Category: Helpful Tips

Contact Lens Health Week

27 Contacts Lenses Found in Eye of 67 year old Woman

Contact Lens mass
 

A 67-year-old woman scheduled, for what was supposed to be a routine cataract surgery, underwent a foreign body extraction procedure instead. A staggering 27 contact lenses were removed from the eye of a woman who had worn monthly disposable contact lenses for over 35 years. As reported in the British Medical Journal last month, the ophthalmologist removed a large mass of 17 fused contact lenses. Upon further inspection under a microscope, an additional 10 contact lenses were retained. Although the patient had poor vision, she did not complain of any issues with her eye prior to the day of surgery.

“This case study underscores the importance of appropriately wearing and caring for your contact lenses. Disposable contact lenses are meant to be disposed of as reuse puts patients at high risk of serious eye infections, and in some cases permanent vision loss,” says Charles Flowers, MD, Associate Professor of Clinical Ophthalmology.

Those who wear contact lenses are at risk of infections of the ocular surface, due to low oxygen levels to the cornea (outermost part of the eye) or if the lenses have not been appropriately cleaned allowing build-up of infective agents.

In honor of Contact Lens Health Week here are some tips to preventing Eye infections

  • Wash your hands thoroughly before touching your eyes or face
  • Thoroughly clean your contact lenses, store in clean containers, and use fresh solutions without sharing
  • Change your contact lens case every three months. Do not use the same case beyond three months.
  • Do not share your makeup, face towels, or any eye drops
  • Wear protective eyewear outdoors or in a workplace where there may be hazards
  • Seek medical attention immediately if you notice symptoms of a suspected eye infection
  • Always use protection to prevent sexually transmitted diseases. Such diseases, although rare, can manifest in the eye

Thus routine eye exams are essential to ensure healthy vision. To schedule a consultation at our Los Angeles, Beverly Hills, Pasadena, or Arcadia location call 323-442-6335.

Reference:

http://www.bmj.com/content/358/bmj.j2783

Helpful Tips for the Upcoming Solar Eclipse

NEWLunarEclipse

What is a solar eclipse, and how does it affect my eyes?

A Solar eclipse occurs when the moon blocks the sun. On Monday August 21st, 2017, North America will experience a solar eclipse that will last about 2.5 hours. Although a small part of USA will experience a total eclipse in which the moon completely blocks the sun, for most places, including the Los Angeles area, it will be partial.

Directly looking at the solar eclipse is as harmful as sun gazing on a regular day. This causes damage in the retina, the light sensitive membrane in the back of the eye, and can result in vision loss – the severity of which depends on the duration of the gaze. In mild cases, the vision loss may be reversible over the course of several months, but in severe cases, it is permanent. It affects the central vision, and affected individuals may not be able to read or see faces; however, it does not affect the peripheral vision.

Here are some very important tips to prevent vision loss while enjoying watching the solar eclipse:

  1. Never look at the sun or solar eclipse without eye protection: use solar eclipse glasses (eclipse viewers) that have been approved by the American Astronomical Society. In those areas of the country where total eclipse occurs, it is safe to remove the eclipse glasses at the time of total eclipse, which may last a maximum of about 2.5 minutes.

  2. Sunglasses, no matter how dark, are not protective.

  3. Do not use eclipse glasses that are damaged or have a scratch on them.

  4. If using a binocular, camera or telescope, wearing eclipse glasses do not protect your eyes; the front lens of these devices that face the sun should be shielded with specially designed filters.

“In the Know” on Men’s Vision

Men's Health Banner

Historically men are less likely than women to go to the doctor and address any health concerns. This month take the time to learn more about how you can maintain healthy vision. When you see an ophthalmologist you will likely be screened for diseases such as glaucoma, age-related macular degeneration and cataracts. Routine vision screenings are essential to maintaining healthy vision, preventing permanent vision loss and even detecting diseases beyond the eye.

3 Systemic Diseases that Manifest in the Eye

Even if you have great vision, seeing a specialist can save your vision and even your life.


#1 Diabetes

Men are at higher risk of developing Type II Diabetes

Changes to retinal blood vessels found in the light sensing tissue in the back of the eye known as the retina, can be early symptoms of diabetes. Detection of bleeding or leaking of these blood vessels can lead to early diagnosis of diabetes which is known to cause a number of eye complications that include conditions such as diabetic retinopathy, diabetic macular edema (DME), cataracts and glaucoma. If left untreated, many have lost their vision and have even gone blind from this disease. Early detection of diabetes within the eye cannot only prevent vision loss, but a multitude of broader diabetic-related complications such as nerve damage, heart disease and even stroke.


#2 Hypertension

High blood pressure can increase with age but can even occur in men younger then 45

Hypertension or high blood pressure can cause damage to the blood vessels in your eye and can lead to hypertensive retinopathy. Over time, if high blood pressure is poorly controlled, major vision loss can occur due to damage to retinal blood vessels and even increase your risk for glaucoma. Associate Professor of Clinical Ophthalmology and Retina specialist, Andrew Moshfeghi MD, MBA, recommends regular eye exams. “Earlier detection of hypertensive retinopathy can alert your physician to the possibility of broader complications of hypertension including heart disease and stroke,” says Moshfeghi.


#3 Cancer

Metastases of lung cancer in and around the eye is more common in men

Breast and lung cancers are the most common primary malignancies that can metastasize to the eye and surrounding tissues. A study recently reported that in multiple cases, detection of eye metastases is often the first indicator of an underlying malignancy. Most notably for men, although relatively rare, prostate cancer can also metastasize to the eye. Regular ophthalmic exams for men in addition to routine physicals, which include prostate exams, are essential, as early detection will lead to better outcomes.

Thus routine eye exams can provide valuable information about your overall health. To schedule a consultation at our Los Angeles, Beverly Hills, Pasadena, or Arcadia location call 323-442-6335.
 

For further information:

1. https://www.niddk.nih.gov/health-information/weight-management/keeping-active-healthy-eating-men
2. https://www.diabetesselfmanagement.com/blog/men-at-higher-risk-for-type-2-diabetes/
3. https://www.cdc.gov/bloodpressure/facts.htm
4. http://bjo.bmj.com/content/bjophthalmol/89/12/1646.full.pdf
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346676/
6. http://www.ocularmelanoma.org/types-of-eye-cancer.htm

Srikiran Eye Institute Residency Rotation Highlights

 

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Chandra Family

The Srikiran Eye Institute (SEI) resident experience is a rich one, not only in terms of surgical SICS training, but also clinically and culturally.

Regarding the day to day clinical and surgical exposure, your mentor for the time is Dr. Avinash, the medical director of SEI. Initially, residents will receive a brief tour of the compound, which will become very familiar after just a couple of days. At the time of this writing, SEI has comprehensive ophthalmology, in addition to the subspecialties of pediatrics and strabismus, oculoplastics, cornea/anterior segment, and retina/uveitis. Residents can spend time in whichever clinic they feel would best suit their interests. Expect to see many things that you’ve only read about in the textbooks here! Please note that the work week is from Monday to Saturday, with both clinic and OR M-F, and clinics alone on Saturday.

A major component of this rotation is the ability to learn small incision cataract surgery, an incredibly elegant surgery with fantastic results. Expect a small trickle of cases on a daily basis, with a large influx of patients after camp outreach days. Dr. Avinash (or designated surgeon) will initially show a few cases of SICS. The first cases will be proctored every step of the way, with more independence as the resident becomes more familiar with the operation.

Expect to busy during this block of time. Residents will be seeing patients in clinic and operating M-F, and seeing patients in clinic on Saturday. If you have a free Sunday, take a moment to explore Kakinada city (approximately 10km away) and the Bay of Bengal (approximately 3km away). If you have a day where clinic is not as busy, consider taking a moment to visit the schools located on the campus. The Sankurathri foundation not only oversees the Srikiran Eye Institute, but there is also a school system (from elementary to high school, and also vocational school).

Making a Difference in the Lives of Those We Serve

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For nearly a century, the Braille Institute has been on a mission to eliminate barriers to a fulfilling life caused by blindness and severe vision loss. This goal is made possible by providing an environment of hope and encouragement and teaching its students that life is more than just vision. Each year the Braille Institute serves more than 80,000 people through a variety of free classes, programs and services at six centers and 220 community outreach locations throughout Southern California.

Adults, young adults and children can take advantage of the Braille Institute’s suite of free services, including classes in art, technology, business of living, health and fitness, music and communication. Each center offers a unique schedule tailored to members of the community. A typical weekday could begin with salsa dancing in the morning, followed by personal home management and end with a game of Scrabble with friends in the afternoon. The Braille Institute also brings its services to various communities through the Mobile Solutions vans that travel throughout the region. Perhaps one of the most reputable and beneficial services is the Braille Institute Library, offering more than 100,000 titles and 1.2 million volumes in their collection. The library amenities include a browsing area, patron computer, mini café, and a Braille and Audio Reading Download (BARD) station.

The Braille Institute offers two seminars a year, focusing on low vision and technology. Vivek Patel, MD, associate professor of ophthalmology and director of neuro-ophthalmology and adult strabismus at the USC Roski Eye Institute, Keck School of Medicine of USC, was a guest speaker at the last event. His discussion focused on how USC Roski Eye Institute researchers strive to understand the structural and functional connections of the visual brain. Deeper understanding of the visual brain holds great promise for future innovations. Attendees asked many questions about brain mapping and what is next on the horizon.

We look forward to meeting many of you at the next event in May.
 

Meet Cathy

Cathy was considered legally blind when she was four years old. Cathy has been a Braille student for more than 30 years and speaks very highly of all the classes offered. She loves that each center offers unique programs, allowing her to break out of her comfort zone. Cathy’s favorite center is the Los Angeles location because of the acting classes.
 

Meet Nancy

In 2012, Nancy noticed that her vision was deteriorating. She saw a specialist who diagnosed her with wet age-related macular degeneration (AMD). After the treatments prescribed by the doctor weren’t helping, she was referred to another specialist who diagnosed her with dry AMD. Nancy decided to reach out to the Braille Institute to utilize their free resources and learn how to adapt to her ever-changing reality. She considers the Braille Institute to be an incredible source of support for her.
 

Meet Beth

Beth has had to undergo countless eye surgeries and corneal transplants. Her optimistic attitude has prevailed in her interactions with her doctors and she is grateful for the care she has received. At the Braille Institute, Beth takes as many art classes as possible and enjoys the support groups where she and other students are able to share their experiences with each other. Beth feels part of a community every time she is at the Braille Institute.

Halloween Eye Safety Tips

EyeCare-Halloween-Instagram

It’s Halloween time and all the ghosts and ghouls come out to play. Halloween is also a busy time for ophthalmologists at the USC Roski Eye Institute because there are a lot of scary and spooky eye injuries that happen! Here are a few tips to keep those eyes safe (and maybe even the goblins away) this Hallows Eve.

 

Tip # 1. Halloween glitter is all fun and games until it gets in your eye

Who doesn’t like to dress up on Halloween? And fun face make up is a great way to complete that killer costume. But this kind of show make up is generally not formulated for the eye so be careful when you apply it! This counts for fake eyelashes, lash glue (this one is really no good for the eyes), glitter, glitz and other Halloween makeup.

 

Tip # 2.  Monster contacts can do major damage to your eye

Scary cosmetic contacts are all the rage at Halloween – and even I will admit they make quite a statement. But they can also wreak all sorts of havoc on your eye including causing vision threatening infections in the cornea – which can really leave you with a scary eye. If you need this last little touch for your costume make sure that you purchase these lenses from a optical shop that stocks sterile contact lenses which can be fit appropriately for your eyes. Please take the contacts out at the end of the night. Curses to those who sleep with contacts in because its ghoulishly dangerous to the eye!

 

Tip #3:  Beware of the Witch’s Brew

Unfortunately, a lot of the severe eye trauma we see comes secondary to too much Witch’s Brew – never a good idea. Be safe and smart when you are out showing off your wicked costume this Halloween. Have a designated driver or use a ride-share service like uber or lyft, be smart about imbibing and remember Tip 2: take your contacts out!

 

Tip # 4. Watch out for your Trick or Treating kiddos

Halloween is a super special day for the kids. What’s more fun than dressing up as your favorite superhero and staying up late to eat candy!?  Unfortunately, pediatric ocular trauma is also common on Halloween. Masks can block peripheral vision, costume accessories like wands and swords can cause blunt trauma to eyes (ouch!), and running around in the dark is a set up for trips and falls – particularly in that slightly-too-long Princess dress.  And if your child needs glasses to see keep them as part of the costume – dress them up and make it fun but ensure they’re still wearing what they need to see! All of this will keep your little monsters safe at play.

 

Tip # 5. Somebody put a spell on you

Uh oh…well let’s hope not! Anyways, the best kind of spell is a sugar coma from Halloween candy for the little ones and Pumpkin Spice lattes for the rest of us! Enjoy Halloween costuming, trick or treating, pumpkins and candy – but do it all safely and keep your eyes out of trouble by following the above tips! Happy Halloween, little goblins!

 

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Dr. Jesse Berry is an Assistant Professor of Clinical Ophthalmology at the Keck School of Medicine of USC and Associate Residency Program Director at LAC+USC Medical Center. She is residency and fellowship trained and a member of the Society of Heed Fellows.

The Latest Advances in Glaucoma that May Help Save your Sight

Q+A session with Dr. Grace Richter

 

Richter Clinic

 

  1. What is Glaucoma and can it make me blind?

Glaucoma affects millions of people worldwide and is the leading cause of irreversible blindness. Approximately 2.7 million Americans have glaucoma with over half that go undiagnosed.1 Glaucoma is a complex eye condition that damages the optic nerve, which is the nerve that connects the eye to the brain and is responsible for transmitting images to the brain.   It is often accompanied with elevated eye pressure. We treat glaucoma by reducing eye pressure to prevent additional nerve damage. There are two main types of glaucoma: primary open-angle glaucoma (POAG) and angle-closure glaucoma, both of which can lead to permanent vision loss if left untreated.

 

  1. Are you at risk of getting Glaucoma?

Knowing the risk factors of glaucoma is essential as early diagnosis is key to saving your sight.

General Risk factors include:

  • Family history of glaucoma
  • Ocular trauma, inflammation of the eye or previous eye surgeries
  • Over the age of 40
  • Suspicious findings on the eye exam

 

Risk factors for open-angle glaucoma include:

  • Family history of glaucoma
  • Increasing age
  • Nearsightedness
  • African American or Latino ancestry

 

Risk factors for angle-closure glaucoma:

  • Chinese ancestry
  • Farsightedness

 

  1. What are the treatment options?

The only proven way to prevent additional damage to the optic nerve is to lower the eye pressure.  While pressure can be managed by eye drops, patients may also benefit from laser treatments and even surgery. Depending on the type and severity of glaucoma, some patients benefit most from minimally invasive glaucoma surgery (MIGS), which has a quicker recovery than traditional glaucoma surgery and can be combined with cataract surgery. Some examples of MIGS procedures2 currently performed at USC include:

 

  • iStent. A 1mm trabecular bypass microstent is inserted into the trabecular meshwork, the natural drainage system of the eye. This improves outflow of fluid from the eye using the natural drainage pathway. This is the smallest implantable device in the human body!
  • Trabectome. A portion of the trabecular meshwork is ablated (removed) to increase outflow of fluid from the eye.
  • Endoscopic cyclophotocoagulation. An endoscopic laser probe is inserted into the eye and used to apply laser to the ciliary body, the part of the eye that produces fluid. The effect is reduced production of fluid in the eye, which lowers eye pressure.
  • Micropulse transcleral cyclophotocoagulation. A micropulse laser probe is applied to the outside of the eye near the ciliary body. The effect is also reduced fluid in the eye.

 

The USC Roski Eye Institute clinical researchers are actively involved in improving glaucoma diagnosis and treatment. Our researchers are also developing novel glaucoma drainage devices, intraocular pressure sensors, as well as drug delivery systems that will improve glaucoma control and quality of life for our glaucoma patients.

 

  1. Which treatment is right for you?

Each glaucoma patient is treated individually with a unique treatment plan considering all clinical factors. After your glaucoma consultation at USC, we will discuss the best treatment options specific to you and your eyes.

 

  1. What lies ahead: new glaucoma treatments on the horizon?

One exciting new device undergoing FDA approval is the XEN gel stent, which was developed in part by USC researchers. This is a promising MIGS device that may provide greater pressure reduction than other minimally invasive treatment options, and will surely be used by the USC glaucoma team in the future.

 

  1. Is there anything you can do to prevent getting Glaucoma?

In general, blindness from glaucoma is preventable through early detection.  If you believe you may be at risk, are over 50 years of age, or have family members with glaucoma, please get your eyes examined with an emphasis on assessing the optic nerve and peripheral vision. In general it is good practice to get regular eye exams.  To make an appointment, please call (323)745-2223.

 

headshot-grace-richter

Dr. Grace Richter is an ophthalmologist and Assistant Professor of Clinical Ophthalmology at the Keck School of Medicine of USC. She is residency and fellowship trained and a fellow of the Heed Ophthalmic Foundation.

References:
1Vajaranant TS, Wu S, Torres M, Varma, R. Am. J Ophthalmol, 152,2; 303–314.e3.
2 Richter GM, Coleman, AL. Clinical Ophthalmology 2016:10 189-206.

How Our Eyes Change From Birth

EyesFromBirth-Info

Five Things to Know about your Child’s Vision: A Call to Action for Early Vision Screening

Children's Eye Health and Safety Month

August is Children’s Eye Health and Safety Month. Here are five things to know about your child’s vision:

1. It starts with the eyes and the brain

A newborn baby’s vision continues to develop through early and middle childhood. From the first day you look into those precious eyes, your baby begins to create essential connections between the eyes and brain, which will allow vision to develop focus, eye-hand coordination, depth-perception, and color vision. As months pass, your baby will be able to recognize expressions such as happiness or anger and try to reach out and touch a close person or object. Given how critical these connections are, it is important to ensure your child has healthy vision to positively impact the early stages of development. Nearly half of the human brain is devoted to some form of visual function.

2. Prevalence of eye diseases in children

In the largest pediatric eye disease study conducted in America, led by USC Roski Eye Institute Director Rohit Varma, MD, MPH, and a team of researchers, the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) assessed more than 9,000 Los Angeles-area children ages 6 months to 6 years old. Findings include:

  • Incidence of childhood myopia (nearsightedness, which is the inability to see objects clearly at a distance) among American children has more than doubled over the last 50 years
  • 4 to 14 percent of children overall are found to have moderate hyperopia (farsightedness, which is the inability to see objects clearly up close)
  • Prevalence of hyperopia is highest in Hispanic (26.9 percent) and Non-Hispanic White children (25.7 percent), but lower in African American children (20.8 percent) and Asian children (13.5 percent)
  • Children with moderate levels of hyperopia were associated with the development of both amblyopia (lazy eye or poor visual development in an eye) and strabismus (misalignment of the eyes)

“While research shows there is a genetic component, the rapid incidence of myopia in the matter of a few decades, particularly among Asians, suggests that close work and use of mobile devices and screens on a daily basis, combined with a lack of outdoor activities and sunlight, may be the real culprit behind these dramatic increases. More research is needed to uncover how environmental and behavioral factors may affect the development and progression of eye disease,” says Varma.

3. Poor Vision could lead to developmental delays

If uncorrected, vision problems may lead to cognitive and social problems. As a child begins to engage in social settings and is unable to recognize facial expressions or other social cues, the results might be inappropriate emotional responses and learning deficiencies. In a National Eye Institute-funded study, researchers reported a literacy deficiency in children with uncorrected farsightedness. Most notably in this study, children with moderate farsightedness and reduced near visual function such as depth perception, had significant challenges distinguishing letters and words.

4. Common eye diseases and conditions in children

  • Amblyopia (lazy eye)
  • Strabismus (eye misalignment)
  • Uncorrected refractive errors (nearsightedness, farsightedness and astigmatism)
  • Conjunctivitis (pink eye)
  • Ptosis (droopy eyelid)
  • Color vision disorders

5. Early vision screening and what to look for

Eye exams at an early age are essential to prevent developmental delays and ensure that children have healthy vision. According to the American Association of Ophthalmology guidelines, see an eye care professional for your child if you observe:

  • Misalignment of eyes, crossed or a wandering eye
  • Child is squinting, unable to view objects at a distance
  • Child is unable to read up close
  • Swelling, redness, irritation or drooping in one or both eyes
  • Child is unable to distinguish colors
  • There is a history childhood vision issues

“If you have any concern at all about your child’s eyes or vision, get them examined as soon as possible. In certain cases, children may develop amblyopia, which is one of the most common eye conditions treated in children. Childhood amblyopia or poor vision in one or both eyes is due to the brain “tuning out” or ignoring the images seen by the eyes. Amblyopia can cause permanent vision loss and loss of depth perception, and is much more successfully treated at younger ages,” says Sudha Nallasamy, MD, pediatric ophthalmologist and assistant professor of clinical ophthalmology at USC.

Timely diagnosis and treatment interventions of pediatric eye conditions can positively impact the long-term eye health and well-being of a child. Receive skilled treatment tailored to your child’s unique needs from the pediatric ophthalmologists at USC Roski Eye Institute, either online at eye.keckmedicine.org or by calling 800-USC-CARE (800-872-2273).

 

References:

http://www.aao.org/eye-health/tips-prevention/common-childhood-diseases-conditions

eye.keckmedicine.org/incidence-childhood-myopia-rise/

www.urbanchildinstitute.org/articles/research-to-policy/overviews/seeing-the-importance-of-vision-development

Enjoy the Fireworks on the 4th of July but leave it to the Professionals

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We hear statistics all the time but it can be astounding to know that over one thousand people suffer each year from fireworks-related eye injuries in the nation.

Here are the top 5 things to know about fireworks and your eyes.

Fireworks can cause permanent vision loss

Did you know that fireworks can reach temperatures greater than 2000 °F?  Emergency rooms across the nation see an increase in fireworks-related eye injuries especially around the fourth of July. Fireworks can cause significant injuries such as:

  • Chemical and thermal burns to your eye and surrounding areas
  • Damage to the surface of the eye such as corneal abrasions
  • Retinal detachments
  • Ruptured globes (breach of the wall of the eye)
  • Contusions, lacerations and foreign bodies

Even sparklers can be dangerous

According to the U.S. Consumer Product Safety Commission, 19% of all fireworks-related injuries are to the eyes, which include eye injuries from firecrackers, bottle rockets and even sparklers. The most alarming statistic according to the commission’s report is that 40% of such injuries occur in children under the age of 15.  Sparklers cause most eye injuries in children under 5 years of age.  So please leave the sparklers on the cake or in the hands of an adult.

Never buy fireworks from the store

Don’t forget that fireworks are explosives.  Some states have banned fireworks all together and only allow use in designated places. Purchasing fireworks from the store can be dangerous if they are not guaranteed to be in good condition.  Fireworks must be stored properly in cool and dry areas as they could fail and misfire if they are unsealed or damaged. Leave fireworks to trained and licensed individuals who can ensure that they are safely fired.

How to protect yourself

You do not have to handle fireworks to sustain injuries.  According to reports from the U.S. Eye Injury Registry, bystanders are more likely to suffer injuries by fireworks than those using them. Always remain behind the designated lines at the fireworks shows.  If you are using fireworks read the instructions carefully, ensure that the fireworks have been stored in the right conditions, never consume alcohol while operating fireworks and always wear protective eye gear such as goggles that wrap around your eyes.

What to do if you have sustained a firework eye injury

Leave the fireworks and the medical care to the professionals.  American Academy of Ophthalmology has made the following recommendations:

  • Go to the ER immediately so that you can receive medical care
  • Do not wash your eye with water or attempt to clean it
  • Do not touch, rub or apply pressure to your eye
  • Do not use ointment on your eye or take any medications such as ibuprofen or aspirin
  • If there is a foreign body in your eye do not attempt to remove it
  • Significant injuries may require surgery so do not eat on your way to the hospital

As we celebrate this beautiful 4th of July enjoy the spectacular fireworks display safely!

 

References:

  1. http://www.preventblindness.org/prevent-eye-injuries-fireworks
  2. http://www.aao.org/eye-health/tips-prevention/injuries-fireworks-eye-safety