Restasis and Dry Eye

It's hard to believe, but if our math is correct the magnificent Dry Eye medicine Restasis is going to be 10 years old this year! It's hard to imagine any more how terribly difficult it was to treat severe forms of dry eye before the introduction of Restasis.

Dry Eye takes many forms, has multiple causes, and produces many different types of symptoms. Restasis has turned out to be a brilliant treatment for the inflammation that underlies a common cause of Dry Eye, not producing enough tears. Whether the inflammation comes first and causes the dryness or vice versa, a vicious cycle begins where one cause the other. Chronic Restasis use unwinds this vicious cycle and revs up a virtuous cycle.

Dr. White at the Dr. Whiteboard - Video

At Skyvision Centers we have taught our Cleveland patients for years that if Restasis is effective one must continue to take it in order to feel well. Thankfully, once it starts to work Restasis is a really easy eyedrop to use. Deciding what type of Dry Eye you might have and then determining what the best treatment will be is one of our strengths!

As an accredited Dry Eye center, SkyVision will help you to determine the best treatment for your Dry Eye symptoms.

A Patient-Centered Approach To Eye Emergencies

                                 

We all have an occasional medical emergency. What happens in Cleveland when you have an eye emergency? What does "same day appointments" mean, the ones that you see on the big billboards around our town? Well, here's what it means if you are a Skyvision Centers patient: you are seen by a Skyvision Centers doctor in the Skyvision Center office you know and love RIGHT AWAY!


                               
It's very hard to know as a patient what is and what really isn't a true emergency. The staff members who answer our phones have been trained to ask you important questions to determine if you have the kind of emergency that requires you to come in on the day you have called. Curtains or shades coming over your vision? Come right in. Pain in the eye that is new and just won't go away? How fast can you get here?

How about nights and weekends? Yup...then too! Dr. White was out of town this weekend and he received a call on his personal cell phone from a patient with a family eye emergency. They were told to come right in. If you have an eye emergency at night or on the weekend a Skyvision Center eye doctor will see you even then.

If it seems like your problem is urgent but not an emergency our staff will discuss the timing of your visit, especially if we or you are very busy that day and we are trying to avoid a big wait for you. But in the end, a patient-centered approach to eye emergencies, the SKYVISION CENTERS APPROACH, is that if you are very concerned about your new eye problem we will find a way to see you that day. That's what Patient-Centered Medicine means at Skyvision.

Do you think that's what they mean on all those billboards around Cleveland?

Macular Degeneration and the iPad

Consumer electronics are making inroads into eyecare! Patients with Macular Degeneration (AMD) now have the option of using electronic devices like the iPad from Apple to assist them in using the vision that they still have, and also to help monitor the progress of their disease.

Traditionally individuals with vision loss have had to use specialty visual aids in order to improve their vision. Magnifiers and CCTV's have been a godsend for folks who have trouble reading because of AMD. Many of these devices are difficult to use or very expensive. About 3 years ago the doctors at Skyvision Centers in Westlake, just outside of Cleveland, started to experiment with electronic reading devices like the Kindle, the Sony Reader, the Nook, and then the iPad. All four have the ability to magnify reading material, and nowadays you have access to not only books but also magazines and newspapers on all of them.

The iPad 2 from Apple is now equipped with a camera. Programs called "apps" are coming out which should allow you to scan a written page or picture and then magnify it automatically on the iPad screen. In upcoming posts we will do reviews of these apps as well as offer some tips on their use.

The SightBook app is a tool that allows patients to evaluate their vision at home and share that information with their eye doctor. A series of up close vision tests is taken by a patient using an iPad connected to the internet. Any changes will then be sent to the eye doctor. This is a free app available through the iTunes store. We'll check it out and report back soon!

Skyvision's New App - Skyvision Staff Getting In On The Fun!

Ok, so you're trying to reach your eye doctor to make an appointment or order some contact lenses. How do you do it? Phone book? Yellow pages? Google? Well, if you have an iPhone or a smartphone with the Android software (like a Droid, for example) now there's an easy way to do that, at least if you are trying to reach Skyvision Centers in Cleveland.

There's an APP for that!

The Skyvision Staff has some fun with the new app!

That's right!  Go to the Apple App store or the Google Android Market and download a FREE App for Skyvision that will allow you to contact us through your phone (without making a call!) to schedule an appointment, get a medicine refill, or ask a medical or billing question. All right from your smartphone!

We know you love your phone, and that it's convenient to do as much as possible without making a call or heading to a computer, so we've come up with a way for you to take care of all of your eyecare needs RIGHT FROM YOUR PHONE.
Yup...that's right...There's a Skyvision App for that!

Patient Education Comes in Many Forms at Skyvision

We are committed to our patients here at Skyvision and part of that committment includes their education.   Education here at Skyvision comes in many forms.   In could be through face to face communication with one or more of our experienced staff members, or it could be through some take home literature we feel will help give you more information or help you share with a family member.   Another way we communicate is through the use of educational videos.  

Skyvision also uses videos in several ways. We show videos to our patients in our exam rooms through the use of LUMA by Eyemaginations. We also send home videos by Eyemaginations via email so patients and family members can view them together in the comfort of their own home.  This type of visual education has proven extremely effective.

Let's take a disease such as Macular Degeneration. If a patient needs to be started on supplements or see our retina specialist, it is much easier for the patient to understand after viewing the animation that explains the disease process. This creates a big “wow” factor for patients because it shows that we are technologically savvy while at the same time making it easier for them to understand their disease.

Our very own Dr. Darrell White has made many, many educational videos in a casual and entertaining setting titled The Doctor Whiteboard. His very latest videos "just out" from The Doctor Whiteboard are a series of 6 videos about Macular Degeneration. The Doctor Whiteboard videos are frequently posted to Skyvision Centers on facebook or are available on SkyvisionCenters105 - YouTube .

We are always striving to provide our patients with the latest information regarding their eye conditions or interests in a variety of ways!

How Do We Diagnose Dry Eye?

So you've come to Skyvision Centers with red, burning or tearing eyes. Your vision gets blurry when you look at a computer. You always feels like there's something in your eyes.   How do we know it's from Dry Eye? How do we make the diagnosis?

Well, the very first thing we do is LISTEN to you! We try very hard to hear what it is that's bothering you. After that there are several tests that the technicians and doctors do to evaluate your tears, like examining your tears themselves. Both the doctors and the technicians look at your tears. Do you have a normal amount present just on viewing? Are they clear? Is there any debris, stuff like mucous or clumps of white blood cells present?

Before we put anything into your eyes we will often use a special instrument called an osmometer to check your tear OSMOLARITY, how salty your tears are. This is a very new, fully FDA approved test to evaluate whether you have a normal amount of salt in your tears. Normal is below 300 and abnormal is above 308, with the 300-308 range being relatively non-diagnostic. This test is very helpful in determining whether or not you have the most common type of Dry Eye, especially when other signs are hard to see.

The doctor will then put a vegetable-base dye called FLUORESCEIN into your tears to evaluate their function. How long does it take before they "break up"? Tears should remain smooth over the front of the eye for at least 8-10 seconds. Does any part of the front of the eye become stained by the flourescein? Dye staining is a sign that your tears do not work well enough. Finally, tiny strips of filter paper may be placed just inside your eyelids for a test of your tear production called a SCHIRMER test. This helps us know the volume of tear production.

That's how we do it! Lots of work to make the diagnosis, but heck...you're worth it! Look for more information on how we TREAT Dry Eye.  

For even more information about Dry Eye,  visit our YouTube channel   Skyvisioncenters105   for many Dry Eye videos by our very own Dr. Darrell White at The Dr. Whiteboard.

What Is Astigmatism?

What is Astigmatism? It's a funny word, isn't it? Lots of people think the word is "stigmatism" and that you have "a stigmatism". That of course means that you could have one or more "stigmatisms", but that's not really how it works!

Astigmatism is an optical term that relates to how an optical system focuses, or doesn't focus, light. In our situation the optical system is the eye! There are three different parts of the eye that make up the focusing elements of our vision system: the TEAR FILM that sits on the very surface of the eye (that's why Dry Eye causes vision problems!), the CORNEA or window to the eye, and the LENS that sits in back of the pupil. Astigmatism is present when the combination of these pieces parts creates two or more focused images from a beam of light.

Most of the time astigmatism is caused by the shape of the CORNEA. In a normal eye, one without astigmatism, the cornea is like the front of a sphere; it's round like a basketball or a soccer ball. A cornea that has astigmatism is longer in one direction than the other. It's STEEPER in one direction and FLATTER in the other. In other words the astigmatic cornea is shaped like a football instead of a basketball.

Whether you are nearsighted or farsighted, if you have astigmatism you will have at least two images focused in the eye. There are lots of ways to correct this, and we'll talk about all of them as time goes on. Be sure to check here, and watch for the Dr. Whiteboard videos on the SkyVision Centers Youtube channel SkyVisionCenters105 for more info on ASTIGMATISM

We are OK With Our Patients Talking Behind Our Backs!

We have been told growing up that it is not nice to talk behind someone's back.   Well, here at SkyVision,  it would not have grown so well if people had not done just that!

So, we are thankful that we have been able to give great eye care to individuals and families and that people are talking about it. 

A big thank you to those of you have done the talking!

Diabetes and the Eye

The occurrence of Diabetes is rapidly increasing in the United States. It has been estimated that there will be more than 30 Million diabetics in the U.S. by 2030, and there are presently 23 Million. In addition, another 57 million people are considered to have prediabetes, meaning that their blood sugar is not normal but not quite abnormal enough to make a diagnosis. Diabetes has many complications associated with it like increased heart disease, stroke risk, and a loss of sensation in your limbs causing difficulty walking. Here at Skyvision, of course, we are engaged every day in the fight against blindness caused by Diabetes.

Diabetes remains a major cause of blindness in all age groups. Diabetic retinopathy consists of abnormal blood vessels which occur where they do not belong. In time these blood vessels can leak causing swelling. The also break and bleed, sometimes filling the eye up with blood. The bleeding often causes a kind of scarring which can lead to a retinal detachment. The most effective treatment is to PREVENT DIABETIC RETINOPATHY from ever happening. Once it occurs, the treatment of all types of diabetic retinopathy is much more successful if it starts early.

Do you have diabetes? If so, what can you do to prevent yourself from going blind? There are two well-studied things you should do. First, and this is really easy, make sure you have an eye exam every year. This exam should include eyedrops that dilate your pupil. Your eye doctor should then explain any findings, and a letter should be sent to your diabetes doctor.

The other thing you can do is keep your diabetes under control! The measurements that are the most important are your morning fasting sugar level, and your Hemoglobin A1c (HbA1c). The safest levels according to the most recent research are a fasting sugar of 100 or below, and an HbA1c or 6.0 or lower. Your risk of diabetic retinopathy goes up by a factor of 2.5--it more than doubles--if your fasting sugars are over 108. The same holds true for your HbA1c: your risk more than doubles with a value of 6.5 rather than 6.0.

Do you have diabetes? Get an annual eye exam. Know your morning fasting sugar levels. Ask your doctor what your Hemoglobin A1c is. You CAN prevent diabetic retinopathy!

How Often For Eye Exams?

Dr. White came back to the office the other day after a dentist appointment. Apparently the dentist was unhappy with our good Doctor. It seems that it had been a little more than a year since Dr. White had been in to have his teeth checked, and the dentist said it should be every 6 months. That got us to thinking: how often should you have your eyes checked?

Every infant has an eye exam performed by a pediatrician before leaving the hospital. This exam rules out any major, obvious problems that can be visible at birth. From that time on a child is examined during well-baby and well-child checks by the pediatrician. In the United States almost all schools test vision at some time around the beginning of first grade and then every few years after that.

While this is wonderful for screening purposes, the doctors at Skyvision Centers feel very strongly that EVERY child should have a complete eye exam performed by an eye doctor, either an ophthalmologist or an optometrist, before starting kindergarten or first grade. If there is a history of eye problems like amblyopia (lazy eye) in the family, an exam at age three should be performed. Children without any eye problems who do not need to wear glasses should then be examined at school junctures: grade school to middle school, middle school to high school, high school to college.

Every day we see an adult who hasn't had an eye exam since leaving high school! Adults under the age of 40 should have a complete exam at least every 4 or 5 years. At the age of 40 there are some eye diseases and problems that start to develop that don't have any symptoms. We suggest that adults between 40 and 60 get an exam every 2 years. After age 60 EVERYONE should have a complete exam every year!

So there you have it, a roadmap to healthy eyes over your lifetime, courtesy of Skyvision Centers and Dr. White's dentist!

The Wonders of Cataract Surgery!

Skyvision Centers in Westlake is Cleveland's leading eyecare center for advanced cataract surgery! Does someone in your family have cataracts? Have YOU been told that you have cataracts? Cataract surgery is the single most frequently performed operation in the United States. It is among the safest and most successful surgeries there is. A recent article in a medical journal found that 98.2% of patients surveyed in a study were satisfied with their results and their medical management with their cataract surgery!

Cataract surgery is very gentle surgery. Our surgeon, Dr. Darrell White, does your surgery with you awake with just a little bit of sedation; this is safer for you medically and actually better for Dr. White, too. The surgery itself is typically pain free and you go home very shortly after the operation is over. A few eyedrops each day and a very few minor restrictions on your activity for a little bit are all that is usually involved afterwards.

You even have some choices with your cataract surgery. You can choose when you will have to wear glasses after the surgery with your choice of lens implants or IOL's. If you choose one of our advanced Lifestyle IOL's for both sharp distance vision and reading vision you might NOT WEAR GLASSES AT ALL!

So if you or someone you know in the Cleveland area has been told that they have cataracts give us a call at Skyvision Centers in Weslake for COMPLETE CATARACT CARE!