Give the gift of sight! Gift Cards on sale through Valentine’s Day.

For most people, vision is the most important of the senses. We experience so much of our world through vision. Vision contributes so much to our awareness of our place in the world, our balance, coordination, depth perception, and general awareness.

Everyone in the family should have regular eye examinations to maintain the greatest potential for clear vision. Dr. Mitchell uses state-of-the-art technology to ensure that you are seeing your very best…..and there is more to it that just a glasses prescription.

From now until Valentine’s Day, gift cards are 20% off! Give those you love the gift of sight!

Today’s post emphasizes some important components of a comprehensive eye health and vision examination performed by Dr. Mitchell. These are considered preliminary tests and give Dr. Mitchell a lot of information about your eyes.

  • Thorough review of you current health status :

    • Various health issues can contribute to vision difficulties. Problems like diabetes, high blood pressure, thyroid disorders, autoimmune disorders like arthritis, Lupus and Sjogren’s. Dr. Mitchell needs to know about these and will discuss how they could influence your vision.

    • Medications can influence how your eyes work. Dr. Mitchell reviews your current medications for any that could be contributing to vision problems….some medications even impact the health of your eyes as a side effect.

    • Family history of medical issues: some problems have strong genetic components. Dr. Mitchell can help determine if your family history puts you at a higher risk of vision altering/threatening concerns.

  • Thorough review of your current vision correction:

    • We measure your current glasses with a lensometer to determine the prescription of your current correction. Dr. Mitchell checks your vision with these to understand how they are working for your currently.

  • Visual field test (look for the lights and click the button):

    • This takes about 2-4 minutes, and helps to identify if there are any areas of your vision that are missing or compromised….this is not only helpful information about your vision, but some patterns of visual field loss can help Dr. Mitchell to identify if a more serious underlying issue is at play.

  • Eye pressure test:

    • We use the iCare tonometer as our primary pressure testing device. This is easy to use on almost everyone (even kids and people who are really sensitive about their eyes). This test doesn’t require eye drops, or puffs of air.

    • Eye pressure is a major factor in glaucoma, and so we check it at every examination. If we need to double check, Dr. Mitchell also uses a Goldmann aplanation tonometer.

  • Autorefraction and autokeratometry:

    • These are accomplished in the ‘hot air balloon test’.

    • Autorefraction is an objective measurement of the focusing quality of your eyes, and can help give Dr. Mitchell a sneak peak at how your eyes focus. This test will identify if you have nearsightedness, farsightedness, or astigmatism. Dr. Mitchell will use this as a starting point for detailed vision testing that will determine your glasses prescription.

    • Autokeratometry is a measurement of the shape of the front surface of your eye. This helps to screen for structural problems with the shape of your eyes like keratoconus. It also helps Dr. Mitchell in fitting contact lenses that are an appropriate size and shape for your eyes.

  • Optomap:

    • Dr. Mitchell offers a unique screening test called Optomap that takes a comprehensive image of the inside of your eye and allows Dr. Mitchell to see nearly all of your retina. The images can also be used to document eye health concerns with the inside of your eyes and allow for straightforward comparison at future examinations.

At Mad River Eye Care, we have the right tools, technology, and expertise to help you…..See clearer.

Vision Correction for Youngsters!

The CDC estimated in 2016 that around 30% of kids from ages 6-17 wear glasses or contact lenses. There are likely many more dealing with un-diagnosed vision issues. See prior blog posts to learn about timing for children’s eye examinations. If your child has vision issues that require correction (such as near or farsightedness, astigmatism, accommodative insufficiency, etc.) there are many options to address the issue.


Most of the time we think of kids as wearing glasses. This is a very straight-forward approach for most children, however there are pros and cons with any vision correction. Young children have difficulty caring for glasses, and often break or loose them…..then there’s some down time while they are being repaired or replaced. For this reason, we carry glasses lines that were designed to hold up for kids, and we offer a full warranty on all of our glasses. We also offer discounts for multiple pairs of glasses. Kids especially should have a back up pair, or a pair for school, and a pair for home….it’s also nice to have a couple of style options.

Some kids have difficulty adjusting to wearing glasses….it can be difficult adjusting to seeing the world differently, and having something on your face. It’s best to ease kids into wearing glasses….unless they seem comfortable with it right out of the gate.

Contact Lenses:

We are often asked how old kids should be in order to wear contact lenses. There is no hard and fast age recommendation that we would apply to all kids. They should be motivated to do it personally, and should be capable of good hygiene……for some kids that might be 7 years old, for others it might be 19 years old. Contact lens technology has come a very long way, and we have so many safe and effective options for contact lens wear. If a child is motivated, we can find an option that suits their lifestyle and needs. When should kids consider contact lenses? When they decide they don’t like wearing glasses, when they get active in sports, or even if they just want the option to not wear glasses sometimes. Whenever we fit children with contact lenses, we teach them how to put them in, take them out, and care for them. We let them try the contacts for a couple of weeks, and make any adjustments if vision changes.


Some kids need glasses for the classroom environment, and may not need to wear glasses when pursuing sporting activities. Other kids benefit from improved vision, coordination, and response time by using their best correction. As mentioned above, contact lenses are a great option for sports because they eliminate the concern for having glasses on (getting broken and injuring the child, falling off, etc), and allow children the flexibility to wear other eye wear (ski goggles, sunglasses, etc). But what if a child isn’t ready for contact lenses? We carry a variety of sports specific glasses and goggles that were designed for high energy, movement, activity, and possible collision or impact. We know that these types of sports eye wear will minimize any injury from impact, will remain in place, and even look pretty cool.

  • For swimmers, we use prescription swim goggles.

  • For skiing and snowboarding, we use prescription goggle inserts.

  • For helmet sports (hockey, baseball, football, lacrosse, skateboarding) we have options with straps that go all the way around instead of hard temples (ear pieces)…..we even have options that switch (temples for some sports, straps for others in one pair of glasses)!

It’s important for children to see clearly to be able to learn and develop normally. At Mad River Eye Care, we do all that we can to ensure your child will see their best! Dr. Mitchell is great with kids, and is comfortable seeing kids of all ages!

The aging eye…..eye exams for life!

As we collect our birthdays, a lot can happen to our bodies! Many things we used to take for granted begin to take effort or special time or accommodations. Our eyes are part of this whole process we call aging. Dr. Mitchell recommends annual eye health and vision examinations for all his patients. The American Optometric Association recommends an eye exam at least every other year through age 64, then annually thereafter. Today we’ll discuss some of the reasons frequent exams are important as we age, and what kind of changes we can expect.

Vision Changes:

  • Nearly everyone experiences vision changes in early to mid 40’s, even if they have never had vision trouble before. This begins with mild delays changing focus from near to far. Over time, we start to hold reading material and phones further and further away, or turn the light brighter. By age 55, our up close focusing ability no longer works very well. This process is called presbyopia. There are many different approaches to managing this decrease in near focusing flexibility

    • some people only wear reading glasses as needed

    • others wear bifocal or progressive lenses with distance vision through the top and reading vision in the bottom to improve flexibility looking near and far

    • some people wear contact lenses which can be designed to give flexibility for distance and near

    • Dr. Mitchell is an expert at helping to determine what approach suits you the best and when to employee some of the helpful tools we have available

Eye Health Changes:

  • As our eyes age, the risk for eye health diseases increases. Here we’ll discuss some of the most common issues, and how to watch for them.

    • Glaucoma: sometimes called the ‘sneak-thief’ of sight, glaucoma can cause slowly progressive vision loss without pain, warning, or obvious acute changes. It is related to loss of nerve tissue inside the eye, and in many people is preventable if identified and addressed early. Dr. Mitchell does three important things in each examination that help identify glaucoma:

      • Visual field screening: this checks for any areas of your vision that may be missing or compromised as a result of early glaucoma

      • Internal eye pressure test: often glaucoma is related to high pressure inside the eye, Dr. Mitchell checks this at every examination for any indication that it is higher than normal

      • Thorough examination of optic nerve tissue: direct observation of the nerve tissue can reveal if glaucoma is a problem

    • Macular Degeneration: this doesn’t often lead to complete blindness, but can cause loss of central vision which is where most of our detail and color vision takes place. Dr. Mitchell checks for early signs of macular degeneration at every examination, and discusses the risk or likelihood that you could develop macular degeneration. If you have some of these risk factors, you should be seen every year:

      • Family history of macular degeneration (especially parents or siblings)

      • History of smoking

      • Over age 65

      • Diabetes or other vascular issues like high blood pressure

      • Loss of clarity or distortion in central vision

    • Cataract: almost everyone develops cataracts, but the timing and severity vary quite a bit. Cataracts happen when the clear lens inside our eyes turn opaque and cloudy. If enough cloudiness occurs, it can be hard to see through. Most people have cataract surgery at some point, which removes the cloudiness and restores clear vision. Dr. Mitchell’s comprehensive eye health and vision examination can determine if you have cataracts, and how significant they are. Here are some symptoms to watch for if cataracts are developing.

      • Increased difficulty with night driving (too much glare from headlights)

      • Needing increased light to be able to read, even with reading glasses

      • Dampening of colors or smearing of vision

      • Difficulty seeing things you used to be able to see

Dr. Mitchell is available for comprehensive examinations, and is comfortable seeing patients of all ages. He can help you understand changes to your vision and eye health, and present solutions to help keep the ride enjoyable!

When should young adults get eye examinations?

Last week, we discussed the importance of regular eye examinations for children, and when they should be seen by an eye care provider. So what’s next….when should young adults have examinations after age 18? Dr. Mitchell continues to recommend annual eye health and vision examinations for everyone. The American Optometric Association recommends at a minimum, an eye exam every 2 years, but definitely every year if there are any ongoing vision or eye health concerns. What happens with vision when you are a young adult, and how do changes to your age influence the need for eye examinations?

  • For most people, the body and eyes reach their pinnacle of development in early 20’s. Your eyes can continue to change depending on how you use them. We often see kids go away to college, then start to have vision issues because of the way they are using their eyes! Increased intense near work and long hours studying, or using the computer can influence how well eyes focus. This can result in difficulty seeing in the distance, and can contribute to eye strain and fatigue generally. Even if you have never had a vision issue before, starting an intense program of study can make your eyes feel uncomfortable, and your vision less succinct. College aside, any job that requires long hours on the computer will influence how your eyes work as well. Here are some things Dr. Mitchell recommends for young adults:

    • Limiting computer work when you can. When you can’t, live by the 20/20/20 rule….this means looking at something over 20 feet away for 20 seconds every 20 minutes. This will allow your eyes to relax on a regular basis….there are even apps for your phone that alert you when it’s time to take a quick break.

    • Use accommodative boost lenses. These are specially designed lenses that alleviate part of the focusing work your eyes have to do leading to less strain, reduced fatigue and the feeling of clearer vision. These can make a difference for any near work, but are particularly helpful at the computer.

    • Use blue-blocking lenses. Emerging research shows that over-exposure to certain high-energy wavelengths of blue light could be damaging your eyes over your life time. Many of our screens today are over-exposing us to these potentially harmful types of light. Dr. Mitchell recommends using a special anti-glare technology or material for your glasses that blocks the harmful types of blue light. In addition, using screens late in the evening or night can influence your circadian rhythm making it hard to settle down and get to sleep. Try setting a hard cut-off time for your screen use around 7 or 8 o’clock to help you settle down easier.

  • Already wear glasses or contact lenses? All the rules above still apply….if you wear glasses, getting an accommodative boost lens with blue blocking technology will help. If you wear contact lenses, you should consider wearing boost lenses over them for near work.

  • Laser correction: In your early 20’s you can start to consider permanent surgical corrective options like LASIK. This can free you from contact lenses and glasses until your mid 40’s in most cases. Dr. Mitchell can help determine if you are a candidate for this approach, and can coordinate the surgery for you. You can continue to see Dr. Mitchell for post-operative care as well.

Children’s vision…when do they need eye exams?

When should children have eye examinations if they haven’t complained of vision issues. Here is the schedule for children’s eye care that Dr. Mitchell recommends. This schedule is based on recommendations by The American Optometric Association.

  1. Each child should be seen for their first comprehensive examination by a primary eye care provider between 6 and 12 months. Why is this necessary if they can’t respond to questions about how they see? Dr. Mitchell can identify major eye health issues, or significant refractive errors (like nearsightedness, farsightedness, or astigmatism) that could hamper visual development. He gathers objective information by observing infant’s behavior about their eyes, and looking for disparities between the eyes based on how light is reflected from inside the eyes. He can view the inside of the eyes by dilating infant’s pupils (which is completely safe) to check for major eye health issues as well. If issues with vision or eye health are noted, Dr. Mitchell will discuss any treatment options, and how frequent ensuing eye exams should be.

  2. If no problems are detected at their first examination, Dr. Mitchell recommends their second eye exam should be between ages 3-5, right about preschool age. As little bodies grow, eyes are changing as well, and as children are developing, there is always potential for refractive/ vision issues to develop. Having an eye exam during preschool, or before kindergarten will help to ensure that children are prepared to use their vision for intense learning as they enter and progress through school. Children rarely complain about vision issues, because most often they don’t realize they could, or should be seeing differently. Dr. Mitchell can help make sure children are prepared with good vision so they can focus on other learning aspects of schooling.

  3. From ages 6-18, Dr. Mitchell recommends an eye examination every year, even if no obvious vision complaint is noted. Again, as children are developing, their eyes may be changing as well. This can especially be true during adolescent growth spurts; for some kids, vision can change in a matter of months!

  4. Children should be seen any time a concern is noted.

    • Child complains of difficulty seeing clearly

    • Eyes seem to cross at times, or turn out unintentionally

    • Child complains of double vision

    • Child has difficulty reading, even if it seems related to learning disorder or dyslexia

    • Child’s eyes are red, watery, or itchy, or child has seasonal allergies

    • Child complains of headaches that seem associated with schoolwork

Call our office to schedule your child’s examination, or if you have any question about Dr. Mitchell’s recommendations!

Start the new year off with great vision- get a comprehensive eye health and vision examination!

A comprehensive eye health and vision examination is good for everyone. Here are some of the major benefits of having your eyes examined regularly:

  • Eye health: As we collect our birthdays, our eyes are more susceptible to developing problems like glaucoma, macular degeneration, cataracts, floaters and other issues. With early detection, often these issues can be mitigated. Patients with chronic health issues like diabetes, or use of some long-term medications should have eye examinations annually, and sometimes more frequently. Dr. Mitchell can help determine how frequently you should be seen.

  • Eye development: Did you know that most of our visual function is learned behavior? Early visual development is important to ensure good visual potential throughout your life. All children should have a comprehensive eye health and vision examination by their first birthday with an eye care provider, then preschool age (3-5), then annually when they start school. Dr. Mitchell has a lot of experience with children of all ages, and can help identify and correct many vision issues that can stand in the way of healthy development and general learning.

  • General vision: Our vision can fluctuate and change throughout our lives, and regular eye examinations help to identify these changes and address them so you can always see your clearest. If you wear contact lenses, Dr. Mitchell recommends a check-up every 6 months. If you wear glasses, your vision could change yearly. If you are in your mid 40’s, your vision will definitely start changing, even if you’ve never had to wear contact lenses or glasses before.

Call today to schedule a comprehensive eye health and vision examination with Dr. Mitchell so you can see your clearest in 2019. Whether you’re from Stowe, Morrisville, Waterbury, Duxbury, or right here in the Mad River Valley, Dr. Mitchell is happy to make time for you in his schedule.

How many pairs of glasses do I need? Gift cards….get 20% more this week!

Patients often ask how many pairs of glasses a person needs. This is a great question, and varies from person to person depending on your day-to-day vision demands. Glasses are a lot like shoes in many ways…….we wear different shoes for different tasks. We have hiking boots to tromp in the hills, flip-flops for the beach, winter boots for snow-shoeing, dress shoes for work or church, etc. Beyond just being a fashion statement, different types of shoes are appropriate for different activities, and glasses are the same way.

  • Everyday glasses: many people who wear glasses have a go-to pair that they wear for general use, and this is usually what we think of when we think of wearing glasses. These can be neutral in fashion, versatile in style, and meet our general vision needs. For those of us who need it, these can include a reading power in the bottom of the lens to give us maximum flexibility.

  • Driving/sun glasses: I always recommend having polarized prescription sunglasses for driving and outdoor wear. Polarized lenses cut glare from wet roads and other vehicles making driving safer and more straight forward, especially at dawn and dusk. They reduce glare and brightness for recreational uses around water and snow improving definition, and depth perception. And we can put polarized lenses in any style of frame from very athletic, to very fashion-oriented.

  • Computer glasses: Many people work on computers or other screens for many hours throughout the day, and don’t realize that their vision could be more comfortable. When working at close proximity, our eyes have to maintain a certain amount of effort to keep things in focus. This taxes our natural focusing system leading to fatigue, decreased blinking which can dry our eyes, and even headaches for some people. There are many options I can prescribe to help alleviate these factors while in the computer environment. I also recommend using high energy blue light blocking lenses especially when at the computer.

  • Other occupational glasses: I can recommend glasses for all occupational needs; weather safety glasses for the factory or construction site, or glasses with an add power in the top for looking under cars, or special outdoor or athletic applications. I can help to create a solution for any need or circumstance.

I know how varied our visual demands can be, and in our office, I always offer 30% off additional pairs of glasses, so you can save money updating your everyday glasses, prescription sunglasses, and computer/occupational glasses.

AND, the week before Christmas, I’m offering a discount for gift cards…..20% more. That means a $50 gift card goes for just $40, $100 for just $80! Give the gift of sight this Christmas with gift cards from Mad River Eye Care!

Flex spending accounts…….use it before you loose it! $50 off sunglasses this week!

There are many ways to pay for health care expenses. Some people have special health care accounts through their employer, or a health savings account they set up on their own. Here are some simple explanations, and how you can leverage the funds in these accounts.

  • Medical flexible spending accounts (FSA)  provide pre-tax dollars, through an employer, to pay for certain medical expenses.  A health reimbursement account (HRA) is set up through your employer to pay for certain health care related expenses as determined by your employer.  Money deposited into these accounts expire at the end of the calendar year, and doesn’t roll-over for use next year.   

  • Health savings accounts are special pre-tax savings accounts that you can contribute to throughout the year and use for health care expenses.  Unlike FSA and HRA accounts, HSA accounts don’t expire at the end of the year, but do have limits on how much you can contribute annually. 

  • Did you know that you can use many of these accounts to pay for eye care?  This can include the cost of eye examinations (including co-pays and co-insurance), prescription eye glasses, and prescription contact lenses (including cleaning supplies).  If you’re looking for ways to use all of your money before it expires, consider a new or back-up pair of glasses, or stocking up on contact lens supplies.  Call us at Mad River Eye Care to schedule an appointment for your eye exam before the end of the year so you don’t loose any of your hard earned money.

See clearer on the slopes…..half off of prescription goggle inserts this week!

Want to see clearer for skiing or riding this winter?  Dr. Mitchell can recommend prescription eye wear solutions that will give you the best vision possible for all your winter sports. Whether at Sugarbush, Mad River Glen, Killington or Stowe, here are some options to help you see your clearest. 

  • Contact lenses can improve your vision and give you the flexibility to wear whatever googles or shades you want.  Call to schedule a contact lens fitting with Dr. Mitchell. Maybe you don’t want to wear contact lenses every day….many people can use single use lenses that you only wear the days you want. Dispose of them when your done; easy and flexible.

  • Universal ski/snowboard goggle inserts put your prescription in most winter sports goggles and are easily installed and removed.  Bring your goggles in, and see if these are the right fit for your needs.

  • Dr. Mitchell has partnered with Smith Optics and carries Smith goggles designed to fit over most regular glasses…..wear your every-day glasses put your new Smith goggles over the top of them.  In addition we carry Smith’s prescription goggle inserts that work with some of their most innovative winter sports goggles, and can be used in several of Smith’s biking glasses as well. 

Dr. Mitchell and staff are happy to help determine the best winter-sports option for your needs and budget, give us a call.

New products: Costa glasses!

We are very pleased to announce a new partnership with glasses manufacturer Costa.  Costa’s tag line is ‘Born on the water’.  Popular in fishing circles and coastal areas, Costa began by creating innovative polarization technology for optimal clarity for water sports and occupations.  Costa’s polarization and light spectrum filtering isn’t only great for water sports, but has been proven an excellent option for winter sports in combating glare from snow and ice.  Many people recognize improved clarity for winter time driving in addition to boating and fishing.  Dr. Mitchell selected Costa for his office because of their reputation for superior optical refinement in their non-prescription sunglasses, but also because of their high-quality, fashionable prescription ophthalmic line (regular every-day glasses).  In addition to their superior quality, innovative technology and attractive fashion sense, Dr. Mitchell appreciates Costa’s commitment to bringing awareness to environmental issues.  Costa supports and/or spear-heads a number of projects that promote healthy oceans.  You can see the fruits of last year’s campaign at Mad River Eye Care;  Costa committed to cleaning beaches in third world countries by recycling discarded fishing nets…and making glasses out of them.  Stop in and see Dr. Mitchell’s selection of Costa at Mad River Eye Care.

Mad River Eye Care