COVID-19 has had far-reaching impacts on our lives, with medical procedures and surgeries deemed “elective” postponed in order to slow the virus’s spread. In reality, these procedures are far from optional: delaying medical interventions can result in increased health problems, such as deteriorating vision.

Increased Patient Safety Measures to Combat COVID-19

In recent weeks, we have resumed elective cases and implemented a number of protocols to ensure your safety as you take charge of your health and schedule procedures at our ambulatory surgery centers. These measures include:

• Screening everyone who enters the center for COVID-19 symptoms
• Taking the temperature of every person who enters the center
• Requiring masks for all employees and patients
• Enforcing social distancing guidelines
• Requesting patient escorts remain in the car until patient is ready to go home
• Increasing cleaning of high-touch surfaces throughout the day
• Providing hand sanitizer and tissues

Learn more about all of the steps we are taking to keep you safe.

Patients Feel Safe at our Centers

Patients who have already returned to the centers have first-hand experience of the new protocols in action. Their feedback has been extremely positive, with reactions like:

“During this COVID-19 time, I was especially nervous about my procedure but was immediately greeted by the friendliest nurse around. She was very courteous and kept asking if I was fine. She prepared me for the procedure by carefully doing everything that needed to be done and listened to me. The rest of the staff was also very professional and took great care of my needs. Thank you all for a great experience that I hopefully won’t have to repeat for a while.” – San Antonio, April 2020

“Even during these crazy times, I was treated with the utmost respect, courtesy, and care. My doctor and her amazing team took the necessary steps to make sure I wasn’t put at greater risk during my procedure. They ensured all my questions were answered, and I was 100% ready going into and out of the procedure.” – Escondido, April 2020

“Sanitary, safe, NICE and COMPASSIONATE staff!! Thank you SO MUCH to all of my nurses throughout the entire experience!” – Lakeside, AZ, May 2020

Safely Schedule a Procedure

With increased safety measures in place, there has never been a better time to schedule cataract surgery. Stop putting it off and call your ophthalmologist today to take the first step toward improving your sight!

A new study at the University of Virginia suggests gene therapy could offer new age-related macular degeneration (AMD) treatments for wet AMD and dry AMD.

What Causes Age-Related Macular Degeneration? (AMD)

Macular Degeneration (AMD) is a leading cause of vision loss and affects more than 10 million people in the United States. This is more than glaucoma and cataracts combined. AMD is caused by the breakdown of the center of the retina, the part of the eye that sends images to the brain through the optic nerve. The middle of the retina is called the macula, and it is responsible for central vision. It provides the ability to read, drive, decipher color, recognize faces and see details in objects.

According to the Centers for Disease Control and Prevention, AMD incidence is expected to double from 48 million to 88 million in the next 30 years.

What are the Types of AMD

AMD is divided into two basic types: wet and dry. Wet AMD comprises about 15 to 20 percent of cases, and the symptoms can often be treated with eye injections. The majority of AMD is dry, and there is no treatment for this variety of the disease.

Gene Therapy Reverses AMD in Mice

Researchers are hopeful that new macular degeneration treatments for wet and dry AMD could be available in the near future. Brad Gelfand of the University of Virginia’s Center for Advanced Vision Science successfully treated age-related macular degeneration in mice. Gelfand discovered the absence of an enzyme called Dicer could initiate both forms of macular degeneration. Dicer levels reduce with age, and the loss of Dicer causes an overgrowth of blood vessels in the retina. Using gene therapy, Gelfand restored Dicer in the mice and found it reversed AMD.

“We weren’t really satisfied with just one system,” Gelfand explained. “We actually got a different model that had originated from a totally different lab, in Japan, and found the same exact thing. Then we went back to some of our old models where we had gotten rid of Dicer and found the same exact thing.”

Further testing will determine the effectiveness and safety of this new macular degeneration treatment.

“It’s not as if this is the final answer to the problem, but it’s certainly a big step along the way,
hopefully… It certainly solidifies the idea that wet and dry AMD share a lot of mechanisms” said Gelfand.

It will take years to develop a new macular degeneration treatment based on Dicer. However, Dicer has the potential to be the premier treatment for dry AMD.

Know Your Risk for AMD

Risk for AMD increases with age, especially in individuals 55 years of age and older. Genetics also play an important role, as well as race. Caucasians are at a higher risk for AMD compared to Latinos and African Americans. Certain lifestyle choices like smoking also increase likelihood of AMD.

Call Your Ophthalmologist

Although currently, there is not a cure for AMD, you can reduce your risk or slow the progression of the disease by visiting your ophthalmologist once a year for a comprehensive eye exam. Healthy lifestyle changes like exercising, eating a balanced diet, avoiding smoking and wearing sunglasses that offer 100 percent UVA and UVB protection can help prevent degenerative eye diseases. Make an appointment today with your eye doctor to talk about ways you can support your vision health.

A recent study reveals a new feedback pathway from the brain to the eye which regulates eye pressure, and this could promote new glaucoma treatments.

Glaucoma is associated with elevated eye pressure due to a reduced ability of the eye to regulate fluid drainage. Excess fluid in the eye causes increased pressure, which can damage the optic nerve over time. This is known as open-angle glaucoma, the most common form of glaucoma in the United States.

Brain Pressure Affects Eye Pressure

A team of neuroscientists from the University of South Florida conducted a study that proves there is a physiological connection between eye pressure and intracranial pressure (brain pressure). The researchers proved this by “altering intracranial pressure in animal models and noting changes in the fluid drainage properties of the eye that could be blocked by chemicals that eliminate feedback signals from the brain” (Science Daily).

The team found the eye was able to adapt to intracranial pressure changes to restore a healthy pressure differentiation across the optic nerve.

Chris Passaglia, PhD, professor of Medical Engineering at the University of Florida, said, “The drainage control system may service to protect the optic nerve from swings in eye or brain pressure. Its discovery offers a new target for glaucoma treatment. . .” Dr. Passaglia hopes the study can be instrumental in developing new treatments for lowering eye pressure in glaucoma patients and halting glaucoma progression.

Now, the researchers are attempting to verify the exact location of the brain cells that are transmitting messages to the eye, as well as pinpoint the nerve fibers in the eye that the brain mediates.

What Factors Influence Glaucoma Risk?

Glaucoma affects more than three million Americans, but only half are aware they have the disease. Do you know your glaucoma risk? Glaucoma usually does not have symptoms in the early stages, but it can cause permanent vision loss before any warning signs appear.

These are a few risk factors for glaucoma:

• Age 45 or older
• Family history of glaucoma
• History of injury to the eye
• African American
• History of steroid use, either in the eye (drops) or systemically (orally or injected)
• Diabetes
• Nearsighted (myopic)
• Farsighted (hyperopic)
• History of elevated intraocular pressure

What is a Comprehensive Eye Exam?

The best protection against glaucoma is routine comprehensive eye exams. Your ophthalmologist will perform a glaucoma test as well as evaluate your vision for focusing problems, refractive errors and common eye diseases.

Call your ophthalmologist today schedule a comprehensive eye exam for the whole family. Your vision is a precious gift that requires regular care.

A new study from University College London suggests living in more polluted areas increases risk for glaucoma, a common cause of vision loss.

The study, led by Paul Foster, Ph.D., professor of ophthalmic epidemiology and glaucoma studies at UCL Institute of Ophthalmology and Moorfields Eye Hospital, examined data from 111,000 people across Great Britain who had their eyes examined between 2006 to 2010. The researchers found people who lived in the top 25 percent most-polluted areas were at least six percent more likely to say they had glaucoma than people in the least polluted areas.

Particulate Matter and Air Quality

Air quality is measured by amounts of particulate matter, the sum of all solid and liquid particles suspended in air molecules. Particulate matter can include pollen, dust, smoke, soot, and both organic and inorganic particles.

Poor air quality increases risk for lung and heart disease, stroke, Alzheimer’s disease and Parkinson’s disease. In fact, exposure to particulate matter is one of the strongest predictors of mortality due to air pollutants.

Few studies analyze the relationship between pollution and glaucoma. However, ninety percent of the Earth’s population breathes air that is above the World Health Organization’s limits for air pollution.

Air Pollution and Glaucoma

People who lived in more polluted areas were also more likely to have a thinner retina, a typical symptom of glaucoma progression. Pollution did not seem to affect inner eye pressure, the mechanism researchers usually associate with glaucoma progression. The team concluded air pollution must influence glaucoma development through a different route.

The researchers were not sure why particulate matter increased glaucoma incidence. Sharon Chua, Ph.D., a research fellow at the UCL Institute of Ophthalmology and Moorfields Eye Hospital suspected, “Air pollution may be contributing to glaucoma due to the constriction of blood vessels, which ties into air pollution’s links to an increased risk of heart problems. Another possibility is that particulates may have a direct toxic effect damaging the nervous system and contributing to inflammation.”

Glaucoma Risk Factors

According to the Glaucoma Research Foundation, more than three million Americans have glaucoma but only half are aware they have it. Often, there are no warning signs, and patients can suffer permanent vision loss before they notice any glaucoma symptoms. For this reason, glaucoma is nicknamed “the sneak thief of sight.”

Besides air pollution, many glaucoma risk factors can increase the likelihood of developing the disease. These may include:

• High eye pressure
• Family history of glaucoma
• Older age
• Thin cornea

Take a moment to complete our Glaucoma Risk Assessment. In a matter of seconds, you can find out whether you are at elevated risk for vision loss.

Make a Comprehensive Eye Exam Appointment

At your annual comprehensive eye exam, your ophthalmologist will evaluate your vision health and test your eyes for degenerative conditions like glaucoma, cataracts and macular degeneration. Do not wait for glaucoma symptoms to appear before you make an appointment for an eye exam. Good vision requires regular maintenance, so call your doctor to schedule a full eye examination.

A 2018 study suggests blood pressure that is not too high or low could help reduce the risk of glaucoma, a common cause of vision loss and blindness.

Researchers have known that blood pressure and glaucoma are connected. Hypotension, or low blood pressure, is a risk factor for open-angle glaucoma. High blood pressure, or hypertension, is another known glaucoma risk factor. A study published in the American Journal of Hypertension suggests maintaining a blood pressure that is somewhere in the middle is best for preventing glaucoma. Scientists refer to this optimum blood pressure range as the “Goldilocks scenario.”

What is the Optimum Blood Pressure Range?

The study included more than 4,000 participants ages 40 or over from the 2005 to 2008 National Health and Nutrition Examination Surveys (NHANES). Standard blood pressure readings are measured in milligrams of mercury (mmHg), with the diastolic blood pressure reading on top and the systolic blood pressure on the bottom.

Glaucoma incidence increased when the systolic blood pressure (the reading on bottom) was greater than or equal to 161 mmHg or less than or equal to 110 mmHg. In other words, having high or low blood pressure increased glaucoma incidence.

Patients with diastolic blood pressure between 81 mmHg and 90 mmHg and systolic blood pressure between 111 mmHg and 120 mmHg were the least likely to develop glaucoma. This blood pressure range is referred to as the “Goldilocks scenario.”

What is Your Glaucoma Risk?

Everyone has an ideal blood pressure, so your optimum blood pressure range may be too high or too low for someone else. The best way to prevent glaucoma is to schedule routine comprehensive eye exams with your eye doctor. Your doctor will perform many tests during your exam to evaluate your eye health, and one of these is a glaucoma test.

In the future, eye doctors may include blood pressure readings as part of glaucoma evaluation. This measure may prove to be a simple, quick method of determining one of many risk factors for glaucoma. Other glaucoma risk factors include:

• Family history of the disease
• Diabetes
• Eye injury or eye surgery
• Severe myopia (nearsightedness)
• Steroid use

Most eye conditions do not show symptoms in early stages, so it is imperative to visit your eye doctor regularly for healthy vision. Along with having yearly eye exams, you should also have annual well visits with your primary care physician for routine checks, preventative screenings and lab work.

If it has been more than a year since your last comprehensive eye exam, call your ophthalmologist today to schedule an appointment.

If you have cataracts and mild to moderate glaucoma, you may be a candidate for a microstent in conjunction with cataract surgery. According to an article published in Ophthalmology Times, intraocular pressure, or IOP, can often be reduced through this safe, routine procedure.

Cataracts and glaucoma are the leading causes of vision loss and blindness. Age is one of the most common risk factors for these diseases, so it is not uncommon for aging adults to develop both cataracts and glaucoma.

Although cataracts and glaucoma can develop simultaneously, they require different types of treatment. Cataracts are easily treatable through cataract surgery, a short procedure that replaces the deteriorated lens with a new one. Glaucoma, on the other hand, has no cure and rarely has symptoms until vision loss occurs. Your eye doctor’s goal is to use safe, efficient surgical methods to lower inner eye pressure and insert a new, clear lens called an intraocular lens (IOL).

Some patients may benefit from the insertion of microstent in conjunction with cataract surgery. A microstent is not appropriate for all glaucoma patients, but it may be right for you.

What is a Microstent?

There are many brands of microstents, but most function in a similar way. A microstent is about the size of an eyelash, and patients cannot feel it or see it in the eye. The effects are quite remarkable because this tiny device opens up the drainage canal in the eye to lower eye pressure. When eye pressure remains in a safe range, there is less risk of optic nerve damage and vision loss.

A microstent often pairs well with cataract surgery because the surgeon can use the same incision for two procedures.  Randomized studies found stents can significantly lower patients’ eye pressure and reduce the need for medication and eye drops.

Call Your Ophthalmologist

Do you have cataracts and glaucoma? Talk to your ophthalmologist about whether you are a candidate for a microstent in conjunction with cataract surgery. One procedure could provide clear vision, reduced eye pressure and less dependence on glaucoma drops. Your eye doctor can create an individual treatment plan that is customized to your vision needs. There are many factors that will affect the type of surgery and timing of the surgery. These may include:

• Your age
• Your physical health
• How active you are
• The type of glaucoma you have and how aggressive it is
• The progression of your cataract

Your eye doctor may prefer to manage your glaucoma with medication or laser treatment until the cataract matures. Sometimes, just having cataract surgery may be sufficient to lower intraocular pressure and relieve symptoms of glaucoma.

As with any eye procedure, it is important to discuss the risks and benefits of cataract and microstent surgery with your eye doctor, so call today to make an appointment.

Cataract surgery is often most affordable at the end of the year once your healthcare deductible is met.

What is a Healthcare Deductible?

Your annual healthcare deductible is the amount you must pay for covered medical procedures before your insurance company begins to contribute. One of the best ways to stretch your healthcare dollars is to schedule elective procedures after you have met your annual deductible. It’s almost the end of the calendar year, so if you haven’t maximized your health insurance benefits, now is the time.

Most deductibles reset on January 1, so evaluate whether you should schedule cataract surgery before December 31. If you meet your deductible, your out-of-pocket responsibility for an elective cataract surgery could be considerably less.

Get the Most Out of Your Healthcare Plan

Here are five tips to help you get the most out of your health plan.

1. Talk to your doctor about your cataract surgery and obtain the procedure codes.
2. Call your health insurance provider. Ask if you have met your deductible or if you are close to meeting it. Using the procedure codes from your doctor, request an estimate of other associated costs, such as diagnostic tests, so you can prioritize your spending.
3. If you have a Flexible Spending Account (FSA) through your employer, call the customer service number on the back of your card or log into your account to check your balance. FSA funds do not roll over into the following year, so plan to use your FSA money on a cataract procedure if you need one.
4. Consider carefully before using Health Account Savings (HSA). HSA contributions do not expire like FSA contributions. You can accumulate HSA funds and save them for a future elective procedure, so use your HSA after you have depleted your FSA.
5. Do not delay scheduling preventive screenings like comprehensive eye exams. Medicare Part B covers eye exams and other eye tests under certain situations.

Set aside a few hours to call your doctor, insurance provider and FSA or HSA account provider. These calls will not take as long as you might think, and they could save you thousands of dollars.

A new study links sleep problems with glaucoma, a leading cause of vision loss and blindness among United States adults.

Glaucoma and Circadian Rhythm

Michael V. Boland, M.D., Ph.D., Director of Information Technology and Associate Residency Program Director at the Wilmer Eye Institute at Johns Hopkins University, specializes in glaucoma and glaucoma surgery. He recently co-authored a study that suggests poor sleep could be either a risk factor or a result of glaucoma.

Glaucoma is a family of eye diseases that elevates inner eye pressure to dangerous levels and can damage the optic nerve. Deterioration of the optic nerve can lead to permanent vision loss or even blindness. Researchers have established a connection between chronic high eye pressure and damage to ganglion cells in the retina, which are hypothesized to impact circadian rhythm and sleep.

Analyzing Sleep Dysfunction and Glaucoma

To investigate the hypothesized connection between ganglion cell loss and poor sleep, Boland examined data from the 2005-2008 National Health and Nutrition Examination Survey. Boland reviewed responses from the nearly 4,500 survey participants: some with glaucoma, some with vision loss and some with no vision problems. Patients answered questions about sleep medication, sleep duration, sleep disorders, sleep disturbances and daytime drowsiness.

The results of the study established a connection between glaucoma and long and short sleep duration. Glaucoma was three times more prevalent in participants who slept ten or more hours per night compared to participants who slept seven hours per night.

Boland discovered patients with glaucoma were more likely to fall asleep very quickly or take longer to fall asleep. Glaucoma was more prevalent in patients who fell asleep in nine or fewer minutes or patients who fell asleep in 30 minutes or more. There was also a connection between glaucoma and pronounced daytime sleepiness.

<h2>Poor Sleep Quality Does Not Always Indicate Glaucoma <h2>

Sleep problems and glaucoma are not always related, but it is important to consult a doctor to help resolve sleep issues. The Centers for Disease Control and Prevention (CDC) declares insufficient sleep a “public health problem.” According to SleepHealth.org, between 50 to 70 million Americans experience poor sleep.

Sleep disorders are common among both genders and all ages and socioeconomic levels, and sleep deprivation can cause chronic health concerns. Poor sleep can lead to heart disease, accidents, hypertension, septicemia, cerebrovascular disease and diabetes.

Boland intends to continue researching the connection. He encourages more communication between physicians and patients.  In an interview with Ocular Surgery News, Boland explained, “Ophthalmologists may want to consider asking their glaucoma patients about their sleep quality.”

Currently, glaucoma affects more than three million Americans, but many are unaware they are developing glaucoma because the condition often has no noticeable symptoms in the early stages. This is why glaucoma is sometimes called the sneak thief of sight. Early diagnosis and early intervention are imperative to minimize optic nerve damage and preserve vision.

Make an Appointment for a Comprehensive Eye Exam

Are you struggling with poor sleep, frequent waking at night, daytime fatigue or forgetfulness? It is probably time to call your ophthalmologist. A comprehensive eye exam can provide you with a full evaluation of your vision health. Your eye doctor will check your prescription and test you for degenerative eye conditions like cataracts, glaucoma and macular degeneration.

Make healthy vision a priority by scheduling an appointment today.

A recent study published in JAMA Ophthalmology found statins, a type of drug that lowers cholesterol, could help prevent primary open-angle glaucoma, or POAG.

Doctors often prescribe statins to patients with high cholesterol to reduce the risk of a stroke or a heart attack, but statins could have another benefit. A research team from Brigham and Women’s Hospital claims using statins for five years or longer could lower the risk of primary open-angle glaucoma, the most common type of glaucoma.