Archive for the ‘vision’ Category
Are Lasik Surgeons a ‘Dime a Dozen’ ?
02.22.2012
Lasik in nearsighted woman, performed by Dr. Paul Krawitz
At the bank today, the manager overheard that I was an ophthalmologist.
“Oh, do you do Lasik?” he asked.
The bias that people without known eye disease have in thinking that eyeglasses and Lasik are the only thing that ophthalmolists do is part of the reason people lose vision due to glaucoma and diabetic retinopathy – they’re oblivious about eye disease. My first thought was that we have to do a much better job communicating the importance of regular eye examinations to make sure none of the really big bad eye diseases have cropped up. The real danger is that some of these conditions, like glaucoma, cause permanent vision loss without any symptoms. So young people can’t afford not to know.
“I had my Lasik done nine years ago,” the bank manager continued.
“By whom?” I asked.
“Can’t remember. Somewhere near San Diego. Some center. I’m not sure,” he answered.
And the bank manager’s last eye exam? Also nine years ago.
What struck me next was that the surgeon who performed his Lasik was not remembered by name or location. In my practice, about 8 out of every 10 patients who underwent Lasik elsewhere has very little recall about the event. I don’t think that it’s so traumatic that they’ve kept it out of their memory. Rather, it’s a fast, automated, highly successful surgery in which the patient often sees the doctor for less than 10 minutes, and then never again. Technicians see the patient before and after the surgery, and because people believe that 20/20 vision protects them from eye disease, they return infrequently, and sometimes not for 10-15 years, for further eye care.
With Lasik, surgeons have commoditized themselves to such a degree that patients don’t even remember our names.
–
Paul Krawitz, M.D., F.A.A.O., President and Founder
VisiVite.Com
New Contact Lenses That are Able to Deliver Drugs Through Your Eye
02.21.2012
A few weeks ago, I had a patient who was telling me that he heard about these new contact lenses that were able to deliver a steady stream of medication to the person wearing them. I know eye drops are a huge problem for many of our patients. It can be extremely difficult to put drops in by yourself and remembering to do them everyday, sometimes more than once a day, can also be challenging.
These new contact lenses, that have yet to be approved by the FDA, supposedly are able to deliver a steady dose of the medication for as long as the lens is worn. Researchers at Auburn University claim this to be more than 100 times more effective than putting drops in your eyes. These aren’t contacts soaked in a medication that only release for a very short time. This new technology administers a drug through controlled release by creating drug memory in the lens itself without changing the way the lens works. These lenses can either be vision correcting or not and have the ability to to release the medication for anywhere from 24 hours to 30 days, depending on the lens. Current types of medication being tested are anti-inflamatories, antibiotics and anti-allergy drops.
Although one could question whether or not someone who has trouble putting drops in, would also have a problem putting a contact lens or taking it out, this has the potential to be a huge step forward for those who already wear them.
Mary Sweetman, C.O.A.
Certified Ophthalmic Assistant
Gene therapy dramatically improves vision in Philadelphia study
02.17.2012
Researchers at the Philadelphia Children’s Hospital and the University of Philadelphia have reported that three patients who underwent gene therapy have seen a dramatic improvement in their vision. The study results were published in the Science Translational Medicine journal. All three patients are afflicted with Leber’s Congenital Amaurosis (LCA) which is a rare inherited disease that is caused by defects in a gene encoding a protein needed for vision.
In 2008, 12 people with LCA had vision partially restored after receiving an injection of an engineered virus carrying the gene RPE65 in one eye. Three of the patients received the same treatment in their other eye in a follow up study which resulted in an even greater improvement in their vision. All three of the patients could see better in dim light and two of them were even able to negotiate their way around obstacles.
Encouraged by these initial results, researchers look to treat the second eye of the remaining nine patients from the initial study and would like to extend the clinical trial. Much more research is needed to fully understand the benefits of gene therapy techniques and how they can be used effectively to treat more common forms of degenerative eye diseases.
“Spot” helps identify undiagnosed vision problems in school children
02.15.2012
According to the U.S. Centers for Disease Control and Prevention (CDC), vision disability is the single most common disabling condition among children. Despite vision screenings at schools using the standard eye chart, many children have undiagnosed vision problems because they are able to pass the eye chart exam. In fact, 25 percent of American school children suffer from a vision problem. A study showed that only ten percent of children in the 9 to 15 year-old age group who needed glasses actually had glasses.
A new screening device called Spot has been developed and is changing how vision screenings are being done. Spot can evaluate the vision of anyone from the age of 6 months to adults with both accuracy and speed. Comprehensive results are delivered immediately. With a capture time of one second or less, Spot is an ideal solution for school settings. It is a handheld device with a touchscreen interface.
The speed and efficiency of spot means most schools can screen their students in one day which lowers the cost of screening significantly. Reports can be printed for large-scale data analysis and follow-up care can be monitored.
Measuring visual acuity in people 65 and older not cost effective, study says
01.23.2012
Dr. Paul Krawitz performing a dilated retinal examination
A recent study suggests that it would be more cost effective for new Medicare enrollees to receive dilated eye exams in place of visual acuity screenings. Currently, when people are enrolled in the Medicare program, they receive a visual acuity screening along with other preventive healthcare checks.
The study involved 50,000 simulated patients with demographic characteristics matched to people 65 years of age. Diabetics were excluded because visual acuity screenings had already been determined to be cost effective and patients with diagnosed eye disease were also left out.
Researchers found that when compared to a no-screening policy, dilated eye evaluations increased quality-adjusted life years by 0.0008 and increased costs by $94. The quality-adjusted life years for those who had visual acuity screenings increased in less than 95 percent of the simulations and the total costs were increased by $32 per person.*
