Age Related Macular Degeneration Awareness Month in New Jersey

“Age Related Macular Degeneration (AMD) is the leading cause of visual impairment and blindness in Americans older than 50, affecting more than two million people. Although AMD is incurable, there are new treatments that can at a minimum prevent further vision loss from the disease and in many cases actually help recover lost vision,” commented New Jersey Retinal Specialist Milton Kahn, M.D.

AMD causes central vision to blur, but leaves peripheral vision intact. It is progressive and painless. There are two types of ARMD: Dry and Wet. Approximately 90 percent of people with AMD have the dry form which results in gradual vision loss. Although only 10 percent of people with ARMD have the wet form, it generally progresses much quicker than the dry form. Wet AMD is characterized by the growth of abnormal retinal blood vessels that leak blood or fluid, causing rapid and severe central vision loss.

Patients can often reduce the risk of developing ARMD by not smoking as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables, avoiding foods with trans fats, exercising and controlling blood pressure and weight. “We are fortunate to be able to provide patient with injections of Anti-Vascular Endothelial Growth Factor (VEGF) drugs that inhibit the development of unwanted blood vessels that cause wet ARMD as these agents are effective in helping to prevent further visual loss and even improve vision," said Dr. Kahn.

Patients older than 50 are encouraged to have a comprehensive, dilated eye examination every one to two years to ensure that ARMD is detected and treated early. The key to successful treatment is early detection and intervention. If you or someone you know is at risk for AMD please have the call The Eye Care & Surgery Center at 908-789-8999 to schedule and eye exam.

Finding the Best Cataract Surgeons in New Jersey

To find the best Cataract Surgeons requires a little bit of work and investigation but is always worth it. Finding an eye surgeon who is a Cataract Specialist can help you to be confident that you are getting the most current information, thoughts and techniques to deal with your cataracts.

Ask People You Trust for a recommendation. Ask your friends, co-workers and family-but most importantly ask you primary care physician who they would go to or who they would send a parent to for cataract surgery.

Don’t Limit Yourself to Insurance Lists. Just because a Cataract Surgeon is “in network” isn’t a reason to use them if you are able to identify a top cataract surgeon you wish to go to who isn’t listed. Paying a slightly higher co-pay or deductible may be very worthwhile to get the Cataract Surgeon of your choice. If the best Cataract Surgeon in your area happens to be in the insurance list then you are all set.

Use the Power of the Internet. Take a minute to search “cataract surgeons in (insert your town/city/state)” or “best cataract surgeon in (insert your town/city/state)”. This will at least give you a starting place to begin creating a list of eye surgeons to investigate further.

Visit the Cataract Surgeon’s Web Site. Once you have compiled a list, visit their web sites and get a feel for their practice culture and philosophy. While a web site by itself can’t tell you much about surgical skills, it can tell you about how well he or she presents information and explains detail to patients. This is important in how comfortable you may feel in that practice.

Schedule a Consultation and Meet the Cataract Surgeon. The only sure fire way to find out if you are comfortable and get a sense of trust from a cataract surgeon is to schedule a consultation and meet the surgeon personally. They should be able to clearly explain your eye health and vision as well as the cataract procedure and answer any questions you have in understandable language and terms. Whether or not you find the right cataract surgeon right off the bat it is never inappropriate to………

Get a Second Opinion. Making a decision about eye surgery is a big deal. Getting to a place where you feel confident, relaxed and comfortable is important.

If you or someone you know has a Cataract or wishes to learn more about Cataract Surgery please call The Eye Care & Surgery Center-908-789-8999.

UV and Contact Lenses

Ultraviolet radiation (UV) from natural sunlight and artificial sources can cause significant damage to our skin and eyes. It is well known that UV exposure damages cells that may lead to the development of skin cancer. Ultraviolet radiation may also harm tissues in the eye that may cause or worsen conditions such as ocular cancer, pterygium, and cataracts. Sunglasses and shading of the eyes protects us from some direct UV exposure but we may be exposed to something known as diffuse solar UV radiation. Diffuse solar UV radiation is caused by scattering of UV light and surface reflection and can reach the eye in significant amounts. Some contact lenses can offer UV protection to the eye which may offer protection from some of these harmful rays that can enter the eye from around sunglasses or a brim of the hat. UV contact lenses may be beneficial to those patients who already wear contact lenses to correct their vision but will not provide protection to the skin and conjunctiva. Their role in protecting patients who do not wear contact lenses for vision correction has not been studied but it may be interesting to see how much protection they can afford. Contact lens wear, however, has intrinsic risks such as increased corneal ulceration/infection and the benefits of their UV protection should be clearly demonstrated before they are recommended for use by the general public.

Guest Blogger: Roslyn Stahl, M.D. Cataract and Glaucoma Specialist at The Eye Care & Surgery Center of Westfield, Warren and Iselin, New Jersey.

Aspirin & Macular Degeneration (AMD)

There may be a relationship between frequent aspirin use and Macular Degeneration (AMD) according to researchers from the European Eye Study who reported some interesting findings on the October 2011 publication Ophthalmology which is the official journal of the American Academy of Ophthalmology. They found that frequent aspirin use may be associated with an increased risk of early or late “wet age-related macular degeneration”, with an “odds ratio” that increases upon frequency of consumption. However the study is somewhat limited in that there was an unknown amount of aspirin taken, as well as the possibility that participants may have taken aspirin after experiencing visual problems. So, at this time the study is interesting but inconclusive and certainly patients taking aspirin to offset the coronary risk profile or other vascular problems should NOT discontinue taking aspirin unless they have been directed to do so by their personal physician. Patients who have question or concerns about Age Related Macular Degeneration (AMD) should feel free to contact The Eye Care & Surgery Center at 908-789-8999for information or to schedule an appointment.

Senior Citizen Driving Requirements

In New Jersey, driving is considered a right, not a privilege. Consequently, there are certain requirements for vision that must be met. In the state of New Jersey, one needs a vision of at least 20/40 in their strongest eye for a regular driver's license. For a commercial driver’s license, one requires a minimum of 20/40 vision in both their eyes. The regulations differ from state to state. There are even some states that require the testing of a driver’s peripheral vision. Driving studies have shown an increase accident rate only when there is a visual problem with both eyes. However, there are many drivers on the road who do not meet these visual requirements, and still drive safely.

The New Jersey Academy of Ophthalmology has been actively working with the state to redefine the visual requirements for driving. One possibility that is in discussion would be to issue a limited license for people whose vision is only slightly worse than 20/40 whereby the individual would still have the ability to drive, but with limitations. Fortunately, many people already self select their driving habits, driving only during daytime hours, when environmental visibility is clear, on local roads, and avoiding bad weather. Just as teenagers have restrictions on their driving licenses, there are many elderly people who should have it as well. As an ophthalmologist, it is always a difficult discussion to have with a patient and their family, as to ‘when to take the keys to the car away’, as independence is lost. As a rule, however, it is better to discourage driving for someone visually impaired TOO SOON rather than TOO LATE.

Guest blogger: Ivan Jacobs, M.D. Founding Partner, New Jersey Cataract and Glaucoma Specialist at The Eye Care & Surgery Center.

LASIK for Contact Lens Problems & Intolerance

“Contact lens problems and intolerance seem to be motivating more and more patients to schedule LASIK consultations these days,” said New Jersey Corneal Specialist Joel Confino M.D. of The Eye Care & Surgery Center.

In fact, contact lens problems and intolerance are the reasons a great many patients seek LASIK Surgery and Laser Vision Correction. “The most common reason for contact lens intolerance that we see is a condition called Giant Papillary Conjunctivitis or GPC,” commented Dr. Confino.

When we wear contact lenses, no matter how successfully or how diligent we are in their care and replacement, they become coated with mucous and protein from our tears. After a number of years of wearing contacts it is not uncommon to develop an allergy to the protein on the contact lens. Initially this may result in patients having some dry eye symptoms and prompt them to use lubricating eye drops. However, as the GPC contact lens problem continues to progress patients begin to notice some itch and stringy mucous type discharge from their eyes. After a while the contacts just become too uncomfortable and gritty and patients become intolerant and just can’t wear their contacts. During a severe episode of GPC, patients may be restricted from wearing their contacts in order to reduce the allergic inflammation of the lids. In some cases, patients are no longer able to wear contacts again at all. Patients with a chronic GPC may decide to have LASIK to correct their vision, so that they no longer need to depend on contacts on a daily basis.

LASIK can be a great option for you to rid yourself of the hassle of contacts and allow you to continue a “glasses free” lifestyle for seeing at distance. If you or someone you know suffers from any type of contact lens problem and would like to learn more about LASIK and whether they are a good candidate please call The Eye Care & Surgery Center at 800-504-1083 for a Free LASIK Consultation and visit us on Facebook at facebook.com/eyecareandsurgerycenter

Skin Peel Preparation and Expectations

Chemical Peels are an easy and affordable way to treat patients with sun damaged skin, fine lines and wrinkles, pigmentary abnormalities, acne and acne scarring. One week prior to having a peel, one should avoid getting electrolysis, waxing, hair laser removal, Botox and the use of depilatory creams. Two to three days before a peel, avoid using Retina-A, Renova, Differine and Tazorac and any products containing retinol, alpha-hydroxy acid (AHA), beta-hydroxy acid (BHA) or benzoyl peroxide. Any exfoliating products that may be drying or irritating should also be avoided. Anyone who has had a medical cosmetic facial treatment or procedure, e.g. laser therapy, surgical procedures, cosmetic fillers or microdermabrasion, should wait until skin sensitivity completely resolves before receiving their treatment.

Patients who should NOT be treated with chemical peels include anyone with active cold sores, warts, open wounds, sunburn, excessive sensitive skin, dermatitis or inflammatory rosacea. Also, patients with a history of allergies (especially to salicylates like aspirin), rashes or other skin reactions, have taken Accutane within the past year, or women who are pregnant or breast feeding, should not be treated with a peel. Lastly, patients who have received chemotherapy, radiation therapy, have vitiligo or anyone with an autoimmune disease such as rheumatoid arthritis, psoriasis, lupus, multiple sclerosis should not receive a peel.

After receiving a chemical peel, it is expected that your skin will be red, possibly itchy and/or irritated. Although most people experience peeling of their facial skin, not every patient notices that their skin peels. Lack of peeling is NOT an indication that the peel was unsuccessful. If you do not notice actual peeling, please know that you are still receiving all the benefits of a peel such as stimulation of collagen, improvement of skin tone and texture and diminishment of fine lines and pigmentation.

Thank you to our Guest Blogger: Stephanie Tribel OSA, Cosmetic Services Coordinator at The Eye Care & Surgery Center in New Jersey