Baltimore Washington Eye Center, Maryland

Thursday, October 27, 2011

Eye Twitch-Help, My Eye is Twitching!

Every now and then my husband complains to me that his eye is twitching and could I please do something to stop it. I tell him the same thing every time it eyelid twitch is harmless, will go away on its own, and has no real treatment.  He never seems to be satisfied with that answer, which is probably why he keeps asking me the same question each time.

An eyelid twitch is repeated firing of the orbicularis muscle, the muscle that encircles the eye and is responsible for closing the eye. Most of the time, the spasms are twitches of one or both lids that may continue on and off for a few days and resolve on their own. These are most often caused by fatigue, stress, dry eye, eye irritation and excess caffeine intake.  While these twitches can be annoying, they are harmless and the treatment is aimed at treating the underlying cause; using eye lubrication, avoiding caffeine, and decreasing (or at least trying to) stress and fatigue are recommended.

However, sometimes the spasms are so strong that they actually cause the eye to close.  Blepharospasm is actually a medical condition where there is uncontrolled episodic contraction of both eyes, at times so strong that it is difficult to open the eyes. This is thought to be a problem with the basal ganglia in the brain and usually starts in the 50s-70s. There is a related condition called Hemifacial spasm, where instead of both eyes squeezing shut only one eye is affected along with one side of the face, often times the corner of the mouth.  In these more severe cases, the spasms can be treated with botulinum toxin injections into the abnormally firing muscles.

Unfortunately, when I tell my poor miserable husband that he has to cut back on stress, get more sleep, drink less caffeine and use artificial tears, he just looks at me incredulously and says, "Oh, is that all?!"

Tuesday, October 25, 2011

Vitamin and Mineral Supplements and Your Eyes

Scientists have long debated whether taking vitamin and/or mineral supplements could help prevent, treat or cure certain eye conditions. Some early scientific studies seemed to show that supplements had the potential to prevent or slow the progression of cataract and age-related macular degeneration (AMD), although more complete study was needed to answer some important questions:

• Which supplements are helpful for which condition(s)?
• Which patients will benefit from supplementation?
• What doses of supplements would benefit patients?
• What other effects might these supplements might have on the body?

The Age-Related Eye Disease Study (AREDS), sought to address these questions, and seems to have given us some (but not all) of the answers to these questions.

What Is AREDS? The Age-Related Eye Disease Study (AREDS) is a major study sponsored by the National Eye Institute (NEI), one of the Federal government's National Institutes of Health, and conducted at 11 major medical center research facilities around the country. In the study, scientists looked at the effects of zinc and antioxidants, and a combination of both, on patients with cataracts, and on those with varying stages and types of age-related macular degeneration (AMD). They also studied patients without evidence of cataract or AMD to determine if zinc and/or antioxidants can prevent the development of these conditions.
What Were the Results? The study showed a number of important things:

• High levels of antioxidants and zinc can reduce the risk of vision loss from advanced AMD by about 19 percent in high-risk patients (patients with intermediate AMD or advanced AMD in one eye but not the other).
• Supplements do not provide significant benefit to patients with minimal AMD.
• These nutritional supplements do not prevent the initial development of AMD, nor do they improve vision already lost to AMD.
• Nutritional supplements do not seem to prevent cataracts or to keep them from getting worse.
• While most patients in the study experienced no serious side effects from the doses of zinc and antioxidants used, a few taking zinc alone had urinary tract problems that required hospitalization. Some patients taking large doses of antioxidants experienced some yellowing of the skin. The long-term effects of taking large doses of these supplements are still unknown.

Should I Take Nutritional Supplements? If you have intermediate or advanced AMD, talk to your physician about taking nutritional supplements. He or she can help you determine if they may be beneficial — and safe — for you, and what types and doses of supplements to take. The doses used in the study were:

• Vitamin C 500 mg
• Vitamin E 400 IU
• Beta-carotene 15 mg
• Zinc 80 mg, as zinc oxide
• Copper 2 mg, as cupric oxide (copper should be taken with zinc, because high-dose zinc is associated with copper deficiency.)

More recent data suggests that antioxidants such as lutein and zeaxanthin also seem to provide protection against AMD. The NEI has embarked upon a follow-up study to the AREDS, logically called the AREDS II, to further investigate the potential benefits of lutein and zeaxanthin. It is very important to talk with your physician before taking large-dose supplements, and to follow his or her dosage recommendations carefully. Some supplements may interfere with each other or other medications. Smokers and ex-smokers probably should not take beta-carotene, as studies have shown a link between beta-carotene use and lung cancer among smokers. Again, always check with your doctor prior to starting a regimen of higher dose vitamins and minerals.

Thursday, October 20, 2011

The Optical Department-One Size Does NOT Fit All

The Baltimore Washington Eye Center has been serving the community for over 40 years and we are always seeking ways to improve our services. In 1990 we chose to add an Optical Department to our practice. 

Yes, we offer a variety of brands, lenses, coatings etc, but without the right people it wouldn’t serve our community.  You deserve not only an excellent product, but excellent service.  Larry Heilman sets the bar for that here in our Optical Department and he sets it high.  We are proud to announce that Chris Spake of our Optical Department just received her A.B.O. certificate, which means that every Optician is A.B.O. certified and they pride themselves on staying up with technology.  Not only are they properly and specifically trained, but their true pride comes from assisting each person with this critical purchase.

When it comes to your optical purchase there are so many options and with so many options that selection can become overwhelming. Ultimately it comes down to what options will truly best serve your individual prescription and lifestyle. Our optician’s goal is to truly serve each person with that critical purchase.  It’s not one size fits all. Additionally, it’s not only about making the correct selections based on your individual needs, but in insuring that the resulting eyewear is true to what was ordered and that it is serving you.  

We have over 71 years of experience in our optical department.   Larry Heilman, our optical department manager has over 35 years of experience in this field and has earned his F.N.A.O. (Fellow of the National Academy of Opticianry) designation.  Chris Spake, Amber Henderson, Danielle Jones, and Larry Heilman are all A.B.O. (American board of Opticianry) certified and they truly enjoy serving the community. 
Here at The Baltimore Washington Eye Center technical training is enveloped with a smile and a desire to serve. Come see for yourself.
Guest Blogger: Larry Heilman, F.N.A.O., Optician with the Baltimore Washington Eye Center

Tuesday, October 18, 2011

Contact Lenses as Drug Delivery Devices?

Why use a contact lens to deliver drugs?  It would seem that if you can achieve the same objective using eye drops; this would be the preferred method.  However, eye drops have several drawbacks.  The amount of medication that actually comes in contact with the eye and is absorbed is small.  The greatest issue is not this, but compliance.  Drops may be difficult to administer, due to an unsteady the hand, arthritis or simply forgetting to use them. 

Many patients do not view drops as medication and do not feel they are important.  If we are using them to prevent a condition that has no symptoms, like glaucoma, they might not take the treatment as being necessary.  Plus they are inconvenient, especially if they require refrigeration or have a short shelf life.  To this effect a contact lens that contains a membrane that will release a measured amount of medication over time is being developed.  As the membrane degrades it could release any type of medication.  It could release an antibiotic, pain killer or anti-inflammatory.  Experiments have shown that it can release a measured amount of antibiotic for more than 100 days.  This technology could be coupled with a lens that measures the intraocular pressure and then delivers the pressure treating medication.  Currently the device only exists as a passive one.  The future of such technology is limitless.

Sunday, October 16, 2011

Decorative Contact Lenses and Halloween

Halloween means tricks or treats, ghosts and goblins, costumes lenses. Specifically, decorative or zero-powered contact lenses. These lenses are designed to give your eyes a different color or look, like a cat or animal character.  Unfortunately, many people obtain these contacts without a prescription either from the Internet or over-the-counter at a beauty salon or convenience store.  For the past several years it has been illegal to sell decorative contacts as over-the-counter products. According to refractive surgeon Brad Spagnolo, M.D., the risks of this type of purchase can't be understated. He states the risks include corneal abrasion, corneal ulcer, corneal scarring with permanent vision impairment, or even blindness. Dr. Spagnolo says that as with any contact lens, a person wishing to wear decorative contacts needs an eye exam from an licensed eye care professional. This exam includes ensuring that the eyes are healthy, that the selected contact lenses fit well, and that the contact lens wearer is instructed in the proper use and care of contact lenses so as to minimize the risks listed above.

To read about someone who bought decorative lenses without a prescription click here.  For more information, check out the following link: FDA and contacts

Thursday, October 13, 2011

Contact Lenses-Smart Enough to Monitor Systemic Conditions?

Diabetes has quickly become an epidemic in this country as well as many others in the world.  It could be linked to our progress in the production and distribution as well as consumption of food.  Even countries that we would never associate with this condition are severely affected.  India is the country in the world with the highest number of diagnosed diabetics. 

The treatment of diabetes is directly related to the measurement of blood sugar.  In order to do this some patients have to draw their own blood sometimes several times a day.  They need to use meters or monitors to provide a reading. Then using this reading some will have to adjust the medication they take.  All this comes at a huge cost, plus the time and inconvenience to the patient or provider.  If you had a device that could be worn and measured the blood glucose without this effort the treatment would be better. 

A smart contact lens is being developed to do just that.  Because the level of sugar in the tear film corresponds directly with the blood sugar, if you had a device that could measure the sugar in the tear, this could be used to monitor treatment.  At this time this device is in the experimental phase, and multiple problems due to design need to be resolved.  But it seems like a matter of time before we can have such a device.
Guest Blogger: Arturo E. Betancourt, M.D., F.A.C.S., Ophthalmologist with the Baltimore Washington Eye Center

Tuesday, October 11, 2011

Glaucoma treatment and smart contact lenses!

Most of us are familiar with contact lenses.  Small round clear plastic lenses that we insert into our eyes and rest on our corneas.  We use them to correct our vision.  That is up to now. 

Smart contact lenses are being developed to monitor disease and dispense drugs.  They do so using embedded sensors and electronics.  They might be able to measure the level of alcohol or cholesterol in your blood and give you an appropriate warning.  These lenses could be both sensors and displays, passing data in and out of the body.  With the use of light emitting elements it is possible to map digital images into your field of vision.

A smart contact is already on the market.  This lens is being used to help patients in the treatment of glaucoma.  It does so by continuously measuring the curvature of the cornea using a strain gauge which is incorporated into the lens.  The advantage is that it provides 24 hour measurements.  In order to treat glaucoma the time of highest pressure is very important.  It is very impractical for a patient to spend 24 hours at an Ophthalmologist’s office having his or her intraocular pressure (IOP) measured.  With this device the Ophthalmologist will have critical information that will aid in the better treatment of the patient.  All the electronics required to handle signal processing and communications are embedded in the contact. An induction wire is used to power and transmit the information.
One drawback of the device is that the induction loop antenna has a very short range and has to be worn very close to the eye.  The antenna has to be taped around the eye socket, giving the appearance of a monocle.  This makes the device less than ideal.  It is foreseen that the patient should wear it once every six month for 24 hours.  The aspiration is that this device will make the treatment of glaucoma more effective.

This smart contact lens is currently approved in eight European countries and approval here is expected by the end of the year.

Thursday, October 6, 2011

Angle-Closure Glaucoma

In the world of ophthalmology, there are several diseases/conditions that rank as true emergencies.  These include chemical injury, ruptured globe, central artery occlusion, and retinal detachment. Another emergency is angle closure glaucoma.

Angle closure glaucoma is a form of glaucoma whereby the eye’s pressure rapidly rises due to a blockage of the normal drainage system inside the eye. This can cause blurry vision, haloes around lights, pain, headaches, nausea, red eyes, and vision loss. According to the National Eye Institute (NEI), "This is a medical emergency. If your doctor is unavailable, go to the nearest hospital or clinic. Without treatment to improve the flow of fluid, the eye can become blind in as few as one or two days."

Symptoms of angle closure glaucoma include:
  • Symptoms appear and disappear in early stages; steadily worsening
  • Decreased vision
  • Cloudy vision
  • Sudden, severe pain most often in one eye
  • Eye feels swollen
  • Red eyes
  • Halos around lights
  • Nausea and vomiting
It is not unheard of for people to suffer bouts of angle closure that come and go. Here is an incredible story about one person’s experience with what turned out to be angle closure glaucoma. Risks factors include farsightedness and a family history of this condition. Fortunately your Ophthalmologist can tell you if you are at increased risk for this type of glaucoma.

Wednesday, October 5, 2011

Contact Lens Wear, Computer Use, and Dry Eye.

A new study from Japan suggests that contact lens wearers who spend more than 4 hours a day looking at a computer screen are much more likely to report/suffer from dry eye symptoms. Specifically, this group was found to have a lower tear volume compared to the non-contact lens wearers studied.  This was true regardless of the type of contact lens being worn. Symptoms such as burning, tearing, and grittiness seemed to be worsened/triggered by environmental conditions like air conditioners, smoke, and dust.  Also of note, contact lens wearers in this study reported higher rates of visual blur and visual difficulties while driving, reading, or watching television.

Other studies have demonstrated an association between computer use and dry eye disease resulting from lower blinking rates and increased tear film evaporation. It is also been shown that the presence of contact lenses further increases tear film instability with a resultant increase in tear film evaporation.

The current study's findings support previous findings that contact lens wear and longer periods of computer use play important roles in causing dry eye symptoms. The study is currently in press and will appear in an upcoming issue of the American Journal of Ophthalmology.

Tuesday, October 4, 2011

Study reveals most eye doctors discuss driving skills with senior patients

An interesting study conducted at the University of Michigan’s Kellogg Eye Center has revealed that most eyecare providers consider it their responsibility to ask patients aged 65 and older about their driving abilities, the University said in a press release. The study, led by Donald C. Musch, Ph.D., surveyed 500 ophthalmologists and optometrists in Michigan on how they evaluate the driving capabilities of senior patients. The majority of eyecare providers routinely asks senior patients about driving and often tests visual acuity and peripheral vision in these patients. Most (87%) also reported asking senior patients about glare, night driving, and the ability to read signs. However, only 8% of practitioners surveyed said they ask senior drivers about their driving records or about more challenging maneuvers such as merging or backing up. The study also found that eyecare providers often neglect to ask seniors about medical conditions or medications that might impact the ability to drive.

Eye Injury Prevention Month at Baltimore Washington Eye Center

Baltimore Washington Eye Center wishes to announce that October has been designated Eye Injury Prevention Month by the American Academy of Ophthalmology. When most people go out to mow the lawn, jump-start the car or get ready to do some spring cleaning, the last thing they think about is protecting their eyes, but it should be first on their mind. It is a good idea to think about protecting your eyes from the extraordinary damage often caused by the most ordinary of activities.

Many household chemicals, such as cleaning fluids, detergents and ammonia, are extremely hazardous and can burn the eye's delicate tissues. When using chemicals, always read instructions and labels carefully, work in a well-ventilated area and make sure spray nozzles point away from you and others before spraying. Be sure to wash your hands thoroughly after use.

Before using a lawnmower, power trimmer or edger, check for debris. Stones, twigs and other items can become dangerous projectiles shooting from the blades of a lawnmower, potentially injuring your eyes or those of innocent bystanders. Prevention is the first and most important step in avoiding serious eye injuries, so be sure to protect your eyes with appropriate protective eyewear. Please feel free to phone Baltimore Washington Eye Center Toll Free at 800.495.3937 to schedule a consultation and examination.