New Technology at Total Eye Care Predicts Glaucomatous Vision Loss

Pattern Electroretinography (PERG) Gives up to 8 Years of Advanced Warning

NOVA-ERGDeviceIncorporating the most advanced technology available in caring for our patients is important to the way we practice at Total Eye Care. The Diopsys® Pattern Electroretinograph is the newest addition to our suite of technology. The Pattern ERG (PERG) measures the signal strength of the retinal information being sent to the optic nerve. Studies show that a 10% decrease in this signal can be detected up to 8 years earlier than a 10% loss of nerve fibers detected by the scanning laser ophthalmoscope or optical coherence tomographer, thus allowing for a much earlier diagnosis and treatment.

Early detection and treatment of glaucoma is important due to the fact that nerve tissue cannot be regenerated. Twenty years ago, in the absence of a very high intra-ocular pressure, it was a common practice to wait until a visual field defect was present before initiating treatment. There is a significant amount of redundancy in the retinal nerve fibers, thus studies have shown that a patient must lose approximately 50% of the nerve fibers serving a given section before the loss of nerve fibers result in a detectable visual field defect. The scanning laser ophthalmoscopes changed all of that allowing us to detect earlier, more subtle changes in the retinal nerve fiber layer. Now patients are treated before visual field defects become apparent.

The Diopsys® Pattern Electroretinograph is the next step in early detection. The PERG will not replace the scanning laser ophthalmoscopes such as the Zeiss Cirrus Optical Coherence Tomographer (OCT) in the diagnosis of glaucoma; however, it gives us another valuable tool in the diagnosis and treatment of glaucoma.

Summer – A Great Time for Orthokeratology

I was asked what is the 60 second brief on OrthoK so here are my high points along with a video. 

Orthokeratology – or·tho·kera·tol·o·gy – a treatment for improving vision by altering the shape of the cornea through the application of corneal molds that are worn while you sleep.

Adult patients, kids, and parents alike express amazement at how we can alter or mold the shape of the cornea with a contact lens, resulting in clear vision during the day without the need for glasses. It’s not magic, the science is very well established and FDA approved.  We remold the cornea like what is done in LASIK. The difference is that Ortho-K achieves this without the use of a laser, it is reversible, and it is easily modifiable.

Check out the video below and see what patients are saying about Orthokeratology. If you want to know more about Orthokeratology call our office for a free consultation 817.416.0333 or visit www.OrthoKDoctor.com

What Does Pink Eye or Red Eye Mean?

Red eye PhotoPink eye is a descriptive term indicating that the eye is inflamed for some reason. Not all pink eyes are infected or contagious. “Pink” eye is usually caused by a virus (often quite contagious), allergies, or bacteria. The most common cause of pink eye is a viral infection or allergies. Patients with pink eye should not wear contact lenses. Read more…..

New Drug For Dry Eye Treatment

Bausch & Lomb announced it has acquired the rights to market a new medication for the treatment of dry eye syndrome. This, yet to be named, medication will improve the quality of tears by promoting the eye’s ability to produce mucin, an essential component of our tears, that is responsible for prolonging the evaporation time.

This medication will be the first of it’s class and the first to focus on improving tear quality instead of quantity. Dosing will be twice a day. Phase 3 clinical trials are to begin by the end of 2013.

While a few years from clinical use this compound will provide a new approach to the treatment of dry eye syndrome..

Study Shows Orthokeratology Effective in Reducing the Progression of Nearsightedness in Children

The study of myopia control (nearsightedness) is a hot field of study, particularly in China where the High Myopia – Partial Reduction Orthokeratology (HM-PRO) study was conducted. This study is the latest in an effort to find an effective means to slow or even stop the progression of nearsightedness in children. The HM-PRO study is unique in that it treated 18 highly myopic children (Rx over -5.75 D) between the ages of 8 and 11 with a combination of OrthoK lenses and glasses, and followed them for two years. The study participants were matched with a control group of 18 children, the same age and also with prescriptions over -5.75D.

In the HM-PRO study 18 participants and 18 control patients were followed for 2 years. 15 of the treatment patients and 13 control patients completed the study.  After two years the treated patient’s nearsightedness increased by – 0.13D and the untreated (control) patients increased their nearsightedness by -1.00D.

Myopic progression is also measured by how much the eye grows in length (called the axial length). In this case the treated patients showed a significant reduction in progression with their axial length increasing by 0.19 mm whereas the control group’s axial length increased by 0.51 mm.

The study authors concluded that orthokeratology lenses slowed axial length elongation by 63% and reduced the prescription change by 87%. It has yet to be shown that orthokeratology lenses stop the myopic progression clearly this study, like numerous other before it, show that orthokeratology is effective in markedly slowing the progression of nearsightedness in children. At Total Eye Care we have been using reverse curve orthokeratology lenses to control myopia since 1999 and have fit hundreds of kids and adults.

The Harlem Shake Total Eye Care Style

See how Total Eye Care does lunch.

Scleral Lenses – An Old Dog With New Tricks

Eye with keratoconusScleral lenses have been around for over 100 years. Until the new gas permeable lens materials were developed patients could only wear scleral lenses for a few hours a day. With the highly oxygen permeable lens materials now in use, patients can comfortably wear these lenses all day. Scleral lenses are most commonly used to treat eyes with irregular corneas such as keratoconus and post surgical eyes (usually following corneal transplant surgery or related to complications from refractive surgery). Another common use for scleral lenses is in the special effects industry where they are used to protect the cornea and/or to give the eye an exotic appearance.

What Is A Scleral Lens?

Scleral lenses are large contact lenses that rest on the sclera (white part of the eye) with the remainder of the lens vaulting over the cornea. Tears are trapped between the lens and the cornea allowing sclerals to treat irregular corneas. The average soft contact lens has a diameter of about 14 mm whereas scleral lenses typically have a diameter exceeding 14.5 mm. 

How Are Scleral Lenses used?

At Total Eye Care Dr. Driscoll has  used scleral lenses to treat many conditions such as irregular astigmatism, keratoconus, high myopia, dry eye syndrome, and complications related to LASIK and PRK. Because of their size, sclerals are quite comfortable. Patients often report the comfort being similar to that of a soft contact lens. Most patients with irregular corneas will see better with a scleral lens than with glasses. 

Below is a good video that shows how scleral lenses are cared for and how to insert and remove them.