replacement therapy is no longer routinely prescribed for menopausal women, as doctors learned about the potential risks associated with the treatment, but it may still be beneficial for some women. Certain types of HRT remain the most effective treatment for postmenopausal symptoms, and the decision of whether to have HRT is one you should discuss thoroughly with your doctor.



In this day and age, it seems we are surrounded by digital screens that vie for our attention constantly. And for most of us, they are hard to resist because they have become affordable, accessible, and portable. Think TVs, laptops, tablets, and smartphones. Together, they’re a major factor in ocular health for the Princeton patients who visit our optometrists and eye care professionals.

As a society, we have become hungry for information — be it useful or mostly irrelevant. Other than reading e-books, this also means extended viewing of our emails, the latest YouTube videos, or our friends’ posts on Facebook and Instagram. We are so attached to our smartphones that a mere few hours apart from it can give us anxiety.

What Causes Digital Eyestrain?

Prolonged Exposure

Every eye doctor in Princeton, New Jersey and throughout the country will tell you that digital eye strain is a serious issue. A new study by the Vision Service Plan (VSP) shows that by the time an American teenager turns 17, that teenager has spent a third of his or her life staring a digital device. That’s almost 6 years — or about 50,000 hours. And because of this amount, eye care specialists are witnessing a growing number of patients suffering from digital eye strain.

So please, encourage your kids to lead an active lifestyle, teach them to enjoy the outdoors and maybe even read a book or 2 during the summer (the old-fashioned way, that is).

Reading Too Close

According to another report published in 2011, we have a tendency to stay closer to digital screens when reading than we do when reading something in print. About 20% closer, to be exact. Reading from devices up close places heavy demands on the eyes, since you are forced to focus harder and your eyes actually angle inward towards each other.

The next time you are staring at a digital screen, try reading from farther away — and if that’s not possible, there’s nothing wrong with increasing the font size.

Reduced Blinking

We also blink less when staring at a digital screen than we do when reading a printed page, which in turn results in our eyes becoming dry and sore.

On a personal note, I think my nephew forgot how to blink entirely when he got his new racing game and started playing it on the big screen TV. So remember to take breaks — and please don’t forget to blink.

Artificial Blue Light

Artificial blue light also plays an important part in contributing to digital eye strain. All the LCD and LED screens that surround us emit it. Due to its short wavelength, our eyes are not very good at blocking blue light. Therefore, it penetrates all the way to the retina. Prolonged exposure to these digital screens will adversely affect the health of the retina, and it can possibly lead to macular degeneration. I will talk in more detail about blue light and its adverse short-and-long-term effects in my next blog post.

How to Protect Your Eyes

Remember, the easiest way to minimize digital eye strain is to reduce overall exposure to digital displays and to take breaks in between. When that’s unavoidable, here are a couple rules of thumb to live by:

1) Follow the 20-20-20 break plan: Take a 20-second break every 20 minutes and look at something 20 feet away.

2) For every inch of screen size you should be 2 ½ times as far away from it. So you should be about 10 feet (i.e., 120 inches) away from a 50-inch HD screen.

Have more questions about how best to take care of your eyes? Leave us a question in the comments below!


Children waving sparklers on the 4th of July is as American as apple pie and baseball. Few of us know, however, that those small wands shooting out sparks sizzle at temperatures of up to 2,000 degrees and, along with other fireworks, cause thousands of eye injuries each year.

Watching fireworks with family and friends on Independence Day is a time-honored tradition, but the reality is that eye injuries caused by fireworks have doubled in recent years, resulting in about 1,200 visits to emergency rooms across the nation in 2014. Outlook Eyecare, with eye doctors in Hamilton Township, Princeton, and Mercerville, NJ is highlighting this fact to help prevent fireworks-related eye injuries this year.

Video Courtesy of the American Academy of Ophthalmology

To help New Jersey residents stay safe this Independence Day, we’ve compiled some tips that will help keep your celebrations free of eye injuries:

  • Never allow children to ignite fireworks. Yes, that includes sparklers and other small, seemingly harmless products. Small doesn’t equal safe. They can even pose more danger because people are less vigilant in supervising kids lighting these fireworks. Even tiny poppers or snappers can ricochet and burn the eyes of toddlers or small children.
  • Be extra cautious handling “duds.” That’s because fireworks that appear defective and are thought to be extinguished are unpredictable. Anyone igniting fireworks or handling them after they’ve been lit should wear protective eyewear to avoid accidents.
  • Even spectators need to be cautious. Just because you’re not the one lighting the firework doesn’t mean you are out of the firing line. Half of those suffering eye injuries caused by fireworks were bystanders, according to an international study. Of those, 1 out of 6 victims sustained severe vision loss.
  • Explosive fireworks that shoot projectiles into the air are illegal for a reason. Bottle rockets and other explosive fireworks are extremely dangerous and should not be used.
  • Attend a community-sponsored fireworks show. These family-friendly events can become a new 4th of July tradition. Go just for the show, or make it a daylong outing with family and friends. Leaving the fireworks to the professionals is the safest way to enjoy the Fourth.

Remember, you should get immediate medical attention if you do suffer an eye injury and avoid rubbing or applying pressure to the eye. If you know or suspect there’s an object in your eye, don’t remove it, apply ointments, or take pain medication before getting medical help.


June is Cataract Awareness Month, an observance created by the American Academy of Ophthalmology to raise awareness of this important eye health issue. At Outlook Eyecare, we see this as an opportune time to educate you about this very common condition. Our eye doctors in Princeton treat patients from surrounding cities like Hamilton Township and other central New Jersey communities, but because it is such a widespread concern, we feel everyone can benefit from learning more about cataracts.

Cataracts occur as we age and the eye’s natural lens thickens and becomes cloudy. They are the main cause of vision loss for men and women older than 55 and, according to the American Academy of Ophthalmology, about 25 million Americans have cataracts. Here are 3 important facts about cataracts that many people might not know.

  • Lifestyle’s role as risk factor: Lifestyle and behavior can influence how early or late in life you develop cataracts, and how the condition will progress. Age is the most common risk factor associated with cataracts, but recent studies indicate that other factors play a role in the timing and severity of developing cataracts. For example, diabetes, extensive exposure to the sun, smoking, and obesity can all contribute to an increased risk of cataracts. High blood pressure and certain ethnicities have also been linked to having a higher risk of having cataracts than the general population. Eye injuries, previous eye surgery, and using steroid medication over a long period can also result in cataracts.
  • You can lower your risk: Cataracts cannot be prevented, but you can take steps to decrease the risk of developing cataracts. Protecting yourself from sun exposure by wearing sunglasses with lenses that block UV rays and using wide-brimmed hats can help. Several studies concluded that people who eat more foods rich in vitamin C lower their risk of developing cataracts at younger ages. Women and men who don’t smoke cigarettes are also less likely to develop cataracts until much later in life.
  • Improved vision is just one benefit of surgery: During cataract surgery, your eye surgeon replaces the natural, clouded lens with an intraocular lens, an artificial lens made of plastic, silicone, or acrylic. There are a range of lenses to choose from, and each provides unique benefits. More than just improving your vision, cataract surgery has been shown to improve patients’ quality of life and reduce the risk of falling.

If you’ve noticed your vision becoming less clear, cataracts could be the cause. Cataract Awareness Month is a good time to request a consultation at one of Outlook Eyecare’s 3 locations. Or call one of the offices at (609)409-2777 (Monroe Township), (609) 419-1920 (Princeton), or (609) 587-4700 (Mercerville), to schedule an appointment.



It’s summer, and everyone is looking forward to those hard-earned vacation days spent at the shore or at some exotic beach in the Caribbean. It is the season of travel, outdoor sports, and family picnics. These activities, while fun, can leave us exposed to direct sunlight for longer periods of time, and we have to exercise some caution so we can diminish its adverse effects on our health.

Most of us are familiar with sun exposure’s detrimental effects on the skin and the increased risk of melanoma, so as an eye doctor, I’d like to focus instead on how such exposure can cause eye damage to varying degrees — and what we can do to protect ourselves. Here’s the advice we at Outlook Eyecare give our patients in the Princeton and Hamilton, NJ area.

How the Sun Damages Eyes

The sun emits UV-A, UV-B, UV-C, infrared, and blue light radiation.

Normally, our body makes good use of these rays as they stimulate the production of vitamin D, which strengthens our bones, immune system, and blood cell formation. Plus light helps our body regulate our sleep/wake cycle. But as with most good things, there are considerable side effects deriving from prolonged and unprotected exposure to sunlight.

Research-based evidence has shown that UV-B radiation has caused cataracts, both in high-intensity, short-term exposure (as with lasers) in animals and in chronic exposure in humans. As shown in the picture below, due to its shorter wavelength (280 nanometers to 380 nanometers), UV radiation primarily affects the front of the eye where cataracts are formed.


Research has also linked blue light radiation with age-related macular degeneration (AMD). Due to its longer wavelength (450 to 495 nanometers), blue light affects the back of the eye, mostly therefore causing damage to the retina, both in acute and chronic exposure. In today’s world, we use digital devices and modern energy-saving lighting that emit a high level of blue light. Our exposure to this light when accumulated over time will lead to an increase in AMD.

Here are some other conditions caused by overexposure:

  • Photokeratitis occurs after overexposure to sunlight, mainly affecting people along the beach, snow, and sand because these environments are highly reflective.
  • Pterygium is a wedge-shaped, benign, elevated tissue in the conjuctiva (clear lining that covers the white part of the eye). Its cause is thought to be exposure to UV light, and it could grow to cover the pupil (black center of the eye). Surgical removal is recommended prior to reaching the pupil.
  • Pinguecula is a yellow-white conjuctival lesion caused by UV light that does not significantly harm vision but is cosmetically unpleasant for patients.
  • Solar or macular retinopathy consists of retinal damage due to high-energy light exposure. It occurs from viewing a solar eclipse, sunbathing, high-energy laser treatments, or mental disturbances due to neurological disorders. Most of the vision is recuperated without treatment over 1 to 2 months, but recovery could last up to a year. Prognosis depends on time of exposure and visual acuity prior to exposure.

Learn how the sun can damage the eyes and what you can do to prevent it.

How to Protect Yourself

Fortunately, there are some simple steps you can take to protect yourself from sun overexposure:

  • Do not miss your yearly eye exams. A good doctor can see early signs of the conditions and the team of professionals at Outlook Eyecare will conduct a thourough exam of your eyes.
  • Wear the right contact lenses and glasses. There are many brands out there that offer blue light and UV protection. See your Outlook Eyecare team for options such as Crizal® Prevencia™ for your everyday eyewear and Xperio UV™ for your sunglasses needs.
  • Wear a hat, and try to avoid the “danger zone.” 10 a.m. to 2 p.m. in the summer. 8 a.m. to 10 a.m. and 2 to 4 p.m. in the winter.

Do you have other tips or strategies for protecting your eyes from the sun? Share them in a comment below.



In recent years, it has become more popular for people who wear eyeglasses to buy them online. At our optical shops serving Princeton, Hamilton, and other New Jersey communities, we now see a lot of patients who come in with ill-fitting, uncomfortable frames or low-quality lenses saying they got a good deal online. Here are 5 reasons this so-called “savings” isn’t really worth it:

  1. Nothing compares to having the frames in your own hands. You get to physically try on the frame instead of seeing a virtual frame imposed on your uploaded picture (how most online shops let you “try on” their frames). Beyond seeing how the frames look, you get to feel the quality of the metals and plastics of the frames, test out the hinge or flexible metal, feel the weight of the frame, and so on.
  2. Quality of the materials and lenses bought online is usually lower. Most online optical retailers do not offer today’s latest technologies when it comes to frame and lens designs, or they have bought frames in bulk that have been discontinued. This is done to offer designer frames at what they state are huge savings. But, in fact, if you are purchasing a discontinued frame and you need repairs or parts in the future, it will be highly difficult to find what you need.
  3. Deciding what frame best suits your prescription can be tricky. An optician takes many considerations into account when helping you choose the best frame for you. The right frame consists of more than just what looks good. Just as one size frame does not fit all faces, one type of frame does not work for all prescriptions. An optician helps guide you into a frame that cosmetically makes your prescription look ideal. He or she can also help you determine what lens materials and options best suit your lifestyle and take your vision to the best levels possible.
  4. It’s imperative that measurements are done correctly. Pupillary distance measurements are just one of many important measurements and requirements for eyeglasses to work properly. Some lens designs and prescriptions are frame-specific and not general for all patients. While helping you select frames, your optician is doing more than just showing you frames that fit your needs cosmetically and prescription-wise — that person is also paying close attention to your general stance and head positions while the 2 of you discuss options. The optician also asks open-ended questions to help determine which lens design will best meet all of your needs and concerns. All of these subtle observations play a huge roll in how opticians measure you for your eyeglasses. Your optician is making several mental notes during the process to help make your experience and result the best they can possibly be.
  5. Problems can arise after you receive your new glasses. Your glasses may not seem right once they arrive at your door. Did you enter the prescription correctly? Did you take the right measurements or choose the correct lens design for the tasks you need the glasses to help you perform? Did the online shop make them correctly or even verify that it did so before it packaged them and shipped them to you? Perhaps the glasses do work correctly but now you need them adjusted, repaired, or simply maintained. You are likely now spending any money that you may have saved from ordering the glasses online with trips back and forth to the doctor trying to figure out what’s wrong. Or you will now have to find an optician to help you adjust or repair your glasses. Because the glasses were ordered online, opticians in your area may not be willing or able to repair, adjust, or troubleshoot them. More charges may occur, and your frustration may build. The few dollars you may have saved will now seem not worth all the inconvenience and additional fees you have incurred.

Although the Internet can be a great resource, one thing is perfectly “clear.” Online eyeglass ordering is not the best solution for your eye care needs. A brick-and-mortar optical shop will have your best interest at heart and solutions at hand. They provide a service that no online optical service can come close to meeting. If you’re still not convinced and have ordered your eyeglasses online, we suggest you have an optician inspect the glasses to make sure they are made correctly.

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Monroe Township
Outlook Eyecare
5 Centre Drive #1B
Monroe Township, NJ 08831
Phone: (609) 409-2777

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Outlook Eyecare
100 Canal Pointe Boulevard #100
Princeton, NJ 08540
Phone: (609) 419-1920

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