Category: Helpful Tips

LASIK Testimonial: When the Doctor Becomes the Patient

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So….eye doctors, in general, don’t get Lasik. Or Lasek. Most of them have seen too many contact lens complications to even wear those. When you deal with all the complications you tend to forget about the 99.99% of people who do just fine. Recently, USC Roski Eye Institute’s Dr. Jesse Berry decided to take the plunge and get LASIK (as the residents looked on with wide-eyed wonderment). Her only regret? She didn’t do it sooner!

Dr. Berry took a moment to sound off with us below:

Why did you decide to get LASIK?

Mostly because I was sick of being attached to contact lenses and glasses. With my too-busy professional women life balancing work and personal life, I was also wearing contacts for 18 hours a day, most days of the week. My eyes started to be irritated by them and I wasn’t willing to be dependent on glasses so I looked for alternatives.

Who did your procedure?

One of USC Roski Eye Institute’s voluntary faculty members, Dr. Gregg Feinerman, while he was hosting a refractive surgery seminar for the residents.

How long did the procedure last?

The procedure was about seven minutes per eye! It was so fast, completely painless, and I saw better IMMEDIATELY after.

What was recovery like?

I operated the next day! Before LASIK without glasses or contact lenses beforehand I was 20/400 or worse, I was about 20/60 immediately after. I felt a little scratchy but pretty ok. By the time I went to bed I was 20/30 and I woke up 20/15 (I am not even kidding!)

Would you recommend it to your friends and family?

100%. My only regret is that I didn’t do it earlier! It has changed my whole life and I am so happy to not be linked to contacts all the time!

 

To learn more about Dr. Berry’s journey, please click here.
 

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Dr. Jesse Berry
is an Assistant Professor of Ophthalmology at the USC Roski Eye Institute, and specializes in ocular oncology, melanoma, and retinoblastoma.

Poor Mascara Removal Leads to Eye Lesions and Serious Infection

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For over 25 years, a woman admitted to using excessive mascara each day without completely removing it at night before she slept. Complaining of feelings that something was in her eye, the 50-year-old sought help from her ophthalmologist. After a thorough eye exam, the ophthalmologist discovered dark pigmented depositions on the conjunctiva, the mucous membrane lining the inside of the eyelid. In addition, the ophthalmologist noted eye lesions or sub-conjunctival concretions. Following a biopsy of the conjunctiva, results of which were published in the American Academy of Ophthalmology, physicians found deposits of mascara as well as evidence of conjunctivitis or infection.
 

“It is important to ensure you wash your hands and clean around your eyes regularly to prevent infections from occurring. Having treated cases like this often, infections can lead to very serious consequences and in some cases even vision loss,” says Charles Flowers, MD, associate professor of clinical ophthalmology at USC Roski Eye Institute and cornea specialist.
 

Tips to Preventing Eye Infections

  • Wash your hands thoroughly before touching your eyes or face
  • Do not share your makeup, face towels, or any eye drops
  • Remove your makeup thoroughly before bed and do not reuse make up if you have had an eye infection to prevent it from reoccurring
  • Thoroughly clean your contact lenses, store in clean containers, and use fresh solutions without sharing
  • Wear protective eyewear outdoors or in a workplace where there may be hazards
  • Seek medical attention immediately if you notice symptoms of a suspected eye infection
  • Always use protection to prevent STI

Infections of the Eye

Infections of the eye can occur in one or both eyes and in individuals of all ages. Typically, those who have ocular infections may describe redness, irritation, discharge, swelling around the eyelid and eye, pain and possible loss in vision.

Type of Ocular Infection

Area of Inflammation

Conjunctivitis Surface of the eye
Blepharitis Eyelid
Keratitis Cornea, the transparent outermost part of the eye
Uveitis Uvea, the inner layer of the eye
Vitritis “Jelly-like” ocular fluid in the eye
Neuroretinitis Optic nerve and retina

Schedule an Appointment at USC Roski Eye Institute Today

Eye infections can be viral, bacterial or even fungal. Please see your eye care specialist if you suspect that you may have an infection, are experiencing irritation or pain in your eye. The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected please complete our online contact form or call 323-442-6335 today!

To learn more about the health services at the USC Roski Eye Institute or to support the Institute with a tax-deductible gift, please contact Rebecca Melville, senior director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.
 

By: Debbie Mitra, PhD

Rare Eye Cancer Cases Found in Two States Leave Physicians Perplexed

Melanoma 3Several people in both Alabama and North Carolina have been diagnosed with a rare eye cancer known as ocular melanoma. Although found in only 6 out of 1 million in the US, dozens of ocular melanomas were diagnosed in mostly women 20 to 30 years of age.

Interestingly, through the use of social media, multiple cases were discovered through websites formed by groups from Auburn University, Alabama as well as in Huntersville, North Carolina.

Similar to skin cancer, the melanin or pigmented cells within your eye can also mutate and cause melanoma in or around the eye although this only accounts for about 5% of cases. Specifically uveal melanoma, or melanoma on the inside of the eye, was discovered in these cases. Such rare melanomas are generally seen in patients between 50 and 60 years of age. Ongoing investigations by physicians have not yet revealed the cause for this unusual geographical collection of cases.

“These reported cases are bizarre in both the incidence and how young the patients are. I applaud the work that is being done to find a common thread, however given the rarity of the disease this will be difficult even in the setting of a localized spike,” says ocular oncologist, Jesse L Berry, MD and assistant professor of clinical ophthalmology at the USC Roski Eye Institute.

Unlike skin cancer, which can be caused by sun damage, identifying the causes of eye cancers has been a challenge. Research has revealed that certain eye cancers can be hereditary or caused by random genetic mutations. Depending on the severity of the eye cancer, treatment options may include radiation via brachytherapy or with proton beam, or even removal of the eye.

Possible symptoms related to uveal melanomas generally include: blurring, distortion or loss of vision, shadow over vision which may come and go, as well as flashes and floaters.

“This is a devastating disease that can lead to blindness and even death if not appropriately diagnosed and treated early – and many of these tumors are asymptomatic so a complete dilated exam by an ophthalmologist is necessary to diagnose melanoma. Bringing awareness to this rare disease through social media platforms can give physicians and epidemiologists more information on the incidence of this disease in hopes of one day finding a cure, “ says Dr. Berry.

If you would like to learn about retinoblastoma, another eye cancer that occurs in children, and the development of a novel liquid biopsy method by Dr. Berry’s team please follow the link below: http://eye.keckmedicine.org/?post_type=post_press_release&p=14339.

Schedule an Appointment at USC Roski Eye Institute Today

The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected from diabetes-related conditions, please complete our online contact form or call 323-442-6335 today!

To learn more about the health services at the USC Roski Eye Institute or to support the Institute with a tax-deductible gift, please contact Rebecca Melville, senior director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.

By: Debbie Mitra, PhD
 

References

1. https://www.nbcnews.com/health/cancer/unusual-cases-rare-eye-melanoma-puzzle-doctors-two-states-n870551
2. https://www.cancer.org/cancer/eye-cancer/about/what-is-eye-cancer.html

AMD Awareness Month- Q&A with Dr. Amir Kashani

AMD blog photo

What is AMD?

Age-related Macular Degeneration (AMD) is a devastating retinal degenerative disease that affects the macula, the part of the eye that provides sharp, central vision. Those who suffer from this progressive disease are unable to drive, read or recognize faces. In AMD, vision loss is the result of the death or dysfunction of retinal pigment epithelial cells (RPE) that provide nutrients and support to the light sensing photoreceptor cells in the eye.

There are two forms of AMD: wet and dry. In the wet form of macular degeneration (known as choroidal neovascularization or CNV), abnormal blood vessels grow under the macula and retina. Fluid from leakage of these blood vessels accumulates and cause vision loss or distorted vision. In dry AMD (non-neovascular form) small yellow deposits form beneath the retina, which can ultimately lead to geographic atrophy (GA) or the advanced form of dry AMD. Dry AMD is the most prevalent form of macular degeneration and can be stable for many years without vision loss. Patients diagnosed with GA have severe loss of vision and a tangible impact on quality of life. To date, there is no cure or known treatment options for GA.

Who is at Risk?

In general the global burden of AMD remains substantial as a result of the aging population. Globally, the projected prevalence of AMD in 2020 is 196 million, increasing to 288 million in 2040. The main risk factors for AMD are age and race. Among Americans of European decent, the prevalence of AMD is projected to rise to nearly 5.44 million by 2050 according to reports from the National Eye Institute. A significant increase in the rate of AMD amongst minority populations has also been observed. Most notably, a six-fold rise of AMD has been reported in persons of Hispanic decent.

Other risk factors for AMD include positive family history, smoking, hypertension, high cholesterol and obesity.

How is AMD Diagnosed?

Pay attention to the signs of early disease including distorted vision and your risk factors for developing AMD. Please make an appointment to see your eye care specialist at least once a year if you are over 40 years of age, if you are at risk as a result of ocular and medical history, family history, age, or race and especially if you are noticing vision loss. Your ophthalmologist or optometrist will conduct a comprehensive eye exam, which will include dilated eye exams, visual acuity, and optical coherence tomography (OCT). Following a thorough assessment, your physician will work closely with you to determine the best course of action.

Are There Treatments for AMD?

RPE patch (white) implanted in the subretinal space.
RPE patch (white) implanted in the subretinal space.

In general there is no known cure for AMD. However, for the wet form of AMD, drug treatment options include anti-VEGF (vascular endothelial growth factor) therapies. Such therapies reduce the level of VEGF, a protein known to stimulate abnormal blood vessel growth in the retina and macula. These drugs are administered as injections directly into the eye.

Thus far there is no FDA approved treatment available for dry AMD. USC vision researchers, Dr. Mark Humayun and David Hinton, funded by the California Institute for Regenerative Medicine, have recently developed a novel stem cell-based therapy for the treatment of advanced dry AMD. The treatment consists of a patch of RPE cells derived from stem cells that is grown onto a polymer scaffold and implanted behind the diseased portion of the eye. A clinical trial is currently underway to evaluate this potential treatment at USC and is led by Assistant Professor of Clinical Ophthalmology, Dr. Amir Kashani. Enrollment in the phase I/IIa clinical trial is ongoing for this stem cell-based treatment.

To learn more, please visit: https://clinicaltrials.gov/ct2/show/NCT02590692?term=subretinal+implant+AMD +dry&rank=1.
 

amir-kashani-ophthalmologist
Dr. Kashani specializes in complicated retinal detachment repair, recurrent retinal detachment repair, macular degeneration, diabetic retinopathy, macular pucker, retinal vein occlusions, and hypertension related eye disease.

References

  1. Wong WL, Su X, Li X, et al. Global Prevalence of Age-Related Macular Degeneration and Disease Burden Projection for 2020 and 2040: A Systematic Review and Meta-Analysis. Lancet Glob Heal. 2014;2(2):106-116. doi:10.1016/S2214-109X(13)70145-1.
  2. Congdon N, O’Colmain B, Klaver CC, et al; Eye Diseases Prevalence Research Group. Causes and Prevalence of Visual Impairment Among Adults in the United States. Arch Ophthalmol. 2004;122(4):477-485.
  3. Varma R, Fraser-Bell S, Tan S, Klein R, Azen SP; Los Angeles Latino Eye Study Group. Prevalence of Age-Related Macular Degeneration in Latinos: The Los Angeles Latino Eye Study. Ophthalmology. 2004;111(7):1288-1297.
  4. http://www.visionaware.org/info/your-eye-condition/age-related-macular-degeneration-amd/risk-factors-for-amd/125
  5. https://www.aao.org/clinical-statement/frequency-of-ocular-examinations

Vision Rehabilitation Services- Offering Hope to Patients with Low Vision

Q&A with Dr. Rachel Young, Assistant Professor of Clinical Ophthalmology

Rachel Young, OD, offers vision rehabilitation services
Rachel Young, OD, offers vision rehabilitation services

What is low vision and who qualifies?

Those who suffer from low vision experience a dramatic decrease in quality of life, as a result of decreased visual acuity, contrast sensitivity or poor visual fields. Generally, patients who have a visual acuity of 20/70 or worse in the better seeing eye, restricted visual fields, are no longer able to correct their vision through prescription glasses, contact lenses or medical intervention qualify as a low vision patient. Many serious eye conditions such as age-related macular degeneration, glaucoma, diabetic retinopathy and retinitis pigmentosa can cause low vision.

What does quality of life mean?

Quality of life is an indicator of how well an individual is able to effectively and independently carry out daily activities such as driving, reading, cooking and cleaning. It is not just about reading the small print, those who suffer from low vision can experience depression and anxiety without some form of intervention.

What is low vision rehabilitation?

At the USC Roski Eye Institute we believe in a personalized-care approach. Each patient I meet will have a customized plan according to his or her own unique lifestyle. General components such as determination of difficulties in activities of daily life, functional vision and visual field assessments are all a part of the initial evaluation. Based on the results, we will devise a plan that is best suited for you, which may include visual aids as well as counseling or training to improve quality of life.

What kind of treatments or devices are available?

After determining an appropriate eyeglass prescription and other factors such as contrast sensitivity, I discuss with the patient which device or assistive technology would be best suited to enhance their ability to perform daily tasks. I train patients on how to use devices offered by the eye institute such as magnifiers or telescopes. As well, I teach patients how to use assistive technologies like cell phones or tablets. USC Roski Eye Institute has also had a long-standing relationship with visual aid partners and many community organizations to offer additional resources.

Are there changes we can make now to improve our quality of life with low vision?

There are many things you can do to navigate and perform tasks better on a daily basis. You can find several tips on our website but here are a few things you can try:

  1. Improve lighting and never work in a dark room
  2. To reduce glare use shades or covers for shiny surfaces
  3. Color code things
  4. Use scissors in the kitchen in place of knives
  5. Use pill organizers for medication
  6. Download menus on your tablet before going to the restaurant
  7. Order large print labels from the pharmacy, financial statements or checks

February is National Age-related Macular Degeneration/Low Vision Awareness Month

IMG_1144Low vision can affect one or both eyes and be caused by aging, birth defects, injury or complications from disease. Those who suffer from vision loss lose their independence and experience a poor quality of life. Everyday tasks such as using a cell phone, driving, reading a favorite novel or even watching the grandchildren play, become challenging and often impossible.

USC Roski Eye Institute Low Vision Rehabilitation Service

The USC Roski Eye institute is committed to enhancing the lives of those diagnosed with low vision. USC Roski Eye Institute brings hope to those who suffer from low vision with new vision rehabilitation services. Assistant Professor of Clinical Ophthalmology, Rachel A. Young, O.D., offers several services such as prescription eyewear, magnifiers or filters and other forms of assistive technology to treat low vision. Patients are also offered personalized counseling or training to improve their general quality of life.

In addition physicians and residents are educated in the diagnosis and treatment of low vision. Dr. Young organized an annual low vision symposium for USC Roski Eye Institute residents. Vision rehabilitation specialists were invited to discuss the latest in low vision treatments. Numerous medical device suppliers also demonstrated the newest technological advances in vision rehabilitation devices.

 

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USC Roski Eye Institute Making a Difference in the Fight Against AMD

AMD blog photo

Researchers at the USC Roski Eye Institute have made great strides in the treatment of vision loss caused by devastating diseases such as age-related macular degeneration (AMD). Mark S. Humayun, MD, PhD, and David R. Hinton, MD, received nearly $38 million from the California Institute for Regenerative Medicine (CIRM) to develop a stem cell-based treatment for AMD. AMD affects over 1.75 million people age 50 and older in the United States. The leading cause of blindness and vision loss among the elderly, AMD is a central retinal disease that impacts the area of the eye that helps process images, leading to catastrophic vision loss. It targets central vision, resulting in the inability to read, recognize faces or even drive. The disease causes a loss of crucial retinal pigment epithelial (RPE) cells, which are essential to the survival of photoreceptors (light sensitive cells). To restore those RPE cells, the USC Roski Eye Institute team developed a unique procedure to grow thin sheets of stem cell-derived cells to be surgically implanted in the eye, replacing diseased sheets and restoring photoreceptors needed for vision. Phase 1 human clinical trial at the USC Roski Eye institute has already begun.

Schedule an Appointment at the USC Roski Eye Institute Today!

The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected from diabetes-related conditions, please complete our online contact form or call 323-442-6335 today!

by Debbie Mitra

Extreme Diet Leads to Permanent Vision Loss in 11-Year-Old Boy

VAD Blog

An 11-year-old Canadian boy suffered vision loss from a rare case of vitamin A deficiency (VAD) as reported in the Journal of American Medical Association of Pediatrics.

Parents of the boy of east-Asian descent took him to the hospital over growing concerns that his vision was worsening over an eight-month period. In addition to vision loss, the boy also complained of dry eye.

Ophthalmologists found that the child had a restricted diet of potato, pork, lamb, apples, cucumber, and Cheerios due to his eczema and numerous food allergies. His vision was hand-motion only. Upon examination of the cornea, which is the outermost part of the eye responsible for refracting or focusing light, it appeared that there were opaque patches and inflammation.

After blood work was conducted, physicians found that the boys vitamin A levels were significantly below normal, measuring at 14.33 μg/dL (normal range, 25.79-48.71). The patient was immediately treated with high doses of vitamin A. While vision loss from VAD is often reversible, in this case, the boy suffered permanent vision loss due to optic atrophy or damage to the optic nerve.

“Conditions like this are rare in developed countries, and are thus often observed in underdeveloped countries where malnutrition is prevalent. You should always consult a physician before restricting your dietary intake. In general, having a proper diet rich in nutrients such as green leafy vegetables, omega fatty acids, zinc, lutein and carotenoids can have an impact on preserving healthy vision,” says cornea specialist, Jonathan Song, MD, MBA, Associate Professor of Clinical Ophthalmology.

According to data provided by World Health Organization, VAD is the leading cause of preventable blindness in children and affects one third of children aged 6-59 months in underdeveloped countries in 2015 (see map below).

VAD Map

(Statistics of VAD-UNICEF global nutrition database, 2017, based on reports from 2015)

Schedule an Appointment at USC Roski Eye Institute Today

The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected from diabetes-related conditions, please complete our online contact form or call 323-442-6335 today!

To learn more about the health services at the USC Roski Eye Institute or to support the Institute with a tax-deductible gift, please contact Rebecca Melville, senior director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.

By: Debbie Mitra

References

http://jamanetwork.com/journals/jamapediatrics/fullarticle/2654882

https://data.unicef.org/topic/nutrition/vitamin-a-deficiency/

Model Risks Losing Eye after Tattooing it Purple

A model in Ottawa, Canada made the decision to tattoo her eye purple, as it was her favorite color. Very quickly she realized something was wrong when the purple ink began to leak from the white part of her eye. Experiencing excruciating pain, her eye began to swell and become infected.

In recent years, the procedure of scleral staining or episcleral tattooing has become an emerging trend. The sclera is the white outer layer of the eye. It is significantly more porous and thinner than skin. As a consequence, these dyes and inks can easily diffuse through the sclera and reach the fragile visual processing structures inside the eye. According to a report in 2015, episcleral tattooing can result in headaches or photophobia (light sensitivity) to more severe complications like infection, hemorrhage or even direct penetration into the eyeball.

Photo: Catt Gallinger
Photo: Catt Gallinger

“Eye tattooing is not recommended as it is very dangerous and can cause serious complications. Once inside the eye, these chemicals will wreak havoc because of their innate toxicity and will most certainly lead to devastating visual loss,” says Charles W. Flowers, Jr. MD, Associate Professor of Clinical Ophthalmology at the USC Roski Eye Institute.

The ophthalmologist who treated model Catt Gallinger, observed a scleral tear from the large needle used to stain her eye as well as a severe infection. Gallinger received grafts and has permanent vision loss from this procedure.

Having posted multiple times on Facebook, Gallinger has brought greater awareness to the dangers of undergoing episcleral tattooing.
 
 

Schedule an Appointment at USC Roski Eye Institute Today

The exceptional eye doctors at USC Roski Eye Institute are experts at diagnosing and treating a wide variety of eye conditions. To receive a comprehensive eye exam and ensure that your vision is protected, please complete our online contact form or call 323-442-6335 today!

To learn more about the health services at the USC Roski Eye Institute or to support the Institute with a tax-deductible gift, please contact Rebecca Melville, executive director of development, via email at Rebecca.Melville@med.usc.edu or by calling USC Roski Eye Institute.

By: Debbie Mitra, PhD
 

References:

https://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886-015-0095-y

https://www.washingtonpost.com/news/to-your-health/wp/2017/12/02/a-model-tattooed-her-eyeball-purple-she-now-could-lose-her-eye/?utm_term=.862cdc8f7131

Contact Lens Health Week

27 Contacts Lenses Found in Eye of 67 year old Woman

Contact Lens mass
 

A 67-year-old woman scheduled, for what was supposed to be a routine cataract surgery, underwent a foreign body extraction procedure instead. A staggering 27 contact lenses were removed from the eye of a woman who had worn monthly disposable contact lenses for over 35 years. As reported in the British Medical Journal last month, the ophthalmologist removed a large mass of 17 fused contact lenses. Upon further inspection under a microscope, an additional 10 contact lenses were retained. Although the patient had poor vision, she did not complain of any issues with her eye prior to the day of surgery.

“This case study underscores the importance of appropriately wearing and caring for your contact lenses. Disposable contact lenses are meant to be disposed of as reuse puts patients at high risk of serious eye infections, and in some cases permanent vision loss,” says Charles Flowers, MD, Associate Professor of Clinical Ophthalmology.

Those who wear contact lenses are at risk of infections of the ocular surface, due to low oxygen levels to the cornea (outermost part of the eye) or if the lenses have not been appropriately cleaned allowing build-up of infective agents.

In honor of Contact Lens Health Week here are some tips to preventing Eye infections

  • Wash your hands thoroughly before touching your eyes or face
  • Thoroughly clean your contact lenses, store in clean containers, and use fresh solutions without sharing
  • Change your contact lens case every three months. Do not use the same case beyond three months.
  • Do not share your makeup, face towels, or any eye drops
  • Wear protective eyewear outdoors or in a workplace where there may be hazards
  • Seek medical attention immediately if you notice symptoms of a suspected eye infection
  • Always use protection to prevent sexually transmitted diseases. Such diseases, although rare, can manifest in the eye

Thus routine eye exams are essential to ensure healthy vision. To schedule a consultation at our Los Angeles, Beverly Hills, Pasadena, or Arcadia location call 323-442-6335.

Reference

:

http://www.bmj.com/content/358/bmj.j2783

Helpful Tips for the Upcoming Solar Eclipse

NEWLunarEclipse

What is a solar eclipse, and how does it affect my eyes?

A Solar eclipse occurs when the moon blocks the sun. On Monday August 21st, 2017, North America will experience a solar eclipse that will last about 2.5 hours. Although a small part of USA will experience a total eclipse in which the moon completely blocks the sun, for most places, including the Los Angeles area, it will be partial.

Directly looking at the solar eclipse is as harmful as sun gazing on a regular day. This causes damage in the retina, the light sensitive membrane in the back of the eye, and can result in vision loss – the severity of which depends on the duration of the gaze. In mild cases, the vision loss may be reversible over the course of several months, but in severe cases, it is permanent. It affects the central vision, and affected individuals may not be able to read or see faces; however, it does not affect the peripheral vision.

Here are some very important tips to prevent vision loss while enjoying watching the solar eclipse:

  1. Never look at the sun or solar eclipse without eye protection: use solar eclipse glasses (eclipse viewers) that have been approved by the American Astronomical Society. In those areas of the country where total eclipse occurs, it is safe to remove the eclipse glasses at the time of total eclipse, which may last a maximum of about 2.5 minutes.

  2. Sunglasses, no matter how dark, are not protective.

  3. Do not use eclipse glasses that are damaged or have a scratch on them.

  4. If using a binocular, camera or telescope, wearing eclipse glasses do not protect your eyes; the front lens of these devices that face the sun should be shielded with specially designed filters.

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