July 4, 2025 • 35 mins
I sat down with Dr. Dámaris Raymondi to talk all things vision—from her personal journey with glasses in middle school to demystifying refractive errors like myopia, hyperopia, and astigmatism. We dive deep into what really causes blurry vision, how lifestyle plays a role, and why the right prescription changes everything.
In this episode, I talk with Dr. Dámaris Raymondi about the surprising causes of blurry vision and the real reasons behind common refractive errors like myopia, hyperopia, and astigmatism. We cover the physics of sight, lifestyle influences, and how to get the most accurate prescription, because seeing clearly starts with understanding how your eyes really work.
Dr. Dámaris Raymondi is a New York City-based optometrist and a recognized leader in vision care. With nearly a decade of experience treating patients from all over the world, she specializes in refractive errors and helping people optimize their vision with the right prescription. She brings warmth, clarity, and deep expertise to every conversation, both in her clinic and on this episode.
Dr. Dámaris Raymondi
Website: https://www.sureyecare.com/our-team
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Episode Transcript
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(00:00):
There's three main refractive errors, and you've probably
heard of them before, and now you're going to get a chance to
really sit with it in detail. So they are medically known as
myopia, hyperopia, and astigmatism.
The colloquial way of saying it,myopia is the same thing as near
(00:21):
sightedness. Hyperopia is the same thing as
farsightedness and astigmatism. That's astigmatism.
Welcome to the IQ Podcast, hosted by Doctor Ronnie Bannock,
America's integrative neuro ophthalmologist.
I'm your host, Doctor Ronnie Bannock, and today I'm so
honored to have our expert guestwith us, Doctor Damaris
(00:44):
Raymondi. Thank you so much for having me.
I'm so excited to cover everything we're going to go
through today. Absolutely.
And just for our audience, Dr. Raimondi is an optometrist,
She's based in New York City. She is well recognized as a
leader in her field, and I'm so privileged to know her as a
colleague as well as a friend. Again, we're so glad to have you
(01:05):
with us today. So I always like to begin by
asking my guests, Dr. Raimondi, what was it about optometry that
interested you so much that you decided to pursue this as your
career? That's such a common question
that I get all the time, and it goes all the way back to the
(01:26):
story of me needing my very own first pair of glasses.
It was in the 7th grade and I started taking Italian class and
my last name is Ramondi, last name R.
So I was not sitting in the front of the classroom, but all
the way in the back. And I grew up speaking Spanish
at home. And the interesting thing about
(01:46):
Spanish grammar is that it's totally different than Italian
grammar. So it learning Italian has a
foreign language as a 7th graderwas challenging.
And I started getting low grade and I didn't understand that the
other kids next to me, we're seeing things clearly.
I brought it up to my parents and somehow they were like, we
(02:08):
got to get you over and get youreyes examined, get your eyes
tested. I got my first pair of glasses
and like most people with their first experience with glasses,
they look outside, they see a tree and they see every single
leaf and they're like, Oh my God, you're supposed to see
every detail. That's exactly how I felt and I
(02:29):
loved it for a month as any 7th grader.
Only for a month because after that, I couldn't stand the
feeling of glasses on my face. This was around the time when
Acuvue was putting out flashy commercials on MTV and they had
you go on their website print out a coupon to try out your
first trial pair of Attitude contacts.
(02:51):
I dutifully went and printed it out and told my parents I want
to wear contacts and they were like, OK, let's go for it.
And they took me. The optometrist was awesome
enough to try them on with me. He was the only middle schooler
with contacts. I would tell everybody about it.
I thought it was the coolest thing, like glasses were cool,
(03:11):
contacts were even cooler and just the fact that I could see
clearly from then on I knew I need everybody needs to see this
clearly and slowly of a trillioninterest start arised from that.
That's how I ended up in optometry.
I'm so glad you pursued your dream because you've helped
countless patients with their eyesight.
And I just want to go back to what you were saying earlier
(03:32):
about not realizing that there'sso much of the world, people you
may be missing if you have the need for glasses or contacts and
you don't know that you need them.
It's really truly, pun intended,eye opening when patients get
their first prescription and allof a sudden they can see so many
details. They see details of the world
(03:52):
around them. They also see details looking at
their own face in the mirror. People say, Oh my goodness, I
didn't know I had so many lines on my face for wrinkles, but now
I can see them so clearly. So I but regardless, it's always
best to optimize your vision, our visual potential by wearing
the right prescription and factor.
Raimondi, if you can just describe for us what is
(04:13):
refractive error, What are the components of refractive error,
which is basically the metric weuse when we talk about someone's
prescription. Yes.
So a refractive error is basically the power that goes in
a person's glasses or contact lenses or intraocular lens.
But refractive error is the formula, the prescription like
(04:35):
you said. And what it is, it tells us
about where the light ends up focusing within your eyeball,
how far away it is from the retina.
Is it right on it? If light focuses perfectly on to
the back of your eye onto your retina and you have no
refractive error, you have no prescription and that's known as
(04:58):
emmetropic. And then there are other forms
of refractive errors that we will get into, but that's what
it is. It tells us where light ends up
focusing within our eye. Yeah.
For our audience, could you justexplain a little bit about the
optics of the eye? What are the components that
play into determining whether light the light can focus
perfectly onto the retina or not?
(05:19):
There's many different components.
Optics is such a, that's anothergoing back to your first
question in physics and undergrad when we got to the
optics chapter of physics, I just found that so fascinating
that oh, this is where the glasses prescription comes from,
from where the light ends up hitting your eye.
So there's lots of different components that we need to see
(05:44):
clearly. And I explained this to every
single patient who's in my chair.
We could start off with the tearfilm.
The tear film itself, it's made out of water, mucin, oil, and it
has all these different subcomponents, all three of
those 3 layers, 3 layers within the tear film itself.
That's on the top most part of your eye.
(06:05):
They all need to be in perfect harmony for you to see clearly.
But what else needs to be in perfect harmony?
Your cornea that's right underneath your tear film and
that holds that actually has a really large refracting power.
Our eyes, it bends light so thatit does hit your back of your
eye and your cornea. So your tear phones got to be
(06:25):
perfect. Your cornea's got to be perfect
for you to see clearly perfect and healthy.
And there could be many corneal diseases.
The next thing that needs to be really good is, well, your
anterior chamber needs to be clear, although that's not
really a refracting power, but I'm thinking about all the
things. The next big component of your
eye that is used to bend light is your crystalline lens.
(06:48):
And it's just, it's just like the name.
It's a little lens, I like to describe it to patients like a
clear little M&M sitting in the middle of your eyeball.
And that also bends light to a large degree.
So that needs to be clear, beautiful and healthy.
And able to focus at different distances.
Dr. Raimundi, like the lens is able is dynamic.
(07:10):
It's a dynamic structure. And if you could explain a
little bit more about how that works when we're looking at
something far away or up close, how the lens changes shape.
Sure, the lens definitely changes shape.
When we are looking at somethingreally far away.
Our lens becomes nice and skinnyand very relaxed, and when we
(07:31):
are looking at something nice and up close, it gets really
nice and thick and fat, like it looks and it changes.
Just like a camera. When we look far, our eyes are
most relaxed. When we're looking up close,
that crystalline lens thickens and it all changes.
OK. So with all of these various
different components working together, how likely is it that
(07:51):
the light stimulus or the light rays coming into our eye will
actually fall perfectly on the retina?
It's pretty actually most people, it seems to me.
Most people would have some errors either in the cornea or
in the lens that would cause them to have some degree of
refractive error. What have you seen in your
practice? Like what percentage of your
patients have some kind of refractive error?
(08:16):
It's really interesting that yousay this, Doctor Bannock.
I've been doing this now for I'mapproaching 10 years in an
official capacity of seeing patients.
I guess the majority of patientsdo have a refractive error.
But I'm based in New York. I get patients from all over the
(08:37):
world. And jumping ahead into some
details, I see a large generational difference from
patients who grew up and in a different country, grew up in
the outdoors. And that could be anywhere
outdoors, could be South Americaoutdoors, could be Asia
outdoors. A lot of these older patients,
(08:58):
their distance vision, the smallest, tiniest refractive era
that you can find. Many times I end up finding 0 or
perfect distance vision. But then when we're going to
younger generations who grew up mainly here in New York, I find
all different ranges of refractive errors.
So it's definitely population based.
I would say nature versus nurture.
(09:20):
A large part nurture depending on what your childhood
experience was like. I'm so glad you brought that up
that there are differences, there are genetic differences,
but then there's also lifestyle differences.
And you mentioned how much time people spend outdoors, how much
time do they spend up close where their lens has to focus so
(09:41):
much and put in so much effort to focus up close.
First, let's talk a little bit about the three main types of
refractive errors there are and what does each of them mean.
So I'll let you explain what that what those three are.
There's perfect, which we were going into in a way where
there's no prescription, but there's three main refractive
(10:03):
errors, and you've probably heard of them before, and now
you're going to get a chance to really sit with it in detail.
So they are medically known as myopia, hyperopia, and
astigmatism. The colloquial way of saying it,
myopia is the same thing as nearsightedness.
(10:24):
Hyperopia is the same thing as farsightedness and astigmatism.
That's astigmatism. So let's go into myopia.
Myopia is hot. It's on everyone's radar.
What myopia basically means, andI have my trusty little model
right here, is that the rays of light, end of end of focusing in
(10:45):
not the most ideal part of the eyeball.
They focus in front of the retina.
And why do they focus in front of the retina?
Because in myopia, in the majority of cases, of course,
with anything scientific, there's nitty gritty details,
but overall overarching myopia means that your eyeball is
longer than average. So if it's longer than average
(11:07):
in a perfect eye, the light is falling right here perfectly in
the back and center of your retina.
But if your eyeballs longer, what, where is the light go?
Where do you think it's going tofocus?
It's going to focus in front andgoing back to the crystalline
lens, as that shifts focus and changes, it never ends up, you
(11:29):
see where my finger's going. It never ends up on the retina.
It stays in front no matter how hard you squeeze, how hard you
focus. So for myopia, typically you
need a pair of glasses, contact,something to get the light race
to focus on the back of the eye.So basically to shift the light
image back onto the red specifictype of lens, it has a certain
(11:51):
shape that will refocus that image.
Again, the optics play into thisvery much and it allows people
to see. So fascinating.
Dr. Rimandi, what's the next type of refractive area that you
commonly see in your practice? So that was near sightedness.
The next type is hyperopia or farsightedness.
So what this means is that the eyeball, it's a little shorter
(12:14):
than average. And where did the light rays
fall in a hyperopic eye or farsighted eye?
They fall back here. So what that means is if you do
crank up the focus, you can reach this part in the back of
the eye to reach clarity and clear vision.
And hyperopia, while it means farsightedness, what I find is
(12:38):
that in large amounts it can impact both things up close, the
clarity of things up close and the things far away.
Hyperopia if a patient has, if the patient has no prescription,
usually they do have a little bit of hyperopia and it's super
common. And a lot of times hidden
hyperopia is revealed after the age of 40.
(13:01):
So that would be hyperopia. The light rays are focused all
the way back here. Could you just explain a little
bit more? What do you mean about hidden
hyperopia? Because I've had so many
patients come to me, they've never worn glasses their whole
life. They always say, oh, I saw
perfectly. I saw 2020 or better than 2020.
Sometimes patients can see 2015 on the chart, but then they hit
(13:24):
their 40s or maybe even earlier and all of a sudden they can't
focus and they end up needing glasses.
So is this what you mean by hidden hyperopia?
Is this kind of an example of why people may have this sudden
need for glasses once they reachmid adulthood?
Partially. Definitely.
So what ends up happening is with myopia, if you recall, the
(13:47):
light rays are focused in front of the eye.
And no matter how hard you strain or how hard you try those
light rays, since they're in front, they're never going to
hit the retina. Now going back to hyperopia, you
can have a power or a need, right?
And it's focused in the back of the eye.
If you strain or focus hard enough, you can make those light
(14:08):
rays reach the back of the eye. Now, when we're younger than 40,
when we're in our 20s and our 30s, that focusing is super easy
to get it back here. Our crystalline lens, the one
that gets skinny and then reallythick, that changes shape.
It's able to be, it's pliable, it's able to crank in that
focusing without you noticing. But what I often explain this to
(14:32):
patients as, it's like holding aweight in your arms.
You hold a weight in your arms and in the beginning it's OK In
the let's pretend that you wake up in the morning and you hold
some 5 LB dumbbells in your hand.
In the morning you're OK. Afternoon going to get fatigued.
By the end of the day, you're done.
And you can compare that to years 30354045.
(14:57):
You can still crank some in, butas soon as that crystalline lens
hardens, you're no longer able to clear that small
prescription. And technically, that hidden
hyperopia, that hidden prescription was always present.
But just like many things change, and once we're a little
older, our eyesight changes a little too.
(15:21):
That would be one part of it. Yes, thank you for explaining
that. And I love that analogy of
having to hold weight, like yourmuscles are just working all the
time. You may not realize it initially
because it's a small amount of weight, but over time it can
really build up and really fatigue you.
So a lot of people will have fatigue, visual fatigue, when
they have this hidden hyperopia or latent hyperopia that they've
(15:45):
been struggling with for most oftheir life.
This has been such an amazing, fascinating discussion.
Doctor Raimondi, I, I'm so interested to learn about the
third type of refractive error, which you mentioned earlier,
astigmatism. I'm so curious to know what that
is. But first, we're going to take a
very short break, hear from one of our sponsors and we'll be
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So, Doctor Ramadi, tell us aboutastigmatism.
What is it and how does it impact our?
Vision. I want to start off with saying
(17:12):
that I see astigmatism every dayin practice.
A lot of people have astigmatismand it depends to what degree
you have it. But what even is this word
confounds all the patients. Some people who say they have
it, some people who don't have it think they have it.
All these things. What does it mean?
So we went over myopia, where the light focuses in front of
(17:36):
the retina. We went over hyperopia where the
light focuses in the back of theretina.
Astigmatism means you have more than one focal point.
You have two and you have two. And they might be two that are
separated in the front or two that are separated in the back.
And there's a whole circle of least confusion optics that goes
(17:58):
into it. But the other way that I like
explaining it very simply to patients is that along 1 axis of
your eye, you need extra power. And that axis, when you trace it
back to optics, let's say it's this line, like let's imagine a
diagonal slash, a slash right here.
You trace it back here and it'llshow up as two different focal
(18:22):
points. So you're saying?
So like a cross, that's what you're saying, like something
like this? So if you're going.
To focus, like if you're lookingat a cross, you're focusing this
at a certain place and you're focusing this at a different
place. Is that safe to say, Doctor
Raimondi? Yes, correct.
And when it's focused in different places before we were
just talking about a point of light.
(18:43):
When they're focused in different places, things are
distorted, those kind of pure WAVY or crooked or what
patients, when patients notice it is when they're driving at
night and all the light is bended.
So when we correct astigmatism, we end up collapsing this cross
and making it into one point when you wear glasses.
(19:04):
Got it. So it's it can be corrected with
glasses. Now where does astigmatism come
from? You said that you mentioned
earlier there's so many components to refractive error.
Where do you see most of your patients that the astigmatism is
derived from? I see most of it as corneal
astigmatism, so that's probably where a lot of patients have
(19:25):
heard that their eye is footballshaped.
Football shape is more so like amath term or a math graph.
If I were to map it out mathematically or graphically,
it would come up as a football. But on the cornea, what it would
look like actually, oh, I have ahandy cornea right here.
(19:45):
Look at that. So do you see this perfect
little Dome? This would be an I without
astigmatism. An I with astigmatism would have
forward facing. It would look like a number, a
large number 8 or like a bow tie.
But if we'd look at it like this, remember I was talking
about the perfect Dome. If you think about this Dome and
(20:08):
no astigmatism, it'll focus to apoint with astigmatism.
This is not a Dome. Instead you have two hilltops.
And when you have two hilltops, you're going to have two
different points of focus. So in majority of cases, corneal
astigmatism, there are details of course, but this is most
(20:29):
patients. It's all, all in the cornea
right here. It's not perfect.
It's a little sometimes in some patients you have to focus, say
that it is a little tiny bit deformed.
So often times I've heard of astigmatism being described as
either a football or more of an elliptical shape.
But it's not something that patients could just look into
(20:49):
the mirror and see themselves, right?
It's not that you hear you have a stigmatism and then you go
looking to see if your eye is perfectly round.
It's not something patients themselves can discern.
Yes, correct. And that's why I shy away from
the, I don't mention it as football shape because it's not
that. It's more about where the points
are sitting and the way that people understand it.
(21:11):
With glasses, if you look at 1 angle, that angle has a
different prescription as opposed to the rest of the
surface of that lens for your glasses.
And I loved how you gave the analogy of the Figure 8 and the
two domes, like there's a littlehilltop and then a through and
then another little hilltop. Wow, that was so helpful.
Doctor Raimondi. I've had so many patients when
(21:32):
they hear the word astigmatism, they get so frightened.
They think it's something reallybad.
They think it's something that will your.
Stigmata. Yes, exactly.
Like it sounds so scary, but in reality it's very common.
And I can just tell you like fora long time I believed that I
was just myopic, meaning I had myopia, near sightedness.
(21:54):
And for many years my prescription was corrected just
for myopia. And then once about, I think it
was about 8-9 years ago, I went to my eye doctor and they said,
oh, you have some astigmatism inyour right eye.
And I said no, that can't be. I don't have astigmatism.
I have only myopia and said no, you have a little bit of
astigmatism. And the truth was I had it all
(22:15):
along and no one ever corrected it for me.
But when it was corrected for me, I realized that a lot of the
glare and the Halos I was seeing, particularly at night,
that all went away. So I know people can be afraid
of the term, but I just want to reassure people that it's very
common and there are wonderful ways to correct for it.
(22:37):
Correct. Absolutely, there's many ways to
correct for it. And this also, if I can give
like another side to the story to it, it highlights the
importance of getting your eyes examined thoroughly and every
year as well. Because on the flip side, a lot
of times astigmatism, even though it's to me, it's a
(23:00):
refractive error, it's somethingthat can be corrected with
glasses or contact lenses. It can be caused from a person
over exerting their eyes. There can be a sort of fake
astigmatism, as you could say there could be some astigmatism
that shows up because remember how I said the cornea is not
perfect and there's the two domes and that through sometimes
(23:23):
that could be brought upon because of dry eye or other
ocular surface diseases. So it's not really the
astigmatism, but it's the tear film and the cornea that are
suffering. And once you fix that, you fix
the astigmatism. So there's so many things that
go into it. Get your eyes checked by an
expert to know exactly where you're at.
(23:44):
Yeah. And as an eye doctor, what are
some of the tools you use in your practice to help to
identify or uncover whether someone has myopia or hyperopia
or astigmatism or maybe a combination of all three?
One of my favorite tools is something that's been around for
a long time and those are dilating drops you mentioned
(24:08):
earlier, Doctor Bannock. All the up close time we spend
on screens, on books, all the demands that society makes of us
today of in all age rages. I often find that eyes are so
tired and so overworked and overfocused that I need to dilate my
patients. What dilating does, it does two
(24:29):
things for me. It well, it opens up your pupils
so that I can check the health inside of your eye and see what
else is going on there. But what it also does when it
opens up your pupils, it relaxesyour focusing system, which what
we call your accommodative system.
And when it relaxes that, I'm able to see all the hidden
(24:50):
prescriptions, I'm able to see what's really going on with your
eyes. And I have uncovered so many
different refractive errors and what a patient presents within
all ages because of the near demand that computers and
screens have on us in the past. I believe we would.
When I graduated in 2015, we learned that mainly children are
(25:13):
able to over focus and overcompensate.
So we've got to be really careful with them.
But I'm finding that all age ranges are very much affected
and I have to be very careful with what I'm prescribing
because that's a huge tool that allows me to see what's going
on. Yeah, I love the fact that you
said your best, most useful toolis the dilation because it's not
(25:36):
some fancy piece of equipment that we need, right?
That's really not it. It's about being thorough.
It's about uncovering things that may explain why patient may
not be comfortable in their glasses prescription or they're
having a lot of glare and Halos or starbursts in their vision,
especially at night. And just for our audience, what
(25:57):
Doctor Raymond is talking about are drops that we typically put
for dilation. And we called this whole process
a cycloplegic refraction. And cycloplegic basically means
that the accommodator of the system is paralyzed.
Typically, we used to use it only for kids, but now it's
really important to get that done even if you're an adult
(26:18):
because, again, there could be refractive errors that are
hidden that could be uncovered. So thank you so much for sharing
that really important piece of information.
I wanted to ask you something, Doctor Rimandi.
A lot of people believe rightly or wrongly, that by wearing
glasses that if they become dependent on their glasses that
(26:41):
their vision will continue to worsen or significantly increase
in their power. So what's your response to that
type of concern that patients may have?
It really depends. There are so many different ways
this could go. It depends on the patient's age,
(27:01):
if they're a child that's emerging into in myopia and if
they're showing signs of near sightedness.
I will say for sure in that case, myopia is something that
snowballs out of control, that avalanches and glasses in a
child underneath 18 years old who has myopia and there's many
(27:21):
different criterias. It can make things worse and it
can cause a quote UN quote dependency.
In a more typical setting, though, I know that I'm
performing a very thorough exam and apart from the dilation
drops, I also review the patient's ocular surface.
Is there a dry eye that's contributing to these starbursts
(27:43):
or Halos? Is there something else
underneath? They might be a disease process
happening that's causing this lack and clarity.
And when this happens, I tell a patient, OK, we got your best
prescription here. If this is your first pair of
glasses, and if it's a large prescription, usually I'll go
(28:04):
into this, I'll say don't be alarmed.
You might find that you're reaching for it more often than
not. And that's when patients refer
to it as becoming dependent. But in reality, I'm getting you
to see how everyone else is seeing.
I'm making sure that we are optimizing your vision so you
can see as clearly as you possibly can.
(28:25):
But of course, there are caveats.
And every single patient is so unique in what they're feeling
or what they're seeing. I have to know how they're like,
we were going into, I'd have to know what their tear film is
doing. I got to know what their cornea
is doing. I need to know what the
different layers of the retinal cells are doing.
Believe it or not, I check this in every you and I, we check
(28:46):
this in every single patient that comes into our door.
And there's many things that go into it.
But if I were to have an overarching answer, I'd say when
it's prescribed, don't be surprised that you're seeing
clearer. The goal of glasses or contacts
when they're indicated is to make you more efficient, to have
(29:07):
you quickly look at things. Vision is automatic.
When you look at something, it should be automatic.
And if it's not, allow us to uncover and see what is going
on. Oh my goodness, there's so many
points you made that I would love to talk more about.
We are nearing the end of our interview, but I did want to
just mention one highlight. One thing that you said is as
(29:30):
eye doctors, it is our responsibility to help our
patients see to the best of their ability.
And if we know that by wearing acertain prescription, whether
it's through glasses or contactsor through surgery and an IOL or
refractive surgery, we can get our patients to 2020 vision or
better. If we know that we will do our
(29:51):
best to try to, to enable that, to help our patients along so
that they can reach their visualpotential.
That's really our goal. And in doing so, yes, you may
realize that, like you said, people, you're reaching for your
glasses more because it's helping you see better.
It's not that you're becoming dependent on the glasses, it's
(30:11):
that they are helping you function better and your brain
is enjoying that clarity, right?The brain wants to see well and
take in the rest of the world. So thank you for bringing up
some of those points. And for other people, I wanted
to also bring this up. Different people have different
visual needs, right? Some patients need to see 2020,
(30:31):
some patients may not. So can you explain some
situations, Dr. Raimondi in which you may not give a patient
the full description because maybe they don't really need it.
And I will say though, I love togive my 100% to every single
patients and I've had a few where I have taken them off of
(30:52):
glasses. So on that that other spectrum,
right, pseudomyopia, fake myopiadidn't touch into I had one
patient who for one reason or another every year was increased
a little quarter before seeing me and I had to tell him your
eyes are actually plain O0. And wouldn't my initial like my
(31:16):
duty as a doctor was to tell himwe have to take you off of
glasses. But instead we slowly decrease
the prescription and after two years we got him to 0.
So I absolutely have situations where I take patients off of it.
I know most patients wish they were the following, but one case
where I do this is monovision. Some of us are very lucky where
(31:39):
we're born with one eye to see far and one eye to see near.
It's not all of us. But in those cases too, if they
are functioning good and they have no complaints and they're
seeing 2020 with both eyes far away and both eyes up close
because one is for the other one.
One is 1 is working for one, oneis working the other way.
(32:01):
In that case, I don't give them glasses.
Let me see what other situationsdepending on what language the
patient speaks or more specifically what language they
read in Roman letters can be very small.
The newspaper writing the traditional English, Spanish,
ABCD, right, It can be written in very tiny font, but other
(32:25):
languages, if you see their font, they, there's no way they
can print it that small And if apatient reads in that language,
whether that's. So what comes to mind is Chinese
characters or Arabic characters or even Russian characters,
Those characters when they're innewspapers, right, The Cyrillic
fonts, they're larger. So that is not going to need to
(32:47):
see your size 8 New York Times font.
So in those cases, I haven't prescribed the full prescription
because it's not necessitating that large demand.
For example, if someone is a pilot for a police officer, they
probably do need their 2020 vision.
(33:08):
But if someone is has a different type of profession
where they don't need to read very small font, they're not
doing up close near work and they're not looking way off in
the distance. They're they're most of their
world is intermediate distance. Maybe they don't need to have
that perfect 2020 vision. So that's another situation
which is more of a career slash lifestyle need situation in
(33:29):
which I may not give the patientthe full prescription and they
may not ask for it. They may say I'm OK, I can do
everything I need to do. My vision's 2040.
I'm very happy with that. And if they say something like
that to me then I'll say OK, that's wonderful.
I'll see you next year and we'llre evaluate and see how you're
doing. So it is really a discussion
amongst the patient, the doctor about the patient's needs.
(33:51):
That's really important. That's why I always ask.
And sometimes patients are like,wait, what?
And I'm like, no, I need to know.
I'm asking your occupation because I need to know how you
are using your eyes throughout the day so that I can help you
out better. Exactly, exactly, Doctor Armani,
this has been such an enlightening conversation.
You helped to clear up so many aspects of refractive errors and
(34:14):
I'm sure many patients, many people out there have questions
about. So we thank you for your
wonderful insights. If anyone wanted to reach out to
you, perhaps use some of your resources, maybe follow you on
social media or even become a patient, how could they find
you, Doctor Ramundi? They can find me 24/7 online.
(34:34):
I'm on Instagram at New York eyedoc.
So that's New York spelled out NEWYORKEYEDOC and that's the
same handle on TikTok. And if they wanted to become a
patient, head on over to my website, suereyecare.com, just
like it's spelled SUREYE care.com and click make an
(35:00):
appointment. And that's where I'll be happy
to see you in my exam chair sometime soon.
Wonderful. And we will share all of those
links to Doctor Raimondi's resources and her website below
underneath the interview. So thank you again, Doctor
Arimondi, for spending this timewith us.
We truly appreciate you and thank you all for tuning in.
(35:21):
And stay tuned for our next interview coming up very soon.
Thank you so much. Take care.
Thank you for tuning into the IQPodcast.
We hope you enjoyed today's episode and learn something new
to help elevate your IQ. If you loved what you heard,
don't forget to subscribe, leavea review and share the podcast
with your friends. Stay connected with Doctor
(35:43):
Ronnie Bannock for more eye opening insights on eye health,
nutrition and lifestyle. Until next time, keep your
vision clear and your IQ sharp.
There's three main refractive errors, and you've probably
heard of them before, and now you're going to get a chance to
really sit with it in detail. So they are medically known as
myopia, hyperopia, and astigmatism.
The colloquial way of saying it,myopia is the same thing as near
(00:21):
sightedness. Hyperopia is the same thing as
farsightedness and astigmatism. That's astigmatism.
Welcome to the IQ Podcast, hosted by Doctor Ronnie Bannock,
America's integrative neuro ophthalmologist.
I'm your host, Doctor Ronnie Bannock, and today I'm so
honored to have our expert guestwith us, Doctor Damaris
(00:44):
Raymondi. Thank you so much for having me.
I'm so excited to cover everything we're going to go
through today. Absolutely.
And just for our audience, Dr. Raimondi is an optometrist,
She's based in New York City. She is well recognized as a
leader in her field, and I'm so privileged to know her as a
colleague as well as a friend. Again, we're so glad to have you
(01:05):
with us today. So I always like to begin by
asking my guests, Dr. Raimondi, what was it about optometry that
interested you so much that you decided to pursue this as your
career? That's such a common question
that I get all the time, and it goes all the way back to the
(01:26):
story of me needing my very own first pair of glasses.
It was in the 7th grade and I started taking Italian class and
my last name is Ramondi, last name R.
So I was not sitting in the front of the classroom, but all
the way in the back. And I grew up speaking Spanish
at home. And the interesting thing about
(01:46):
Spanish grammar is that it's totally different than Italian
grammar. So it learning Italian has a
foreign language as a 7th graderwas challenging.
And I started getting low grade and I didn't understand that the
other kids next to me, we're seeing things clearly.
I brought it up to my parents and somehow they were like, we
(02:08):
got to get you over and get youreyes examined, get your eyes
tested. I got my first pair of glasses
and like most people with their first experience with glasses,
they look outside, they see a tree and they see every single
leaf and they're like, Oh my God, you're supposed to see
every detail. That's exactly how I felt and I
(02:29):
loved it for a month as any 7th grader.
Only for a month because after that, I couldn't stand the
feeling of glasses on my face. This was around the time when
Acuvue was putting out flashy commercials on MTV and they had
you go on their website print out a coupon to try out your
first trial pair of Attitude contacts.
(02:51):
I dutifully went and printed it out and told my parents I want
to wear contacts and they were like, OK, let's go for it.
And they took me. The optometrist was awesome
enough to try them on with me. He was the only middle schooler
with contacts. I would tell everybody about it.
I thought it was the coolest thing, like glasses were cool,
(03:11):
contacts were even cooler and just the fact that I could see
clearly from then on I knew I need everybody needs to see this
clearly and slowly of a trillioninterest start arised from that.
That's how I ended up in optometry.
I'm so glad you pursued your dream because you've helped
countless patients with their eyesight.
And I just want to go back to what you were saying earlier
(03:32):
about not realizing that there'sso much of the world, people you
may be missing if you have the need for glasses or contacts and
you don't know that you need them.
It's really truly, pun intended,eye opening when patients get
their first prescription and allof a sudden they can see so many
details. They see details of the world
(03:52):
around them. They also see details looking at
their own face in the mirror. People say, Oh my goodness, I
didn't know I had so many lines on my face for wrinkles, but now
I can see them so clearly. So I but regardless, it's always
best to optimize your vision, our visual potential by wearing
the right prescription and factor.
Raimondi, if you can just describe for us what is
(04:13):
refractive error, What are the components of refractive error,
which is basically the metric weuse when we talk about someone's
prescription. Yes.
So a refractive error is basically the power that goes in
a person's glasses or contact lenses or intraocular lens.
But refractive error is the formula, the prescription like
(04:35):
you said. And what it is, it tells us
about where the light ends up focusing within your eyeball,
how far away it is from the retina.
Is it right on it? If light focuses perfectly on to
the back of your eye onto your retina and you have no
refractive error, you have no prescription and that's known as
(04:58):
emmetropic. And then there are other forms
of refractive errors that we will get into, but that's what
it is. It tells us where light ends up
focusing within our eye. Yeah.
For our audience, could you justexplain a little bit about the
optics of the eye? What are the components that
play into determining whether light the light can focus
perfectly onto the retina or not?
(05:19):
There's many different components.
Optics is such a, that's anothergoing back to your first
question in physics and undergrad when we got to the
optics chapter of physics, I just found that so fascinating
that oh, this is where the glasses prescription comes from,
from where the light ends up hitting your eye.
So there's lots of different components that we need to see
(05:44):
clearly. And I explained this to every
single patient who's in my chair.
We could start off with the tearfilm.
The tear film itself, it's made out of water, mucin, oil, and it
has all these different subcomponents, all three of
those 3 layers, 3 layers within the tear film itself.
That's on the top most part of your eye.
(06:05):
They all need to be in perfect harmony for you to see clearly.
But what else needs to be in perfect harmony?
Your cornea that's right underneath your tear film and
that holds that actually has a really large refracting power.
Our eyes, it bends light so thatit does hit your back of your
eye and your cornea. So your tear phones got to be
(06:25):
perfect. Your cornea's got to be perfect
for you to see clearly perfect and healthy.
And there could be many corneal diseases.
The next thing that needs to be really good is, well, your
anterior chamber needs to be clear, although that's not
really a refracting power, but I'm thinking about all the
things. The next big component of your
eye that is used to bend light is your crystalline lens.
(06:48):
And it's just, it's just like the name.
It's a little lens, I like to describe it to patients like a
clear little M&M sitting in the middle of your eyeball.
And that also bends light to a large degree.
So that needs to be clear, beautiful and healthy.
And able to focus at different distances.
Dr. Raimundi, like the lens is able is dynamic.
(07:10):
It's a dynamic structure. And if you could explain a
little bit more about how that works when we're looking at
something far away or up close, how the lens changes shape.
Sure, the lens definitely changes shape.
When we are looking at somethingreally far away.
Our lens becomes nice and skinnyand very relaxed, and when we
(07:31):
are looking at something nice and up close, it gets really
nice and thick and fat, like it looks and it changes.
Just like a camera. When we look far, our eyes are
most relaxed. When we're looking up close,
that crystalline lens thickens and it all changes.
OK. So with all of these various
different components working together, how likely is it that
(07:51):
the light stimulus or the light rays coming into our eye will
actually fall perfectly on the retina?
It's pretty actually most people, it seems to me.
Most people would have some errors either in the cornea or
in the lens that would cause them to have some degree of
refractive error. What have you seen in your
practice? Like what percentage of your
patients have some kind of refractive error?
(08:16):
It's really interesting that yousay this, Doctor Bannock.
I've been doing this now for I'mapproaching 10 years in an
official capacity of seeing patients.
I guess the majority of patientsdo have a refractive error.
But I'm based in New York. I get patients from all over the
(08:37):
world. And jumping ahead into some
details, I see a large generational difference from
patients who grew up and in a different country, grew up in
the outdoors. And that could be anywhere
outdoors, could be South Americaoutdoors, could be Asia
outdoors. A lot of these older patients,
(08:58):
their distance vision, the smallest, tiniest refractive era
that you can find. Many times I end up finding 0 or
perfect distance vision. But then when we're going to
younger generations who grew up mainly here in New York, I find
all different ranges of refractive errors.
So it's definitely population based.
I would say nature versus nurture.
(09:20):
A large part nurture depending on what your childhood
experience was like. I'm so glad you brought that up
that there are differences, there are genetic differences,
but then there's also lifestyle differences.
And you mentioned how much time people spend outdoors, how much
time do they spend up close where their lens has to focus so
(09:41):
much and put in so much effort to focus up close.
First, let's talk a little bit about the three main types of
refractive errors there are and what does each of them mean.
So I'll let you explain what that what those three are.
There's perfect, which we were going into in a way where
there's no prescription, but there's three main refractive
(10:03):
errors, and you've probably heard of them before, and now
you're going to get a chance to really sit with it in detail.
So they are medically known as myopia, hyperopia, and
astigmatism. The colloquial way of saying it,
myopia is the same thing as nearsightedness.
(10:24):
Hyperopia is the same thing as farsightedness and astigmatism.
That's astigmatism. So let's go into myopia.
Myopia is hot. It's on everyone's radar.
What myopia basically means, andI have my trusty little model
right here, is that the rays of light, end of end of focusing in
(10:45):
not the most ideal part of the eyeball.
They focus in front of the retina.
And why do they focus in front of the retina?
Because in myopia, in the majority of cases, of course,
with anything scientific, there's nitty gritty details,
but overall overarching myopia means that your eyeball is
longer than average. So if it's longer than average
(11:07):
in a perfect eye, the light is falling right here perfectly in
the back and center of your retina.
But if your eyeballs longer, what, where is the light go?
Where do you think it's going tofocus?
It's going to focus in front andgoing back to the crystalline
lens, as that shifts focus and changes, it never ends up, you
(11:29):
see where my finger's going. It never ends up on the retina.
It stays in front no matter how hard you squeeze, how hard you
focus. So for myopia, typically you
need a pair of glasses, contact,something to get the light race
to focus on the back of the eye.So basically to shift the light
image back onto the red specifictype of lens, it has a certain
(11:51):
shape that will refocus that image.
Again, the optics play into thisvery much and it allows people
to see. So fascinating.
Dr. Rimandi, what's the next type of refractive area that you
commonly see in your practice? So that was near sightedness.
The next type is hyperopia or farsightedness.
So what this means is that the eyeball, it's a little shorter
(12:14):
than average. And where did the light rays
fall in a hyperopic eye or farsighted eye?
They fall back here. So what that means is if you do
crank up the focus, you can reach this part in the back of
the eye to reach clarity and clear vision.
And hyperopia, while it means farsightedness, what I find is
(12:38):
that in large amounts it can impact both things up close, the
clarity of things up close and the things far away.
Hyperopia if a patient has, if the patient has no prescription,
usually they do have a little bit of hyperopia and it's super
common. And a lot of times hidden
hyperopia is revealed after the age of 40.
(13:01):
So that would be hyperopia. The light rays are focused all
the way back here. Could you just explain a little
bit more? What do you mean about hidden
hyperopia? Because I've had so many
patients come to me, they've never worn glasses their whole
life. They always say, oh, I saw
perfectly. I saw 2020 or better than 2020.
Sometimes patients can see 2015 on the chart, but then they hit
(13:24):
their 40s or maybe even earlier and all of a sudden they can't
focus and they end up needing glasses.
So is this what you mean by hidden hyperopia?
Is this kind of an example of why people may have this sudden
need for glasses once they reachmid adulthood?
Partially. Definitely.
So what ends up happening is with myopia, if you recall, the
(13:47):
light rays are focused in front of the eye.
And no matter how hard you strain or how hard you try those
light rays, since they're in front, they're never going to
hit the retina. Now going back to hyperopia, you
can have a power or a need, right?
And it's focused in the back of the eye.
If you strain or focus hard enough, you can make those light
(14:08):
rays reach the back of the eye. Now, when we're younger than 40,
when we're in our 20s and our 30s, that focusing is super easy
to get it back here. Our crystalline lens, the one
that gets skinny and then reallythick, that changes shape.
It's able to be, it's pliable, it's able to crank in that
focusing without you noticing. But what I often explain this to
(14:32):
patients as, it's like holding aweight in your arms.
You hold a weight in your arms and in the beginning it's OK In
the let's pretend that you wake up in the morning and you hold
some 5 LB dumbbells in your hand.
In the morning you're OK. Afternoon going to get fatigued.
By the end of the day, you're done.
And you can compare that to years 30354045.
(14:57):
You can still crank some in, butas soon as that crystalline lens
hardens, you're no longer able to clear that small
prescription. And technically, that hidden
hyperopia, that hidden prescription was always present.
But just like many things change, and once we're a little
older, our eyesight changes a little too.
(15:21):
That would be one part of it. Yes, thank you for explaining
that. And I love that analogy of
having to hold weight, like yourmuscles are just working all the
time. You may not realize it initially
because it's a small amount of weight, but over time it can
really build up and really fatigue you.
So a lot of people will have fatigue, visual fatigue, when
they have this hidden hyperopia or latent hyperopia that they've
(15:45):
been struggling with for most oftheir life.
This has been such an amazing, fascinating discussion.
Doctor Raimondi, I, I'm so interested to learn about the
third type of refractive error, which you mentioned earlier,
astigmatism. I'm so curious to know what that
is. But first, we're going to take a
very short break, hear from one of our sponsors and we'll be
right back. Did you know that most adults
(16:07):
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So, Doctor Ramadi, tell us aboutastigmatism.
What is it and how does it impact our?
Vision. I want to start off with saying
(17:12):
that I see astigmatism every dayin practice.
A lot of people have astigmatismand it depends to what degree
you have it. But what even is this word
confounds all the patients. Some people who say they have
it, some people who don't have it think they have it.
All these things. What does it mean?
So we went over myopia, where the light focuses in front of
(17:36):
the retina. We went over hyperopia where the
light focuses in the back of theretina.
Astigmatism means you have more than one focal point.
You have two and you have two. And they might be two that are
separated in the front or two that are separated in the back.
And there's a whole circle of least confusion optics that goes
(17:58):
into it. But the other way that I like
explaining it very simply to patients is that along 1 axis of
your eye, you need extra power. And that axis, when you trace it
back to optics, let's say it's this line, like let's imagine a
diagonal slash, a slash right here.
You trace it back here and it'llshow up as two different focal
(18:22):
points. So you're saying?
So like a cross, that's what you're saying, like something
like this? So if you're going.
To focus, like if you're lookingat a cross, you're focusing this
at a certain place and you're focusing this at a different
place. Is that safe to say, Doctor
Raimondi? Yes, correct.
And when it's focused in different places before we were
just talking about a point of light.
(18:43):
When they're focused in different places, things are
distorted, those kind of pure WAVY or crooked or what
patients, when patients notice it is when they're driving at
night and all the light is bended.
So when we correct astigmatism, we end up collapsing this cross
and making it into one point when you wear glasses.
(19:04):
Got it. So it's it can be corrected with
glasses. Now where does astigmatism come
from? You said that you mentioned
earlier there's so many components to refractive error.
Where do you see most of your patients that the astigmatism is
derived from? I see most of it as corneal
astigmatism, so that's probably where a lot of patients have
(19:25):
heard that their eye is footballshaped.
Football shape is more so like amath term or a math graph.
If I were to map it out mathematically or graphically,
it would come up as a football. But on the cornea, what it would
look like actually, oh, I have ahandy cornea right here.
(19:45):
Look at that. So do you see this perfect
little Dome? This would be an I without
astigmatism. An I with astigmatism would have
forward facing. It would look like a number, a
large number 8 or like a bow tie.
But if we'd look at it like this, remember I was talking
about the perfect Dome. If you think about this Dome and
(20:08):
no astigmatism, it'll focus to apoint with astigmatism.
This is not a Dome. Instead you have two hilltops.
And when you have two hilltops, you're going to have two
different points of focus. So in majority of cases, corneal
astigmatism, there are details of course, but this is most
(20:29):
patients. It's all, all in the cornea
right here. It's not perfect.
It's a little sometimes in some patients you have to focus, say
that it is a little tiny bit deformed.
So often times I've heard of astigmatism being described as
either a football or more of an elliptical shape.
But it's not something that patients could just look into
(20:49):
the mirror and see themselves, right?
It's not that you hear you have a stigmatism and then you go
looking to see if your eye is perfectly round.
It's not something patients themselves can discern.
Yes, correct. And that's why I shy away from
the, I don't mention it as football shape because it's not
that. It's more about where the points
are sitting and the way that people understand it.
(21:11):
With glasses, if you look at 1 angle, that angle has a
different prescription as opposed to the rest of the
surface of that lens for your glasses.
And I loved how you gave the analogy of the Figure 8 and the
two domes, like there's a littlehilltop and then a through and
then another little hilltop. Wow, that was so helpful.
Doctor Raimondi. I've had so many patients when
(21:32):
they hear the word astigmatism, they get so frightened.
They think it's something reallybad.
They think it's something that will your.
Stigmata. Yes, exactly.
Like it sounds so scary, but in reality it's very common.
And I can just tell you like fora long time I believed that I
was just myopic, meaning I had myopia, near sightedness.
(21:54):
And for many years my prescription was corrected just
for myopia. And then once about, I think it
was about 8-9 years ago, I went to my eye doctor and they said,
oh, you have some astigmatism inyour right eye.
And I said no, that can't be. I don't have astigmatism.
I have only myopia and said no, you have a little bit of
astigmatism. And the truth was I had it all
(22:15):
along and no one ever corrected it for me.
But when it was corrected for me, I realized that a lot of the
glare and the Halos I was seeing, particularly at night,
that all went away. So I know people can be afraid
of the term, but I just want to reassure people that it's very
common and there are wonderful ways to correct for it.
(22:37):
Correct. Absolutely, there's many ways to
correct for it. And this also, if I can give
like another side to the story to it, it highlights the
importance of getting your eyes examined thoroughly and every
year as well. Because on the flip side, a lot
of times astigmatism, even though it's to me, it's a
(23:00):
refractive error, it's somethingthat can be corrected with
glasses or contact lenses. It can be caused from a person
over exerting their eyes. There can be a sort of fake
astigmatism, as you could say there could be some astigmatism
that shows up because remember how I said the cornea is not
perfect and there's the two domes and that through sometimes
(23:23):
that could be brought upon because of dry eye or other
ocular surface diseases. So it's not really the
astigmatism, but it's the tear film and the cornea that are
suffering. And once you fix that, you fix
the astigmatism. So there's so many things that
go into it. Get your eyes checked by an
expert to know exactly where you're at.
(23:44):
Yeah. And as an eye doctor, what are
some of the tools you use in your practice to help to
identify or uncover whether someone has myopia or hyperopia
or astigmatism or maybe a combination of all three?
One of my favorite tools is something that's been around for
a long time and those are dilating drops you mentioned
(24:08):
earlier, Doctor Bannock. All the up close time we spend
on screens, on books, all the demands that society makes of us
today of in all age rages. I often find that eyes are so
tired and so overworked and overfocused that I need to dilate my
patients. What dilating does, it does two
(24:29):
things for me. It well, it opens up your pupils
so that I can check the health inside of your eye and see what
else is going on there. But what it also does when it
opens up your pupils, it relaxesyour focusing system, which what
we call your accommodative system.
And when it relaxes that, I'm able to see all the hidden
(24:50):
prescriptions, I'm able to see what's really going on with your
eyes. And I have uncovered so many
different refractive errors and what a patient presents within
all ages because of the near demand that computers and
screens have on us in the past. I believe we would.
When I graduated in 2015, we learned that mainly children are
(25:13):
able to over focus and overcompensate.
So we've got to be really careful with them.
But I'm finding that all age ranges are very much affected
and I have to be very careful with what I'm prescribing
because that's a huge tool that allows me to see what's going
on. Yeah, I love the fact that you
said your best, most useful toolis the dilation because it's not
(25:36):
some fancy piece of equipment that we need, right?
That's really not it. It's about being thorough.
It's about uncovering things that may explain why patient may
not be comfortable in their glasses prescription or they're
having a lot of glare and Halos or starbursts in their vision,
especially at night. And just for our audience, what
(25:57):
Doctor Raymond is talking about are drops that we typically put
for dilation. And we called this whole process
a cycloplegic refraction. And cycloplegic basically means
that the accommodator of the system is paralyzed.
Typically, we used to use it only for kids, but now it's
really important to get that done even if you're an adult
(26:18):
because, again, there could be refractive errors that are
hidden that could be uncovered. So thank you so much for sharing
that really important piece of information.
I wanted to ask you something, Doctor Rimandi.
A lot of people believe rightly or wrongly, that by wearing
glasses that if they become dependent on their glasses that
(26:41):
their vision will continue to worsen or significantly increase
in their power. So what's your response to that
type of concern that patients may have?
It really depends. There are so many different ways
this could go. It depends on the patient's age,
(27:01):
if they're a child that's emerging into in myopia and if
they're showing signs of near sightedness.
I will say for sure in that case, myopia is something that
snowballs out of control, that avalanches and glasses in a
child underneath 18 years old who has myopia and there's many
(27:21):
different criterias. It can make things worse and it
can cause a quote UN quote dependency.
In a more typical setting, though, I know that I'm
performing a very thorough exam and apart from the dilation
drops, I also review the patient's ocular surface.
Is there a dry eye that's contributing to these starbursts
(27:43):
or Halos? Is there something else
underneath? They might be a disease process
happening that's causing this lack and clarity.
And when this happens, I tell a patient, OK, we got your best
prescription here. If this is your first pair of
glasses, and if it's a large prescription, usually I'll go
(28:04):
into this, I'll say don't be alarmed.
You might find that you're reaching for it more often than
not. And that's when patients refer
to it as becoming dependent. But in reality, I'm getting you
to see how everyone else is seeing.
I'm making sure that we are optimizing your vision so you
can see as clearly as you possibly can.
(28:25):
But of course, there are caveats.
And every single patient is so unique in what they're feeling
or what they're seeing. I have to know how they're like,
we were going into, I'd have to know what their tear film is
doing. I got to know what their cornea
is doing. I need to know what the
different layers of the retinal cells are doing.
Believe it or not, I check this in every you and I, we check
(28:46):
this in every single patient that comes into our door.
And there's many things that go into it.
But if I were to have an overarching answer, I'd say when
it's prescribed, don't be surprised that you're seeing
clearer. The goal of glasses or contacts
when they're indicated is to make you more efficient, to have
(29:07):
you quickly look at things. Vision is automatic.
When you look at something, it should be automatic.
And if it's not, allow us to uncover and see what is going
on. Oh my goodness, there's so many
points you made that I would love to talk more about.
We are nearing the end of our interview, but I did want to
just mention one highlight. One thing that you said is as
(29:30):
eye doctors, it is our responsibility to help our
patients see to the best of their ability.
And if we know that by wearing acertain prescription, whether
it's through glasses or contactsor through surgery and an IOL or
refractive surgery, we can get our patients to 2020 vision or
better. If we know that we will do our
(29:51):
best to try to, to enable that, to help our patients along so
that they can reach their visualpotential.
That's really our goal. And in doing so, yes, you may
realize that, like you said, people, you're reaching for your
glasses more because it's helping you see better.
It's not that you're becoming dependent on the glasses, it's
(30:11):
that they are helping you function better and your brain
is enjoying that clarity, right?The brain wants to see well and
take in the rest of the world. So thank you for bringing up
some of those points. And for other people, I wanted
to also bring this up. Different people have different
visual needs, right? Some patients need to see 2020,
(30:31):
some patients may not. So can you explain some
situations, Dr. Raimondi in which you may not give a patient
the full description because maybe they don't really need it.
And I will say though, I love togive my 100% to every single
patients and I've had a few where I have taken them off of
(30:52):
glasses. So on that that other spectrum,
right, pseudomyopia, fake myopiadidn't touch into I had one
patient who for one reason or another every year was increased
a little quarter before seeing me and I had to tell him your
eyes are actually plain O0. And wouldn't my initial like my
(31:16):
duty as a doctor was to tell himwe have to take you off of
glasses. But instead we slowly decrease
the prescription and after two years we got him to 0.
So I absolutely have situations where I take patients off of it.
I know most patients wish they were the following, but one case
where I do this is monovision. Some of us are very lucky where
(31:39):
we're born with one eye to see far and one eye to see near.
It's not all of us. But in those cases too, if they
are functioning good and they have no complaints and they're
seeing 2020 with both eyes far away and both eyes up close
because one is for the other one.
One is 1 is working for one, oneis working the other way.
(32:01):
In that case, I don't give them glasses.
Let me see what other situationsdepending on what language the
patient speaks or more specifically what language they
read in Roman letters can be very small.
The newspaper writing the traditional English, Spanish,
ABCD, right, It can be written in very tiny font, but other
(32:25):
languages, if you see their font, they, there's no way they
can print it that small And if apatient reads in that language,
whether that's. So what comes to mind is Chinese
characters or Arabic characters or even Russian characters,
Those characters when they're innewspapers, right, The Cyrillic
fonts, they're larger. So that is not going to need to
(32:47):
see your size 8 New York Times font.
So in those cases, I haven't prescribed the full prescription
because it's not necessitating that large demand.
For example, if someone is a pilot for a police officer, they
probably do need their 2020 vision.
(33:08):
But if someone is has a different type of profession
where they don't need to read very small font, they're not
doing up close near work and they're not looking way off in
the distance. They're they're most of their
world is intermediate distance. Maybe they don't need to have
that perfect 2020 vision. So that's another situation
which is more of a career slash lifestyle need situation in
(33:29):
which I may not give the patientthe full prescription and they
may not ask for it. They may say I'm OK, I can do
everything I need to do. My vision's 2040.
I'm very happy with that. And if they say something like
that to me then I'll say OK, that's wonderful.
I'll see you next year and we'llre evaluate and see how you're
doing. So it is really a discussion
amongst the patient, the doctor about the patient's needs.
(33:51):
That's really important. That's why I always ask.
And sometimes patients are like,wait, what?
And I'm like, no, I need to know.
I'm asking your occupation because I need to know how you
are using your eyes throughout the day so that I can help you
out better. Exactly, exactly, Doctor Armani,
this has been such an enlightening conversation.
You helped to clear up so many aspects of refractive errors and
(34:14):
I'm sure many patients, many people out there have questions
about. So we thank you for your
wonderful insights. If anyone wanted to reach out to
you, perhaps use some of your resources, maybe follow you on
social media or even become a patient, how could they find
you, Doctor Ramundi? They can find me 24/7 online.
(34:34):
I'm on Instagram at New York eyedoc.
So that's New York spelled out NEWYORKEYEDOC and that's the
same handle on TikTok. And if they wanted to become a
patient, head on over to my website, suereyecare.com, just
like it's spelled SUREYE care.com and click make an
(35:00):
appointment. And that's where I'll be happy
to see you in my exam chair sometime soon.
Wonderful. And we will share all of those
links to Doctor Raimondi's resources and her website below
underneath the interview. So thank you again, Doctor
Arimondi, for spending this timewith us.
We truly appreciate you and thank you all for tuning in.
(35:21):
And stay tuned for our next interview coming up very soon.
Thank you so much. Take care.
Thank you for tuning into the IQPodcast.
We hope you enjoyed today's episode and learn something new
to help elevate your IQ. If you loved what you heard,
don't forget to subscribe, leavea review and share the podcast
with your friends. Stay connected with Doctor
(35:43):
Ronnie Bannock for more eye opening insights on eye health,
nutrition and lifestyle. Until next time, keep your
vision clear and your IQ sharp.
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