Statistics shows that there are more than two million Americans that live with age-related macular degeneration. Of those two million an estimated 10% will develop an even more severe condition known as neovascular macular degeneration also known as “wet” AMD. This condition is characterized by the growth of abnormal blood vessels from the choroid underneath the macula. The patients who progress to “wet” AMD typically experience a more rapid decline in their vision than those of “dry” AMD.
Let’s face it; permanent loss of our central vision is a terrifying thought for anyone. Even more terrifying is that there have been few available treatments for this blinding disease until the recent introduction of eye injections. Two anti- aging drugs: Lucentis and Avastin are commonly used to help manage wet AMD. Most injections for neovascular (wet) AMD typically are recommended administered via intravitreal injection once a month. However, the argument is that the so-called “good” doses are causing more harm than good to patients receiving them. Dr. Edward Kondrot refers to these injections as the “Watergate of eye care” and is on somewhat of a crusade to increase the awareness of the controversial treatment.
Kondrot believes that patients in his words have been “bullied into getting the injections for their wet AMD…and the side effects of Anti-VEGF do not outweigh the benefits.” Kondrot further adds that the systemic side effects of the drug can include: “myocardial infarction, angina, hemorrhage, hypertensive crisis, and congestive heart failure to name only a few….”
Kondrot also believes that the injections enhance the occurrence of retinal detachment, glaucoma as well as cataracts. He references a study by the University of Pennsylvania in which 18% of patients receiving the injections were found to have developed some of the serious complications mentioned above.
There are of course, safe and effective alternatives to this injection and Kondrot believes many patients can be helped by various treatments including microcurrent therapy, cold laser therapy, syntonic light therapy and other virtually risk-free methods which you can find a further discussion of on his website (link provided at end).
Early prevention is the important key, regular check ups, and Kondrot recommends improving diet, reducing stress and chelation therapy among some of the strategies available.
Kondrot is clear, he is saying only to not be “bullied” or told that the injection is the “only” treatment available for wet AMD. He cautions everyone no matter what their diagnosis to seek all the information available, seek more than one opinion and education yourself to the alternatives and then make an informed decision, not one made from fear and a place of non-education. He urges that you begin safely by trying alternatives and if you do not see or like the results you are receiving, then consider the injections but cautions to be aware of the risks involved.
Additional information on this and other eye related topics at the American Optometric Association.
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]]>Some answers from Dr. Tina, D. Turner, ophthalmologist at Henry Ford Health System’s Grosse Pointe Ophthalmology and the author of An Introduction to Cataracts and Cataract Surgery.
Many that suffer from cataracts have the same question. Should I or should I not have surgery?
To date, there is no medication or eye drop has been proven to prevent or reverse cataract formation. If a cataract causes nearsightedness or a change in an individual’s prescription, new prescription eyeglasses can help improve blurred vision. The “only” treatment for a cataract, however, is surgical removal of the natural lens, but do you have it removed sooner or later?
A cataract should not be removed simply because it is present. Many people have cataracts that do not cause blurred vision, interfere with their activities of daily life, or otherwise prevent them from leading active and productive lives. In such cases, these individuals should not undergo unnecessary surgery to remove their cataracts.
However, if an individual has blurred vision that makes it difficult to read print or read signs while driving; has disabling glare while driving at night; or has difficulty engaging in hobbies such as card games, etc.it is time to consider cataract surgery.
In short, if an individual has a cataract and results in blurred vision that makes it difficult to do anything he or she wants and needs to do; it is time to consider cataract surgery.
If there are cataracts in both eyes that require surgery, the surgeries are usually performed several weeks apart. Cataract surgery on both eyes at the same time is not recommended because there is a possibility of complications affecting both eyes; the most worrisome is infection.
Dr. Turner writes that a cataract does not have to become “ripe” before it can be removed. In the past, the lens could not be extracted safely from the eye unless it was at a relatively advanced stage of development. With modern advances in cataract surgery, the lens can now be removed from the eye at any stage of development.
It is true that the longer a cataract develops, the more it hardens. At advanced stages, a firmer or more developed cataract can be difficult to remove. In certain situations, it is safer to remove a cataract sooner rather than later; in most cases, however, an individual should not undergo cataract surgery unless he or she is experiencing blurred vision caused by the cataract.
It is also true that if cataracts are allowed to develop for long periods of time, they can cause inflammation or increased intraocular (within the eye) pressure that can lead to glaucoma.
In these situations, it is extremely important to remove the cataract to prevent loss of vision from the resultant inflammation or glaucoma. This however would rarely occur in the United States, due to regular access to most types of health care.
It’s important to understand that it is the patient who should – and must – make the decision to undergo cataract surgery. It is the doctor’s responsibility to educate patients and give them the knowledge they need to make an independent and well-informed decision regarding cataract treatment.
Additional information on this and other eye related topics at the American Optometric Association.
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]]>To begin: You don’t have “a stigmatism” – you have astigmatism.
Astigmatism is a refractive error, like nearsightedness and farsightedness, meaning that it is not a ‘health’ problem or a disease of the eye itself. Simply put, it is a problem with how the eye focuses light – the light fails to come to a single focus on the retina to produce clear vision, rather multiple focal points occur, either in front of the retina or behind it (or both).
Generally astigmatism cause one’s vision to be blurred or distorted to some degree at all distances, if gone uncorrected astigmatism cause severe eyestrain and headaches, especially so after reading or other prolonged visual tasks. Another common symptom of astigmatism is squinting.
Astigmatism most usually is caused by an irregularly shaped cornea. Instead of the cornea having a symmetrically round shape – it is shaped like a football, rather than a baseball, with one meridian being significantly more curved than the meridian perpendicular to it. The steepest and flattest meridians of an eye with astigmatism are called the principal meridians. In some special cases, the astigmatism is caused by the shape of the lens “inside” the eye. This is called lenticular astigmatism, to be able to differentiate from the more common corneal astigmatism.
(Definition of types from: American Optometric Association)
Irregular astigmatism can result from an eye injury that has caused scarring on the cornea, from certain types of an eye surgery or from keratoconus, a disease that causes a gradual thinning of the cornea.
Astigmatism usually occurs early in life, so it is most important to get an early eye exam for your child to avoid any vision problems that might occur in school from this uncorrected condition. Statistics show that children in the United States between the ages of 5 to 17 years of a study of 2, 523 (American youngsters) that 28% of those suffered from astigmatism. There seems to be some significant prevalence based on ethnicity as well, with Asian and Hispanic children having astigmatism conditions over white children.
Astigmatism is detected during a routine eye exam with the same instruments and techniques used for the detection of nearsightedness and farsightedness. Your eye doctor can estimate the amount of astigmatism you have by shining a light into your eye while manually introducing a series of lenses between the light and your eye.
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]]>Amblyopia, other wise known as “lazy eye”, is the most common cause of preventable blindness in children. While the loss of vision usually occurs in one eye, rarer forms of bilateral amblyopia do exist. This type of “blindness” occurs in approximately 2 out of 100 healthy children. In amblyopia the loss of vision is not from a disease of the eye but rather the lack of development of the visual brain. Therefore, by definition, a child with amblyopia has healthy eyes, yet the brain cannot see.
Therefore, the cause of amblyopia is not due to a disease process. Instead the cause of amblyopia is when there is interference in the infant’s binocular visual development. This means that amblyopia occurs when the visual brain of the baby stops developing normally from the lack of proper “two-eyed” visual input. As a result, even with healthy eye structure, the child is not able to see clearly from the affected eye. So, a child with amblyopia will typically have 20/20 eyesight in one eye and the other eye will be poor. The severity of the amblyopia will be measured by how poor the eyesight is in the affected eye. In addition to poor sight, the child with amblyopia will also have “stereo blindness” or poor depth perception. This only adds to the visual difficulty since the child who is “stereo blind” will not be able to experience the benefits of three-dimensional vision.
There can be many causes for amblyopia. But, the underlying mechanism for amblyopia is when something prevents a developing child from seeing with both eyes simultaneously. The most common causes are strabismus (eye teaming failure, such as crossed eyes) and unequal refractive error (example: high farsightedness in one eye while the other eye is normal).
Myths and practices-debunking the old myths:
Over the years amblyopia was thought to be only treatable if caught before age 6. This myth has been disproven. Current research shows that amblyopia can be treated even in 18 year olds.
A commonly prescribed form of treatment for amblyopia, yet insufficient by today’s standards is what is called “occlusion therapy”. Occlusion therapy or “patching” is where the patient wears an eye patch on the “good eye” for typically hours at a time during their waking hours. While the research shows that a child’s visual brain will show improvement in their amblyopic eyesight with a patching regimen, this “old school” approach (when used alone) can be very difficult and disruptive for the developing child to handle. It creates visual disorientation and confusion in spatial judgments. This in turn creates frustration and often-emotional upset in the patient. Furthermore, unilateral patching therapy only teaches a patient how to be a “one eyed person” since it does not address the underlying cause for the amblyopia which is the lack of binocular (two-eyed) vision development.
Therefore today’s “best practices” approach for the treatment of amblyopia involves a combination of monocular and binocular training of the visual brain through office-based vision therapy. This is done with a vision therapist under the direct supervision of a Doctor of Optometry along with prescribed home-oriented visual activities to complement the weekly or bi-weekly in-office procedures.
This treatment approach yields the best outcomes, often resulting in normalization of eyesight in the amblyopic eye and the development of stereo vision (3-D vision) for the child.
Dr. Dan L. Fortenbacher, O.D., talks about this condition more on the American Optometric Association.
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]]>Tips:
Additional information on this and other eye related topics at the American Optometric Association.
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]]>Congratulations, you have decided to seek to improve your vision through cataract extraction. It is my goal to educate you about the options in intraocular lens technology and thereby help you understand what to expect of your vision after your cataract is removed. When cataract surgeryis performed, the cataract (or clouded lens of the eye) is removed and a crystal-clear intraocularlens implant is inserted into the eye to help focus sight clearly after surgery. The use of intraocularlenses has been widely used for over forty years and today nearly 100% of all cataract surgeries are performed with intraocular lenses.
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]]>Patients with insurances which require co-pays or deductibles will be required to have a credit card on file which would be used only in the event of an outstanding balance. This card can only be used for your co-pays, deductibles, co-insurances, or balances that are patient responsibility. When we apply your payment, a receipt will be mailed out to you for your records.
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]]>I authorize any holder of medical information about me to release to the Health Care Finance Administration (HCFA) and its agents any information needed to determine benefits payable to related services.
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]]>Mark A. Latina, M.D., Vicki S. Kvedar, M.D., Karen Gladstone, O.D.
Financial Policy for Patient Care Services
To help our office provide the most efficient and reasonable health care services, it is necessary for us to have a Financial Policy stating our requirements for payment of services rendered to our patients. Patients are responsible for the payment of all services provided by our office. It is our policy to file for insurance payment as a courtesy to you if we have accurate and complete insurance information. The balance due is still your responsibility if we have not received payment from the insurance company within 30 days. If we receive duplicate payment from both the patient and the insurance company, we will then prepare a refund for any overpayment and send it to you.
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]]>This form provides our practice with your demographics and Consent for Treatments.
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