Newsletter Issue 10 | Dec 2011
Florida Eye News and Views
As usual, the days are speeding by! Weren’t we just reminding everyone to wear good UV protection sunglasses and remember to use sunscreen a few months ago? Well, that advice is still appropriate — it may not be summertime anymore, but we Floridians have to protect our eyes and our skin all year round. What’s also appropriate is to remind everyone to keep safety in mind when choosing toys for the kids and grandkids. We’ve included some handy tips from our friends at eyesmart in this newsletter to guide you in your holiday shopping.
Also in this issue is an update on one of Dr. Randy Katz’s diabetic retinopathy patients, Sal Gulino. Find out how he’s been doing with his Lucentis treatments, and how his vision has so improved that he’s almost ready to go back to work. Dr. Katz also shares the importance of special guidelines diabetics should adhere to regarding their vision. Dr. Schechter has been keeping busy as well, becoming something of a local expert on how to preserve eyesight when using smart devices (computers, phones, iPads, etc.). He was also recently featured on Eyetube Journal’s Episode 6 to discuss his study in which he used a dispersive OVD inside the clear corneal incision to ensure a watertight closure.
After more than 30 years we bid Dr. Jonathan Chua adieu as he gets ready to say goodbye to Florida Eye this month. We’ll be sorry to see him leave, but we know he’ll be able to spend more time with his family and friends — and on the golf course!
More updates and info you can use inside, and at the end of this issue, make sure to take a peak at how our Florida Eye family is growing.
Everyone here at Florida Eye wishes all of our patients, friends, families, fellow physicians and our wonderful supportive community a happy and healthy holiday season filled with joy, peace and love.
Happy New Year!
Director of Marketing & Public Relations
In this Issue:
Sal Gulino’s eyesight was getting so bad that he knew it wouldn’t be long before he might be virtually blind. When he came to Florida Eye, he told Dr. Randy Katz that he “felt as close to blind as I guess I could be.” Sal says he knew he was losing his sight, plain and simple.
Kind of ironic for Sal, since he has spent a lifetime helping people to see better himself, as an optician in New Jersey.
After a thorough exam, Dr. Katz diagnosed Sal with diabetic retinopathy. “Sal had quite a bit of swelling and there was hemorrhaging as well,” explains Dr. Katz. “I decided the best possible course of action for him would be to get him started on bilateral Lucentis.” In a matter of months on the drug, the former optician went from 20/100 ou to 20/25.
Sal has continued with his treatments by Dr. Katz every other month for about a year and a half now. “Lucentis has eliminated all of the swelling I had (within the first few months!) and Dr. Katz told me at my last checkup there’s absolutely no signs of leakage or swelling at all. It’s really incredible,” says Sal, who remembers that before treatment, “I had no real detail. I would look at a lawn and see a sea of green. Now, I can see each and every blade of grass — it’s amazing. And when I look at a plain wall, I can see the texture of the wall — also amazing.”
“Luckily we were able to arrange for Sal, who had no insurance, to receive bilateral Lucentis at no charge through the Lucentis Access Program,” says Dr. Katz. “That option may be available for other patients, or, if a patient who hasn’t had any previous types of treatments for their eye condition qualifies, they may be eligible to participate in our national clinical trial study. If they did qualify, their treatments with Lucentis (which normally costs about $2,000 per dose) would be administered at no charge, along with their medical visits and follow-up care.”
For more information about Lucentis or diabetic retinopathy in general, contact Study Coordinator Debbie Rankin at (561) 736-5055.
From Dr. Barry Schechter:
- We currently have one trial for new cataract patients who are having cataract surgery. We are evaluating visco elastic vs. saline irrigation to close cataract surgery wounds.
From Dr. Randy Katz:
- We have a wet AMD for treatment naïve patients that is Lucentis plus a study drug.
- We have another wet AMD for sub- and non-responders to either Lucentis or Avastin. Patients need to have had 4-6 injections within the past 4-6 months and not be significantly better and still have bleeding.
We will be having another wet study coming up and another dry study, as well as a blepharitis study. We will send out an email when these studies open.
. . . . . . . .
As with any of our studies at Florida Eye, if you refer patients and they are enrolled, we will update you on the progress of your patient and return the patient to your care at the end of the study. The sponsor covers all expenses and costs of these trials.
If you would like to discuss these studies further, please contact our study coordinator Debbie Rankin at (561) 736-5055 or email her at [email protected].
There are approximately 29 million Americans age 20 and older that have diabetes and almost one third of those are at risk for vision loss because they do not know they have the disease. Those numbers make Randy Katz, M.D., Florida Eye Microsurgical Institute’s Retinal, Diabetic Retinopathy and Macular Degeneration Specialist very upset. “This is a tragedy waiting to happen because people with diabetes can develop diabetic retinopathy, a degenerative disease of the retina (the sensitive area at the back of the eye) that affects 5.3 million Americans age 18 and older.”
According to Dr. Katz, “More than one third of those diagnosed with diabetes do not adhere to vision-care guidelines by forgoing a dilated eye exam every year. So, as part of November’s Diabetic Eye Disease Awareness Month, I am urging Americans with diabetes to get a dilated eye exam this year, and every year. Also, pregnant women with diabetes should have an eye exam in the first trimester, since diabetic eye disease can progress rapidly during pregnancy.”
The longer a person has diabetes, the greater the risk for developing diabetic retinopathy, says Dr. Katz,, who also points out that diabetic retinopathy does not only affect people who have had the disease. For some people, diabetic retinopathy is one of the first signs of the disease.
What are the signs to look for? Fluctuations in blood sugar levels can temporarily affect vision, so it’s sometimes difficult to know if a serious eye problem is developing. That’s one of the reasons strict control of a diabetic’s blood sugar is so important, says Dr. Katz. “If a diabetic notices a vision change in one eye, a change that lasts more than a day or two or changes not associated with fluctuations in blood sugar, call your ophthalmologist immediately.”
Read the labels!
First and most important, keep your blood sugar levels under tight control.
Second, bring high blood pressure under control.
Third, quit smoking.
Fourth, see your eye care professional at least once a year for a dilated eye exam.
Fifth, see your eye care professional if:
- your vision becomes blurry
- you have trouble reading signs or books
- you see double
- one or both of your eyes hurt
- your eyes get red and stay that way
- you feel pressure in your eye
- you see spots or floaters
- straight lines do not look straight
- you can’t see things at the side as you used to.
When to See an Eye Care Professional
- If you are between 10 and 29 years old and have had diabetes for at least 5 years, you should have an annual dilated eye exam.
- If you are 30 or older, you should have an annual dilated eye exam, no matter how short a time you have had diabetes. More frequent exams may be needed if you have eye disease.
- If you have any changes in your vision.
- You should have a dilated eye exam if you are pregnant or planning to get pregnant.
Eyetube Journal Club features a monthly video webcast on the latest research in cataract and laser surgery. In each edition, discussion leader Christopher Starr, MD, selects an outstanding recent paper, poster, or study and interviews the author or investigator to discuss how the findings will impact daily practice and patient care. Florida Eye’s Dr. Barry Schechter was recently featured in Episode 6: Using a Dispersive OVD Inside a Clear Corneal Incision to Seal It.
After noticing that some cataract incisions continued to leak despite stromal irrigation of their edges with saline, Dr. Schechter investigated alternative options to placing a suture using readily available materials that would not add a significant cost to the procedure. Here, the director of the department of cornea and external disease at Florida Eye reviews the study in which he used a dispersive OVD inside the clear corneal incision to ensure a watertight closure.
In an effort to help the Lions Club, Florida Eye began collecting used eyeglasses (and sunglasses) at three of its four locations about fourteen months ago. Since we began our efforts, patients, community members, family and friends have dropped off more than 3,000 pairs of glasses and for that, we are truly thankful.
It is through organizations such as the Lions Club that millions of men, women and children are fitted year after year with recycled glasses, allowing some the chance to see clearly for the first time in their lives. Studying in school, reading for pleasure, going to work, running errands and simply handling day to day tasks are every day rituals most of us take for granted, but for the recipients of these glasses, being able to accomplish these tasks is a gift.
Lions Club spokesperson Michael Melnick said that 30,000 pairs of glasses were collected in the state last year. “We sort them, and then have doctors discover what prescription they are and then give patients examinations. Every pair of glasses, if you can donate one pair and help one person, you are saving the world.”
Eyeglasses may be dropped off at any time during normal business hours, 8:30 a.m. to 5:00 p.m. at our Boca Raton, Boynton Beach and Wellington locations. We urge all patients to drop off old or unused glasses at their convenience. For more information about the Lions Club and its many volunteer
programs, visit the Lions Club website.
Florida Eye recently participated in the Valencia Lakes Health & Wellness Fair in Boynton Beach. As a vendor it’s always wonderful to be asked to be a part of such a top class production. The event ran smoothly from start to finish and the vendors enjoyed a terrific turnout. Florida Eye’s Dr. Jennifer Garib and Gwen Cohan were on hand to greet booth visitors and answer questions. Rosie Feeley, the Sponsorship Director for the Greater Boynton Beach Chamber of Commerce was very pleased with the event’s turnout. “We are committed to the area’s health care community and are excited to be able to host health fairs.The Valencia Lakes Health and Wellness Fair was a huge success. Over 300 attendees were able to enjoy a number of fitness demonstrations, health seminars by esteemed physicians, free health screenings, and a variety of offerings from over 45 vendors.”
Brought to you by:
No one chooses gifts with the intent to harm, but some popular children’s toys can cause serious eye or other injuries. According to the Consumer Product Safety Commission, there were more than 250,000 toy-related injuries treated in U.S. emergency rooms in 2010; nearly three quarters of those injured were children under age 15.
Gifts potentially unsafe for eyes include BB guns, darts, pellet guns and paintball guns. But saying no to so much can leave parents feeling like a kill-joy. So, what to do?
- As a general rule, choose toys that are appropriate for your child’s age and abilities.
- Consider your own willingness to supervise use of the toy and buy accordingly.
- If giving sports equipment, a popular gift, include appropriate protective eyewear with polycarbonate lenses. Check with your local eye doctor to learn about protective gear recommended for your child’s particular sport.
- Avoid buying toys with sharp, protruding or projectile parts.
- Keep toys made for older children away from younger children.
And a final last tip for those enjoying Christmas trees in their homes …
The branches and needles of Christmas trees can be hazardous to the eyes, so be especially careful when untying your tree. The branches can burst forward, hitting and injuring eyes. Also glass ornaments should be hung out of a child’s reach to avoid potential injury.
Dear Dr. Katz:
What’s involved in testing for diabetic retinopathy?
The diabetic retinopathy exam involves a thorough eye exam, including a dilated retinal exam with both slit lamp biomicroscopy and indirect ophthalmoscopy. These methods of examining the retina with special microscopes and lenses in the office allow the ophthalmologist to see the retina in great detail in order to assess the potential changes that diabetic retinopathy causes. As always, I like to point out that it is extremely important for diabetics to have their eyes checked annually. Annual exams can find potential problems before patients are even aware they are having issues. Annual exams can mean the difference between preserving vision or possibly losing it.
Dear Dr. Friedman:
I’ve heard of children being diagnosed with strabismus (lazy eye), but I am a 35-year-old female and have recently been diagnosed with adult strabismus. One of my eyes has traveled inward. How did this happen and how do I fix it?
An adult onset inward turning eye can be due to restriction of the muscles from Graves disease, or a pterygium growing on the eye, or a myriad of other causes. It may also be neurological such as a palsy of a specific cranial nerve, or myasthenia, or other diagnosis. Therefore, resolution has to begin with a diagnosis by an ophthalmologist who specializes in adult strabismus. The underlying cause has to be treated first. Then, and only then, surgery can be considered to correct the position of the eye.
Dear Dr. Schechter:
I work with computers all day and I use the computer at home a lot. I also read books on my Ipad. How much damage am I doing to my eyes and how long would you recommend the use of computers?
Actually, I was recently interviewed by WPBF ABC Channel 25’s Tiffany Kenney on this exact topic. It’s amazing how many of us tend to neglect our eyes simply because we take our sight for granted. Watch the full report at our Media page (see the videos at the top).
In the meantime, here are some basic precautions for smart device users:
- Blink more frequently to bath the eye in nutrients.
- Increase the font size on your devices.
- Hold the device further away from your face.
- Use tears for dry eye.
- Follow the “10-10-10 rule” — every ten minutes give your eyes a break, look away at something else ten feet away, for ten seconds.
Dear Dr. Gorscak:
I recently heard that the newest thinking about cataracts was that it was best to have them removed early in their development, rather than waiting for them to more fully develop. Is that true? My doctor has told me to wait for them to get worse before operating. I am a little confused and wonder if I should have someone else look.
I think you are getting good advice from your present doctor. Although a cataract can be removed early, if you are not having any difficulty with your vision, there is no reason to remove it. Most patients have slight cataracts as they get into their late 60s and 70s, and the cataracts usually develop slowly. In fact, insurance regulations require problems with some aspect of your vision, like reading or driving a car for example, to justify payment for cataract surgery. Early cataracts that are removed to eliminate the need for glasses are considered “refractive lensectomy” and the expense of the surgery should be paid for by the patient rather than by the insurance company. Since there is always a slight risk with cataract surgery, you must balance the minimal risk with the potential benefit before proceeding with surgery.
Jonathan Chua, M.D., Ph.D., F.A.C.S. has practiced for more than thirty years as a comprehensive ophthalmologist, scientist and researcher and has treated literally thousands of patients during his professional career. Knowing the practice he created long ago was in exceptional hands, Dr. Chua decided 2011 would be his last year of practice with Florida Eye. It is with great admiration and respect that we thank Dr. Chua for his years of dedicated service. Everyone at Florida Eye wishes him all the best.
Visit Dr. Schechter’s cosmetic specials website (www.drbarryschechter.com) to find out about special price savings on cosmetic procedures.
Look how our Florida Eye family has grown!!
The newest baby on board was born November 5th, to Florida Eye’s Dr. Jason Gorscak and his lovely wife Paulina. Little Nio Bond Gorscak just after arrival (center) and then just five weeks later!
Zion Christopher Sanders then … AND NOW!! Age 7 months.
Zion is the adorable cutie of Chante & Christopher.
Reese Alvarado Eng now 8 1/2 months old! Aspiring model/actor/singer. Current occupation: adorable baby of Abby and Eric.
Dr. Jennifer Garib and V.J. Sreeram’s beautiful daughter Anjali Sreeram, born last January — almost one!!