Baltimore Washington Eye Center, Maryland

Thursday, July 28, 2011

Preventing Eye Injuries

More than 1 million people suffer from eye injuries each year in the United States. Ninety percent of these injuries could have been prevented if the individual had been wearing appropriate protective eyewear. Protecting your eyes from injury is one of the most basic things you can do to keep your vision healthy throughout your life.  “Most people are aware of the possible risk of eye injuries, according to Brad Spagnolo, M.D. of the Baltimore Washington Eye Center. “However,” he says, “many don’t take the easiest step of all to prevent 90% of those injuries, which is wearing the proper protective eyewear”. 

If you are not, then you are not alone. According to a recent nationwide survey by the American Academy of Ophthalmology, only 35% of respondents said they always wear protective eyewear when performing home repairs or maintenance. Even fewer do when playing sports.

Of the injuries reported in the survey, almost half (44.7%) occurred in the home. More than 40% of the injuries were caused by activities such as home repairs, yard work, cleaning and cooking. Over a third of the injuries in the home occurred in the bedroom, bathroom, kitchen, living room, or family room.

More than 40% of eye injuries each year are related to sports or recreational activities.

In this survey of eye injuries, 78% of the people were not wearing eye wear of any kind. Of those reported to be wearing some form of eye wear (glasses or contacts) only a little over 5% were wearing safety or sports spectacles. For most repair projects and activities around the home, basic ANSI-approved (American National Standards Institute) protective eyewear will be sufficient. Sports eye protection should meet that sport’s specific requirements. These are usually established and certified by the sport’s governing body and/or the American Society for Testing and Materials (ASTM).

Tips to Prevent Eye Injuries
In the house: when using household chemicals, read instructions and labels carefully, work in a well-ventilated area, and make sure to point spray nozzles away from you. Many chemicals are extremely hazardous and can permanently destroy the surface of your eyes, resulting in blindness.

In the workshop: think about the work you will be doing and wear protective eyewear to shield your eyes from flying fragments, fumes, dust particles, sparks, ultraviolet and infrared radiation, and splashing chemicals. Many objects or substances can fly into your eyes unexpectedly and cause injury.

In the garden: put on protective eyewear before you use a lawn mower, power trimmer or edger and be sure to check for rocks and stones as they can become dangerous projectiles if picked up in these machines. Don’t forget the risk to bystanders (including children and pets) when using these machines.

In the workplace: wear appropriate safety eyewear for your job. Many who suffer eye injuries each day don’t think that they need eye protection so they don’t have appropriate eyewear for the job.

Around the car: battery acid, sparks and debris from damaged or improperly jumpstarted auto batteries can severely damage your eyes. Keep protective goggles in the trunk of your car to use for those emergencies as well as everyday repairs.

Dr. Spagnolo reiterates, “Prevention is the first and most important step in protecting your eyes from injuries, so be sure to protect your eyes with appropriate protective eyewear.” If you do experience an eye injury, seek medical attention promptly. For more on what to do and what not to do if you experience an eye injury, please check out the previous link.  

Tuesday, July 26, 2011

Do Cataracts Regrow?

Cataracts do not “regrow” once they have been removed through a cataract operation. However what does happen from time to time is something called “posterior capsular opacification”. The crystalline lens of the eye is where a cataract forms. The crystalline lens has a soft protein center and is surrounded by a “capsule”. A Cataract forms because the protein becomes cloudy. During cataract surgery Dr. Betancourt and Spagnolo use microscopic instruments to break up and remove the cloudy material as this is what blurs your vision. However, they leave the “capsule” in place and actually place the intraocular lens implant (IOL) to correct vision inside the capsule to help correct your vision. In some patients the capsule become “opacified” sometime after surgery leaving the patient’s vision cloudy and often with glare sensitivity, much like the symptoms they had from the Cataract. Fortunately, using a YAG Laser Drs. Betancourt and Spagnolo are able to quickly, safely and effectively create an opening in the capsule along the visual axis that restores the vision almost instantly. This procedure called a “YAG Capsulotomy” takes only a few minutes using simple eye drop anesthesia without discomfort. Please feel free to schedule an appointment and 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, July 21, 2011

Sunglasses-Performance & Prevention

When the pool in our neighborhood opened my children both came home sunburned.  As a parent I felt terribly guilty. Not just because they were both uncomfortable but because we are all so acutely aware of the dangers of ultraviolet light and how it can damage skin.  As an eye doctor though, I sometimes think we do not do a good enough job educating the public about the risk of visible and ultraviolet light to the eye.

Cumulative exposure to utraviolet light can cause cataracts, pterygia and skin cancers on the surface of the eye and on the lids. Excessive exposure to visible light especially blue light may increase the risk of macular degeneration.

How can we protect the eyes? Simple things like a hat with a wide brim and sunscreen, carefully applied to the lids, can reduce exposure. Contact lenses that block ultraviolet light can certainly help but they do not protect a large part of the eye surface and none of the eye lid. In addition, they do not block blue light at all. Good, large, wraparound sunglasses are the best way to protect the largest area. The lenses must block UVA and UVB up to 400 nanometers. Polarized lenses with a brown or amber tint are designed to reduce glare and block blue light.  Melanin lenses are specifically designed to absorb the blue light thought to pose the greatest risk to the retina. Many clear prescription lenses are also made with materials that absorb ultraviolet light.

With all of these options it should be possible to follow the mantra, “Protect your eyes from sun damage everyday and every season.”

Tuesday, July 19, 2011

Contact Lenses Technology Advances

The most recent advances in contact lenses have often come in material design. Manufacturers are always striving to find the healthiest and most comfortable materials. Silicone lenses historically had excellent transmission of oxygen through the lens to the eye. Unfortunately poor wettability and stiff lenses made for very poor comfort. The advent of silicone hydrogel lenses change all that. PureVsion and Night and Day lenses had unsurpassed oxygen transmission and reasonably good patient comfort. More recently continued advances have brought us silicone hydrogel lenses that are thinner, more flexible and even more comfortable. These newer lenses include Acuvue® Oasys®, Air Optix®, Avaira™ and Biofinity. In addition, improvements have been made in the PureVision and Night and Day lenses that further enhanced their comfort without sacrificing oxygen transmission. Many of these lens materials are also now available in designs that address astigmatism and presbyopia (a near vision issue that occurs after age forty requiring a multifocal design solution). This means that a wide variety of vision issues can now be addressed with these state of the art lenses, improving patients’ health, comfort and wear time.

Guest Blogger:

Thursday, July 14, 2011

How Safe Is LASIK?

For many people considering LASIK it is important to have them understand some information about LASIK safety and its solid overall track record of safety so that they can overcome any fear or anxiety they might have regarding the procedure. The safety of LASIK depends on a number of factors. By far the most important factors that can affect LASIK safety are the laser and instrumentation to be used to perform the treatment and even more so, the skill and experience of the LASIK Surgeon.

Long Term Track Record

Laser Eye Surgery for the Laser Vision Correction of nearsightedness was first performed in the United States upon Food and Drug Administration (FDA) approval of the Excimer Laser on October 20, 1995. The Excimer Laser was specifically FDA approved for LASIK in 1998. So Laser Eye Surgery for vision correction has now been performed in the U.S. for over 15 years and LASIK for over 13 years-quite a long time. In general, LASIK is considered one of the most successful and safe eye surgery procedures we provide patients. With proper patient selection to ensure they are good candidates our nearsighted patients can expect to achieve 20/40 vision more than 98 percent of the time and uncorrected vision of 20/20 or 20/25 more than 90 percent of the time. The safety of LASIK is illustrated by the minimal loss of best-corrected vision where vision loss to a level of worse than 20/40 is quite rare occurring in about only 3 per 1,000 cases and serious complications such as infection or corneal damage occur even more infrequently in fewer than 1 in 1,000 cases. While not an infinite amount of time the availability of the various Laser Vision Correction procedures, including LASIK for this 10-15 year timeframe with these results does give the real world experience and data that can be used to evaluate the various Laser Eye Surgery procedures and their safety. But, there is more to safety than simply the laser itself.

Safety is really in the “Hands of the LASIK Surgeon”. FDA approval does not ensure that a LASIK Surgeon is going to provide a thorough evaluation and consultation. FDA approval does not indicate or imply that LASIK Surgeons will provide a complete review of the possible risks and complications of LASIK-nor does it imply that a LASIK Surgeon will use the appropriate screening and decision criteria to be sure that a patient is in fact a good candidate for LASIK or any Laser Eye Surgery for that matter. That is why the choice of a LASIK Surgeon is the most important factor in the ultimate safety of LASIK Surgery

You should not choose a LASIK Surgeon based on slick advertising or low price. You should choose a LASIK Surgeon based on reputation in the community, the length of time they have been performing LASIK and the comfort and rapport established during your consultation. While the equipment used may provide a slight advantage or disadvantage in safety, it is ALWAYS the skill and experience of the surgeon that contributes the most to the overall safety of Laser Eye Surgery for the correction of nearsightedness, farsightedness and astigmatism. If you would like to learn more about the safety of LASIK or find out if you are a good candidate please feel free to phone Baltimore Washington Eye Center at 410-761-8258 to schedule an appointment.

Tuesday, July 12, 2011

Implants for Astigmatism-Advanced Technology

We are very pleased to report that we now can offer the benefits of the Toric Intraocular Lens to many more of our patients. Starting next month we will have available 4 new astigmatism powers. This means we can correct astigmatism of up to 4 Diopters.  The unique design of a toric IOL makes it possible to reduce or eliminate astigmatism and significantly improve uncorrected distance vision following cataract surgery.  Toric IOLs provide significantly improved distance vision and may reduce the need for corrective lenses compared to a traditional monofocal IOL. 

If an eye has astigmatism it means that eye does not focus light to a single point; instead the eye focuses light to two distinct points. Almost all eyes have some degree of astigmatism. If the amount of astigmatism is great enough, then a person will experience blurred or distorted vision as depicted in the image on the right. The majority of astigmatism results from a cornea that has different curvatures. Astigmatism occurs in nearly everybody to some degree. For significant astigmatism, treatment is required, either with glasses, contact lenses, or sometimes implants. For further information, please visit the abstracts linked below:

Thursday, July 7, 2011

Benefits of a Dilated Eye Exam

Guest Blogger:
Shari E. Strier, O.D. with the Baltimore Washington Eye Center

Recently I saw a patient for a routine eye exam. She was in her forties and reported being in good health. She had no significant complaints, she just wanted to come in for an exam because it had been a long time and her near vision was starting to become blurred. She was 20/20 at distance with no correction and was in the early stages of presbyopia. We discussed a low powered pair of reading glasses to address that issue. As part of the full exam we dilated her eyes. When I examined her retina I discovered that in one eye she had a cluster of flame-shaped hemorrhages near a blood vessel on her retina. I diagnosed a branch retinal vein occlusion.  This is a condition that occurs when an artery that has become stiff and inflexible crosses over a vein and pinches it impeding the outflow of blood through that vessel. Since the blood cannot drain it backs up on to the retina presenting as small hemorrhages.

Although the patient appeared to be in good health and had no other symptoms I asked her to see her primary care physician for a routine physical and blood work. Since the vein occlusion was not threatening her vision no treatment was required and I scheduled her to follow up in two months. When she returned for her follow up visit I asked how things and gone with her primary care. She reported that although almost all of the tests had been normal her triglyceride levels were through the roof!

Elevated triglycerides have long been associated with atherosclerosis or plaque formation in the arteries. But a recent Danish study has found a strong link between elevated triglycerides and increase risk of stroke. The study found that women with triglyceride levels of 443 mg/dL had nearly quadruple the risk of suffering a stroke, compared to women whose levels were less than 89 mg/dL. Those with levels between 89 and 177 mg/dL had a 20 percent increased risk. Men’s increased risk ranged from 20 percent to 2.3-times higher, with the risk increasing as triglyceride levels went up. With proper diet and sometimes the use of statin medications triglyceride levels can be reduced.

The only way to view someone’s blood vessels without cutting them open is with a dilated eye exam. Luckily my patient came in for her exam and we saw a sign that pointed us toward a silent underlying problem before it had caused any devastating consequences. 

Tuesday, July 5, 2011

Fireworks Eye Safety Awareness Month at Baltimore Washington Eye Center

Baltimore Washington Eye Center wishes to announce that Prevent Blindness America has designated July as National Fireworks Eye Safety Awareness Month.
Contrary to what you might think, there is no safe way for nonprofessionals to use fireworks. It is only safe to enjoy the splendor and excitement of fireworks at a professional display. According to the U.S. Consumer Product Safety Commission, fireworks are involved in approximately 10,000 injuries per year that are treated in U.S. hospital emergency rooms. Of those, 2/3 occurred during the one-month period surrounding the July 4th holiday. It is important to note that:
·         Eyes were the Second Most Commonly Injured Part of the Body!
·         Males Were Injured 3x More than Females.
·         Approximately 25% of Injuries are to Children Under 15.

Fireworks and celebrations go together, especially during the Fourth of July. But there are precautions parents can take to prevent these injuries. The best defense against kids suffering severe eye injuries and burns is to not let kids play with any fireworks. Do not purchase, use or store fireworks of any type. Protect yourself, your family and your friends by avoiding fireworks. Attend only authorized public fireworks displays conducted by licensed operators, but be aware that even professional displays can be dangerous. If an eye accident does occur, what should I know?
·         Do not rub the eye.
·         Do not attempt to rinse out the eye. This can be even more damaging than rubbing.
·         Do not apply pressure to the eye itself- but protecting the eye from further contact with any item, including the child's hand.
·         Do not stop for medicine! Over-the-counter pain relievers will not do much to relieve pain. Aspirin (should never be given to children) and ibuprofen can thin the blood, increasing bleeding. Take the child to the emergency room at once.
·         Do not apply ointments or drops. They may not be sterile and may make the area around the eye slippery and harder for the doctor to examine.

Once you are seen in the emergency room please feel free to have them call Baltimore Washington Eye Center at 800-495-3937 as we always have an eye doctor “on call” to provide consultation and continued care for you.

Friday, July 1, 2011

Astigmatism correction

Astigmatism is an optical aberration that is caused by the cornea being shaped more like a football than a baseball.  This can occur due to changes in your cornea, lens or other ocular structures.  The image viewed by a patient with astigmatism is a blurred one.  Astigmatism can be corrected with glasses, contacts, refractive laser surgery or intraocular lenses at the time of cataract surgery.

Astigmatism can be regular or irregular.  Regular astigmatism can usually be corrected by the above methods.  Irregular astigmatism such as that caused by keratoconus (coned shaped cornea) might need a corneal transplant or a new procedure to strengthen the cornea prior to using one of the above procedures.

Guest Blogger: Arturo E. Betancourt, M.D., F.A.C.S. with the Baltimore Washington Eye Center