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3 Reasons To Wear Prescription Sunglasses

Designer Frames & Sunglasses at North Country Eye Care

Designer Frames & Sunglasses at North Country Eye Care

Sunglasses offer clear, comfortable vision while also protecting your eyes from the sun’s harmful ultraviolet light — which is a known risk factor for developing cataracts, macular degeneration, and other sight-threatening eye conditions. That’s why it’s important to always wear sunglasses whenever outdoors.

If you don’t already own a pair of prescription sunglasses, below we’ll explore 3 compelling reasons to pick up a pair from your local optometrist in West Lebanon.

They’re Convenient

When you have a pair of prescription sunglasses, protecting your eyes while outdoors becomes a no-brainer.

Even those who wear contact lenses can benefit from owning a pair of prescription sunglasses for days when you just want to give your eyes a break from lenses.

They’re Customizable

Ask your eye doctor about how to personalize your prescription sunglasses to suit your needs.

Whether you prefer anti-reflective coatings, polarization, or other optical upgrades — your pair of prescription sunnies can be tailor-made for your eyes.

You can even order a pair of bifocal or multifocal sunglasses if you require more than one prescription.

They Offer Better Protection

When you order a pair of prescription sunglasses from your local optometrist, you can be sure you’re getting superior quality.

Sunglasses should always offer 100% UVA and UVB protection, but the fact is that many sunglasses available from other vendors don’t always provide that level of protection. And don’t be fooled by “UV blocking” stickers on the lenses — “UV blocking” is not the same as “100% UV protection”.

At North Country Eye Care in West Lebanon, we carry a wide range of fashionable, high-quality, protective sunglasses that will keep your eyes feeling and looking their best.

For all of your optical needs, we’re here for you. Call us today to learn more or schedule your appointment.

Frequently Asked Questions

Q: Why is it important to wear sunglasses?

  • A: It’s important to wear sunglasses all year round. Prolonged exposure to harmful UV light has been known to cause a handful of sight-threatening diseases like cataracts, macular degeneration, and photokeratitis. Sunglasses also shield your eyes from harsh winds that carry debris and irritating allergens.

Q: Why should I buy eyewear from a local optometrist rather than online?

  • A: Whether you’re buying glasses, contact lenses, or sunglasses, it’s best to order them directly from your eye doctor rather than an online source. Online eyewear is more prone to manufacturing errors that can cause visual discomfort and even damage your eyes. When you buy from a local optometrist you get personal care and attention and can bring in your eyewear for adjustments and repairs.

Quality Frames For Prescription Eyeglasses & Computer Glasses. Visit North Country Eye Care for an eye exam and eyeglasses that match your style.

Refs & Inspo
https://www.allaboutvision.com/sunglasses/reasons-you-need-prescription-shades/

Are You Susceptible To Vision Loss?

Vision loss is more common than you may think! In fact, it’s among the most prevalent disabilities in adults and children. Knowing what puts you at risk of developing vision loss is important and can help you to be proactive about caring for your eyes.

Below, we’ll explore the most common causes of vision loss and the risk factors associated with each.

Spreading awareness and education about visual health is just one way that our eye doctors near you can help. To schedule your comprehensive eye exam, call us today.

Common Causes of Vision Loss

Glaucoma

Glaucoma is a group of eye diseases caused by a buildup of pressure within the eye. Too much inner-eye pressure can damage the optic nerve and lead to vision loss.

Since symptoms don’t usually manifest in the early stages of glaucoma, getting regular eye exams is all the more crucial. Advanced or rapidly progressing glaucoma can show a variety of symptoms, such as blurred vision, headache, severe eye pain and redness, seeing halos around lights, and nausea.

Risk factors for developing glaucoma include:

  • Being 60 years or older
  • Family history of glaucoma
  • African, Asian, or Hispanic descent
  • High myopia (nearsightedness) or hyperopia (farsightedness)
  • Previous eye injury or certain eye surgeries
  • Certain medications, like corticosteroids
  • Thin corneas
  • Certain medical conditions, like diabetes, hypertension, heart disease, and sickle-cell anemia

Cataracts

Cataracts occur when the eye’s lens becomes cloudy. A healthy lens is clear and allows light to pass through it undisturbed.

Common cataract symptoms include cloudy or blurred vision, difficulty seeing at night, light sensitivity, double vision in the affected eye, and seeing colors as faded or yellowish.

Risk factors for developing cataracts include:

  • Aging
  • Diabetes
  • Hypertension
  • Smoking
  • Previous eye surgery, injury, or inflammation
  • Alcoholism
  • Extended use of corticosteroids

Age-Related Macular Degeneration (AMD)

AMD is the leading cause of severe vision loss in adults over the age of 60. It occurs when the macula (the small central portion of the retina, which is responsible for sharp, colorful, central vision) begins to wear down.

Early stages of AMD usually go unnoticed, but later stages of the disease can produce symptoms like blurred vision, dark or blurry areas in your central vision, and problems with color perception.

There’s not yet a cure for AMD, but certain treatments can help prevent vision loss.

Risk factors for developing AMD include:

  • Smoking
  • Obesity
  • Aging
  • Long-term sun exposure
  • Hypertension
  • Heart disease
  • Family history of AMD
  • Light-colored eyes
  • Farsightedness

Diabetic Retinopathy (DR)

Diabetic retinopathy is a complication of Type 1 or Type 2 diabetes that affects the light-sensitive tissue at the back of the eye called the retina.

Initially, diabetic retinopathy shows no symptoms but can eventually lead to blindness. As it develops, it can cause increased floaters, impaired color vision, dark spots in your visual field, and blurred vision.

Risk factors for developing diabetic retinopathy include:

  • Length of time from diabetes diagnosis — the longer you’ve had it, the higher your chances of developing visual complications
  • Uncontrolled blood sugar
  • Obesity
  • High cholesterol or blood pressure
  • Pregnancy
  • Smoking
  • African American, Hispanic, and Native American ethnicities
  • Family history of DR

So, what’s the bottom line ?

Multiple factors contribute to eye disease and vision loss, and some may even be relevant to you. If you think you may be at risk for vision loss or experience any of the symptoms listed above, speak with your eye doctor in West Lebanon as soon as possible. We also recommend you have your eyes thoroughly examined every 1-2 years, or as often as your eye doctor recommends. To schedule your comprehensive eye exam, call North Country Eye Care today.

 

Frequently Asked Questions With Our West Lebanon Eye Doctors

  1. Can blindness be prevented?

When caught early, many eye diseases can be treated to halt or slow the progression of the disease and potentially prevent vision loss. The best things you can do to preserve your vision for the long term is to lead a healthy lifestyle and make sure you undergo a comprehensive eye exam every 1-2 years.

  1. Which eye diseases are genetically inherited?

More than 350 ocular diseases have some sort of genetic component. Certain diseases, like retinitis pigmentosa and albinism, are directly inherited through chromosomal information. In other cases, a predisposition to the disease is inherited, rather than the disease itself.

What Are The Main Causes Of Blindness?

Eye Exams and Vision Care at North Country Eye Care

Eye Exams and Vision Care at North Country Eye Care

About 39 million people around the world currently live without sight.

Why so many? What causes it?

There are several reasons people become blind, which we will delve into below. Hopefully, by spreading awareness about the causes of blindness and ways to prevent it, North Country Eye Care in West Lebanon will help people like you preserve their vision for a lifetime. Call today to schedule your eye exam.

Top Causes of Blindness

1. Age-Related Macular Degeneration (AMD)

This eye disease is the leading cause of near-vision impairment in people over the age of 50. Patients living with AMD often lose part or all of their central vision, making it hard to perform daily tasks like driving, recognizing faces, and watching television.

2. Cataracts

A cataract occurs when the eye’s natural lens begins to cloud. While most people associate cataracts with advanced age, they can actually occur at any point in a person’s life, and for a variety of reasons. Risk factors for cataracts include genetics, age, radiation, trauma, and certain medications.

An estimated 17% of North Americans above the age of 40 have cataracts. Fortunately, they are easily removed through surgery. Left untreated, cataracts can eventually lead to blindness.

3. Glaucoma

Glaucoma is a group of eye diseases caused by increased ocular pressure. The two most common forms are open-angle glaucoma and closed- angle glaucoma. Open-angle is more common and typically progresses silently over a long period of time. Closed-angle glaucoma is a more painful and acute form of the disease. All forms of glaucoma can eventually lead to blindness.

Early detection and treatment are key in preventing vision loss from glaucoma.

4. Diabetic Retinopathy (DR)

DR is a complication of diabetes that occurs when excess sugar in the blood damages the retina’s blood vessels. There are 4 stages of DR, with the first stages rarely presenting noticeable symptoms. In many cases the condition can be managed and treated by your eye doctor, especially if caught early on.

Regular dilated eye exams are crucial for patients with diabetes, as it helps ensure the earliest possible detection of DR.

Frequently Asked Questions About Vision Care

Q: What does it mean to be ‘legally blind’?

  • A: People often assume those who are blind are unable to see anything. The truth is that to be considered legally blind, a person’s eyesight must be 20/200 — in other words, you’d need to stand 20 feet away from an object that one with healthy vision could see at a distance of 200 feet away. Furthermore, those who are legally blind cannot correct their vision with glasses or contact lenses.

Q: Can blindness be reversed?

  • A: Certain types of blindness are reversible. In cases of cataracts, corneal diseases, wet AMD and some instances of diabetic retinopathy, surgery, injections, and other treatments can return at least some sight to an individual who has experienced vision loss. On the other hand, diseases like glaucoma, retinitis pigmentosa, and dry age-related macular degeneration can cause irreversible vision loss.

Quality Frames For Prescription Glasses & Computer Glasses


As you may have noticed, the underlying theme in preventing all of these sight-threatening conditions is early detection. By undergoing yearly comprehensive eye exams, you stand a higher chance of keeping your eyes and vision healthy for the long term.

To schedule your annual comprehensive eye exam, call North Country Eye Care in West Lebanon today.

Refs
https://ibvi.org/blog/what-are-the-main-causes-of-blindness/

5 Sunglasses Trends Worth Knowing

Designer Sunglasses at North Country Eye Care

Designer Sunglasses at North Country Eye Care

Sunglasses have been a fashion accessory for decades, so it’s no wonder that favorite styles frequently make a comeback, while others remain popular year after year. So what’s changed? The realization that sunglasses aren’t just a fashion statement. They also protect your eyes from the sun’s harmful rays.

At North Country Eye Care in West Lebanon we can offer you cool stylish looks while protecting your eyes with our large selection of designer sunglasses.

We’ve listed 5 sunglasses trends to keep in mind when shopping for your new pair of shades.

1. Oversized Lenses

Oversized designer sunglasses are not only a must-have accessory. They’re also highly functional. Larger frames and lenses help block more sunlight from your eyes. Oversized sunglasses also come in polarized and nonpolarized lenses, so you can see better and more clearly while still looking great.

2. Colorful Shades

If you already have a large collection of sunglasses, sunglasses with colorful lenses can be an inspired addition, both fashion-wise and functionally. Each tint provides different benefits to suit your lifestyle. For example, to improve depth perception choose a brown/amber or red tint. Red and yellow tints reduce eye strain. Gray-tinted lenses reduce glare on both sunny and cloudy days.

3. Aviator Sunglasses

There’s a reason that aviator glasses are a staple. They go with everything. Aviator sunglasses protect your eyes while also giving you a sporty, fashionable edge. To add some fun, check out aviator shades in pink, blue, or classic grey.

4. Round Sunglasses

Round sunglasses, which were immortalized by John Lennon, are always trending. They’re especially flattering to people with a round, square or heart-shaped face.

5. Mirrored Lenses

Mirrored lenses are not only stylish but provide a reflective optical coating. From the outside, the coating looks like a mirror and has a reflective surface that reflects a clear image. However, the mirror doesn’t pass on the inside of the lens. Mirrored lenses offer several advantages: they help with glare, making it more comfortable to drive; they keep light from getting into your lenses; they improve how well you see colors, and they protect your eyes from UV rays. They’re a sleek fashion accessory that enhances any outfit.

No matter what style you go for, remember it’s also about protection. The sun gives off strong UV rays, so it’s just as important to protect your eyes while looking cool and stylish. Visit us to see our large variety of designer sunglasses and get the look you’ve always wanted.

Frequently Asked Questions About Sunglasses

Q: Should I wear sunglasses during the winter?

  • A: Absolutely! Ultra-violet (UV) rays are present and harmful whether it’s cloudy out or sunny! While we all know that UV rays can cause damage to the skin, UV exposure can also cause damage to several important parts of the eyes and can lead to problems such as early-onset cataracts and macular degeneration later in life.

Q: How do I know which sunwear lenses absorb UV rays the most?

  • A: Generally, most sunwear lenses will absorb UV lenses to some degree. Lenses that are marked CR-39R plastic, absorb about 88 percent of UV light. If sunglasses contain polycarbonate lenses, UV absorption will be 100 percent.


How To Prevent “Mask Fog” on Your Glasses

If you wear glasses and a face mask, you’ve probably struggled with “mask fog.” Your lenses get all misty, requiring you to wipe your eyewear throughout the day. Below are a few strategies to help you prevent your eyeglasses from fogging up when wearing a mask.

But First, Why Do Glasses Fog Up?

Quite simply, condensation forms whenever moist warm air hits a cool surface. Your specs fog up when the mask directs your warm breath upward instead of in front of you — which is great for preventing virus transmission but bad for anyone with less-than-stellar eyesight.

Is Your Mask Well Fitted?

The mask should fit securely over your nose. Ideally, you’ll want to wear a mask with a nose bridge or one that can be shaped or molded to your face. When the mask fits properly, hopefully most of your breath will go through it, not out the top or sides.

Use Your Glasses To Seal the Top of Your Mask

This method works best with large, thick eyewear frames. By pulling your mask up higher on your nose and placing the lower part of your eyeglasses on the mask, you can get a snug fit that blocks your warm breath from escaping upward toward your eyewear.

Tape Your Mask to Your Face

You can always use tape to secure your mask across the bridge of your nose and the top of your cheeks. Use easy-to-remove tape, including adhesive, medical, or athletic. Just be sure to stay away from duct tape.

Soap and Water Help Prevent Fogging

This trick is one that healthcare professionals regularly turn to. All you need for this hack is soapy water (dish soap works best) and a microfiber cloth. Stay away from soaps with lotions in them as they can leave a thick residue, making it even harder to see.

Simply rub both sides of your lenses with a drop of soap, then buff the lenses with a soft microfiber cloth. This effective trick helps prevent your lenses from fogging up as a transparent, thin film of soap acts as a barrier.

Anti-Fog Wipes and Sprays

Another option is to purchase wipes and sprays designed to tackle foggy lenses.

Ask us about Zeiss Fog Defender which we offer for $7 per kit ( includes cleaner and cloth)!

Contact North Country Eye Care in West Lebanon today.

Important Update

We want to inform you about actions we are taking to mitigate the transmission of COVID-19 at North Country Eye Care. While we are always careful to maintain clean and safe office, we are taking extra precautions to strictly maintain the high standards of cleanliness at our practice, and we are following recommendations from the Centers for Disease Control and Prevention.

For the health and safety of our staff and other patients, we kindly ask you to reschedule your appointment if you are sick, have recently traveled, or have been exposed to anyone who is sick. Please contact us if you need to reschedule your appointment and we will be happy to accommodate you. Thank you for helping us to maintain the good health of our patients and our eye care team.

Our practice is taking the following steps:

  • We sanitize all equipment and patient contact surfaces after every use and again at the end of the day.
  • Our team wash their hands and/or use sanitizer after contact with each patient and throughout the day.
  • Writing implements are rotated and cleaned frequently.
  • Any team member who has symptoms of illness will be told to stay home.
  • We continue to offer free shipping for annual supplies of contact lenses and are working with our contact lens supplier to offer low-cost or free shipping of less than annual supplies to patients’ home or workplace. We are also offering to ship eyeglass orders at no additional cost to patients who choose this option.

During this time, it is important for us all to remember to focus on things we can control. Taking measures to prevent the spread of COVID-19 is important for the welfare of our patients, staff and community. This is something we take very seriously. For information and updates on COVID-19, we recommend reviewing the information shared by the Centers for Disease Control and Prevention here: https://www.cdc.gov/coronavirus/2019-ncov/protect/index.html

While this situation is evolving rapidly, we expect to continue to see patients though our hours will be changing for the short term. We will announce any future changes on our website, Google, and Facebook as well as by email. We encourage you to contact our practice if you have questions or concerns.

Thank you for your trust in us for your eye care needs.

Best wishes from Dr. Stegen, Dr. Eid and the North Country Eye Care team!

12 Tips for Optimal Eye Health

Expert Eye Care| Optometrist in West Lebanon | North Country Eye Care

Good Eye Care Habits & Hygiene

By practicing good eye care habits and hygiene, you can prevent many vision problems from occurring. Eye problems and the risks associated with vision loss only grow as you age. By neglecting eye care, you place yourself at a higher risk of suffering from cataracts, macular degeneration, glaucoma, diabetic retinopathy, and low vision.

So make sure you maintain great eye health by following these 12 tips for optimal eye health.

1. Avoid rubbing your eyes

Itchy eyes can be a hallmark symptom of allergies, and though rubbing may bring temporary relief, it ultimately increases swelling and worsens the itch. If you wear contact lenses, rubbing your eyes can also dislodge or even break a lens, causing the lens to get lost or scratch the cornea. Plus, eye rubbing can lead to eye infections, since our hands are typically covered with a host of germs.

2. Regularly wash your hands

Conjunctivitis (pink eye) is often caused by germs and bacteria carried to your eyes by unclean hands. Frequently washing your hands with soap and warm water helps keep bacteria away and prevents eye contamination. Prior to inserting or removing contact lenses, make sure to wash your hands with mild soap and dry them using a lint-free towel.

3. Beware of UV rays

By exposing yourself to sunlight and UV rays, you increase the risk of developing macular degeneration and corneal sunburn. Beyond just adding some style and zest to your look, sunglasses should protect your eyes from dangerous UV rays. Speak to your optometrist about the different options available for people who wear prescription eyeglasses or contact lenses too, to keep your eyes safe in the sun.

4. Stay hydrated

Staying hydrated is crucial for your body’s overall health and wellbeing — and that includes your eyes. Among other complications, if you don’t have enough fluid in your body, it impacts tear production and can cause dry eyes and irritation. Drink up!

5. Don’t smoke cigarettes

Need some extra motivation to quit smoking?

Smokers are more prone to developing age-related macular degeneration, cataracts, and other eye conditions. Cigarette smoking can also destroy optic nerves, which can adversely affect your vision over time. So think twice before you light up, and speak to your doctor about getting help to quit.

6. Eat a healthy diet

Eat plenty of fruits and vegetables to ensure that your diet is rich in antioxidants, such as Vitamins A and C. These can be found in leafy greens (your mom was right about spinach!), orange vegetables (think, carrots and sweet potato) and citrus fruit. Furthermore, fatty fish like salmon contain essential omega-3 fatty acids which also promote excellent eye health.

7. Keep a healthy distance from screens

Nip digital eye strain in the bud by positioning your computer monitor about an arm’s length away from the eyes and 20 degrees below eye level. Ideally, work in a room with enough diffused lighting to reduce stress on your eyes from the computer light.

8. Remember the 20-20-20 rule

Speaking of computers, have you heard of the 20-20-20 rule? When using digital devices, rest your eyes every 20 minutes by looking 20 feet away for 20 continuous seconds.

Once you’re at it, blink 20 times in succession to prevent dry eyes, and make it a habit to rise from your seat and take 20 steps to promote good posture and blood circulation, which helps your vision too.

9. Be careful with eye make-up

Make sure that your eye shadow, mascara, and eyeliner don’t cause your eyes an allergic reaction. Get in the habit of removing your make-up before going to sleep in order to avoid bacterial build-up from residual make-up left in the eye area. And, from time to time, clean your make-up brushes, especially those used to apply cosmetics around the eye area.

10. Sleep is golden

Just as with the rest of your body, your eyes need a break. So make sure that you get sufficient shut-eye (8 hours) each night to keep your eyes revitalized and healthy.

11. Wear protective eyewear

Whatever you do, make sure your eyes are well-protected. If you’re swimming, wear goggles to prevent chlorine from entering your eyes. If you’re gardening or engaged in a DIY project at home, wear safety glasses to keep dust particles and bacteria at bay and prevent eye injuries. Ask your local eye doctor about protective eyewear for sports and other activities.

12. Regularly visit your eye doctor

Don’t underestimate the importance of getting a routine eye exam, whether you need an updated prescription or not. Even if you can see well today, a comprehensive eye exam can pick up early signs of eye diseases and conditions before symptoms become noticeable, such as glaucoma, diabetes, retinal holes which could lead to retinal detachment, and cancers like melanoma. Early detection and management can prevent further complications and serious vision loss down the line.

Only an eye doctor has the required knowledge, experience, tools and techniques to determine whether you have these or other eye conditions.

It is recommended that everyone gets a comprehensive eye exam once every year. Children, whose eyes are rapidly developing, and people at higher risk for developing eye problems such as diabetics and people over the age of 60, need to undergo eye exams even more frequently: at the minimum, yearly.

During the evaluation, the eye doctor will check for things like:

  • Farsightedness, nearsightedness, astigmatism and/or presbyopia
  • Eye coordination
  • Overall eye health including checks for glaucoma, macular degeneration, cataracts among many other eye conditions and diseases

It’s also important to be on the look-out for any changes in your vision. If you experience hazy or double vision, worsening eyesight, red eyes, eye pain, swelling or floaters, contact Dr. Richard Stegen.

Incorporate these tips and habits into your lifestyle to maintain healthy eyes and a high quality of life. North Country Eye Care offers comprehensive eye exams in West Lebanon, New Hampshire, and will be happy to answer any questions you may have about ways to maintain healthy vision.

Neurolens

neurolens banner 2The average american spends more than 8 hours a day on digital devices. This constant strain on our visual systems has caused a large portion of the population to have symptoms such as dry eye, migraines, neck and shoulder pain as well as eye strain. Some treatments consist of dry eye management and prescription eyewear. Other patients who still struggle may be candidates for a new technology from Neurolens. This latest technology measures how well your visual system works when focusing on near activities. Many patients would benefit from contoured prism lenses that help reduce the stimulation of the Trigeminal nerve, causing migraines as well as neck and shoulder pain. Technological advancements have allowed us to diagnose this issue and provide lenses that will help treat this misalignment.

North Country Eye Care is the first to bring this advanced technology to New England. During your eye exam, you may have specialized testing to determine how well your eyes work together to provide clear comfortable vision. Good vision includes comfort, clarity and a healthy visual system. Contact our office and see how we can provide the best vision possible for you.

Ultimate Lens Hoax

I have been asked by patients to explain the Essilor Ultimate lens package. Whenever a company offers a buy one get one free deal, you should know that it is charging the price of two total. It is a way of deceiving the consumer into believing they got a deal when in reality they just purchased double the amount of product. I do recommend different glasses for particular usage for patients and offer a discount incentive to do so, not just because I like more sales, but because it is my responsibility to provide the best most comfortable vision for my patients. You can get glasses anywhere, but to get the best results you want to have the help and advice of an expert in optics. It is my job as an optician to sort through all of the product available on the market and recommend what would work best and provide the best value for my patients.

How important is good vision to your child’s success?

By Scott Thielen ABOC-AC

Girl Child Doing homework 1280x480Many parents rely on school vision screenings to determine if their child has a vision issue, however these screening generally only pick up 25% of children with vision problems. The fact is school nurses only check for visual acuity and not the complete visual system. Worse yet is only 39% of the children who fail these screenings see an optometrist or ophthalmologist. Many children who are diagnosed with learning disorders, really are in need eyeglasses or vision therapy. Being able to see a vision chart is not the same as being able to see without straining the visual system. An analogy I often give to parents is try reading a book while doing push ups and see how much you retain. A child that is exerting lots of energy just to be able to read is not comprehending what is read. Local Lions Clubs are doing a lot to screen local children and bring awareness to vision issues, but still many parents are not taking the results of failed screenings seriously. We know vision accounts for 80% of what we learn, so it is very important for the future of our children.

Symptoms of learning-related vision problems include:

  • Headaches or eye strain
  • Blurred vision or double vision
  • Crossed eyes or eyes that appear to move independently of each other (Read more about strabismus.)
  • Dislike or avoidance of reading and close work
  • Short attention span during visual tasks
  • Turning or tilting the head to use one eye only, or closing or covering one eye
  • Placing the head very close to the book or desk when reading or writing
  • Excessive blinking or rubbing the eyes
  • Losing place while reading, or using a finger as a guide
  • Slow reading speed or poor reading comprehension
  • Difficulty remembering what was read
  • Omitting or repeating words, or confusing similar words
  • Persistent reversal of words or letters (after second grade)
  • Difficulty remembering, identifying or reproducing shapes
  • Poor eye-hand coordination
  • Evidence of developmental immaturity