A New Test For Pinkeye

It's Pinkeye season in Cleveland! Well, it's pretty much ALWAYS Pinkeye season around here, or so it seems. Pinkeye, or conjunctivitis, is an infection of the front of the eye. It is caused by either a bacteria or a virus and causes things like discomfort, discharge, and a drop in your vision. It's called Pinkeye because the most obvious symptom is a red eye! (No, we're not going to post an icky picture of Pinkeye here). While it's easy to diagnose conjunctivitis, it's not necessarily all that easy to diagnose what caused it.

Until now!

We are putting in place a new protocol to diagnose the underlying cause of some cases of infectious conjunctivitis. Using the Adeno+ from RPS we can now identify whether a case of Pinkeye is caused by the most common viral cause with an accuracy of greater than 90%. A quick sample is taken of your tears and 10 minutes later we get a result that tells us if your conjuctivitis is caused by an adenovirus.

This is especially important now that we have a medicine which appears to be effective against some of the viruses that cause conjunctivitis. If we are able to show that your Pinkeye is caused by a virus we will be able to prescribe a medicine that is more targeted to your case and save you from using an antibiotic (used for bacterial infections) that you do not need. We will still prescribe any additional medicines that may be necessary to improve your comfort as your infection is treated.

One more way that we are bringing the latest and most advanced care for even the oldest and most common problems you may face!

Omega 3 Fatty Acids

Are you getting yours? Omega-3 fatty acids, that is. It turns out that almost everyone doesn't get enough of these essential fatty acids in their diet.

Omega-3 fatty acids can be obtained most easily through dietary supplements. Fish oil capsule and Flax Seed oil capsules are probably the most accessible options. Omega-3 fatty acids can help to prevent heart disease and stroke, especially in men. They have been shown to decrease joint and muscle pain in people who suffer from diseases like Fibromyalgia.

In the eye world Omega-3 fatty acids are important in the care of Dry Eye of all kinds, especially EVAPORATIVE Dry Eye caused by problems with the glands in your eyelids that produce the oil in your tears. Also, there is lots of research that suggests that increasing the amount of Omega-3 fatty acids you take in can reduce the severity of Macular Degeneration. Taking Fish Oil, Flax Seed Oil, or a specialty formulation like Doctor's Advantage products can do the trick!

Does it matter what kind you take? What brand or what form of Omega-3 fatty acids you use? Of course it does! Purity of the Omega-3 sources is important, and some forms simply work better than others. The Skyvision Centers doctors have done their homework and we offer the Doctor's Advantage forms of nutritional supplements right here in the office.  You can also opt to have your Omega-3's delivered right to your home!

There are some healthy things that are pretty easy, like making sure you are getting Omega-3 fatty acids every day!

Newest Glaucoma Surgery

As the U.S. population ages we are seeing more and more cases of Glaucoma, damage to the optic nerve usually associated with high pressure inside the eye. In America the treatment strategy usually involves eyedrops and lasers with surgeries reserved for the most advanced cases. This is not the case in the United Kingdom where surgery is most frequently used if a single eyedrop is not effective enough to control the eye pressure. The surgery most often used in both the U.S. and the U.K. is a trabeculectomy, but newer surgeries now available will probably be used instead of the trabeculectomy. Glaucoma is very likely to become a surgical rather than a medical disease.

The company Glaukos very recently had approval granted for a unique and exciting glaucoma implant called the micro-bypass iStent. This tiny instrument is inserted into the eye's natural drainage system called the trabecular meshwork. It functions as an enhanced drain to decrease eye pressure. Usually inserted along with cataract surgery, it can also be used in stand-alone glaucoma surgery.

The studies that were used to prove that the iStent is effective have shown that a single shunt will decrease pressure to the point where pressure is very often controlled with one or no eyedrops! In addition, two or more iSent devices can be implanted at the same time to give a greater decrease in eye pressure. You don't have to use them during cataract surgery; the iStent can be implanted in a stand-alone procedure for Glaucoma only.

Research into new medicines and surgeries for Glaucoma continues. At SkyVision Centers we pledge to remain on the front line in fighting this disease.

Glaucoma 201: Side Vision Loss

Why is Glaucoma such a devastating disease? Well, two reasons. The first, of course, is that it robs you of your vision. The second is that this "thief" steals your vision slowly and painlessly, and you may not even know you have glaucoma until it's too late!

Your peripheral, or side vision is the first part of your vision to be lost in glaucoma. This is one of the reasons it's so hard to know that you have the disease, because your central vision, the vision you read and drive with, is preserved until very late in the disease.

We measure your side vision with a test called a "Visual Field" or Perimetry test. Modern testing is computerized. You place your chin on a chin rest and look into a dim, white bowl. When you see a light come into view you press a button. The readout looks like this: 

   

In the early stages you might only lose a very small portion of your vision.

In very late stages much of your side vision is gone; it can be like looking through a tunnel.

Don't let glaucoma steal your vision!                  

Glaucoma 101

Glaucoma is one of the "silent blindness" disease of older folks all over the world. Most glaucoma has no symptoms at all, no warning that there is a problem. The only way to know that you have glaucoma is to have a complete eye examination performed by an eye doctor. Even then addtional testing might be necessary.

Glaucoma is damage to the optic nerve, the nerve that carries "light" from the eye to the brain. It usually comes with high eye pressure, but not always. There are lots of people who have glaucoma who have eye pressure that seems normal, and there are even more people who have high pressure who will never get glaucoma. The "normal" pressure in the eye is 11-21. Most people who get glaucoma are older, usually older than 60.

There are several ways to measure pressure in the eye. The two most common methods are Non-Contact Tonometry--the air puff-- and Contact Tonometry--the blue light. The "blue light" technique is much more accurate and is necessary to treat glaucoma. The "air puff" is a great screening test for glaucoma because it's easy to do, and easy to have done.

There's lots to talk about with Glaucoma so we'll try to teach you as much as we can here on the Skyvision Blog. All of our Doctors, Dr. White, Dr. Kaye, and Dr. Schlegel have lots of experience in treating people with glaucoma here in Cleveland. Stay tuned!

Cataract Rates Rising In U.S.

Here's some more information for you during Cataract Awareness Month. It appears that the rate of cataract diagnosis has risen ~19% in the U.S. since the year 2000. Remember our post from the other day about cataracts? Everyone who lives long enough will develop a cataract! At least 50% of those people who develop cataracts will go on to have surgery, and it's probably also true that if you live long enough you will need your cataract out!

There are some risk factors for cataract growth, especially for early onset of cataracts. Family history is important as is your medical history. Diabetes is a very strong risk factor for the development of cataracts. Exposure to ultraviolet light can also increase not only your risk for developing a cataract, but also the speed with which that cataract may get worse.

Thankfully, cataract surgery is one of the most frequently performed, successful, and safest surgery in the United States. Not only is it possible to improve your vision once the cataract has caused it to decrease, but there are also implant options that you can choose that will reduce your need to wear glasses after your cataract surgery like the Crystalens from Bausch & Lomb.

Here's the link for the recent story with info from the AAO. Give us a call at SkyVision Centers if you have any questions about cataracts!

Plaquenil and Retinal Toxicity

There are many medicines that have side effects that can affect the eye. Most of them are minor and little more than a bit of an inconvenience. Some of them can cause vision loss, and for those it is sometimes necessary to visit an eye doctor to rule out and problems.

One of these medicines is Plaquenil, also known by its chemical name hydroxychloroquine. Plaquenil is a medicine which was developed from chloroquine, one of the original medicines used to treat malaria. Doctors discovered that a beneficial side effect of these medicines was a decrease in joint inflammation and pain in people who suffer from rheumatoid arthritis and other inflammatory diseases. Unfortunately there is also a risk for toxic side effects from these medicines. In the 1960's ophthalmic reseachers at NYU (Dr. White's alma mater) demonstrated that chloroquine has an irreversible toxicity that causes blindness once you take a certain amount.

Thankfully, the development of hydroxychloroquine or Plaquenil has allowed people to obtain the pain relief with a much lower incidence of toxicity, and the toxic effects can be stopped and often reversed if the medicine is no longer taken. Approximately 8 patients out of every 1000 are diagnoses with toxicity each year. In order to prevent this some screening guidelines have been developed which were recently updated.

If you take Plaquenil you should see an eye doctor trained to rule out toxicity. 200 mg (1 pill) each day means an annual exam, and 400 mg (2 pills) each day requires a follow-up exam every 6 months. At least once each year a central visual field (VF) should be performed. The most recent recommendations say that an OCT should be done as well. We expect that additional testing will be requested as more information about this medicine continues to become available. Check back here for periodic  updates.