The doctors at Skyvision Centers recently hosted a Continuing Education seminar for local Cleveland area Optometrists. Nearly 50 optometrists gathered at The Surgery Center in Berea for a 2 hour educational session sponsored by Skyvision Centers. Dr. David Eldridge from the TearLab company was the guest speaker. An Italian dinner menu was prepared by Bucci's of Berea.
Dr. Schlegel was the official host for the evening. "We wanted to reach out to our colleagues in the Cleveland area and offer an addtional way for them to obtain CE credits without having to travel. I was particularly thrilled that Dr. Eldridge was able to join us and give his unique perspective on Tear Osmolarity since he was involved in the formation of the TearLab company. Tear Osmolarity has been an enormous help to us in taking care of Dry Eye patiens at Skyvision."
After Dr. Eldridge gave his talk on Tear Osmolarity Dr. White took the floor and discussed the pre-operative evaluation of cataract patients who have Astigmatism. He shared the great enthusiasm that all three Skyvision doctors have for the Alcon IQ Toric implant for cataract surgery when a patient wishes to see well for distance after surgery despite lots of Astigmatism. He noted that the implant was "great technology", and suggested that the patient's Personal Eye Doctor could help them make the right decision about whether or not to use the Toric implant.
Dr. Kaye has been very pleased by the feedback from his colleagues around Cleveland. "I've heard nothing but positive things! We are looking forward to our next meeting, and I think my fellow Optometrists are too!" Skyvision Centers is planning on another meeting in late Winter, and Dr. Kaye said "we hope to have at least three each year."
Tuesday, November 15, 2011
Monday, November 7, 2011
Why Does Dr. White Wear A Bowtie?
We recently asked Dr. White why he wears a bowtie. Here’s what he said (after he stopped laughing!):
“Why a bowtie? Wow...it’s been so long I haven’t given all that much thought to that. When I was in medical school my wife and I cleaned out the bargain tie bin at a local department store that was going out of business. Silk ties for 2 and 3 bucks! When we got home we noticed two bowties in the mix. I happened to be on call the next night so Beth tied one for me to wear—bowties stay out of the way of all kinds of icky stuff you encounter in a hospital.
Well, as luck would have it, the most popular show on TV was “Hill Street Blues”, and one of the detectives wore a bowtie. Whenever Henry Goldblum got stressed his bowtie came undone. Of course, my wiseguy fellow med students thought it would be fun to untie MINE...and I didn’t know how to tie it yet! Sooo, three hours in front of a mirror later and I was an expert on bowtie tying.
I must have gotten good feedback about the bowtie as a resident because I found myself wearing it more and more. Not everyone at NYU knew Dr. White the ophthalmology resident, but everyone knew Dr. Bowtie the eye doctor! Now if I go someplace without a bowtie I’m almost invisible.”
So there you have it, why Dr. White wears a bowtie. If you’re interested Dr. White gets his bowties from Beau Ties Ltd. in Vermont, and leeallison.com in Chicago.
Well, as luck would have it, the most popular show on TV was “Hill Street Blues”, and one of the detectives wore a bowtie. Whenever Henry Goldblum got stressed his bowtie came undone. Of course, my wiseguy fellow med students thought it would be fun to untie MINE...and I didn’t know how to tie it yet! Sooo, three hours in front of a mirror later and I was an expert on bowtie tying.
I must have gotten good feedback about the bowtie as a resident because I found myself wearing it more and more. Not everyone at NYU knew Dr. White the ophthalmology resident, but everyone knew Dr. Bowtie the eye doctor! Now if I go someplace without a bowtie I’m almost invisible.”
So there you have it, why Dr. White wears a bowtie. If you’re interested Dr. White gets his bowties from Beau Ties Ltd. in Vermont, and leeallison.com in Chicago.
Monday, October 31, 2011
Restasis and Tylenol
It's a very typical day at Skyvision Centers: we've written several new prescriptions for Restasis for people with dry eye. We know that they will start to feel better in a couple of weeks, and then we'll have to answer this question: "Do I have to keep taking my Restasis? Why? I feel great!" Happens every time!!
Well, that's the exact answer...you feel great! In fact, you feel great BECAUSE you are taking your Restasis. Dry eye is a chronic problem, one that needs to have on-going treatment. When Restasis is the right medicine to use it's important to understand just how and why Restasis works. It takes a while for Restasis to decrease the inflammation that causes lots of dry eye; that's why it can be several weeks before you feel better. Then, after the inflammation is controlled it's necessary to keep taking the Restasis in order to prevent the same inflammation from making your eyes hurt again!
Dr. White likes to say that Restasis is not a typical American medicine. It takes a while for it to kick in. Not like Tylenol for a headache. You have a headache, you take a Tylenol and you feel great. You don't have to keep taking the Tylenol to keep the headache away, but you DO have to keep taking your Restasis in order to keep comfortable eyes!
Well, that's the exact answer...you feel great! In fact, you feel great BECAUSE you are taking your Restasis. Dry eye is a chronic problem, one that needs to have on-going treatment. When Restasis is the right medicine to use it's important to understand just how and why Restasis works. It takes a while for Restasis to decrease the inflammation that causes lots of dry eye; that's why it can be several weeks before you feel better. Then, after the inflammation is controlled it's necessary to keep taking the Restasis in order to prevent the same inflammation from making your eyes hurt again!
Dr. White likes to say that Restasis is not a typical American medicine. It takes a while for it to kick in. Not like Tylenol for a headache. You have a headache, you take a Tylenol and you feel great. You don't have to keep taking the Tylenol to keep the headache away, but you DO have to keep taking your Restasis in order to keep comfortable eyes!
Tuesday, October 25, 2011
Dr. White's LASIK Anniversary
It's been 12 years since Dr. White had LASIK surgery on his eyes! Happy Anniversary, Dr. White!
"LASIK is one of the nicest things I've ever done for myself," he says. "My friend Dr. Dave Hardten (who taught me how to do LASIK!) did my surgery 12 years ago. What a difference!"
Dr. White had worn Gas Permeable (hard) contact lenses for almost 30 years before his LASIK. "I broke 12 pairs of glasses in 12 months playing basketball in Jr. High and my Dad, who made glasses for a living, strongly 'suggested' I try contacts. They got me through all of my sports, including playing football in college."
Like many people who have had LASIK, Dr. White is now wearing reading glasses. He had his surgery at age 39 so he knew that his years of no glasses at all would be short. "I only need to wear my reading glasses in the morning and at night, so I'm STILL glasses-free in the office every day!"
Did you know that the VISX laser is the most widely used LASIK laser in the U.S.? Dr. White actually performed the very first VISX laser LASIK in Cleveland all the way back in 1994!! Dr. White uses the Intralase femto-second laser to creat the LASIK flap for a complete laser operation. Come visit us in Westlake and see if you are a candidate for LASIK. Talk to the doc who has been using the VISX laser longer than anyone else in Cleveland and ask him how HIS eyes are doing!!
Sunday, October 2, 2011
Let's Talk About Tears!
Before we get to the topic of how to treat Dry Eye let's take a couple of minutes to learn about tears. We have two kinds of tears lubricating the front of our eyes. We have our reflex, or emotional tears. These tears are created by the lacrimal gland that sits up and above our eyes. The lacrimal gland makes the tears that we cry when we watch a sad movie, or if something gets in our eye.
It's the tears that lubricate our eyes from minute to minute that we are more interested in when we are talking about dry eye. These tears are made by different types of microscopic glands on the surface of our eyes, as well as deep within our eyelids. These tiny glands can be affected by all kinds of medical problems like arthritis, lupus, and the hormonal changes that come with getting older.
Normal tears consist of three different, separate substances. We have mucin which is created by the goblet cells on the front surface of our eyes. We also have a salt water or aqueous component created by the glands of moll and zeiss. Lastly, we have an oily substance called meibum which is created by the tiny glands that sit just inside our eyelashes on the upper and lower eyelids. These three substances are mixed together, kind of like Italian salad dressing, to form a lubricating layer between our eye and the air.
Shake up a bottle of salad dressing and let it sit for a minute or two. Notice how there is a little bit more oil on the top surface, a thicker middle layer that is a mixture of everything in the salad dressing, and then a layer on the bottom that is really thick. This is a good way to visualize our tears. We have more mucin close to the eye, a mixture or emulsion of mucin and aqueous in the thicker middle, and then a layer which is mostly oil sitting on the surface and preventing evaporation of our tears.
When our tears are healthy we have just the right amount, and we have just the right proportion of the three different components. We start to have problems with dry eye when we either have too few tears, or when the three components do not mix well. Next, we'll talk about the different types of dry. See you soon!
It's the tears that lubricate our eyes from minute to minute that we are more interested in when we are talking about dry eye. These tears are made by different types of microscopic glands on the surface of our eyes, as well as deep within our eyelids. These tiny glands can be affected by all kinds of medical problems like arthritis, lupus, and the hormonal changes that come with getting older.
Shake up a bottle of salad dressing and let it sit for a minute or two. Notice how there is a little bit more oil on the top surface, a thicker middle layer that is a mixture of everything in the salad dressing, and then a layer on the bottom that is really thick. This is a good way to visualize our tears. We have more mucin close to the eye, a mixture or emulsion of mucin and aqueous in the thicker middle, and then a layer which is mostly oil sitting on the surface and preventing evaporation of our tears.
When our tears are healthy we have just the right amount, and we have just the right proportion of the three different components. We start to have problems with dry eye when we either have too few tears, or when the three components do not mix well. Next, we'll talk about the different types of dry. See you soon!
Dry Eye 101
" My eyes hurt!"
"My eyes feel like they're burning up!"
"It seems like my eyes are always red."
"When I'm reading at night or working on the computer my eyes get really tired. My vision starts to get blurry."
"I tear all the time. My friends always want to know what's wrong."
"It feels like there's something in my eye all the time."
And of course, the obvious, "my eyes are dry!"
These are the kinds of things that patients say when they come to the eye doctor and have a problem with dry eye. Sometimes it's hard for your eye doctor or the staff in the office to figure out that what you are really complaining about is that your eyes are dry. This really isn't as much of a problem Skyvision because we have become experts at treating dry! In fact, Dr. White lectures all over the country, teaching other eye doctors how to diagnose and treat dry eye.
Your tears are actually an emulsion, a complex mixture of three different parts: salt water, mucin, and oil. Tears are actually like the vinaigrette you put on your salad. Your tears work best when the three parts are mixed just right, just like salad dressing! You need just enough of the three parts, and the proportions of the ingredients have to be just right, too.
In general there are two types of tear problems that can lead to the symptoms of dry eye. We call them "quantity" and "quality". If the microscopic glands in your eyes are not producing enough tears, if your tear "quantity" is too low, you can have any of the symptoms above caused by dryness. This is actually pretty easy to understand -- not enough tears equals a dry eye.
The "quality" part of dry eye is a little more difficult to get a handle on. If you have too little of any of the components that make up your tears, your tears just may not work well enough. In addition, even if you have the right amount of each component, if any of the three parts (mucin, salt water, and oil) is not working well enough, the entire mix may be ineffective. In other words, you may have plenty of tears, but they may just do not work well enough. Kind of like trying to put out a fire with kerosene-- its wet, but it won't put out the fire. Sometimes it even makes the fire worse. You, too, have a dry eye.
So if any of the statements at the top sound like you, perhaps it's time to come visit us at Skyvision Centers. We are experts in the diagnosis and treatment of all kinds of dry eye!
"My eyes feel like they're burning up!"
"It seems like my eyes are always red."
"When I'm reading at night or working on the computer my eyes get really tired. My vision starts to get blurry."
"I tear all the time. My friends always want to know what's wrong."
"It feels like there's something in my eye all the time."
And of course, the obvious, "my eyes are dry!"
These are the kinds of things that patients say when they come to the eye doctor and have a problem with dry eye. Sometimes it's hard for your eye doctor or the staff in the office to figure out that what you are really complaining about is that your eyes are dry. This really isn't as much of a problem Skyvision because we have become experts at treating dry! In fact, Dr. White lectures all over the country, teaching other eye doctors how to diagnose and treat dry eye.
Your tears are actually an emulsion, a complex mixture of three different parts: salt water, mucin, and oil. Tears are actually like the vinaigrette you put on your salad. Your tears work best when the three parts are mixed just right, just like salad dressing! You need just enough of the three parts, and the proportions of the ingredients have to be just right, too.
In general there are two types of tear problems that can lead to the symptoms of dry eye. We call them "quantity" and "quality". If the microscopic glands in your eyes are not producing enough tears, if your tear "quantity" is too low, you can have any of the symptoms above caused by dryness. This is actually pretty easy to understand -- not enough tears equals a dry eye.
The "quality" part of dry eye is a little more difficult to get a handle on. If you have too little of any of the components that make up your tears, your tears just may not work well enough. In addition, even if you have the right amount of each component, if any of the three parts (mucin, salt water, and oil) is not working well enough, the entire mix may be ineffective. In other words, you may have plenty of tears, but they may just do not work well enough. Kind of like trying to put out a fire with kerosene-- its wet, but it won't put out the fire. Sometimes it even makes the fire worse. You, too, have a dry eye.
So if any of the statements at the top sound like you, perhaps it's time to come visit us at Skyvision Centers. We are experts in the diagnosis and treatment of all kinds of dry eye!
Wednesday, September 7, 2011
Skyvision Centers Interview EMR
EMR Daily News
How They Did it – One Ophthalmologist’s Experience with ePrescribing
August 25, 2011
Did you hear the one about the ophthalmology practice that was forced to use ePrescribing to achieve meaningful use? The one where the doctors in the practice as well as the technicians and office folks were certain the entire process of ePrescribing would be a productivity sinkhole leading to little more than lost time? Whether you’ve heard this story or not please read on because this is the story of such a practice but the results were not at all what they expected.
Dr. Darrell White and his partners started Skyvision Center of Westlake® ,an ophthalmology and optometry practice in Westlake Ohio about six and a half years ago. From the point when they launched they knew they wanted to use an Electronic Health Record (EHR) system and their research showed that there were only two available at that time that would meet their specific needs.
After carefully considering both options they chose the SRS EHR from SRSsoft, primarily because they saw it as a product created by ophthalmologists for eye care practices. It was also the best fit that they were going to be able to get for their practice in 2005. Skyvision Centers has been using the SRS EHR since then.
Dr. White and his partners at Skyvision Centers didn’t buy an Electronic Health Record system so they would receive the HITECH Act EHR incentive money – there was no incentive money available when they made the decision to go electronic. But now things have changed and the incentive money is available, if they can demonstrate meaningful use. However, that wasn’t their only reason for moving forward. According to Dr. White “there is that nasty little penalty out there if we didn’t start ePrescribing, so we had to commit to moving forward with at least an ePrescribing system.”
In talking with Dr. White it’s clear that Skyvision Center is an extremely well run and productive practice. They’re able to help a large number of people in their area and they do it by being a patient centered high volume and high efficiency practice. They didn’t want to introduce anything that would negatively impact that productivity or their interaction with patients.
Dr. White said that while they were committed to putting the ePrescription system in place the expectations were quite low, with some referring to the process “as a boondoggle that would have a significant negative impact on productivity.”
They looked around and fairly quickly decided that since they were already using the SRS EHR the SRS ePrescribing system, Rx Workflow Manager™ would have the least negative impact on their existing workflow patterns.
After overcoming some of the initial issues that crop up in any new software installation Dr. White and his partners noticed that their front desk people actual found that the ePrescribing process worked “pretty well”. Even more surprising, the technicians discovered that they actually liked working with it – saying that ePrescribing was actually becoming a time saver, in some cases saving as much as 50% over the manual prescribing process.
Well, this is not at all what they expected. In a fairly short period of time Skyvision Center went from being a practice that tolerated the idea of using ePrescribing to one that embraced the idea to the point where they are activity encouraging all of their patients to allow them to ePrescribe.
In the past few months Dr. White has personally gone from hand signing about 150 prescriptions a week to signing only around one a day, helping to make an incredibly productive guy even more productive.
The HITECH Act is causing a lot of health care professionals to consider changes that they’re not comfortable making. While we should note that Skyvision Centers has found fully embracing the chase for “meaningful use” incentives is not cost effective, the experience that Dr. White, his partners and their team at Skyvision Center had can serve as an example of how some times, those changes can increase productivity and patient satisfaction
Read more: http://emrdailynews.com/2011/08/25/how-they-did-it-one-opthamologists-experience-with-eprescribing/#ixzz1XIpgL37s
How They Did it – One Ophthalmologist’s Experience with ePrescribing
August 25, 2011
Did you hear the one about the ophthalmology practice that was forced to use ePrescribing to achieve meaningful use? The one where the doctors in the practice as well as the technicians and office folks were certain the entire process of ePrescribing would be a productivity sinkhole leading to little more than lost time? Whether you’ve heard this story or not please read on because this is the story of such a practice but the results were not at all what they expected.
Dr. Darrell White and his partners started Skyvision Center of Westlake® ,an ophthalmology and optometry practice in Westlake Ohio about six and a half years ago. From the point when they launched they knew they wanted to use an Electronic Health Record (EHR) system and their research showed that there were only two available at that time that would meet their specific needs.
After carefully considering both options they chose the SRS EHR from SRSsoft, primarily because they saw it as a product created by ophthalmologists for eye care practices. It was also the best fit that they were going to be able to get for their practice in 2005. Skyvision Centers has been using the SRS EHR since then.
Dr. White and his partners at Skyvision Centers didn’t buy an Electronic Health Record system so they would receive the HITECH Act EHR incentive money – there was no incentive money available when they made the decision to go electronic. But now things have changed and the incentive money is available, if they can demonstrate meaningful use. However, that wasn’t their only reason for moving forward. According to Dr. White “there is that nasty little penalty out there if we didn’t start ePrescribing, so we had to commit to moving forward with at least an ePrescribing system.”
In talking with Dr. White it’s clear that Skyvision Center is an extremely well run and productive practice. They’re able to help a large number of people in their area and they do it by being a patient centered high volume and high efficiency practice. They didn’t want to introduce anything that would negatively impact that productivity or their interaction with patients.
Dr. White said that while they were committed to putting the ePrescription system in place the expectations were quite low, with some referring to the process “as a boondoggle that would have a significant negative impact on productivity.”
They looked around and fairly quickly decided that since they were already using the SRS EHR the SRS ePrescribing system, Rx Workflow Manager™ would have the least negative impact on their existing workflow patterns.
After overcoming some of the initial issues that crop up in any new software installation Dr. White and his partners noticed that their front desk people actual found that the ePrescribing process worked “pretty well”. Even more surprising, the technicians discovered that they actually liked working with it – saying that ePrescribing was actually becoming a time saver, in some cases saving as much as 50% over the manual prescribing process.
Well, this is not at all what they expected. In a fairly short period of time Skyvision Center went from being a practice that tolerated the idea of using ePrescribing to one that embraced the idea to the point where they are activity encouraging all of their patients to allow them to ePrescribe.
In the past few months Dr. White has personally gone from hand signing about 150 prescriptions a week to signing only around one a day, helping to make an incredibly productive guy even more productive.
The HITECH Act is causing a lot of health care professionals to consider changes that they’re not comfortable making. While we should note that Skyvision Centers has found fully embracing the chase for “meaningful use” incentives is not cost effective, the experience that Dr. White, his partners and their team at Skyvision Center had can serve as an example of how some times, those changes can increase productivity and patient satisfaction
Read more: http://emrdailynews.com/2011/08/25/how-they-did-it-one-opthamologists-experience-with-eprescribing/#ixzz1XIpgL37s
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