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How Sleep Apnea Affects The Eyes

Did you know that some eye conditions are associated with sleep apnea? According to the National Sleep Foundation, more than 18 million Americans have sleep apnea, and Health Canada reports similar prevalence. It’s a sleep disorder where people stop breathing — often multiple times per night — while sleeping.

If you have sleep apnea: it tends to take longer for your tears to be replenished, you’re more likely to have ocular irritation, you have a higher chance of developing floppy eyelids, and you’re at increased risk for glaucoma.

What Is Obstructive Sleep Apnea?

There are different types of sleep apnea. The most common one is obstructive sleep apnea (OSA). During OSA, your airway becomes partially blocked due to relaxed muscles in your nose and throat. This causes apnea (the absence of breathing) or hypopnea (abnormally shallow, slow breathing). It’s twice as common in men, and is more likely to affect people with obesity, hypertension, diabetes or heart disease.

What are the common symptoms of sleep apnea?

Sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These temporary breathing lapses cause lower-quality sleep and affect the body’s oxygen supply, which can lead to potentially serious health consequences.

While snoring is a common symptom, not everyone who snores has sleep apnea. Interrupted sleep can cause excessive daytime sleepiness, fatigue, irritability or depression, headaches in the morning, difficulty concentrating and thinking, and a sore throat.

Which Eye Conditions Are Associated With Sleep Apnea?

Glaucoma

Glaucoma occurs when increased pressure within the eye damages the optic nerve, which connects the eye to the brain, leading to vision loss and sometimes blindness. In some cases, it might be due to a drop in blood oxygen levels, which happens when you stop breathing. However, CPAP machines, one of the most common treatments for sleep apnea, can also cause glaucoma.

So, people with sleep apnea — even if it’s being treated — need to get their eyes checked on a regular basis for glaucoma.

Floppy Eyelid Syndrome

Floppy Eyelid Syndrome (FES) is an eye condition where a person has an unusually large and floppy upper eyelid. It can cause eye redness, irritation, discharge, or blurry vision — and over 90% of people with FES also have sleep apnea.

Non-Arteritic Anterior Ischemic Optic Neuropathy

Non-arteritic anterior ischemic optic neuropathy (NAION) is an eye condition that occurs when there is a loss of blood flow to the optic nerve. Patients typically complain of significant vision loss in one eye without any major pain. Approximately 70-80% of patients with NAION have been found to have OSA.

Retinal Vein Occlusion

Also referred to as an ‘eye stroke,’ retinal vein occlusion (RVO) is a blockage of the small veins that carry blood away from the retina. A recent study of 114 RVO patients found that sleep apnea was suspected in 74% of the patients that had previously been diagnosed with RVO.

Other Eye Health Issues Associated With Sleep Apnea

Some other ocular conditions that are more common in patients with sleep apnea include: papilledema, keratoconus, and central serous chorioretinopathy. Furthermore, in addition to glaucoma mentioned above, CPAP machines are associated with dry eye syndrome and bacterial conjunctivitis.

Talk To Your Doc

Get eye exams regularly to rule out eye disorders and prevent potential vision loss, especially if you have been diagnosed with sleep apnea. At Eyes On Randolph in Randolph we encourage you to share your medical history with us so we can better diagnose and treat any eye conditions or ocular diseases you may have, and help you keep your eyes nice and healthy.

Frequently Asked Questions with Dr. Nicholas Feucht

Q: What Causes Sleep Apnea?

A: Sleep apnea occurs when in-part or completely stop breathing when sleeping. This causes your lungs to strain harder for oxygen, and makes the brain send signals that jerk your body awake to resume proper breathing.

Q: What are the Warning Signs of Sleep Apnea?

A: A common sign of sleep apnea is loud snoring. Snoring that is loud enough to disturb the sleep of the patient as well as others around, even across the walls. That said, not everyone who snores suffers from obstructive sleep apnea.

Quality Frames For Prescription Eyeglasses & Computer Glasses In Randolph, Massachusetts. Visit Eyes on Randolph for an eye exam and eyeglasses that match your style.

3 Benefits of Anti-Glare Coating

Glare refers to the excessive brightness caused by direct or reflected light. It can cause eye strain, digital eye strain (when using a computer, for example), halos, and headaches. Glare can also reduce visibility, making it unsafe to drive.

Anti-glare coating, also known as anti-reflective (AR) coating, is a thin layer applied to the surface of your eyeglass lenses that allows more light to pass through your lenses. By reducing the amount of glare that reflects off of your lenses, you can see more clearly and experience more comfortable vision. You can request anti-glare coating for lenses when you buy eyeglasses.

AR Coating Offers 3 Major Advantages

Better Appearance

Without an anti-glare coating on your glasses, camera flashes and bright lights can reflect off your lenses. This can hinder your appearance when speaking to people or in meetings, cause flash reflections when picture-taking, and make it difficult to find the right angle for video calls. Anti-reflective coating eliminates the harsh reflections and allows others to clearly see your eyes and face.

Reduced Digital Eye Strain

You know that tired, irritated feeling you get after staring at a digital screen for several hours? That’s digital eye strain. Anti-glare coating helps reduce digital eye strain by lowering exposure to excessive glare from digital devices and lighting.

Safe Driving at Night

The bright headlights from cars driving in the opposite direction can pose a serious danger when driving at night. These sudden glares can lead you to momentarily lose focus of the view ahead. AR coating on your prescription eyewear effectively reduces reflections from headlights at night, allowing you to enjoy a better view of the road and safer driving at night.

Let your eyes look and feel better every day with anti-glare coated lenses. Contact us to book your appointment today!

Frequently Asked Questions with Dr. Nicholas Feucht, O.D.

Q: Can you request lenses made from glass? Is glass still used for lenses?

A: Yes. Opticians still sometimes use glass for lenses. However, glass is not used very often because they aren’t as safe. If these glass lenses breaks, they can shatters into many pieces and can injure the eye. Glass lenses are much heavier than plastic lenses, so they can make your eyeglasses less comfortable to wear.

Q: Can a coating be added to eyeglasses to protect them from further scratches?

A: A protective coating can’t be added to a lens after it’s scratched. The coating is applied when the lens is manufactured and can’t be put on later.

Quality Frames For Prescription Eyeglasses & Computer Glasses In Randolph, Massachusetts. Visit Eyes on Randolph for an eye exam and eyeglasses that match your style.

March & April Flowers Brings Eye Allergy Showers

Why do I get eye allergies in the Spring or Fall?

Dr. Nick Feucht

It’s Springtime! The winter is slowly going away. The weather is starting to warm up outside. The flowers are beginning to bloom and that means lots of pollen is in the air. While this can be a wonderful thing to behold, it also means it’s allergy season.

Allergies mean, that in addition to that runny or stuffy nose, you may start to feel redness or itchiness in the eyes. Our Randolph eye doctors call this allergic conjunctivitis but more simply put, you have eye allergies. The immune system is being sensitized to the pollen, dust or other allergens in the air. The eyes become inflamed and start to feel uncomfortable.

There are two types of eye allergies, seasonal and chronic. Seasonal is the more common type and what you are now feeling with spring in the air. Chronic, though less common, continue continuously throughout the year due to dust or other allergens present year round.

What can I do to deal with my eye allergies?

The effect allergies have on your eyes can range from slightly annoying to painful. Knowing how to cope with them can improve quality of life. Tips include

Try to stay indoors when the pollen count is high, especially in the morning or evening
Remove rugs that tend to gather dust as hard floors will collect less dust
Clean and dust the house frequently
Clean the filter on your air conditioning
Wash dirty clothes to get rid of dirt and dust
Remove mold found in and around the home

Often, these tips aren’t enough. At that point, we would suggest various artificial tears and eye drops that can be bought over the counter. If the pain is extreme, we may even prescribe prescription drugs.

While eye allergies may be an unavoidable outcome of the wonderful spring or fall weather, with some of these tips, you can begin to alleviate the pain. Call us to discuss all the options we offer for dealing with eye allergies.

An Active and Eye Safe Lifestyle

90%! That’s the number of sports eye injuries that studies show can be prevented using proper eye protection. Yet most sports leagues don’t require protective eyewear as part of their uniform or safety requirements. This leaves it up to athletes, parents and coaches to ensure that proper measures are taken to keep eyes safe during athletic play.

Protective sports eyewear can come in a number of forms depending on the sport, and includes sports glasses or goggles, eye shields and eye guards. Regular prescription eyeglasses or sunglasses do not protect the eyes and can sometimes cause greater injury if impact is made and lenses or frames are shattered or broken. If you do wear prescription eyewear, there are a number of options including wearing contact lenses with safety eyewear, purchasing prescription safety eyewear or wearing safety goggles over your regular prescription glasses.

What Makes Safety Eyewear Safer?

Protective eyewear is made of impact resistant lenses from materials such as polycarbonate or trivex, which are much stronger than other types of plastic used to make typical eyewear lenses. Polycarbonate has a long history of safety eyewear use in adults and children and Trivex is a newer optical material that is lighter than polycarbonate and offers better optical quality. Both materials have built in ultraviolet protection to protect your eyes from damage from the sun.

Sports frames are also made from strong, impact-resistant materials such as strong plastics or polycarbonates. They tend to cover larger areas than traditional glasses to protect more of the area around the eye and block dust, sunlight and other elements from entering from the sides or top of the frame. Sports glasses and goggles usually incorporate impact resistant padding to create a cushion between the frame and the face or nose for increased comfort, impact absorption and to prevent slipping.

Some goggles do not fit well under helmets, such as those used in football and lacrosse, so it is wise for athletes to bring in their helmets when shopping for sports eyewear to ensure they fit under the helmet properly.

Although athletes often shy away from wearing sports eyewear due to concerns of reduced performance, in reality they often can improve performance with new innovations in sportswear that offer improved peripheral vision.

Common Sports Eye Injuries

Eye injuries commonly occur in baseball, basketball, racquetball, tennis, badminton, and other sports. Here are some of the common types of injuries.

Scratched eye or corneal abrasion – This is when damage occurs to the external surface of the eye and commonly occur from being poked, scratched or rubbed when there is a foreign body present on the surface such as sand or dust. Corneal abrasions can be very painful, cause redness and sensitivity, particularly to light. Scratched eyes should be treated immediately by a doctor because bacteria can enter through the eye causing serious infections, that can even lead to blindness.
Blunt trauma/swelling – is when an object, such as a ball or an elbow impact the eye causing swelling or bleeding such as a black eye (in which the eyelids bruise and swell) or a subconjunctival hemorrhage (bleeding from a blood vessel between the white of the eye and the clear conjunctiva). Black eyes may not appear serious but they should be checked out by a doctor to make sure there is no internal damage.
Traumatic iritis – an inflammation that occurs following an eye injury such as a blunt trauma that affects the color part of the eye that surrounds the pupil. The inflammation should be treated to ensure there is no permanent vision loss.
Penetrating injury – injuries that occur when a foreign object enters the eye, causing the eye to rupture, can cause severe damage, swelling and bleeding. These should be considered a medical emergency and treated immediately.

As you can see, most of these injuries can be prevented simply by wearing proper protection over the eye. Your vision is essential for playing the sports you love, so don’t put it as risk by failing to protect your eyes properly. With the increasing selection of frames and lenses for safety and sports eyewear at affordable pricing, an active lifestyle can also be safe.

10 Tips to Teach Children About Eye Safety

It is important to teach your children about eye health and safety from a young age. This includes awareness about how your overall health habits affect your eyes and vision as well as how to keep your eyes safe from injury and infection. Starting off with good eye habits at a young age will help to create a lifestyle that will promote eye and vision health for a lifetime.

10 Eye Health Tips for All:

Eat right. Eating a balanced diet full of fresh fruits and vegetables (especially green leafies such as kale, spinach and broccoli) as well as omega-3s found in fish, such as salmon, tuna and halibut, help your eyes get the proper nutrients they need to function at their best.
Exercise. An active lifestyle has been shown to reduce the risk of developing a number of eye diseases as well as diabetes – a disease which which can result in blindness.
Don’t Smoke. Smoking has been linked to increased risk of a number of vision threatening eye diseases.
Use Eye Protection. Protect your eyes when engaging in activities such as sports (especially those that are high impact or involve flying objects), using chemicals or power tools or gardening. Speak to your eye doctor about the best protection for your hobbies to prevent serious eye injuries.
Wear Shades. Protect your eyes from the sun by wearing 100% UV blocking sunglasses and a hat with a brim when you go outside. Never look directly at the sun.
Be Aware: If you notice any changes in your vision, always get it checked out. Tell a parent or teacher if your eyes hurt or if your vision is blurry, jumping, double or if you see spots or anything out of the ordinary. Parents, keep an eye on your child. Children don’t always complain about problems seeing because they don’t know when their vision is not normal vision. Signs of excessive linking, rubbing, unusual head tilt, or excessively close viewing distance are worth a visit to the eye doctor.
Don’t Rub! If you feel something in your eye, don’t rub it – it could make it worse or scratch your eyeball. Ask an adult to help you wash the object out of your eye.
Give Your Eyes a Break. With the digital age, a new concern is kids’ posture when looking at screens such as tablets or mobile phones. Prevent your child from holding these digital devices too close to their eyes. The Harmon distance is a comfortable viewing distance and posture – it is the distance from your chin to your elbow. There is concern that poor postural habits may warp a child’s growing body. Also, when looking at a tv, mobile or computer screen for long periods of time, follow the 20-20-20 rule; take a break every 20 minutes, for 20 seconds, by looking at something 20 feet away.
Create Eye Safe Habits. Always carry pointed objects such as scissors, knives or pencils with the sharp end pointing down. Never shoot objects (including toys) or spray things at others, especially in the direction of the head. Be careful when using sprays that they are pointed away from the eyes.
Keep Them Clean. Always wash your hands before you touch your eyes and follow your eye doctors instructions carefully for proper contact lens hygiene. If you wear makeup, make sure to throw away any old makeup and don’t share with others.

By teaching your children basic eye care and safety habits you are instilling in them the importance of taking care of their precious eye sight. As a parent, always encourage and remind your children to follow these tips and set a good example by doing them yourself.

Of course don’t forget the most important tip of all – get each member of your family’s eyes checked regularly by a qualified eye doctor! Remember, school eye screenings and screenings at a pediatrician’s office are NOT eye exams. They are only checking visual acuity but could miss health problems, focusing issues and binocularity issues that are causing health and vision problems.

When 20/20 Vision isn’t Enough For Your Child

Since studies show that learning is 80% visual, children with untreated vision problems can really suffer when it comes to school. Most people think that good “vision” means 20/20 acuity but in reality, vision is much more complex. Your brain is actually what completes the processing of the visual world around you and visual processing disorders can be present even when there is no evidence of a so-called “vision problem”.

The American Optometric Association reports that 2 out of 5 children have a vision condition that affects learning and estimates that 10 million American children have undiagnosed and untreated vision problems. In Canada, it’s reported that one in 4 school age children have undiagnosed vision problems, many with no obvious symptoms.

A major reason for this is that when parents and teachers see issues in school, they often run to learning or behavioral issues first. In reality, difficulty in reading, understanding, focusing, paying attention and even disruptive behavior can all be symptoms of an underlying vision disorder.

There are a number of skills that we need in order to successfully see and process the outside world. These include, eye teaming (being able to use the eyes together as a team), focusing, tracking, recognition and comprehension. When these skills are delayed or insufficient, learning, reading, understanding and motor skills can all be affected. Most of these visual processing issues cannot be treated by corrective glasses or contact lenses alone. Sometimes a regime of vision therapy exercises may be prescribed to teach the brain how to properly process the information that is coming in through the eyes.

Vision Therapy

Vision therapy often involves a combination of glasses, to optimize visual acuity if needed, and therapeutic exercises designed to train eye coordination and comfortable focusing ability. Typically, there is a comprehensive in-office assessment, then half-hour in-office sessions once every 1-3 weeks. The patient is given home eye exercises to be done 15-20 minutes per day, often with help from the parent.

Vision therapy is a process that can take up to several months before improvement or goals are met. In addition, going through vision therapy does not ensure that your child will get better grades, we are simply trying to give them all the proper learning tools so they can achieve to their fullest potential.

Identifying Vision Disorders

One example of a visual processing disorder is Convergence Insufficiency (CI), a common eye coordination disorder in which the eyes have problems viewing near tasks due to convergence problems. This is when the eyes have difficulty working together and focusing as a team, resulting in eyestrain, headaches and double vision. Children with CI often report that words appear to be “moving across the page”, making reading and comprehensive impossibly difficult.

As with many vision problems, children often don’t realize that their experience is abnormal so they often don’t report the difficulties they are having. Here are some indications that your child might have a vision problem:

Headaches
Avoiding close tasks such as reading or playing certain games
Frequent Blinking and Eye Rubbing
Difficulty reading – losing place frequently
Covering one eye when trying to focus
Double vision
Poor memory or reading comprehension
Short attention span
Clumsiness or poor hand-eye coordination

If your child is having difficulty in school, particularly with tasks involving reading, it is worth getting an eye and vision exam. The sooner a visual processing issue is diagnosed and treated, the greater chance your child with have to thrive and enjoy the school years.

Cutting Edge Eye-dentification

We have all seen the futuristic thrillers that use high-tech eye scanning identification systems but nowadays the technology does exist to use them in real life. A greater number of high security establishments have begun to use iris recognition for identification and security systems.

How does it work?

The iris is the colored part of the eye that forms a ring around the black pupil that is responsible for contractions of the pupil to let in more or less light. It is also the only internal organ that is visible from outside the body. Like a fingerprint, the colors and patterns of the iris are completely unique to each individual, and this unique texture usually doesn’t change throughout a person’s lifetime. Because of these characteristics a scan of the iris is a highly reliable source of personal identification.

Iris recognition measures these unique patterns and textures through a specialized camera which captures an image of the iris from about 3-10 inches away. Iris recognition is considered one of the most accurate forms of biometrics (the use of body measurements for identity checks) because it is non-intrusive, fast and accurate. As a comparison, while fingerprint identification uses 40 unique characteristics, the iris has 256 unique markers.

In order for iris recognition to work, your iris first needs to be scanned and enrolled into the system so it can recognize your identity. Enrollment requires your eyes to be photographed using both ordinary and infrared light which helps to highlight the unique patterns present in the iris. These digital photographs then go through a specialized analysis that identifies the unique features (the 256 markers mentioned above) and then stores the information as a 512-digit number (your IrisCode®) along with your name and personal details into a database. This all happens within a few minutes.

Once you are in the system, you simply need to stand in front of the iris scanner and within minutes your iris can be verified.

Limitations of Iris Scanning

The markers on your iris usually remain unchanged throughout your lifetime except in cases of extreme injury to the eye, inflammation (such as iritis) or changes due to cancers. Additionally, certain surgeries for glaucoma involve removing part of the iris (iridectomy) or using lasers to put holes in the iris (iridotomy) which would also change the iris pattern. Lastly, certain tinted contact lenses could be a complication with iris scans because some of them have an artificial iris pattern imprinted on them. Nevertheless, iris scanning is still considered to be the most accurate and effective form of biometric identification.

Iris scanning is already being used in airports, military and prison institutions, high security government and corporate institutions and even at ATM and bank tellers. Looking into the future, it is likely we will see much more of this technology in common use.

Innovations in Color Blindness

There have been a lot of videos going viral lately of color blind people “seeing color” for the first time using specialized glasses. The emotional reactions of amazement, shock and joy even lead some to break down into tears. The glasses provide these individuals a way to view the world in vibrant, living color, as everyone else around them is able to.

One in every 12 men and one in every 200 women have some degree of color blindness or color vision deficiency (CVD). The condition is not actual blindness, but an inability or a decreased ability to see color and perceive differences in color. CVD can be a partial or total deficiency, although total color blindness is not as common. There are two main types of color blindness:

red-green – which is most often inherited from the mother’s side on the x chromosome, and
blue-yellow – which is much more rare and usually occurs from damage to the nerve. CVD can sometimes be acquired through disease, brain injury or certain drugs or chemical reactions

The World of the Color Blind

Contrary to common misconceptions, a person who is color blind does not see only grey. He still usually sees color to some extent, but often the colors appear dull or washed out and can be easily confused with other colors. People often have trouble identifying or naming certain colors or distinguishing colors, for example, red and green, as well as orange, yellow and brown may appear similar, particular in low light situations. In fact, while people with normal color vision typically see about one million unique shades of color, individuals with color deficiency are only able to perceive 5-10% of that.

People with color deficiency often do not know they are color blind until they are tested. They assume everyone else perceives colors the same way. Often individuals are tested when they are seeking out certain career paths in which it is essential to distinguish colors such as pilots, electricians or police officers among others.

Innovations in Color Vision

Color blindness can impair certain aspects of daily life and limit certain activities or job options and therefore there are a number of companies out there working on technology to overcome these difficulties. While there is no cure for CVD, there are aids available that can sometimes assist with increased color perception.

Eyeglasses/Sunglasses

There are a couple of brands of color enhancing glasses available that help some individuals with red-green colorblindness.

Both EnChroma and o2Amp Oxy-Iso Color Correction Glasses work for about 80% of people with red-green colorblindness – which means that not everyone will have the same experience as those that appear in the videos. The lenses enhance color perception by filtering out the light into different spectral components. EnChroma has two versions – indoor, designed for looking at computer screens and outdoor, sunglasses.

Another solution is a custom designed ColorCorrection System in which contact lenses and glasses are customized for the individual and are available with or without a prescription. These lenses work by changing the wavelength of the colors as they enter the eye to enhance color discrimination and perception.

Apps for CVD

There are a growing number of apps available for smartphones and tablets that serve as color vision aids for those with CVD. One example is the Colorblind Avenger which is a color identification program will allows the person to use their mobile device as a visual aid. The user takes a photo or selects an existing photo and when he touches an area on the image the app displays the color of the selected area.

Huevue is another app of colorblind tools that help people with CVD identify, match and coordinate colors. There are many other apps available out there to help aid those with CVD and educate others about living with the condition.

There are even video games and software design tools that are now created with colorblind modes to allow use by people with CVD. While none of these tools and aids are able to restore color vision permanently, they do allow those with the condition to live a more vibrant life.

Pink, Stinging Eyes?

Conjunctivitis, also called pink eye, is one of the most frequently seen eye diseases, especially in kids. It can be caused by viruses, bacteria or even allergies to pollen, chlorine in swimming pools, and ingredients in cosmetics, or other irritants, which touch the eyes. Some forms of conjunctivitis might be quite transmittable and quickly spread in school and at the office.

Conjunctivitis is seen when the conjunctiva, or thin transparent layer of tissue covering the white part of the eye, becomes inflamed. You can identify conjunctivitis if you notice eye redness, discharge, itching or swollen eyelids and a crusty discharge surrounding the eyes early in the day. Pink eye infections can be divided into three main types: viral, allergic and bacterial conjunctivitis.

The viral type is usually a result of a similar virus to that which produces the recognizable red, watery eyes, sore throat and runny nose of the common cold. The red, itchy, watery eyes caused by viral pink eye are likely to last from a week to two and then will clear up on their own. You may however, be able to reduce some of the discomfort by using soothing drops or compresses. Viral pink eye is transmittable until it is completely cleared up, so in the meantime maintain excellent hygiene, remove eye discharge and try to avoid using communal pillowcases or towels. If your son or daughter has viral conjunctivitis, he or she will have to be kept home from school for three days to a week until symptoms disappear.

A bacterial infection such as Staphylococcus or Streptococcus is usually treated with antibiotic eye drops or cream. One should notice an improvement within just a few days of antibiotic drops, but be sure to adhere to the full prescription dosage to prevent pink eye from recurring.

Allergic pink eye is not contagious. It is usually a result of a known allergy such as hay fever or pet allergies that sets off an allergic reaction in their eyes. First of all, to treat allergic pink eye, you should eliminate the irritant. Use cool compresses and artificial tears to relieve discomfort in mild cases. When the infection is more severe, your eye doctor might prescribe a medication such as an anti-inflammatory or antihistamine. In cases of chronic allergic pink eye, topical steroid eye drops could be used.

Pink eye should always be diagnosed by a qualified eye doctor in order to identify the type and best course of treatment. Never treat yourself! Keep in mind the sooner you begin treatment, the lower chance you have of giving pink eye to loved ones or prolonging your discomfort.

Welcome to our New Website

We invite you to take a look around our new site to get to know our practice and learn about eye and vision health. You will find a wealth of information about our optometrists, our staff and our services, as well as facts and advice about how to take care of your eyes and protect your vision.

Learn about our Practice specialties including comprehensive eye exams, contact lens fittings and the treatment of eye diseases. Our website also offers you a convenient way to find our hours, address and map, schedule an appointment online, order contact lenses or contact us to ask us any questions you have about eye care and our Practice.

Have a look around our online office and schedule a visit to meet us in person. We are here to partner with you and your family for a lifetime of healthy eyes and vision. We look forward to seeing you!