BALTIMORE WASHINGTON EYE CENTER EYE CARE BLOG

Age Related Macular Degeneration Awareness Month

2012-02-02T10:50:00.000-05:00

“Age Related Macular Degeneration (AMD) is the leading cause of visual impairment and blindness in Americans older than 50, affecting more than two million people. Although AMD is incurable, there are new treatments that can at a minimum prevent further vision loss from the disease and in many cases actually help recover lost vision,” commented Baltimore Ophthalmologist Brad Spagnolo, M.D.

AMD causes central vision to blur, but leaves peripheral vision intact. It is progressive and painless. There are two types of ARMD: Dry and Wet. Approximately 90 percent of people with AMD have the dry form which results in gradual vision loss. Although only 10 percent of people with ARMD have the wet form, it generally progresses much quicker than the dry form. Wet AMD is characterized by the growth of abnormal retinal blood vessels that leak blood or fluid, causing rapid and severe central vision loss.

Patients can often reduce the risk of developing ARMD by not smoking as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables,

avoiding foods with trans fats, exercising, controlling blood pressure and weight.

“We are fortunate to be able to offer Anti-Vascular Endothelial Growth Factor (VEGF) drugs that inhibit the development of unwanted blood vessels that cause wet ARMD as these agents are effective in helping to prevent further visual loss and even improve vision, said Dr. Spagnolo.

Patients older than 50 are encouraged to have a comprehensive, dilated eye examination every one to two years to ensure that ARMD is detected and treated early. The key to successful treatment is early detection and intervention. If you or someone you know is at risk for AMD please have the call Baltimore Washington Eye Center at 800-495-3937 to schedule and eye exam.

Driving Safety & Vision

2012-01-31T08:32:00.000-05:00

For many people, driving is an important part of each and every day. Doing so safely is even more important. If you have any difficulty seeing when you drive you need to be aware that there are some things you can do to maximize your vision and your safety.

Regular Eye Examinations

If you are between the ages of 40 and 65 we recommend that you have your eyes examined every two years-and more frequently if you have any family members that have sight-threatening eye conditions or problems. If you are over 65, we suggest a complete exam every 1-2 years depending on your overall health. As we get older, it is important to check for eye conditions such as glaucoma, cataracts and age related macular degeneration at more frequent intervals. Should you experience any sudden changes in your vision or begin experiencing driving problems, especially at night, then it is important to schedule an eye exam right away.

Consider Your Eyewear

Your eyewear is an important part of driving safely! Sometimes our eyeglasses get a great deal of wear and tear. Your ability to get the best vision from your eyeglass prescription depends on having eyeglasses that are clean, fit well, and are free of scuffs and scratches. Scuffs and scratches cause light to be scattered making it difficult to see, especially at night. When getting a new pair of eyeglasses, you may want to consider antireflective and scratch resistant lenses, which help to decrease glare at night and have good longevity because of their special coatings. If you are driving during particularly bright daylight hours, consider prescription sunglasses and even polarized lenses if you drive near reflected sunlight from snow or water.

Automobile Maintenance

Be sure to keep your windshield clean, your washer full and your headlights and taillights in good working order. During a routine service ask to have your headlight alignment checked to be sure they are pointing at the correct position on the road. You may want to consider carrying an extra pair of eyeglasses or sunglasses in the glove box just in case you have an emergency.

Personal Judgment

If you are driving on a long trip, take a break and give your eyes a rest. Also, the use of artificial tears at regular intervals can soothe and comfort your eyes during long car trips. Driving can be taxing. If you are venturing on a new route it may be worth avoiding traveling at dusk, night, dawn or in poor weather conditions. Let your comfort be your guide. When you visit us for your regular eye exam, please ask us about the medications you are taking and whether they can cause any difficulties with your vision. We are happy to take the time to answer your questions.

If you are having difficulty driving or feel uncomfortable with your vision for driving, please schedule an appointment by calling 800-495-3937.

Driving Safety & Vision

2012-01-31T08:28:00.000-05:00

For many people, driving is an important part of each and every day. Doing so safely is even more important. If you have any difficulty seeing when you drive you need to be aware that there are some things you can do to maximize your vision and your safety.

Regular Eye Examinations

Consider Your Eyewear

Automobile Maintenance

Personal Judgment

If you are having difficulty driving or feel uncomfortable with your vision for driving, please schedule an appointment by calling 800-495-3937.

Kids and Eye Injuries

2012-01-29T10:10:00.000-05:00

A study looking at pediatric eye injuries reveals that most of these injuries occur in the spring and summer to kids between the ages of 15 and 17. Corneal abrasion was the most common diagnosis. The most frequent cause of injury was being struck by or against an object. Interestingly, if not surprisingly, the injuries were most likely to occur at home. It is always a good idea to remind teens of the need to protect their eyes, even if they are just playing around the house.

http://www.springerlink.com/content/g4rmp6806t486tx1/

Finding the Best Cataract Surgeons in Baltimore

2012-01-26T09:45:00.000-05:00

To find the best Cataract Surgeons requires a little bit of work and investigation but is always worth it. Finding an eye surgeon who is a Cataract Specialist can help you to be confident that you are getting the most current information, thoughts and techniques to deal with your cataracts.

Ask People You Trust for a recommendation. Ask your friends, co-workers and family-but most importantly ask you primary care physician who they would go to or who they would send a parent to for cataract surgery.

Don’t Limit Yourself to Insurance Lists. Just because a Cataract Surgeon is “in network” isn’t a reason to use them if you are able to identify a top cataract surgeon you wish to go to who isn’t listed. Paying a slightly higher co-pay or deductible may be very worthwhile to get the Cataract Surgeon of your choice. If the best Cataract Surgeon in your area happens to be in the insurance list then you are all set.

Use the Power of the Internet. Take a minute to search “cataract surgeons in (insert your town/city/state)” or “best cataract surgeon in (insert your town/city/state)”. This will at least give you a starting place to begin creating a list of eye surgeons to investigate further.

Visit the Cataract Surgeon’s Web Site. Once you have compiled a list, visit their web sites

And get a feel for their practice culture and philosophy. While a web site by itself can’t tell you much about surgical skills, it can tell you about how well he or she presents information and explains detail to patients. This is important in how comfortable you may feel in that practice.

Schedule a Consultation and Meet the Cataract Surgeon. The only sure fire way to find out if you are comfortable and get a sense of trust from a cataract surgeon is to schedule a consultation and meet the surgeon personally. They should be able to clearly explain your eye health and vision as well as the cataract procedure and answer any questions you have in understandable language and terms. Whether or not you find the right cataract surgeon right off the bat it is never inappropriate to………

Get a Second Opinion. Making a decision about eye surgery is a big deal. Getting to a place where you feel confident, relaxed and comfortable is important.

If you or someone you know has a Cataract or wishes to learn more about Cataract Surgery please call Baltimore Washington Eye Center at 800-495-3937.

2012-01-26T09:40:00.001-05:00

The next time your having difficulty putting in your contacts, think about this:
http://www.rnw.nl/english/bulletin/amsterdam-elephant-gets-contact-lens.

Just a little twist on something we do practically everyday in our clinic; using a contact lens as a bandage when a patient (usually of the human kind), suffers a scratched cornea. Just placed one yesterday on a poor guy who's cat went bonkers and attacked his face. Fortunately, he'll recover and hopefully this pachyderm will as well.

Placing contact lens on elephant's scratched eye

Preventing Eye Injuries

2012-01-24T10:49:00.000-05:00

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 following link: http://www.geteyesmart.org/eyesmart/living/eye-injuries-care-treatment.cfm

Got Grapes?

2012-01-22T13:49:00.001-05:00

An interesting study has shown that eating grapes might help prevent age-related macular degeneration, or AMD. AMD is the leading cause of blindness among people 65 and older in the United States. A study published last month in Free Radical Biology and Medicine supports the notion that antioxidants, such as those in grapes, appear to be directly beneficial for retinal health and function, which should offer protection against developing AMD. http://www.sciencedirect.com/science/article/pii/S0891584911012081

Longer Fuller Eyelashes & LATISSE™

2012-01-19T09:43:00.000-05:00

LATISSE™ is an FDA approved treatment that can help you grow fuller, longer lashes. Most people who are interested in their appearance know the value of having big, bright, beautiful eyes. While eye makeup alone may be able to help you achieve a fuller and longer look for your eyelashes, LATISSE™ can actually help you grow fuller, longer eyelashes on your own! Your lashes are a big part of making your eyes more visible and adding that bright beautiful look to your appearance.

Lash enhancers have been used since ancient times to brighten the look of eyes. Today there are numerous eyelash cosmetics and treatments available to help you look your best. An option for those who want to fully benefit from these treatments is to make the most of their own natural lashes by enhancing their growth so that they are actually longer, fuller and darker.

LATISSE™ is a solution intended for use on the upper eyelid margins or the base of the eyelashes. It is a solution we can prescribe after an initial examination and consultation so that it can be determined if LATISSE™ is a good choice for you. It is important to follow your physician's instructions for LATISSE™ use. You should make your physician aware of any side effects that may occur in a small number of patients so that they can be addressed. These can include itching and redness of the eye itself, eye irritation, darkening of the skin around the eye, dryness or redness of the skin around the eye. Make sure that you keep the appointments for follow-up visits with your physician so that they can be sure you are getting the results you desire and not experiencing any of the side effects mentioned.

LATISSE™ is available from many physicians. As Board Certified Ophthalmologists at Baltimore Washington Eye Center we are eye physicians and surgeons who are specialists in understanding your eyes and the delicate tissue around your eyes including your lashes, eyelid margins, and eyelids. We are specifically trained and experienced in the examination and treatment of these of these areas for your eye health and cosmetic appearance-and we are here to help you look your best!

Cataract Surgery Recovery

2012-01-15T11:25:00.002-05:00

One of the most commonly asked questions my patients have is what is the recovery like following cataract surgery. I tell them that most folks return to their normal routine within a day, which is one of the great aspects of today's modern cataract procedure. Because we make a incredibly tiny incision on the eye to remove the cataract, there is usually very little discomfort, if any, and there is no need for stitches. Except for avoiding rubbing their eyes or getting water directly in their eyes for a couple of days, our patients routinely return to their usual activities within a day.

Cataract & Ovarian Cancer Risk

2012-01-12T16:17:00.002-05:00

There may be a relationship whereby women who develop Cataracts are less prone to developing Ovarian Cancer according to researchers. It is widely recognized that the major health benefit of exposure to Ultraviolet (UV) Radiation from the sun is the production of Vitamin D, which is helpful in protection against several human cancers, including Ovarian Carcinoma. On the other hand, Ultraviolet (UV) Radiation from the sun is a recognized risk factor for Cataract development. Researchers reporting in the November 2011 publication Cancer Epidemiology, Biomarkers & Prevention studied 709 women with primary invasive ovarian carcinoma and 1101 controls to examine the association of Ovarian Carcinoma risk with a history of Cataract. Some interesting findings were that older age, a history of Type 2 Diabetes and skin cancer were significant risk factors for developing a Cataract. Further, a history of Cataract was reported by 14% of cases and 17% of controls and was significantly associated with a reduced Ovarian Carcinoma risk. These findings add indirect evidence to the hypothesis that lifetime Vitamin D exposure may be inversely associated with risk of Ovarian Carcinoma. Additional studies are needed to further investigate the potential behavioral and biological factors that might influence association of cataract with ovarian cancer.

Near Vision Stress & Nearsightedness

2012-01-10T11:02:00.001-05:00

A perfectly seeing or emmetropic eye allows distant objects to focus clearly on the retina of the eye. A near sighted or myopic eye focuses distant light too quickly and the image of a distant target is blurred on the retina. If the object being viewed is moved closer to the eye it eventually reaches a point that allows it to be focused perfectly on the retina. This is called the patients “far point”. The more near sighted or myopic someone is the closer in to the eye you need to bring an object for it to be viewed clearly. When we “correct” a nearsighted patients vision, we place a lens in front of the eye that bends light in a way as to make distant objects focus clearly on the retina.

When we look at a near object our eye, which in its relaxed state is set to make distant objects focus on the retina, must refocus to zoom in on the near object and allow the divergent light rays coming from the near object to focus sharply on the retina. This process is called accommodation. Also when we regard near objects our eyes turn in to point at the target. Some people have poor accommodative function. Others have a tight posture so that even when the eyes are relaxed and not regarding a near target they are still slightly turned in relative to each other. This is called esophoria.

It has long been postulated that the effort and stress of near work can cause progression of myopia. For years many behavioral optometrists have recommended magnifying reading glasses or bifocals in children to slow the progression of myopia. A recent study published in April demonstrated that progressive lenses (no line bifocals) were more effective than single vision distance spectacles in school age children with accommodative insufficiency and esophoria in slowing myopic progression. Another study publish ed this fall in Survey of Ophthalmology analyzed nine different studies and found progressive lenses reduced progression of myopia compared to single vision lenses and that the effect was greater in patients with higher myopia and the outset and in patients of Asian descent.

Ask to have your child evaluated for risk factors related to near point stress at their next eye exam and see if progressive spectacle lenses can help slow down myopic progression.

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

Cataract Surgery & Lens Implant Cost

2012-01-05T12:15:00.000-05:00

The cost of Cataract Surgery and Lens implants can get a little confusing. Almost all insurances and Medicare cover the bulk of the cost of Cataract Surgery and basic Lens Implants. HOWEVER, deductibles, co-pays and the extent to which certain services are or are not covered can affect the actual amount you might need to pay out of pocket.

Preoperative Testing and Consultation

With the exception of co-pays and deductibles specific to your insurance plan the eye examination, consultation and measurements necessary for Cataract Surgery and basic Intraocular Lens (IOL) implantation are covered services. If there are specialized tests that might be required such as more precise types of testing for multifocal lens implants or toric lens implants, you may need to pay for these tests out of pocket as your insurance and Medicare may only cover the basic testing. If this is the case these extra tests may range in cost up to a few or several hundred dollars depending on the scope of the necessary testing.

Surgery Center Facility Fee

The surgery center facility fee is generally covered by insurances and Medicare although there may be a small co-pay or deductible with certain plans. This fee will cover the use of the facility including the operating room, the nursing staff, the instrumentation and equipment and all related operating room supplies. Depending on the types of anesthesia used it is possible that there will be an additional fee-mostly covered by your insurance or Medicare-for the administration of anesthesia and the staff.

Cataract Surgeon’s Fee

The Cataract Surgeon’s fee is generally covered by insurances and Medicare although there may be a small co-pay or deductible with certain plans.

Lens Implant Fee

The cost of a basic Monofocal lens implant is generally covered by insurances and Medicare within the facility fee. However, should you and your Cataract Surgeon elect to use an astigmatism correcting toric lens implant or multifocal lens implant there will be an out of pocket fee as most insurances and Medicare do not cover these more advanced types of Lens Implants.

If you or someone you know has questions about the cost of Cataract Surgery and Lens Implants please feel free to call Baltimore Washington Eye Center-800-495-3937.

Glaucoma Awareness Month in Baltimore

2012-01-03T10:06:00.000-05:00

The eye doctors and staff at Baltimore Washington Eye Center want to focus patient’s attention on Glaucoma this month as January is National Glaucoma Awareness Month. “This is an important time to spread the word about this sight-stealing disease. Our understanding of this disease along with the ways in which we can diagnose and treat it have improved considerably,” commented Baltimore Ophthalmologist Arturo Betancourt, M.D. of Baltimore Washington Eye Center.

Glaucoma is the leading cause of preventable blindness. Moreover, among African American and Latino populations, Glaucoma is the leading cause of blindness overall. Of particular note is that Glaucoma is 6 to 8 times more common in African Americans than Caucasians.

Over 4 million Americans, and nearly 70 million people worldwide, have Glaucoma. Experts estimate that half of them don’t know they have it. Combined with our aging population, we can see an epidemic of blindness looming if we don’t raise awareness about the importance of regular eye examinations to preserve vision.

The most common type of Glaucoma—Primary Open Angle Glaucoma—is hereditary. The Nottingham Glaucoma Study published in the British Journal of Ophthalmology evaluated the risk that siblings of Glaucoma patients would themselves develop Glaucoma within their lifetime. “ While we already knew that there was a strong likelihood that family members of Glaucoma patients were at greater risk, the Nottingham Study found that siblings were 5 times more likely to develop glaucoma by age 70. This is why we strongly recommend that siblings of Glaucoma patients and Glaucoma suspects be screened for Glaucoma, each and every year,” said Dr. Betancourt.

If you, a relative or someone you know is at risk for Glaucoma based on their age, heredity or health please tell them to call Baltimore Washington Eye Center at 800-495-3937 to schedule an eye exam and Glaucoma screening. Early diagnosis and treatment goes a long way to preserving eye health and vision.

2011-12-28T14:14:00.000-05:00

In order for everyone to enjoy a fun, safe and injury-free New Year's Eve, the American Academy of Ophthalmology is providing instruction on how to properly open a champagne bottle.

Make sure sparkling wine is chilled to at least 45 degrees Fahrenheit before opening. The cork of a warm bottle is more likely to pop unexpectedly.

Don’t shake the bottle. Shaking increases the speed at which the cork leaves the bottle, thereby increasing your chances of severe eye injury

To open the bottle safely, hold down the cork with the palm of your hand while removing the wire hood. Point the bottle at a 45-degree angle away from yourself and from any bystanders

Place a towel over the entire top of the bottle and grasp the cork

Keep the bottle at a 45-degree angle as you slowly and firmly twist the bottle while holding the cork to break the seal. Continue to hold the cork while twisting the bottle. Continue until the cork is almost out of the neck. Counter the force of the cork using slight downward pressure just as the cork breaks free from the bottle

Never use a corkscrew to open a bottle of champagne or sparkling wine

A cork can fly up to 50 miles per hour as it leaves the bottle, generating a force powerful enough to shatter glass. Eye-related cork injuries can lead to acute glaucoma, a detached retina, and/or corneal scarring, all of which can result in decreased vision. Follow these simple tips and have a safe and happy 2012!

Cataract surgery - What do I do after surgery?

2011-12-27T09:36:00.000-05:00

Many people know someone who has had cataract surgery. We frequently have patients who come to our ambulatory surgery center with a pre-conceived notion of how their recovery is going to limit their activities. Not so! Today, cataract surgery is performed using a small incision that will heal within a couple of days allowing patients to resume normal activities usually within one week.

After your surgery you will most likely have a patch and shield on your eye. This is because your eye has been given an anesthetic to make it numb and the shield helps to protect it from becoming irritated or dry. You will only need to wear it until late afternoon on the day of your surgery. After you take it off you will start a series of eye drops that help to prevent swelling and infection as prescribed by your doctor.

The eye shield will be worn over your eye at night for one week to help prevent possibly rubbing the eye or scratching it on your sheets. Some mild itching or discomfort may occur which is normal. It is very important that you DO NOT rub your eye! Tylenol is suggested as a pain reliever for any discomfort you may have.

On the day of surgery, when you remove the shield at home, you may find that your eyesight is still somewhat blurry or you may experience double vision. This is not unusual and is the result of a combination of the anesthetic agent and the dilating drops which were put into your eye before the surgery began. This sensation should resolve over the course of the evening.

You will be given a pair of sunglasses at your first surgery in the ambulatory surgery center. These are designed for you to be able to wear over your glasses or shield. They can still be worn after your recovery if you so desire. If you are going to have cataract surgery on the other eye, we ask that you be sure to hang onto your glasses for use after that surgery.

Following your surgery you should not bend over with your head below your waist. That is, do not try to pick up anything from the floor as this can create pressure to your newly operated eye. The bending and stooping restriction will be reevaluated at your follow up appointment with your surgeon the next day, but usually you are allowed to resume normal activities within a week.

You should refrain from any strenuous exercise or attempting to lift heavy objects that may cause you to strain or "bear down" for approximately 10 days. However, you may go up and down stairs, read or watch T.V.

When you shower do not let water into your eyes either directly or from run off your head. You may wade into a pool if you would like, but you will be asked to refrain from swimming or immersing your head under water for at least 10 days.

You should be able to drive within a day or two after your surgery, but ask your doctor for his recommendation!

You will be using eye drops for about a month after the surgery to ensure that your eye heals completely.

It is important to remember that everyone and every eye is unique and your healing time may vary.

Guest Blogger

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

The most comfortable eyewear

2011-12-26T08:20:00.001-05:00

A patient told me last week that the new Maui Jim sunglasses we recently fit him with were "the most comfortable eyeglasses" he had ever had. Looked good to boot.

Diabetic Eye Problems & Complications

2011-12-22T09:34:00.001-05:00

Over time diabetes can damage the small blood vessels of the body. This is the underlying etiology for diabetic retinopathy the most well known ocular complication of diabetes. Damage to these small blood vessels can cause bleeding on the retina, poor oxygen supply to the retina and possible retinal detachment and scarring. Evidence shows that good blood sugar control greatly reduces the risk of diabetic retinopathy and new injectable medications are effective in treating complications when they do occur.

Although diabetic retinopathy is the most well known, it is not the only ocular pathology for which diabetic patients are at risk. Because diabetes affects the blood supply it increases the risk of diseases with a vascular etiology. Retinal vein occlusions are more common in diabetic patients. Diabetic patients are also at greater risk of glaucoma and optic nerve swelling. Poor blood flow to the cranial nerves that innervate the eye muscles can increase the risk of muscle palsy in diabetics. Eye muscle palsies will manifest as sudden onset double vision. Elevated levels of blood glucose in diabetics increase the risk of cataract development.

Consistent blood sugar control long-term has been demonstrated to help decrease complications from diabetes. Yearly eye exams are a hallmark of good diabetic management. However, any unusual eye symptoms require prompt attention by your eye care provider.

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

Retinal Detachment

2011-12-20T09:33:00.000-05:00

Symptoms of retinal detachment may include the presence of increased eye floaters, light flashes (especially in peripheral vision), blurred vision, a veil or curtain blocking your vision, or a sudden dramatic decrease of vision. Patients with these symptoms should contact their eye doctor immediately and be seen for an exam the same day if possible. This type of eye problem is considered an emergency. Therefore, treatment from an eye doctor should not be delayed. The sooner a retinal detachment is diagnosed, the better the chances of saving vision.

Retinal detachment can occur for various reasons. The most common cause is a blunt or penetrating injury to the eye. However, sometimes a retina detaches on its own without an underlying cause. Additional causes of retinal detachment may include:

Spontaneously (perhaps due to an underlying anatomic abnormality)
Posterior vitreous detachment
Complication of cataract surgery
Extreme nearsightedness
Diabetes
Inflammatory disorder

Anyone can be at risk for retinal detachment since the most common cause is blunt or penetrating injury to the eye, which can occur in a variety of ways ranging from being poked in the eye with a finger or pen to being injured during an athletic event. Certain factors can increase your risk of developing retinal detachment, such as:

Age (24-45 years old)
Gender (males more common than females)
Trauma
Family history of detached retina
Myopia (nearsightedness)
Diabetic retinopathy
Retinal detachment in other eye
History of any intraocular surgery
Aphakia (absence of lens) or Pseudophakia (artificial implant after cataract surgery)
Connective tissue disorders such as Wagner’s disease
Sickle cell retinopathy
Severe retinopathy of prematurity (ROP)

Fortunately, over 90% of people who experience a detached retina are treated successfully. On occasion a second treatment is needed. However, it may take several months after the initial treatment to determine whether a second treatment is required. Since the most common cause of retinal detachment is injury to the eye, it is important to wear protective eyewear during all activities. If you participate in high impact sports such as football or hockey, make sure you wear a face mask that completely covers your eyes. If you have diabetes, control your blood sugar levels. If you are at risk for retinal detachment, avoid risk factors if possible. Always see your eye doctor at least once a year or as often as they recommend, especially if you are at risk for retinal detachment.

Dry Eye and Omega 3 and 6 Fatty Acids

2011-12-15T09:32:00.001-05:00

Dry eye is a chronic condition that occurs when the tears which naturally lubricate the ocular surface are either deficient in quantity or quality. A reduced tear film or a tear film that evaporates too quickly will result in irritated red eyes that may over water. The tear film aids the focusing of light so a poor tear film may result in blurred or variable vision. The tear film also contains proteins and enzymes that kill microbes helping to ward off infection. A compromised tear film creates an environment more prone to infection. The National eye institute of the National institutes of health states that "nearly five million Americans 50 years of age and older are estimated to have dry eye." Although new medications are available to treat this condition many of my patients over age 50 loathe to add anything new to the growing list of medications they take on a regular basis. Omega 3 and Omega 6 fatty acids, due to their anti- inflammatory properties, are showing promise in the long term treatment of chronic dry eye.

Omega 3 and 6 fatty acids can be found naturally in seafood such as salmon and anchovies. They may also be found in flax seed and walnuts. Vitamin supplements are also available. We recommend at least 2500 mg of Omega 3 and 6 fatty acids a day. Patients trying this more natural approach to dry eye therapy should commit to 3 months of consistent treatment before evaluating the efficacy of this treatment for them. Even when topical or oral medications are needed in the short term to ameliorate the symptoms of severe dry eye, omega 3 and 6 supplements may be useful in the long term management to reduce the risk of future exacerbations.

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

EyeSmart® public education website

2011-12-15T08:23:00.000-05:00

The Internet is loaded with an overwhelming amount of medical information. However, how much of what you see and read is accurate? That's why the American Academy of Ophthalmology created EyeSmart®, a public education website where you can get accurate, MD-reviewed information about a wide range of topics regarding your eyes and their health. Check it out by going to http://www.geteyesmart.org/eyesmart/

New FDA LASIK Video

2011-12-14T19:55:00.002-05:00

So the FDA has posted a brief new LASIK Video for patients. If you want even more detail and the answers to your questions about LASIK you can visit www.seewithlasik.com or if you would like more personal answers visit us at www.bweyecenter.com or call our Baltimore Washington Eye Center LVC counselor @ 410/761-8258 so we can help you.

Macular Degeneration (AMD)

2011-12-13T09:31:00.000-05:00

Macular degeneration is commonly referred to as age-related macular degeneration or AMD due its tendency to affect older adults. There are two types of macular degeneration: dry and wet. Dry Macular Degeneration occurs when small, yellowish deposits (drusen) begin accumulating beneath the macula. The drusen gradually break down the light-sensing cells within the macula. This break down leads to distorted vision in the eye.

Wet Macular Degeneration accounts for only 10 percent of all cases and occurs when abnormal blood vessels begin growing behind the retina, toward the macula. Typically, these abnormal blood vessels are tiny in size and leak blood and fluid, damaging the macula and causing severe and rapid vision loss. Wet macular degeneration is much more severe than the dry form. Fortunately, over that past few years, treatment for wet macular degeneration has significantly advanced. New medicines have been developed to slow down and stop problematic blood vessels from forming. These new medicines are also known to improve treatment, which was not the case with earlier treatment methods. The medicines used are called anti-angiogenic or anti-vascular endothelial growth factor drugs. The two most common ones are Avastin and Lucentis. The medicine is injected into the eyeball and begins taking effect immediately, although injections are typically repeated every 1 to 2 months or until the disease is stabilized.

Prevention of macular degeneration includes reducing UV exposure, not smoking, and eating healthy diets of antioxidants and zinc. Eating foods rich in Vitamins A, C and E could help reduce chances of developing this disease. To date, some studies have suggested a protective effect from lutein and zeaxanthin. In 2006, the National Eye Institute started the AREDS II study to further determine whether lutein and zeaxanthin (nutrients found in eggs and green vegetables) might indeed be protective against the disease. Exercising and keeping healthy are always good preventive methods for all diseases.

Additional ways to prevent Macular Degeneration include:

Wear sunglasses
Avoid alcohol when possible
Avoid all types of sugars when possible
Avoid excessive saturated fats and foods containing fats and oils that have been subjected to air or heat (lunch meats, hamburgers, fried foods, etc.)
Increase your consumption of legumes

For more Background on Macular Degeneration and AMD Risk Factors

Amazing Vision with Astigmatism Implants

2011-12-10T14:52:00.000-05:00

Forgot to mention a very happy patient we had this past week. She had suffered a previous retinal detachment requiring surgical repair. Subsequently, she developed a cataract. She was quite nearsighted with significant astigmatism in both eyes. She also had a smaller cataract in the eye that hadn't had a retinal surgery.

We decided to remove her cataracts and replace them with astigmatism(toric) correcting implants. We also gave her a modifed monovision, or blended vision, result. This would very likely enable her to use her computer without glasses as well as drive without glasses. Well, she is simply AMAZED at her result. One day after her second eye surgery last week, she asked "What did you do to my eye?" When I asked her what she meant, she said she not only could read the computer, she was seeing better than she had her entire life. Very satisfying moment for us to say the least. Pretty neat.

Corneal Crosslinking for Keratoconus

2011-12-10T12:36:00.002-05:00

For decades, people suffering from advanced keratoconus had few options other than corneal transplant surgery, otherwise known as Penetrating Keratoplasty (PKP). Beyond the risks posed by the surgery itself, PKP patients face many months of healing and always carry the risk of transplant rejection. Researchers have long sought a means by which keratoconus and similar diseases might be stopped or even reversed; thereby reducing the need for invasive procedures like PKP

Since the late 1990's, and especially over the past several years, there has been an increasing body of evidence suggesting that applying riboflavin (Vitamin B2) to the human cornea followed by an application of ultraviolet (UV) light can stabilize diseases like keratoconus. During this process, the UV light interacts with riboflavin to create more bonds between collagen molecules in the cornea. The increased bonds, or cross-linking, creates an increase in corneal strength.

In the US, there is an FDA phase III study underway. Hopefully, the study results will make corneal cross-linking (CXL) available to the general public before too long. While there are certain risks associated with CXL, the hope is that by treating keratoconus in its early stages, we can halt its progression, improve patients' vision, and reduce, if not eliminate, the need for PKP surgery. Eyewiki video of CXL

Intraocular Lens Implant Types

2011-12-09T10:52:00.000-05:00

Intraocular Lens Implants or IOLs 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. There are a number of types of Intraocular Lens Implants (IOL) that can be used today.

Monofocal Lens Implants (IOL) vs. Multifocal Lens Implants (IOL)

The traditional type of intraocular lenses are called Monofocal Lens Implants and are used to correct problems with distance vision leaving patients to rely on glasses or contacts for near vision. At Baltimore Washington Eye Center Drs. Betancourt and Spagnolo offer our patients Multifocal Lens Implants to help them see more clearly at a range of distances. This technology allows us to replace the eye’s natural lens with a new artificial lens that can help restore visual clarity to near, intermediate and distance vision.

Astigmatism Correcting Toric IOLs

If you have astigmatism, you may still experience blurred and distorted vision after traditional Cataract Surgery unless you wear eyeglasses because ordinary Monofocal IOLs cannot correct astigmatism. 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 and may reduce or eliminate the need for corrective lenses for seeing at a distance for those patients who had astigmatism before their Cataract Surgery.

Spherical Aberration and Cataracts

Your eyes contain some imperfections called aberrations. An aberration is an irregularity in the shape of the eye's refractive surface that can distort vision. One type of common aberration is spherical aberration. Spherical aberrations are generally associated with:

Blurriness
Halos
Loss of contrast
Poor night vision

Drs. Betancourt and Spagnolo often implant an Aspheric Lens Implant designed to reduce spherical aberration and improve contrast sensitivity in order to help patients see better in low contrast environments such as for driving in dim illumination or during rainy, foggy times. Aspheric Lens Implants offer these advantages over traditional lens implants and some can even correct astigmatism.

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.

Contact Lens-The EYE App Technology Advances

2011-12-06T10:26:00.000-05:00

Advances in contact lens design have made lenses healthier, more comfortable and able to correct a wider array of vision problems. However, have you ever considered the other ways contact lenses can be used that have nothing to do with correcting vision?

For years contact lenses have been used to aid in the healing of corneal abrasions. Scratches on the surface of the eye will often heal on its own. However, every blink causes discomfort as the lid rubs over the abraded area. Additionally the mechanical force of the lid on the surface of the eye can make it more difficult for new cells to fill the area of the abrasion. Inserting a contact lens acts as a bandage protecting the delicate surface as it heals and improving patient comfort during the healing process.

Glaucoma is a complex disease whose etiology is a matter of debate. Although once thought to be the hallmark of glaucoma, elevated eye pressure is now known to be just one of the risk factors for this disease. As a matter of fact, some people with glaucoma never have a pressure outside of the normal range and some patients being treated for glaucoma with pressure lowering drops seem to progress in their disease despite having pressures measured in the office at adequate levels. The pressure reading done in the doctor’s office is merely a momentary snapshot of a dynamic pressure reading that likely fluctuates through the day and night. Sensimed, a Swiss company, has developed the Triggerfish electronic contact lens that can measure and record eye pressure readings for an entire day. This new information will likely prove invaluable for scientists as they strive to understand the true role of intraocular pressure in the diagnosis and management of glaucoma.

Delivering medications to the eye and having them absorbed effectively has always been a challenge. It has been estimated that "approximately 95% of the drug contained in the drops is lost due to absorption through the conjunctiva or through the tear drainage.” Contact lenses impregnated with drugs have been used since the 1960s. However, the goal of continuous consistent sustained release of medication was difficult to achieve. Recent advances in contact lens materials and nano particle technology may make a commercially viable product a reality. An article reviewing the current state of these technologies notes that "The use of soft contact lenses for therapeutic drug delivery may correct three inherent deficiencies seen with the typical administration of eye drops into the eye: (i) the contact time of drug with the precorneal tear film may be longer; (ii) compliance as compared to frequent and complicated dosage regimens may be improved; and (iii) less systematic toxicity may be expected because of the total amount of drug administered compared to multidrops”.

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

Sinus Problems and Vision Loss

2011-12-01T08:35:00.000-05:00

We had an interesting case present to the eye clinic at Baltimore Washington Eye Center recently. The case involved a patient complaining of a blurred area in the vision of their right eye. The visual acuity was normal. However, while the patient did not complain of bulging eyes, upon exam it was clear that the right eye was protruding compared to the left eye. Furthermore, the right optic nerve was swollen. The diagnosis was made following an MRI of the head and orbits. The patient’s condition turned out to be the result of sinus condition called a mucocele.

Mucoceles are cyst-like, expanding masses found in the sinus cavities. Mucoceles are most commonly found in the frontal sinus, with the ethmoid and sphenoid sinuses involved less frequently. The most common causes of mucoceles are chronic infection, allergic rhinitis, trauma, and previous surgery. Depending upon its location, a mucocele can cause a variety of symptoms including orbital pain, decreased visual acuity, visual field defects, exophthalmos (bulging eye), and problems with eye movement. Fortunately, mucoceles affecting the eye(s) are rare and when they do occur, endoscopic sinus surgery is an effective treatment for sinus mucoceles with a favorable long-term outcome. Our patient was referred to an Ear, Nose, and Throat specialist for surgical treatment. Here are several articles furthers detailing sinus mucoceles and the eye.

Malignant Eyelid Lumps and Bumps-What are They?

2011-11-29T08:43:00.002-05:00

Here are definitions/descriptions of some of the most common eyelid cancers

· Basal Cell Carcinoma-This is the most common skin cancer found on the eyelid. It is seen most often in people with fair skin who have a history of significant sun exposure. It can occur on the upper or lower eyelid. Basal cell lesions usually appear relatively well defined, often with pearly edges and small blood vessels overlying it. Sometimes, depending on the location of the lesion, people will notice a loss in lashes in the same area. Most of the time, this is a very slow growing malignancy that is present for months before it is recognized. It rarely spreads to other parts of the body, but it does require removal and biopsy. The extent of the tumor may be larger than it appears on the surface and a biopsy allows the pathologist to look for abnormal cells at a microscopic level so ensure that the tumor has been completely resected.

· Squamous Cell Carcinoma-This is the second most common type of eyelid skin cancer. It is also found more often in patients with fair skin and a history of sun exposure and is usually found on the lower lid, but can occur on the upper. Fortunately, it is a relatively slow growing cancer. It does, however, have the potential to invade the surrounding tissue, as well as metastasize and spread. Squamous cell lesions appear flat or slightly elevated and are red and scaly; sometimes early lesions can present like a papilloma. The treatment is surgical, but this cancer often has microscopic spread, so the excision can be wider than with basal cell and often is done in collaboration with a dermatologist specializing in this type of surgery.

· Melanoma-This is a rare form of eyelid skin cancer. The lesions are often tan, black or gray with irregular edges and can be rapidly growing. It is the most lethal of the skin cancers, but fortunately, it is rare, accounting for <1% of all eyelid cancers. The prognosis depends on the size of the lesion, the depth of growth, and the microscopic cell type. Treatment is excision and biopsy and dermatologic evaluation for lesions elsewhere on the body.

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

Bladder Cancer and Eye Disease?

2011-11-25T10:15:00.001-05:00

A fascinating bit of research news out of New Orleans. Research conducted by Dr. Jayne S. Weiss, Chair of the Department of Ophthalmology at LSU Health Sciences, and colleagues has found that a defect in a gene involved in Schnyder's dystrophy, a rare disease of the cornea, also contributes to the progression of invasive bladder cancer. The findings are published in the November 2011 issue of the journal, DNA and Cell Biology.
http://www.liebertonline.com/toc/dna/30/11

Dr. Weiss remarks, "Research like this helps us target new treatment or prevention approaches for many seemingly unrelated diseases. She goes on to say, "Discovering a new component of the dynamic cellular cholesterol regulatory network gives us information that can be applied to every disease arising from a defect in it. Besides Schnyder's corneal dystrophy, this includes many types of cancer."

FLEX for LASIK

2011-11-25T09:08:00.000-05:00

The end of the year is fast approaching. As you know, those Flex Spending Accounts, or FSAs, need to be used or the benefits are lost. Were you aware that LASIK costs 30% less if you use your Flexible Spending Account this year? That's right, because beginning in January 2013 FSA benefits change. Currently, there is no federally imposed limit on FSA amounts. After December 31, 2012, FSA accounts will be capped at $2,500 by the federal government.

If you are planning a big elective medical or dental procedure — like LASIK, braces or long-needed tooth implants or caps — you may want to schedule these treatments while you can still pay for a big chunk of the out-of-pocket expenses with pretax dollars.

Stye Alert! Help to Get Rid of a Stye!

2011-11-22T10:43:00.000-05:00

A stye (also referred to as a chalazion) is a sometimes painful nodule that can develop in the upper or lower eyelids. It is caused by a blockage in the oil glands of the lids. This can occur when people have thick oil and inflammation in their glands, a condition known as meibomian gland dysfunction. When the oil glands get blocked, the resulting stagnant oil is a nidus for infection and once infected, the area becomes red, swollen and often tender. Sometimes these resolve on their own with hot compresses. Other times, there can be a fluctuating in the size of the chalazion where it can grow in size and will then start to get smaller until all you are left with is a small bump that is not painful, but that is not changing or resolving. The chalazion may get smaller if it "pops" and some of the infected/inflammatory tissue has a chance to get out. However, when the chalazion reaches a chronic stage where it is not changing, it has likely walled itself off from the body and the only way to treat it is to incise it to release the inflammatory tissue. At this stage, there is no active infection, but rather chronic inflammation.

At the onset of a stye or chalazion, the best treatment is hot compresses for 5 min at a time at least twice a day. In addition, you may be prescribed and antibiotic/anti-inflammatory ointment to help treat the infection and this oftentimes alleviates the need for a procedure. However, if after 2 weeks of this conservative treatment, there has not been a resolution of the chalazion, the best option is to incise and drain the lesion. This is done by anesthetizing the eyelid, making an incision from the inside of the lid, and excising the inflammatory tissue. This gives the body's immune system a chance to get to the source of the inflammation and help it heal.

If you think you have a stye the best course of action is to see an Ophthalmologist who can accurately diagnose you and start you on the appropriate treatment. Feel free to phone Baltimore Washington Eye Center at 800-495-3937.

Guest Blogger: D. Chimene Richa, M.D., Ophthalmologist and Oculofacial Surgeon with the Baltimore Washington Eye Center

Lucentis for Diabetic Eye Disease

2011-11-17T10:40:00.000-05:00

The anti-vascular endothelial growth factor (VEGF) drug Lucentis has been reported to provide positive results when used to treat Diabetic Macular Edema (DME) a cause of significant vision loss in patients with diabetes. Patients with Diabetic Retinopathy in the form of DME who received the drug experienced rapid and sustained improvement in vision compared to those who received a placebo injection.

Diabetic Macular Edema or DME is the swelling of retina in people with diabetic eye disease called diabetic retinopathy, which causes damage to the blood vessels of retina. The DME patients suffers fluid leak from the damaged blood vessel to the central portion of retina, causing it to swell leading to blurred vision, severe vision loss and blindness.

Of the 26 million U.S. people with diabetes, a portion of up to 10 percent tends to develop DME during their lifetime, and up to 75,000 new cases of DME are estimated to develop each year. Currently, DME patients are treated with laser surgery that helps seal the leaky blood vessels to slow the leakage of fluid and reduce the amount of fluid in the retina.

Lucentis is approved for use by the U.S. Food & Drug Administration (FDA) for the treatment of “Wet” Age-Related Macular Degeneration (AMD) and for Macular Edema following Retinal Vein Occlusion. In 2011, Lucentis was approved for treatment of visual impairment due to DME in Europe.

The key to successful treatment of Diabetic Retinopathy is early detection and intervention. If you or someone you know has diabetes or is even prediabetic please feel free to schedule a Diabetic Eye Examination at Baltimore Washington Eye Center by phoning us at 800-495-3937.

Droopy Eyelids-Help, I Can Barely Open My Eyes!

2011-11-15T11:50:00.000-05:00

Some people have eyelids that droop so much that they can barely see and they need to use their brow to help raise their lids or even pick their chin up so that they can see better. I often hear the complaint "People always ask me if I'm tired" or "My husband thinks I am asleep." Sometimes people work so hard to keep their lids lifted that they get headaches as a result. This drop in the height of the upper eyelid, also known as ptosis (pronounced TO-sis), is very different from the excess eyelid skin, medically referred to as dermatochalasis.

There are different causes of ptosis, but the most common is involutional ptosis caused by aging. As we age, the muscle tendon that attaches to the firm part of the upper eyelid (known as the tarsal plate) starts to lose its strength. It pulls away from its normal anatomic attachment, which weakens its ability to raise the upper eyelid. As a result, patients see a higher eyelid crease and an upper eyelid that comes down and covers some or their entire pupil, blocking part of their vision. In order to raise the upper lid, surgery is performed to reattach the muscle that elevated the lid (the levator muscle) to the tarsal plate. This is done by making a skin incision in the upper lid along the eyelid crease and then dissecting down into the substance of the lid to find the levator and sew it back to its proper position on the tarsal plate. Then the skin incision is closed using dissolvable sutures.

Another not uncommon cause of ptosis is congenital ptosis; this is generally present in childhood and results from a poor development of the levator muscle and it is too weak to lift the lid properly so it stays droopy. Surgery in these cases is different than that for involutional ptosis and is typically performed by a pediatric ophthalmologist. Lid lesions, eyelid swelling, trauma, among other things are common causes of mechanical ptosis; this means that there is something in or on the upper lid that is weighing it down. In these situations, the treatment actually consists of treating the cause of whatever is pushing the lid down, rather than treating the muscle of the upper lid.

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

Guest Blogger: D. Chimene Richa, M.D., Ophthalmologist and Oculofacial Surgeon with the Baltimore Washington Eye Center

FLEX for LASIK

2011-11-14T09:43:00.002-05:00

The end of the year is fast approaching. As you know, those Flex Spending Accounts, or FSAs, need to be used or the benefits are lost. Were you aware that LASIK costs 30% less if you use your Flexible Spending Account this year? That's right, because beginning in January 2013 FSA benefits change. Currently, there is no federally imposed limit on FSA amounts. After December 31, 2012, FSA accounts will be capped at $2,500 by the federal government.

If you are planning a big elective medical or dental procedure — like LASIK, braces or long-needed tooth implants or caps — you may want to schedule these treatments while you can still pay for a big chunk of the out-of-pocket expenses with pretax dollars.

Take a Moment for Our Veterans

2011-11-11T10:02:00.000-05:00

We want to take a moment to thank all the men and women and their families in our Armed Forces around the world for keeping us safe. Your sacrifices in service to our country are very much appreciated.

Do BOTOX® or Dysport® Prevent Wrinkles?

2011-11-10T08:55:00.000-05:00

Botox® and Dysport® are in a class of molecules referred to as neuromodulators. They are both purified toxin from the bacterium Clostridium botulinum and they differ only in their carrier proteins and are made by different companies. Because of the different proteins, the dosing is different between the two products, but they both work very well and via the same mechanism. Neuromodulators act by preventing the release of Acetylcholine, a chemical that is released in response to a nerve stimulating a muscle. The Acetylcholine is what triggers the contraction or movement of the muscle. Therefore, by stopping the release of Acetylcholine, we can prevent the contraction of certain muscles such as the muscles in the brow that cause the "11" lines.

So what does muscle contraction have to do with wrinkles? There are certain wrinkles, known as dynamic wrinkles that are only present when a muscle contracts and these are ideal to treatment with neuromodulators.

These dynamic wrinkles are caused by repeated movement of the muscle, which then pulls and creases the skin. Years of performing the same movement leads to the formation of wrinkles. By relaxing the muscle and stopping its contraction, the skin is also allowed to relax and the crease can fade and, in many cases, disappear. The effects can last up to 3-4 months. However, performing repeated injections every 3 months can actually have longer lasting effects and longtime users of neuromodulators can notice effects for more than 3-4 months.

So the answer to whether Botox®/Dysport® can prevent wrinkles is...sort of. They do not prevent wrinkles, but if injections are started before deep creases form and are done regularly, then the muscle spends less time contracting and pulling on the skin, which gives you smoother, younger looking skin.

BOTOX® Cosmetic marks owned by Allergan, Inc.

Dysport® is owned by Medicis Aesthetics.

Guest Blogger: D. Chimene Richa, M.D., Ophthalmologist and Oculofacial Surgeon with the Baltimore Washington Eye Center

Benign Eyelid Lumps and Bumps-What Are They?

2011-11-08T08:55:00.000-05:00

Here are descriptions/definitions of some of the eyelid lumps and bumps that are seen most often.

· Chalazion- also referred to as a "stye"- this is chronic inflammation that is caused by a clogged oil gland in the eyelid. These can be single or multiple and can occur in both upper and lower eyelids. Chalazia can affect vision if they grow large enough to cause the lid to droop over the eye. The treatment is initially hot compresses, but if that fails they oftentimes require surgery.

· Hordeolum- also referred to as a "stye"- this is the earlier stages of a chalazion where the clogged oil gland is actively infected and is swollen, red, and tender. These may resolve on their own or may need local antibiotic treatment along with hot compresses.

· Cysts- small fluid filled sacs; these can become infected, but this is not common. They usually grow slowly. If they contain clear fluid, they appear translucent; if they contain proteinaceous fluid, they can appear white or yellowish. Cysts can affect your vision if they grow large enough and rub the eye. The treatment is surgical, but the cysts can sometimes recur after removal.

· Papillomas- painless pink or skin colored bumps; if they grow on the eyelid margin, they can rub the eye and be irritating. Most are benign, but if there is a suspicious growth pattern, they can be a sign of an early skin cancer. Treatment is surgical and biopsies can be sent if there is high suspicion for malignancy.

· Xanthelasma- painless raised yellow plaques on the eyelids and on the surrounding skin; these are often associated with age, but can occasionally be a sign of a systemic condition, such as high cholesterol or primary biliary cirrhosis. Excision of the lesions is not recommended unless they are very small because they cannot be removed without also removing the overlying skin, which could potentially leave a cosmetically unappealing scar.

· Milia- pinpoint, nontender white lesions on the eyelids or surrounding skin that are often mistaken for acne; however, these lesions are not inflamed nor do they contain pus. They are actually small cysts filled with proteinaceous material and dead skin cells that appears just under the skin. They can be present in people of all ages, from newborns to the elderly. The treatment, usually for cosmetic reasons, is surgical.

Guest Blogger: D. Chimene Richa, M.D., Ophthalmologist and Oculofacial Surgeon with the Baltimore Washington Eye Center

Contact Lens-Critical Care and Cleaning

2011-11-03T11:49:00.000-04:00

It happened again. One of our contact lens patients came in for an emergency visit with an uncomfortable red eye that was sensitive to even moderate light. The patient had developed a corneal ulcer, a painful, possibly infectious condition that required aggressive therapy with drops, frequent follow up and ... Discontinuation of contact lens wear! No one who loves the convenience of their contact lenses ever wants to hear that. So what can you do to decrease the chances of having a similar problem?

Do not sleep in your contact lenses. Even the new generation of silicone hydrogel lenses, which let an enormous amount of oxygen in them, have an increased risk of corneal infection with extended wear contact lenses.

Wash hands thoroughly and dry completely before handling contact lenses. We all know that many germs are spread through hand to hand contact, so good hand washing greatly reduces the risk of introducing these pathogens to the eye. What most people do not realize is that some pretty nasty germs can live in tap water and completely drying your hands is critical to protecting your eyes and contact lenses.

For the same reason, never shower or swim in contact lenses. Acanthamoeba a Protozoa found in tap water and standing water like lakes can cause a severe infection that is very difficult to treat and may result in permanent scarring requiring corneal transplant.

Always rub your lenses gently with your disinfecting solution before rinsing and soaking. Debris left on lenses creates places for germs to cling and hide making it much harder for the disinfecting solution to do its job. A recent study showed a significant decrease in debris after rubbing contact lenses even when using “No Rub" cleaning systems.

When infections related to contact lens wear do develop, the offending organism is very often cultured from the patient's contact lens case. Cleaning contact lens cases thoroughly and replacing them often can help eliminate this potential source of infection.

Remember, even with every precaution problems may still occur. A contact lens wearer with a red eye should seek care for their eye care practitioner within 24 hrs of developing symptoms.

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

Diabetic Eye Disease Month at Baltimore Washington Eye Center

2011-11-01T09:13:00.000-04:00

Baltimore Washington Eye Center wishes to announce that Prevent Blindness America has designated November as National Diabetic Eye Disease Awareness Month. This is an important time to spread the word about this potentially blinding disease. We need to work to help patients avoid the complications of diabetic retinopathy, which blinds over 8,000 Americans each year. The vision loss from diabetic retinopathy can be prevented if it's caught and treated in time. A recent study found that more than one third of those diagnosed with diabetes do not adhere to vision care guidelines recommending a dilated eye exam every year.

As part of Diabetic Eye Disease Awareness Month we are urging people with diabetes to have a dilated eye exam every year. The longer a person has diabetes, the greater his or her risk for developing diabetic retinopathy. However, diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease.

Patients can help to reduce the risk of developing diabetic eye disease by not smoking, controlling their cholesterol and lipid profile and blood pressure, as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables and exercising.

The key to successful treatment of diabetic retinopathy is early detection and intervention. If you or someone you know has diabetes or is even prediabetic please feel free to schedule a diabetic eye examination at Baltimore Washington Eye Center by calling us Toll Free at 800-495-3937.

Eye Twitch-Help, My Eye is Twitching!

2011-10-27T12:49:00.000-04:00

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 happens....an 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?!"

Guest Blogger: D. Chimene Richa, M.D., Ophthalmologist and Oculofacial Surgeon with the Baltimore Washington Eye Center

Vitamin and Mineral Supplements and Your Eyes

2011-10-25T08:50:00.002-04:00

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.

The Optical Department-One Size Does NOT Fit All

2011-10-20T10:41:00.000-04:00

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

Contact Lenses as Drug Delivery Devices?

2011-10-18T09:04:00.000-04:00

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.

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