Baltimore Washington Eye Center, Maryland

Tuesday, June 28, 2011

Droopy Eyelids – Why do my eyes look so tired?

Sometimes as we age, the skin around our eyelid becomes loose and begins to bunch up. This can cause our eyes to feel weighed down and to look tired. Some women notice that they have a hard time applying makeup to the upper lid or that their makeup is always getting smeared because of the excess skin. In some cases, the extra skin is so severe, that the upper eyelid skin is sitting on the eyelashes and interfering with vision. The medical term for this extra skin is dermatochalasis and it is treated via a surgical procedure called a Blepharoplasty. During this procedure, an incision is made in the upper eyelid crease, the extra skin is removed, and the wound is sutured together. The scar is hidden in the upper lid and is not very visible.

Dermatochalasis can also occur in the lower lid and this, in combination with more visible fat pads, can lead to "bags" under the eyes. Lower lid dermatochalasis is also treated with a blepharoplasty.

Often during a lid evaluation for upper eyelid dermatochalasis, additional testing such as taped and untaped visual fields may be performed to determine if the extra eyelid skin is blocking part of your vision. 

Guest Blogger:
D. Chimene Richa, M.D. Oculofacial Surgeon, Baltimore Washington Eye Center

Thursday, June 23, 2011

Your LASIK Evaluation-What to Expect

The only completely reliable way to determine whether Laser Vision Correction or Laser Eye Surgery of any type is going to help you achieve your personal vision correction goals is to have a thorough consultation.

Your LASIK Consultation

Your LASIK consultation should consist of a number of clinical tests including:
Ø  Measurement of your uncorrected visual acuity
Ø  Measurement of your visual acuity with your current eyeglasses or contact lenses
Ø  Optical measurement of the current prescription that you are wearing in your eyeglasses and/or a review of your current contact lens prescription
Ø  A thorough review of your medical and eye history including all prescription and non-prescription medication that you have been or are currently taking
Ø  A refraction-automated or manual-to determine your current prescription
Ø  A topography measurement to digitally map the shape of your cornea
Ø  A pachymetry measurement of the thickness of your cornea
Ø   A measurement of pupil size
Ø  A microscopic evaluation of the health of your cornea and tear film including testing for dry eyes

“From this testing it can be determined whether you should proceed to the final level of testing whereby the actual preoperative measurements are taken for your treatment and a thorough examination of the Retina and Optic Nerve can be performed,” said Corneal Specialist and LASIK Surgeon Brad Spagnolo, M.D. at Baltimore Washington Eye Center. “In addition to the actual clinical testing, your LASIK evaluation will include a full discussion of LASIK risks, benefits and complications and a thorough analysis of the personal goals and objectives that you feel are important to your success.”

Please feel free to phone Baltimore Washington Eye Center at 410.761.8258 to schedule an appointment for a LASIK consultation.

Tuesday, June 21, 2011


Conjunctivitis is the term used to describe inflammation of the conjunctiva, which is the very thin membrane that covers the inside of your eyelids and the white part of your eye (the sclera). It is most commonly referred to as “red” or “pink” eye and can be caused by a viral or bacterial infection, allergies or environmental irritants. Symptoms of conjunctivitis include:
  • Inflammation of the eye
  • Increased tearing
  • Soreness of the eye
  • Foreign body sensation
  • Itchiness of the eye
  • Excess mucous (pus)
  • Crusting of the eyelashes in the morning
Viral conjunctivitis is much more common than the bacterial kind. It may last several weeks and is frequently accompanied by a respiratory infection (or cold). Antibiotic drops or ointments usually do not help, but symptomatic treatment such as cold compresses or over-the-counter decongestant eye drops can be used while the infection runs its course.

Bacterial conjunctivitis is less common and characterized by considerable amounts of pus. Some bacterial infections are more chronic, however, and may produce little or no discharge except for some mild crusting of the eyelashes in the morning. Bacterial conjunctivitis can be treated with a variety of antibiotic eye drops or ointments. These treatments usually cure the infection in a day or two.

Another kind of conjunctivitis is caused by allergies and often occurs in spring and fall. Itchy eyes are common with this variety, but can be treated with eye drops. It is important, however, to not use medications that contain steroids unless prescribed by an ophthalmologist (Eye M.D.). Names of steroids usually end in “-one” or “-dex.”

Conjunctivitis caused by a virus can be very contagious. If you have been diagnosed with viral conjunctivitis or suspect you might be suffering from this condition, practicing good hygiene can help prevent the spread of conjunctivitis if you are infected. You should:
  • Avoid re-using handkerchiefs and towels to wipe your face and eyes
  • Not share towels, pillowcases or makeup
  • Wash your hands frequently
  • Keep your hands away from your eyes
  • Replace your eye cosmetics regularly
  • Properly clean your contact lenses
  • Stay out of swimming pools and consider staying home from school or work
Regardless of the cause, conjunctivitis should not cause a disruption in vision. More serious conditions, such as damage to the cornea, very severe glaucoma or inflammation inside the eye can also cause the conjunctiva to become inflamed and pink. If your case of “pink eye” affects your vision or you experience eye pain, you should see an ophthalmologist.

Dr. Brad V. Spagnolo, M.D. with the Baltimore Washington Eye Center

Friday, June 17, 2011

Eye Protection

If you work in an environment that is prone to dust or other flying objects, or if you practice any type of sport that involves any size ball or racquet, it is wise that you protect your eyes.  You should be using safety glasses or goggles.  This will protect not only your globe, but your orbit. The frame should either be a full lens or the aperture should be smaller that the size of the object that might strike you.  Remember that objects at high speed become oblong, and are therefore smaller than their spherical shape.  The material of the lenses should be polycarbonate. 
Polycarbonate: Polycarbonate is a premium lens material that is the lightest and most impact resistant available. This lens provides excellent optical quality, thinner style lens, ultraviolet protection, scratch resistance, and can be tinted to any color.
Guest Blogger:
Arturo E. Betancourt, M.D., F.A.C.S. with the Baltimore Washington Eye Center

Wednesday, June 15, 2011

No Line Progressives

Progressive lenses, commonly called no line progressives, correct for: distance (driving), intermediate (viewing the dashboard) and near (reading a map) vision with no visible segments (lines) to get in the viewers way and age their appearance. Progressive lenses are the latest bifocal technology. They are better for your vision because they correct not only for distance and near but also intermediate.  This technology makes it smoother and easier for your eye to look up and down, and perhaps best of all there's no line for others to see. No one will know you're wearing the no line bifocals or progressive lens unless you tell them. 

Guest Blogger:
Chris Spake, with the Baltimore Washington Eye Center Optical Department

Thursday, June 9, 2011

LASIK or PRK-Which Should I Have?

“Patients should know that both LASIK and PRK are excellent vision correction procedures when prescribed for the right patients with realistic expectations,” offered Corneal Specialist and LASIK Surgeon Brad Spagnolo, M.D. at Baltimore Washington Eye Center. Here are some considerations for you to know and understand about PRK vs. LASIK. First, the long-term clinical studies comparing PRK and LASIK show that the ultimate visual results of both types of laser treatment are virtually identical. However, there are some subtle differences, as well as some not so subtle, differences.

Patients who have LASIK may have very slightly reduced contrast sensitivity in dim illumination. Often it is so slight that the patient does not notice it except in the testing conditions or in very extreme instances of reduced contrast situations such as driving at dusk in the rain. Thus it is a limited problem for most patients.

The real differences between PRK and LASIK are based on the fact that PRK is a “surface laser treatment” and LASIK is a “lamellar laser treatment.” PRK is performed on the surface of the cornea whereas LASIK is performed between the layers of the cornea. To do a LASIK surgery, it is a 2-step procedure-one to create the “layer” or “flap” and one to apply the laser. To do a PRK is a single step procedure, just applying the laser. Thus, whenever you have a multi-step eye surgery procedure there is always a possibility of greater risk. Fortunately the risks, side effects and complications of LASIK are relatively few and minor if you are indeed a good candidate. So, PRK does offer a safer risk profile because it is a single step procedure. However one of the not so subtle differences is that because it is a lamellar procedure, LASIK does not disturb the surface of the cornea during treatment. This provides patients with a much faster visual recovery and significantly less discomfort than PRK. This is why from a consumer perspective patients have tended to want LASIK eye surgery more than PRK. They can get back to many normal activities within a couple of days without any real pain-just some mild discomfort-and with good vision. Most LASIK patients are able to pass a drivers test with 24-48 hours of their laser treatment. PRK patients often experience moderate discomfort that can last a few days and depending on the degree of their prescription can take a week or so to achieve good functional comfortable vision. Thus, the best thing to do if you are considering Laser Eye Surgery for vision correction, is to schedule a consultation with Dr. Spagnolo so that he can carefully review you individual situation and help decide whether LASIK or PRK might be the best choice for you. Please feel free to phone Baltimore Washington Eye Center at 410.761.8258 to schedule an appointment.

Tuesday, June 7, 2011

Cataract Awareness Month at Baltimore Washington Eye Center

Baltimore Washington Eye Center wishes to announce that Prevent Blindness America has designated June as National Cataract Awareness Month. Cataracts are the leading cause of blindness worldwide. About 20.5 million Americans age 40 and older have cataracts and more than half of all Americans develop cataracts by age 80.

Many patients do not actually know that a cataract is a clouding of the crystalline lens of the eye preventing light rays from passing through it easily. This results in a clouding and blurring of vision. They need to understand that cataracts are not a growth or a film over the eye. For many patients cataracts start out slowly and have little effect on vision, at first. But, as the cataract becomes denser, so does the impact on vision. The most common symptoms that bother patients with cataracts include:

blurring of vision
sensitivity to light and glare
double vision in one eye
poor night vision
fading or yellowing of colors
frequent changes in glasses or contact lens prescriptions

When cataracts do begin to interfere with daily activities or with patient comfort and safety, they can be treated surgically. Cataract surgery is one of the safest and most frequently performed surgeries in the United States. Today, at Baltimore Washington Eye Center, we have a full range of Intraocular Lens Implants (IOL) available that allow us to correct near vision as well as distance vision without requiring bifocals or reading glasses for the vast majority of patients. Please feel free to contact us with your questions about Cataracts, Cataract Surgery or Lens Implants by calling Baltimore Washington Eye Center Toll Free at 800.495.3937.

Thursday, June 2, 2011

Intraocular Lenses: Are they right for you?

Intraocular lenses, or IOLs as they are more commonly known, are artificial lenses that are used to replace natural lenses that have become clouded with cataracts. They can also be used as a solution for people who suffer from presbyopia, a condition in which the lens becomes less flexible, thus losing its ability to focus on near objects.  Before the U.S. Food and Drug Administration approved the use of intraocular lenses in 1981, patients who had cataract surgery were forced to wear thick eyeglasses or contact lenses to improve their vision. Early monofocal IOLs were generally used to correct problems with distance vision, leaving patients to rely on glasses or contacts for near vision.

Monofocal vs. Multifocal IOLs

Traditional, or monofocal IOLs, can only offer patients improvement at one distance (intermediate, far, or near). At our eye centers, we happily offer multifocal implants to help our presbyopia and cataract surgery patients see more clearly at a range of distances. We use this breakthrough technology in our on-site surgical center to replace the eye’s natural lens with a new, artificial lens that can help restore visual clarity to near, intermediate and distance vision.


Cataracts, Astigmatism Toric IOLs

If you have astigmatism, you may still experience blurred and distorted vision after traditional cataract surgery because a monofocal IOL cannot correct astigmatism. To achieve quality distance vision with a traditional IOL, you may still require glasses, contact lens or further surgery. If freedom from glasses for distance vision is important to you, you now have a better option.  The unique design of a toric IOL makes it possible to reduce or eliminate astigmatism and significantly improve uncorrected distance vision.  Toric IOLs provide significantly improved distance vision and may reduce the need for corrective lenses compared to a traditional monofocal IOL.


Spherical Aberration and Cataracts

It's a little-known fact that, in spite of all the advances in eye care technology today, even healthy eyes still contain some imperfections called higher order aberrations. One type of higher order aberration common to cataract patients are spherical aberrations, which can lead to a gradual reduction in vision acuity and function. An aberration is an irregularity in the shape of the eye's refractive surface that can distort vision. As you get older, your eyes’ lenses get thicker and rounder, causing image quality to deteriorate. Spherical aberrations are generally associated with:
  • Blurriness
  • Halos
  • Loss of contrast
  • Poor night vision
Our doctors can implant a lens designed to reduce spherical aberrations, increase contrast sensitivity, and improve functional vision.  Aspheric implants offer these advantages over traditional spherical lens implants: improved vision quality especially in lower light, enhanced clarity, and filtered blue light for rich vibrant color.

An exam at one of our locations can help determine if you will benefit from one of these advanced technology implants. Our skilled cataract surgeons, Dr. Betancourt and Dr. Spagnolo will help you decide which of our lens technologies will best suit your specific needs.  

Dr. Brad V. Spagnolo, M.D. with the Baltimore Washington Eye Center