Baltimore Washington Eye Center, Maryland

Thursday, September 29, 2011

Eyeglasses-Risks of Online Ordering

Online ordering of eyewear, while appealing from a cost standpoint, has severe limitations:
·         The buyer cannot:
o   Verify the prescription in the eyewear
o   Verify if the lens material or brand is the one ordered (there are more than 250 brands of progressive lenses)
o   Try on frames for comfort, fit or correct size.

·        It is not possible to take the necessary measurements (interpupilary distance, vertex distance and bifocal height) over the internet with current technology.  These measurements are NOT a part of a vision examination but rather are determined by opticians as an integral of their dispensing eyewear.

·        There is no one to fit the completed eyeglasses or to provide periodic adjustments or repairs.

Yes, you might save money with an online purchase of eyewear but only at the risk of getting inferior workmanship, a limited selection and service from a non-licensed or non-certified optician. Here at the Baltimore Washington Eye Center, each member of our optical department has achieved their A.B.O.C. (American Board of Opticianry Certification) designation.    Our staff is dedicated to helping you find the best solution for your individual needs to include: sunglasses, reading glasses, progressives, no-line bifocals, computer glasses, and many other options designed to meet your personal needs. 

Guest Blogger: Larry Heilman, F.N.A.O., Optician with the Baltimore Washington Eye Center

Tuesday, September 27, 2011

Medications-Not All Generic Medications are Created Equal!

We are constantly using brand medications to treat many conditions.  Many times the brand becomes synonymous with the agent that treats it.  That is called branding.  In the past when we had few options in the way of medications to treat conditions, the climate was better for such branding.  Today, pharmaceuticals have patents on their products.  These patents have a certain duration.  Once the patent expires, any company that has the ability can create a similar medication.  Herein lies the big dilemma-similar!  For years you have been using brand X and getting the results your physician wants for you.  Now the medication is available as a generic.  The use is the same, you are familiar with the indications, dosage, and the price might be less expensive.  This is a very big drawing point-you are saving money, while getting the same result.  Sounds like a winner! But is it?

Not all generic medications are the same as the brand name.  Yes, they have the same active ingredient, but they might have different preservatives and other substances that might not make them work as well for you.  What can you do when the pharmacist gives you a generic other than the brand name?  If your ophthalmologist hasn't informed you that there is a possibility that your next prescription will be filled with a generic, take the bottle in to the next visit.  It is likely that you will have a follow up visit at a closer interval to access efficacy.  Once he is sure that the medication does not have any ingredients that might not suit you and that the effect is the same, you will return on regular intervals.  When in doubt ask questions, describe any symptoms that are unusual.  It is important to you and your doctor to know about any changes in medication.

Remember, just because it is less expensive it doesn't mean that it is better, or not as good!

Sunday, September 25, 2011

Diabetic Retinopathy

Nice young lady came to the clinic last week for an emergency. Unfortunately, she had suffered some bleeding inside her one eye because of diabetes. Her other eye had evidence of some bleeding within the retina which had fortunately not spread yet.  Hopefully, the blood will either clear in a few weeks time or one of our retina specialists will be able to remove the blood with surgery. Once cleared, the specialist can then treat the eye with laser in order to prevent future bleeding and vision loss.

Her visit serves as an important reminder to folks with diabetes to have regular visits with their primary care doctor to ensure good blood sugar control. Also, diabetics need to have yearly dilated eye exams to help prevent the sort of eye problems I detailed above today.

Friday, September 23, 2011

What is Glaucoma and how can it be treated?

Glaucoma refers to eye disorders where high pressure inside the eye causes damage to the optic nerve and subsequent vision loss.  If glaucoma is untreated, it can lead to permanent loss of you peripheral (side) or central vision.  In fact, glaucoma is the second leading cause of blindness, and approximately 2.5 million people in the United States are affected. An estimated 50% of those affected do not know they have glaucoma. People at highest risk are those with a family history of glaucoma, diabetics, those older than 60 years of age, African-Americans, and the extremely farsighted.

Glaucoma Symptoms
Glaucoma is often referred to as the “silent thief of sight," because it can cause vision loss slowly without obvious detection.  However, with some forms of glaucoma, such as acute angle closure, symptoms can develop rapidly and include blurred vision, halos around lights, eye pain, nausea and vomiting.  If you develop these symptoms, you should go to an emergency room or visit an ophthalmologist immediately to prevent permanent loss of vision.

Diagnosis, Screening and Tests for Glaucoma
There are several screening tests that help establish the diagnosis of glaucoma.  The first step is to check the eye pressure with a small tonometer probe.  A drop of numbing solution is placed on the eye and the pressure is measured.  There is no pain and the test lasts only seconds.  There is no unexpected puff of air anymore.  The eyes are also dilated with eye drops so that the optic nerves can be assessed for damage.  A picture of the eyes may also be performed to check the health of the optic nerves.

Treatment of Glaucoma
If your doctor determines that you have glaucoma, there are several treatment options.  Every option involves lowering the eye pressure to prevent vision loss.  The most common treatment is the use of eye drops to lower eye pressure.  There are many different drops that work in various ways to reduce pressure.  Most glaucoma patients are treated adequately with drops; if drops are ineffective, and in a few other circumstances, medical lasers can be used to reduce the eye pressure in an office setting.  If the eye pressure remains high despite these treatments, incisional surgery may be considered.  The most common type of glaucoma surgery, trabeculectomy, creates a new drain for the eye to lower pressure.  Filtering tubes can also be implanted to help control pressure.

Final Thoughts
Glaucoma is a common and treatable condition.  Screening tests can detect glaucoma early enough to prevent vision loss.  If you have symptoms of glaucoma or anyone in your family has glaucoma, a visit to one of our ophthalmologists for a screening is a good place to start.

Thursday, September 22, 2011

Central Serous Retinopathy

Central Serous Retinopathy (CSR) is a relatively uncommon retinal condition that usually resolves after a few months, but can occasionally lead to vision loss. CSR has the following characteristics:

-  Young, healthy adults ages 20-45
-  Occurs more frequently in males
-  Associated with trauma, pregnancy, allergy, migraine, steroid use, antibiotic use
-  Type A personalities

Symptoms include:
-  Blurred spot in vision with reduction in acuity
-  Distorted vision
-  Longer time for eye to recover from bright light exposure

For reasons not yet fully known, a person with CSR develops a “leak” in a layer of his or her retina that allows fluid to collect or pool within the retina itself. It is this leakage that leads to symptoms.
Fortunately the natural course of the disease is limited. Typically, normal acuity, i.e. 20/20, returns over several weeks to months.  However, some people continue to experience a persistent blurry spot, reduced contrast sensitivity and color perception, and mild image distortion. The disease often recurs either in the same or other eye. If CSR does return, it usually happens within 1 year of the previous episode

Again, without treatment, most eyes will recover. In some cases, though, laser treatment to “seal” the leak is recommended. Laser treatment may be considered for the following:
-  Persistence of serous detachment beyond 3-4 months
-  Recurrence in eye with visual deficit from prior episode 
-  Exam findings of chronic signs like cystic retinal changes or diffuse retinal pigment abnormalities
-  Occupational/patient needs for prompt visual recovery, i.e. pilot, police officer.

Laser treatment can allow recovery to occur within 2 to 4 weeks, but the ultimate vision is the same whether or not treatment is performed. The treatment is performed on an outpatient basis by one of our retinal specialists. There are usually no restrictions after the procedure. 

Tuesday, September 20, 2011

Recovery after Cataract Surgery

“Almost all of our patients who are being scheduled for Cataract Surgery at Baltimore Washington Eye Center want to know what to expect from their recovery period,” said Arturo Betancourt, M.D. “Cataract surgery today is really very advanced and quite patient friendly.”

First, if you are in generally good health it is most likely that your cataract operation will be performed in the ambulatory surgery center at Baltimore Washington Eye Center-a close to home, convenient and friendly facility.” Our surgery center is comfortable and efficient and your entire cataract surgery procedure should take only 2-3 hours from the time you check in until the time you check out, commented Brad Spagnolo, M.D.

Second, modern cataract surgery is most often performed with either local or topical anesthesia so that there is really minimal if any “recovery” from the anesthesia used. Generally, you are feeling “back to normal” by the end of the day of your surgery or certainly by the next morning.

Third, with the advanced cataract surgery technique of “small incision phacoemulsification” there is only a need to create a tiny incision-often just a few millimeters-through which the cataract is removed and the intraocular lens is implanted. This tiny incision is so small that the wound healing is very quick.

Finally, depending on the type of lens implant that is used it is highly likely that your distance vision will be dramatically improved within 24 hours. In fact many patients actually are comfortable driving the next day after their cataract operation. If you have a multifocal or accommodating lens implant to correct both your distance and near vision, it might take a bit longer to appreciate the full clarity of the near vision correction. So, it is pretty likely that you will be back to work in a few days and you should be able to resume all of your normal activities within a couple of days.

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, September 15, 2011

Eyeglasses-Proper Cleaning & Care Don’t Forget the Spare Pair

Your eyeglasses are an investment, so here are some great tips to remember:
Cleaning:
·         Paper products should not be used to clean your eye glasses, unless they have been specifically designed for this use.  Most paper products contain wood fibers which may scratch the lenses and are too harsh for uncoated or specially coated lenses.
·         Warm water and mild dish soap with a soft cotton cloth is a wonderful cleaning option.  Products containing alcohol or ammonia should not be used as they may strip special coatings or discolor frames and lenses.
·         Pre-moistened lens clothes, which are easily tote able are also a great option for cleaning your eyewear.
General Care:
·         Prevent exposure to extreme heat or cold.
·         Use a hard shell case to ensure safety of your eyewear.
·         Use of a strap or band to hold your eyeglasses in place will help to prevent sudden loss which might happen during boating, athletic events or in everyday activities.
Also remember when traveling to take a spare pair!
Guest Blogger: Christine Spake, A.B.O.C. with the Baltimore Washington Eye Center

Wednesday, September 14, 2011

Football, Astigmatism and LASIK

Not sure what our laser vision patients who are Ravens and Redskins fans have been happier about this week…Their great vision after their laser procedure or the fact that the 2011 NFL season is underway. Believe it or not, a football and laser vision correction do have something in common.  Some people have corneas that are shaped much like a football. We use the term astigmatism to describe that shape. Most of our laser vision patients have astigmatism that is easily corrected by our excimer laser. And for our patients who have astigmatism and need Cataract Surgery we can correct their astigmatism with astigmatism correcting toric lens implants.  If you have astigmatism and desire to be less dependent or even free from the hassle of glasses or contacts, think about LASIK and maybe the next time you’ll be seeing your favorite NFL team in a whole new way.

Tuesday, September 13, 2011

Astigmatism Correction at time of Cataract Surgery-Seems like HD!

Astigmatism is quite prevalent in the general population.  It can be minor, less than 0.75 diopters or greater.  Some people can tolerate large amounts of astigmatism, but most of us don't.  It can be corrected with glasses, special contacts called toric contacts, and surgery.  In the realm of surgery the ophthalmologist has several tools to tackle this problem. 

We can make incisions on the cornea, limbal relaxing incisions or penetrating incision, peripheral limbal relaxing incisions.  These are effective for low levels of astigmatism but not always predictable or lasting. 

We can use the excimer laser to perform PRK or surface ablations or Lasik.  Both these procedures are more predictable but also are more costly and carry a different set of risks. 

Within the past few years, toric intraocular lens have become available, which we use to replace the natural lens that became a cataract.  This is a great advance, since prior to this lens a person with any significant amount of astigmatism would have to wear some type of optical correction to see clearly at distance or undergo another surgical procedure.  Not only are we correcting the astigmatism at the time of cataract surgery but the patients are describing their vision as being in HD.

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

Thursday, September 8, 2011

Lyme Disease and Vision Changes

In recent years the incidence of Lyme Disease has more than doubled in the Potomac area. After a mild winter and a wet spring the deer ticks were predicted to be plentiful in summer 2011. Symptoms of Lyme Disease peak from July to September. Most people know that a Bull’s Eye rash is highly suspicious for Lyme Disease but not everyone exposed to Lyme disease exhibits a rash and some mild rashes go unnoticed.  Early on the symptoms of Lyme Disease are flu like. If the disease is not detected and treated thoroughly at this stage chronic Lyme symptoms develop. Lyme Disease is one of the great masqueraders, it can mimic the symptoms of 350 different diseases.

Although commonly associated with joint pain and fatigue chronic Lyme Disease can affect any of the body systems. When Lyme Disease affects the central nervous system intracranial pressure can become elevated causing swelling of the optic nerve and compression of one of the cranial nerves (Abducens) responsible for movement of the eyes. Twice in the last few years we have had patients come to the office in the month of July with these symptoms. After referral for appropriate testing both had confirmed diagnosis and were treated for central nervous system Lyme.  When dealing with unusual or mysterious symptoms Lyme Disease always needs to be on the list of differential diagnoses.

Wednesday, September 7, 2011

Back to School Eye Exams at Baltimore Washington Eye Center

Another school year is here and as the kids head off to school many parents are scheduling yearly physicals. Now is also a good time of year to get a thorough check of the eyes. Many pediatricians and school districts do yearly vision screenings. These quick checks of visual acuity are merely that, screenings, and although they can sometimes detect problems and facilitate referrals they do not evaluate the visual system thoroughly.

When children are focused on learning we want to eliminate distractions. Poor vision, asymmetric vision, difficult focusing, and poor eye teaming are all issues that if undetected and untreated can impact a child's ability to attend to tasks and learn efficiently. A comprehensive eye exam including dilation will address all of these issues. For healthy children with no obvious visual complaints a routine exam every two years is recommended.
Guest Blogger:

Thursday, September 1, 2011

Baltimore Washington Eye Center's Surgery Center & AAAHC

The Accreditation Association for Ambulatory Health Care is a Federal organization that serves to oversee health care services that are provided on an out-patient basis.  Their purpose is to ensure these facilities are providing the highest quality care for patients through observations, interviews, and record review.  They not only look at the actual patient care but all of the processes that have been put into place that lead to a provision of safe and ethical care. 

Although highly recommended, it is not mandatory for ambulatory surgery centers to participate in this process.  However, Baltimore Washington Eye Center is committed to providing the highest standard of care to our patients and embraces this process as a means to have a benchmarking system in place to ensure our compliance with all State and Federal regulations.  The accreditation status survey is conducted by surveyors selected by AAAHC.  As a rule they are selected based on their experience in the service provided by the organization seeking accreditation.  Once the survey has been conducted the accreditation is awarded based on the findings of the survey.  The award given that reflects an organizations dedication to providing high quality care and services as well as being in compliance with all requirements set forth from the AAAHC and Medicare's Conditions for Coverage is three years.  That means, the organization has proven its commitment to giving the best care possible to its patients. 

We are proud to say that we have consistently received the three year awards since we first joined the AAAHC in 1986 and we will continue to endeavor to serve all of our patients with the highest quality care and service possible.  

Guest Blogger: Katie Guglietta, R.N., ASC Manager with the Baltimore Washington Eye Center