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Local optometrists have clear vision on headaches

At right Jamie Krall, brother of Jeff Krall, removes a pair of lenses after they've been polished while Carl Ernst, lab manager at Krall Eye Clinic, prepares to cut a pair of lenses to fit their frames in the laboratory at Krall Eye Clinic on Thursday morning in Mitchell. (Matt Gade/Republic)1 / 2
Jamie Krall, brother of Jeff Krall, peels off the covering over a lens after it's been polished and before it's cut to fit specific frames at Krall Eye Clinic on Thursday in Mitchell. (Matt Gade/Republic)2 / 2

Have a headache? See an optometrist.

Two years ago, optometrists Jeff and Joe Krall, brothers and owners of Krall Eye Clinic in Mitchell, created a new type of spectacle lenses called NeuroLens, and Jeff Krall believes it is on the verge of worldwide distribution.

"I do believe that we've stumbled onto something that hasn't been done before that no one understood very well," said Jeff Krall, adding roughly 5,000 people have been outfitted with NeuroLenses so far.

Jeff Krall said he was continually seeing people arrive at his clinic with the same symptoms, including frequent headaches, computer vision syndrome, stiff necks, glare at night and dry or burning eyes.

Optometrists typically treat the symptoms with anti-reflective lenses, eye drops or referring the patient to a chiropractor, but Krall began to suspect their eyes could be the culprit.

"We saw these indications, and we figured out that it's really an imbalance between how your central vision and your peripheral vision work together," Krall said.

Central vision is what the eyes see when a person looks directly at object. Peripheral vision is what the eyes use to see items around that object, even allowing people to see objects located near their ears.

The Kralls discovered that their patients' central visions were not aligned with their peripheral visions, so signals from the brain to move the eyes and the head were not coordinated. The nerves that coordinate movement were causing the symptoms.

Just like neves in the heart are connected to the left arm, creating arm pain during a heart attack, the nerves that coordinate eye and head movement are connected. People may see an object with their peripheral vision and turn to look at it. If the movements of the head and eyes are not coordinated, then the head will be pointed directly toward the object, but one or both eyes will point slightly to the side.

The eyes then make rapid, imperceptible changes to line up properly and focus on an object. Because the eyes are working harder than they are supposed to, people experience headaches and other symptoms.

"The brain will do anything it has to do to line up the two targets constantly. If they're not coordinated together, just like if your legs were not coordinated together, it starts creating problems, and the problem manifests itself in all these types of symptoms," Jeff Krall said.

"It's not intuitive to the patient that their eyes are causing the problem," said Davis Corley, president of eyeBrain Medical, which purchased the technology from the Kralls. "Most people associate this with something else, like bad posture or a car accident."

Finding a solution

To address the situation, the Kralls developed the SightSync, a machine that measures the misalignment between a person's peripheral and central vision. A patient looks into a screen and sees images of drifting planets circling the screen's edges. Then, a white dot makes instantaneous movements, which the patient is asked to follow with his or her eyes.

From the SightSync diagnosis, an optometrist can design a pair of lenses using various level of prism, an optical element that reflects light. NeuroLenses use varying amounts of prism to shift images to where a person's eye naturally rests, effectively fooling the brain into believing the eye is looking directly at an object.

"Regular glasses determine how sharp the image is, whereas the NeuroLens shifts the image in the eyes so they don't have to," said Danny Perales, eyeBrain COO.

The prism doesn't affect image clarity, but NeuroLens spectacles can be modified to perform the same function as regular glasses, if needed.

Krall said prism has been used for hundreds of years, but these glasses adjust for a person's sight at near and far distances, for which eye alignment is different, by using increasing thickness of prism from the top to the bottom of the lens, which has never been done before.

"I don't think our profession understands this really well. I don't think they've connected all the dots," Krall said.

Ryan Ackerman, an optometrist and eyeBrain's director of medical affairs, said vision correction needs to address both clarity and alignment to be successful, but optometrists typically focus on the clarity aspect.

"(Optometrists) are just taught to make people see clearer because that's what's going to make them happy with glasses ... and it will for a lot of people, but the patients don't realize, and the doctors don't realize, there's a missing component of alignment and efficiency, and that's what we're fixing," Ackerman said.

"You have two eyes for a reason. You want to be able to take two really clear images and make them one extremely clear image," Ackerman said. "It just makes it so much easier for your two eyes to work together as a team."

Krall said most patients' symptoms disappear after about three days with the NeuroLenses, give or take a couple days.

According to Perales, the treatment has been effective for 94 percent of patients who have purchased the lenses, and 87 percent are "absolutely happy" with their investment.

The lenses cost $650 for single-vision lenses — which have the same amount of prism across the entire lens — and $850 for progressive lenses — which have different amounts of prism from top to bottom.

'Don't have to live with this'

Krall said people who have started using NeuroLens spectacles have improved their quality of life.

"People are suffering with these symptoms. They don't have to live with this anymore, and that's the exciting thing," Krall said.

According to Corley, 65 percent of Americans have reported experiencing some form of eye strain, but only 10 percent talk about it with an optometrist.

"There's a huge education (aspect) that needs to happen in order for these patients who are suffering to know there is a solution," Corley said.

"Normally when you go to your optometrist, you might not talk about dizziness or frequent headaches or stiffness in your shoulders or necks," Perales said.

Angy Murphy, 34, of Springview, Nebraska, about 45 minutes south of her hometown in Winner, travels to Mitchell to see Jeff Krall for her eye care needs.

Murphy said she suffered from migraines and frequent headaches caused by multiple sclerosis, but when Krall gave her a pair of NeuroLens glasses in May 2014, the pain stopped almost completely.

"If I don't wear them, I get a headache instantly," Murphy said. "I just know that he fixed it."

Murphy said without the lenses, her depth perception was not right. Although it became "normal" for her, she still had to be careful in some situations, like walking up or down stairs.

"My off depth perception was normal to me. After (Krall) put these on, these were my new normal, and it really was normal," Murphy said.

Murphy said it has taken some adjusting to get the lenses just right and she is on her third pair of glasses, but she expects this to be her final pair as her vision is better than ever.

Gary Lovcik, an optometrist at Anaheim Hills Optometric Center in Anaheim, California, one of the five places where NeuroLenses are available, praised the technology, saying it has proven to be the best treatment for over 100 patients since he adopted the lenses in November.

"The impacts of these glasses are absolutely amazing. The 'wow factor' it creates with patients is unbelievable," Lovcik said.

Lovcik said patients have given hugs and high-fives and have even cried after receiving the glasses, responses he has never seen in 30 years of optometric practice.

"I think it's a huge deal. I'm just amazed that somebody figured this out," Lovcik said.

Lovcik now screens every patient for headache issues and uses his SightSync machine often because patients typically do not think their headaches are related to their eyes.

He said NeuroLenses may still be too expensive for some, but if the price drops, they could become the standard around the nation.

Expansion

The lenses are available at five locations: Krall Eye Clinic, the Headache Center of Neurology Associates in Sioux Falls, Sioux Falls Family Vision, Dunes Eye Consultants in Dakota Dunes and Anaheim Hills Optometric Center, but Jeff Krall has also been traveling to Ann Arbor, Michigan, to work with the Michigan Headache & Neurological Institute, one of the foremost neurological centers in the country.

The eyeBrain team has created enough SightSync devices to expand the NeuroLens offering to 10 optometry clinics by the end of the year, and they expect the technology to catch on quickly after that. After a few more years of research and testing, eyeBrain believes the lenses could become a fixture in optometry clinics around the world.

"Something that is really going to change the landscape of optometry in the future is still in its infancy right now, and we're learning a ton," Corley said.

About four years ago, the Kralls' technology caught the eye of Vance Thompson, of Vance Thompson Vision, a provider of LASIK surgery and other eye services in Sioux Falls.

Thompson saw patients who were wearing NeuroLens glasses after receiving LASIK surgery to treat headaches or other optical issues the surgery can't fix.

Thompson discussed the lenses with eventual eyeBrain CEO Andy Corley, co-founder of Eyeonics and former president of Bausch and Lomb's surgical division, who saw value in the Kralls' invention and incorporated eyeBrain Medical in June 2012 to purchase the rights to the Kralls' technology.

The company then asked Neurology Associates in Sioux Falls to conduct a 10-month study of about 185 patients, which led Neurology Associates to found the Headache Center in 2013 to continue the study and provide treatment for symptomatic patients.

At the beginning, the study focused on headaches, but it quickly became clear that the lenses' implications could be much further reaching.

"We saw there's a lot of different applications for this. It's not just a headache treatment," Ackerman said.

On July 1, 2013, eyeBrain began selling NeuroLenses in its partner clinics.

Although eyeBrain moved its business office to Costa Mesa, California, the Kralls are still heavily involved with the company and the NeuroLens technology, and all NeuroLenses are made at Krall Eye Clinic.

"I think what we found was a fantastic partner in the Krall brothers, and they are continuously helping improve the technology," Davis Corley said.

Corley said the struggle the Kralls and eyeBrain faces is getting optometrists to understand new technology to which they haven't been exposed.

"Unfortunately, eyeBrain knows that the technology works, but mainstream optometry and physicians out there still don't," Corley said. "This is something for all patients with visual discomfort."

Ackerman said it is possible for NeuroLens technology to be fitted into contacts, but eyeBrain has no plans to make that move yet.

"There's all kinds of ways this technology can be brought to other modalities, as many ways as you can dream of, but the focus of the company right now isn't there. The focus of the company is helping people and helping our profession understand," Krall said.

For now, the Kralls and eyeBrain are focused on further developing the technology and discovering exactly what kind of impact their invention could have.

"It affects a lot of people looking at a lot of different things," Krall said.

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