Tuesday, December 27, 2011

What is CME Cystoid Macular Edema?

CME, or cystoid macular edema, is a painless disorder of the central retina or macula. When CME is present, multiple cyst-like areas of fluid appear in the macula and cause swelling of the retina, or edema. The exact causes of CME are unknown, but it does accompany a variety of diseases such as retinal vein occlusion, uveitis, age related macular degeneration, or diabetes. CME has also been linked to eye injury and can be a side effect of medication. CME most commonly occurs after cataract surgery. If a patient gets CME in one eye, there is up to a 50% that it will affect the second eye.

Symptoms of CME included blurred or decreased central vision; however, most patients recover their vision with treatment. The treatment for CME varies depending on what appears to have caused it. Retinal inflammation can be treated with anti-inflammatory medications that include steroid eye drops, pills, or local injections. Diuretics can help reduce the swelling in some cases. If the vitreous is believed to be the source of the issue, then surgery to remove the vitreous, called a vitrectomy, may be required. CME can bring on glaucoma; if this happens, the glaucoma must be treated with medications to reduce pressure.

Thursday, December 22, 2011

Billing for Eye Refractions

An eye refraction is one of the most basic components of most eye exams, yet from a billing standpoint, can be one of the most controversial. An eye refraction is the process of making a clinical decision for prescribing a prescription lens. A manifest refraction is an undilated test; that is, it is done without dilating drops, and allows the crystalline lens of the eye to accommodate. This allows the eye to be examined in its natural state. A manifest refraction is a very subjective test; that is, it's based on the patient’s answer of what looks best to them. A cycloplegic refraction uses cycloplegic drugs to paralyze the ciliary muscles of the eye. This temporarily stops the patient’s ability to accommodate and allows for a more precise refraction. Many cycloplegic drops also dilate the pupil, making it easier for the physician to see the back of the eye and diagnose any retinal issues.

From an insurance standpoint, eye refractions are considered part of a routine eye exam. Because refractions are normally used to determine refractive errors such as myopia, hyperopia, and astigmatism, and therefore prescribe glasses or contact lenses, many insurance companies, particularly Medicare and Medicaid, do not pay for them. It's important to convey that to patients when they are having their eye exam. Refractions are a necessary part of a routine eye exam and must be paid for out of pocket.

If you have any questions regarding your current glasses or contact lens prescription, please contact Eyecare Medical Group at 1-888-374-2020.

Tuesday, December 20, 2011

Contact Lenses in Maine

Contact lenses are lenses placed on the cornea generally for the purpose of vision correction. They are used as an alternative to glasses for millions of people. It is estimated that 125 million people worldwide are contact lens users.

Contact lenses generally correct refractive errors, such as myopia, hyperopia, or astigmatism. They are also used therapeutically to treat such diseases as keratoconus, and have been used for cosmetic purposes as well, to change the color or appearance of the eye. Contact lenses vary in many different ways, including the material that they are made up of. There are hard, gas permeable and soft contact lenses. The majority of people who wear contact lenses wear soft lenses because they are immediately comfortable, as opposed to gas permeable lenses, which require some getting used to. Soft contact lenses also have more oxygen permeability and are easier to wear.

Contact lenses are broken down into two categories- daily wear lenses and extended wear lenses. Daily wear lenses are he most popular type of contact lens and are made to be worn during waking hours and taken out before an individual goes to bed at night. Extended wear contact lenses can be kept in over night and worn for periods of up to 30 days but patients who use extended wear lenses tend to have a higher incidence of corneal infections and ulcers.

Contact lens replacement is determined by the manufacturer of the lens. There are daily contact lenses that are thrown away each day and a new lens is inserted the next day. Typically, soft contact lenses last between 2 and 4 weeks, although hard lenses could be worn up to 10 years, and gas permeable lenses are durable to be worn for several years.

If you are in need of contact lenses, please contact Eyecare Medical Group at 1-888-374-2020.

Thursday, December 15, 2011

The Importance of Corneal Topography

Corneal topography is a vital diagnostic tool in any ophthalmology practice. Since the majority of the refractive power of the eye is in the cornea, topography can be critical in determining the quality of a patient’s vision.

Corneal topography maps the curvature of the cornea by using a special camera that photographs a pattern of concentric lighted rings onto the corneal surface. Several maps are produced that carry different information. The images are analyzed to produce a detailed map of the cornea and are useful in showing areas that are irregular or steeper or flatter than others. It can help diagnose diseases such as keratoconus. Corneal topography is also important in picking intraocular lenses for cataract surgery, and for planning refractive surgeries such as LASIK, as well as assessing their outcomes.

Corneal topography is an essential element of a LASIK screening. If you are interested in having LASIK surgery, please call Eyecare Medical Group at 1-888-374-2020 to set up a free screening.

Tuesday, December 13, 2011

What is Uveitis Inflammation?

Uveitis is the inflammation of the uvea. The eye is made up of three different layers of tissue- the innermost layer is the retina, the middle layer is the uvea, and the outermost layer is the sclera. The uvea contains the veins and arteries that carry blood flow to the eye. Because it nourishes many important parts of the eye, including the retina, inflammation of the uvea, or uveitis, can damage your sight.

Symptoms of uveitis include light sensitivity, pain, redness of the eye, and blurring of vision. Uveitis can come on suddenly either with redness and pain or with a painless blurring of vision.

Uveitis can be caused by many different things. Viral infections, such as herpes, can cause uveitis, as well as fungi such as histoplasmosis or parasites such as toxoplasmosis. Disease in other parts of the body, like arthritis or bacteria such as syphilis are also causes of uveitis. Uveitis can even occur as a result of an eye injury.

Uveitis is a serious condition that can scar the eye and should be treated immediately. Eye drops can help inflammation and pain caused by uveitis. Uveitis can exacerbate existing eye conditions such as glaucoma, cataracts, or neovascularization, so it is important to seek treatment if you believe you have uveitis.

Friday, December 9, 2011

Blepharitis: What is it?

Blepharitis is a common condition of the eyelids and eyelash follicles. It is caused by a buildup of normal bacteria found on the skin and is characterized by redness of the eyelid, flaking of the skin on the eyelids, or crusting on the eyelids. Blepharitis is not serious, although it can be the cause of other eye issues such as styes and chalazia.

Diagnosing blepharitis is fairly easy and generally done through a routine eye examine. Eye doctors use a slit lamp to look at the eyelids and lashes to identify any problems. Treatment of blepharitis is fairly simple. Proper cleansing of eyelids and margins is important, and baby shampoo is often recommended as a cleanser. Warm compresses are a common treatment to help soften build up debris on the eyelids and lashes. In some cases, an antibiotic solution is prescribed to help clear up blepharitis.

Tuesday, December 6, 2011

Meet Sonja Laiho!

Sonja has been in ophthalmology for 21 years. She currently works for Dr. Bruce Cassidy and has been with EMG for about a year and a half. She previously worked for EMG in 2003-2004 before moving to California.

Sonja started in ophthalmology 21 years ago as a certified scrub tech. During the past 21 years, all but 5 were spent in ophthalmology. She took a 5 year break and worked for Youth Alternatives at a group home for at risk and homeless youth. She’s currently a COA, or certified ophthalmic assistant. Sonja has worked for several physicians in her tenure in ophthalmology, and has worked in Maine, Vermont, and California as an ophthalmic assistant. She worked for Dr. Jack Singer in Randolph, Vermont, who was one of the doctors that was part of the FDA clinical trials for the Crystalens. Sonja even got to meet Dr. Stuart Cumming, the inventor of the Crystalens, when she worked for Dr. Singer.

Sonja has been very active with Project Guatemala, a medical mission to give the gift of sight to the Indigenous and Mayan people of Guatemala. Sonja has participated in the mission all but 2 years since she started going to Guatemala in 1998.

We’re happy to have Sonja and all of her ophthalmic experience back at EMG!

Thursday, December 1, 2011

What is Glaucoma?

Glaucoma is a disease of the optic nerve, the part of the eye that carries the images that we see to the brain. This damage is often caused by increased pressure to the eye, otherwise known as intraocular pressure (IOP). Pressure in the eye increases when aqueous humor, the clear liquid inside the eye, becomes blocked and excess fluid cannot flow out of the eye. This fluid pushes against the optic nerve, causing damage.

There are four major types of glaucoma, as the disease can manifest itself in different ways. Symptoms include blurred vision, severe eye pain, headache, halos around lights, and nausea and vomiting. Glaucoma is one of the leading causes of vision loss in the United States, but is easily detectable through a routine eye exam with an optometrist or ophthalmologist. There are risk factors, such as age, ancestry, and other systemic health problems that put individuals at a higher risk for the disease.

Damage caused by glaucoma is not reversible; however, there are steps that can be taken to prevent further damage to the optic nerve. Eye drops to lower IOP are common for those who suffer from glaucoma. There are also several different surgeries that can be done to create new drainage within the eye and help control eye pressure. “Medications to treat glaucoma must be taken exactly as prescribed, and patients must make sure they continue to be seen for follow up exams,” says Dr. Samuel Solish, Glaucoma and Cataract Surgeon at Eyecare Medical Group.

If you have a family history of glaucoma, or are at an increased risk for the disease due to other factors, now is the time to call for a glaucoma screening.

Tuesday, November 29, 2011

Eyecare Medical Group Receives Hanley Award

Eyecare Medical Group and Maine Eye Center were awarded the 2010 Hanley Centers Honors for Medical and Humanitarian Service for their work with Project Guatemala. Project Guatemala has provided eye care to the Mayan Indians, the indigenous people of the mountainous Quiche province in Northern Guatemala, for the past 15 years. Maine Eye Center has been participating in Project Guatemala since 1998; Eyecare Medical Group joined them in 2003.

Once a year, these two practices come together to send a team that includes eye surgeons, optometrists, technicians and translators to Guatemala. During this trip, the team sees over one thousand patients. About 50-60 cataract surgeries are performed each year, many of them restoring sight for patients who had been blind for years. In the clinic, patients are screened for eye diseases and provided medications and eyeglasses when necessary. Work takes place throughout the year to collect supplies, which are often donated by ophthalmic companies, and prepare them for transport to Guatemala. Project Guatemala was started in the mid 1990s by ophthalmologist Dr. John Detwiler and his technician, Bonnie Togliotti in New Hampshire. After Dr. Detwiler died suddenly, Bonnie restarted the project in Maine with the support of Drs. Frank Read and Peter Hedstrom of Maine Eye Center in 1998. Drs. Bruce Cassidy and Robert Daly have provided much of the on-going participation from the Eyecare Medical Group since 2003.

SOURCE: www.hanleytrust.org

Tuesday, November 22, 2011

DSAEK Corneal Transplant

DSAEK, or Descemet's Stripping Automated Endothelial Keratoplasty, is a newer technology in the world of corneal transplantation. It allows only the damaged endothelial layer of the cornea to be removed. The primary population for this type of procedure is those who suffer from the corneal disease Fuchs’ Dystrophy. During a DSAEK procedure, the damaged endothelial layer is stripped away and replaced with a thin back portion of tissue from a donor cornea. Instead of replacing the entire cornea, this allows for the replacement of only the damaged tissue. According to Dr. Ravi Shah, Corneal and Refractive Surgeon at Eyecare Medical Group, DSAEK has a lot of advantages over the traditional method of corneal transplantation.

“There’s a lot more wound stability with a DSAEK because there is less trauma to the eye. DSAEK has a quicker post op healing time than a PK, and there is less post surgical astigmatism than with a PK because of the lack of sutures.” DSAEK does have some disadvantages- a bubble has to be placed in the anterior chamber to hold the donor graft, and if the graft becomes dislodged, another surgery to place a new air bubble may be required. It can also be difficult to get the endothelium off of the donor cornea. If the donor cornea is damaged, there is a higher chance of rejection.

Not all patients who require a corneal transplant are candidates for a DSAEK procedure. The conventional full thickness graft, or penetrating keratoplasty, may be required depending on what disease is present and what area of the cornea is damaged.

Thursday, November 17, 2011

Eye Floaters & Flashes

Eye floaters are something that will bother 70% of people at one time in their life. Although they can be annoying, floaters are generally not something that you need to worry about.

Floaters are caused when the vitreous humor of the eye starts to change. In youth, the vitreous is transparent, but over time, imperfections can build, causing strands of the vitreous to clump together. They become visible by casting a shadow on the retina and are considered to be a normal sign of aging.

Floaters are extremely common and rarely something to be concerned about. However, if they are accompanied by flashes, decreased vision, or a sudden increase in the amount of floaters present, they can be a sign of a larger problem, such as a retinal tear or detachment . If you have any of these symptoms, it is important to contact your eye doctor and be evaluated.

Treatment is not necessary for floaters unless they are related to a larger problem like a retinal tear or detachment. In that case, a procedure called a vitrectomy may be done to decrease the amount and severity of the floaters by removing the vitreous humor from the eye.

Tuesday, November 15, 2011

New England Ophthalmic Photographers Society (NEOPS) Meeting

A large part of the New England Ophthalmic Photographers Seminar centered on new developments in photography. Sarah Moyer, CRA, OCT-C, spoke about the changes with OCT, or optical coherence tomography. Sarah also ended the seminar with a rare case symposium, comprised of photos of rare ophthalmic diseases or injuries, including photos of a patient who lost both eyes due to a C4 explosion, a patient with UV exposure burns from a laser, and a patient with a traumatic injury to the eyelid from a dog bite.

Darrin Landry, CRA, OCT-C, from Eyecare Medical Group in Portland, ME, gave a discussion on imaging for Age-Related Macular Degeneration and vascular occlusions. Darrin discussed different imaging techniques for these diseases, including fluorescein antiography, ICG, and OCT, and showed photographs of different stages of these diseases, as well as how the diseases respond to different treatments.

Laura Vittorioso, M. Ed, from the Iris Network, discussed Low Vision. She discussed the differences between being legally blind versus total blindness, and the different tools that can assist patients who suffer from low vision. Laura went over a low vision evaluation, which includes a comprehensive case history, co morbidities that can affect low vision, and a plan of care for the patient that includes a meeting with an occupational therapist to establish training goals and treatment. Laura identified that people are living longer enough now to develop eye disease, and she discussed how Maine has a large visually impaired population.

Jean Proctor, RN, of Eyecare Medical Group in Portland, Maine, gave a discussion on the technician’s role in laser vision correction surgery. Jean talked about all the testing that is done to determine if a patient is a candidate for laser vision correction, including a manifest and cycloplegic refraction, determination of a patients dominant eye, and pachymetry testing, or the measurement of a patients corneal thickness. Jean also talked about what makes a person a good candidate for refractive surgery, including assessing a patient’s personality to make sure that their expectations are realistic, and the different kinds of surgery a patient might be a candidate for, such as LASIK surgery, or a surface treatment such as PRK. She discussed monovision for patients who are already presbyopic, and the differences between a myopic LASIK correction versus a hyperopic correction.

Thursday, November 10, 2011


Meet Jana Boudreau. Jana has been Dr. Holt’s secretary for the past 26 years, even before EMG existed. She started out with Dr. Holt and Dr. Serrage in their first practice together on Park Avenue in Portland, Eye Physicians and Surgeons, and has worked for Dr. Holt ever since. She was 8 months pregnant with her first child when EMG’s current location on Sewall St was built in 1987. “We thought the place was huge at the time. We had what we called “future rooms” which were rooms that we didn’t know what we were going to do with yet,” said Jana. At that time, each secretary did their own doctors transcription, as well as all the billing and collections, and there were only 4 physicians in the practice. A lot has changed since then- EMG has grown to 9 physicians and a fully staffed billing department that has 5 full time employees!!!

Jana is still Dr. Holt’s secretary and continues to do his transcription. She has recently taken on the added responsibility of becoming Dr. Shah’s secretary as well.

Jana continues to be a great source of Eyecare Medical Group history. She has seen literally thousands of patients walk through the front door, many doctors and technicians come and go over the years, several remodels of our current building, and she saw Dr. Serrage, with whom she had worked for 26 years, retire last year.

Thank you for your dedication, Jana!!!

Tuesday, November 8, 2011

Monovision LASIK for Near Vision

“As we all enter our 40’s it is quite typical to experience the onset of presbyopia-a condition whereby the crystalline lens inside your eye that is typically soft and flexible begins to lose that flexibility and thus limit your ability to change focus from far to near and near to far,” commented Maine LASIK Surgeon and Corneal Specialist Ravi Shah, M.D. at Eyecare Medical Group in Portland. “Patients with presbyopia typically report that their “arms are too short” and that near objects and reading material are becoming fuzzy or blurry.”

Most often LASIK is performed to correct nearsightedness, farsightedness and astigmatism in order to help patients see clearly at distance. However LASIK does have some application in correcting near vision through a technique called monovision LASIK. Monovision LASIK corrects one eye for distance and one eye for near. Thus, the need for glasses with two different focal lengths is resolved by focusing each eye at a different focal length. Monovision LASIK can be effective for some patients with the need for mild near vision correction. Depending on the amount of close work you do at work and for how long each day monovision LASIK may be a good alternative.

The best way for you or someone you know to find out if they are a good candidate for Monovision LASIK is to have an evaluation, examination and consultation at Eyecare Medical Group. Please feel free to schedule an appointment by calling us Toll Free at 888-374-2020.

Thursday, November 3, 2011

Eye Photography Seminar in Maine at EMG

The New England Ophthalmic Photographers Society (NEOPS) held their fall meeting at Eyecare Medical Group on Saturday, October 1st. The meeting, which was held from 8 am - 6 pm, was attended by approximately 35 technicians and photographers from around New England. Those who attended the seminar were granted 8 JCAHPO or OPS continuing education credits.

Dr. Jordan Sterrer of Eyecare Medical Group opened the seminar with “Systemic Illness and the Eye: An Eye Opening Look at Internal Medicine.” He discussed several different systemic illnesses such as metabolic syndrome, hyperlipidemia, and Graves disease and the affects that they can have on the eye. “Any disease that affects blood vessels or nerves to/from the eye has the potential to alter ocular function,” says Jordan Sterrer, M.D. Dr. Sterrer discussed how he evaluates patients when he enters the room, and how he assesses the whole patient before he looks at their eyes, by checking out their hands, face, body position, and noting their level of discomfort as he begins to exam them. Dr. Sterrer discussed the affects that diabetes can have on the eyes, and discussed the importance of proper history taking with these patients in particular. Finding out if they check their glucose at home, if its typically high or low, what kind of diabetes they have, what their latest A1C was, and whether or not they require insulin are all important parts of the picture.

Dr. Sterrer ended his discussion on systemic diseases and the eye with what a medical emergency in the office looks like. He discussed vasovagal attacks, fluorescein reactions, and malignant hyperthermia as some of the more serious office emergencies, and how to diagnose and treat those conditions.

Dr. Ravi Shah of Eyecare Medical Group spoke about Current Concepts in Corneal and Refractive Surgery. He began his talk with a discussion of endothelial disease, specifically Fuchs' Dystrophy, and keratoplasty. He discussed the DSAEK procedure, and why more physicians are choosing to use DSAEK versus penetrating keratoplasty, the traditional method of corneal transplantation. Dr. Shah also spoke about the corneal disease keratoconus. “Keratoconus is not rare, but it is uncommon,” said Ravi Shah, M.D., Corneal and Refractive Surgeon in Portland, ME. “The younger a patient is when they are diagnosed, the worse the prognosis.” Dr. Shah discussed the options for those with keratoconus, including corneal transplantation, Intacs, and corneal cross linking. Dr. Shah closed with a discussion about corneal cross linking and how this may affect the future of refractive surgery as well as medically necessarily corneal surgeries.

Laura Savage, COMT, CRA from Dartmouth Hitchcock Clinic in Manchester, NH gave a talk about the changes in healthcare and how to put a positive spin on change in her lecture, “The Times They are A-Changin’- how to Facilitate Positive Change.” She discussed some of the changes affecting healthcare today, including the implementation of new technology, such as electronic health records, and funding issues in the state of New Hampshire. She also discussed different types of personalities and how they can negatively and positively affect the changes taking place in the office. She stressed helping facilitate positive change by using communication and encouraging others to take the learning opportunities provided to them.

Tuesday, November 1, 2011

Maine Diabetic Eye Disease Month at Eyecare Medical Group

Eyecare Medical Group wishes to announce that Prevent Blindness America has designated November as National Diabetic Eye Disease Awareness Month. This is an important time to spread the word about this potentially blinding disease. We need to work to help patients avoid the complications of diabetic retinopathy, which blinds over 8,000 Americans each year. The vision loss from diabetic retinopathy can be prevented if it's caught and treated in time. A recent study found that more than one third of those diagnosed with diabetes do not adhere to vision care guidelines recommending a dilated eye exam every year.

As part of Diabetic Eye Disease Awareness Month we are urging people with diabetes to have a dilated eye exam every year. The longer a person has diabetes, the greater his or her risk for developing diabetic retinopathy. However, diabetic retinopathy does not only affect people who have had diabetes for many years, it can also appear within the first year or two after the onset of the disease.

Patients can help to reduce the risk of developing diabetic eye disease by not smoking, controlling their cholesterol and lipid profile and blood pressure, as well as working to eat a heart-healthy diet rich in fish, fruit and green leafy vegetables and exercising.

The key to successful treatment of diabetic retinopathy is early detection and intervention. We are fortunate to have Scott Steidl, M.D. and Jackie Nguyen, M.D. who are fellowship trained in Vitreoretinal Surgeons specializing in Diseases & Surgery of the Retina and specialists in the diagnosis and treatment of Diabetic Retinopathy. If you or someone you know has diabetes or is even prediabetic please feel free to schedule a diabetic eye examination at Eyecare Medical Group by phoning 888.374.2020.

Thursday, October 27, 2011

Eye Protection

Eye protection in all forms is extremely important. Sunglasses are an excellent way to protect your eyes from sunlight and reflections from the sun off surfaces such as water, snow, and pavement. Sunglasses are important in protecting your eyelids, cornea, and lens from ultraviolet rays, as well as other parts of your eye. It is important to limit your UV exposure as it can contribute to the development of cataracts and can cause cancers of the eye and eyelids.

Safety goggles are another important type of protective eyewear. Safety goggles are worn in many types of jobs, especially those where dust, metal, or dirt particles are in the air. Safety goggles are also important in the medical field to prevent the spread of blood borne pathogens. Many day to day activities, such as motorcycling or using household chemicals, are dangerous enough to necessitate safety goggles.

If you have any questions about what kind of protective eyewear is right for you, or are looking to purchase a pair of sunglasses with UV protection, you can call Eyecare Medical Group toll free at 1-888-374-2020 or visit our Optical Shop located at our facility in Portland.

Discussing Driving Skills with Seniors

A study conducted at the University of Michigan’s Kellogg Eye Center has found that most eyecare providers consider it their responsibility to ask patients aged 65 and older about their driving abilities.

The study was led by Donald C. Musch, Ph.D. and surveyed 500 ophthalmologists and optometrists in Michigan on how they evaluate the driving capabilities of senior patients. The majority of eyecare providers routinely asks senior patients about driving and often tests visual acuity and peripheral vision in these patients. 87% of practitioners reported asking senior patients about glare, night driving, and the ability to read signs. However, only 8% of practitioners surveyed said they ask senior drivers about their driving records or about more challenging maneuvers such as merging or backing up. The study also found that eyecare providers often neglect to ask seniors about medical conditions or medications that might impact the ability to drive. The study was supported by a grant from M-CASTL, a unit of the U-M Transportation Research Institute, the University said in the release.

SOURCE: Eyeworld Magazine Volume 16, Number 33 September 5, 2011

Thursday, October 20, 2011

How Safe Is LASIK Surgery?

“For anyone thinking about Laser Eye Surgery for vision correction such as LASIK it is worthwhile to know about the safety of these Laser Vision Correction procedures," said Corneal and LASIK Surgeon Ravi Shah, MD at Eyecare Medical Group in Portland Maine. LASIK has a solid overall track record of safety but the safety of LASIK depends on a number of factors. “By far the most important factors that can affect LASIK safety are the laser and instrumentation to be used to perform the treatment and even more so, the skill and experience of the LASIK Surgeon,” commented Dr. Shah.


Laser Eye Surgery for the Laser Vision Correction of nearsightedness was first performed in the United States upon Food and Drug Administration (FDA) approval of the Excimer Laser on October 20, 1995. The Excimer Laser was specifically FDA approved for LASIK in 1998. “So as of 2011, Laser Eye Surgery for Laser Vision Correction has been performed for just over 15 years and the LASIK procedure has been performed under FDA approval for just over 11 years,” said Dr. Shah.

Properly selected patients with realistic expectations who are nearsighted generally achieve 20/40 vision more than 98 percent of the time and uncorrected vision of 20/20 or 20/25 90 percent of the time. Vision loss to a level less than 20/40 is quite rare after LASIK , occurring in about only 3 per 1,000 cases and serious complications such as infection or corneal damage occur even more infrequently, in fewer than 1 in 1,000 cases. There is more to safety than simply the laser device itself.

Safety is the Hands of the LASIK Surgeon

FDA approval does not guarantee that a LASIK Surgeon is going to provide a thorough evaluation and consultation, nor does not indicate that LASIK Surgeons will provide a complete review of the possible risks and complications of LASIK or imply that a LASIK Surgeon will use the appropriate screening and decision criteria to be sure that a patient is in fact a good candidate for LASIK or any Laser Eye Surgery for that matter.

With regard to LASIK safety choosing a LASIK Surgeon is the most important decision a patient makes in deciding to have LASIK Surgery. This choice is a meaningful factor in making LASIK a safe and effective procedure. You should not choose a LASIK Surgeon based on slick advertising or low price. You should choose a LASIK Surgeon based on reputation in the community, the length of time they have been performing LASIK and the comfort and rapport established during your consultation. While the equipment used may provide a slight advantage or disadvantage in safety, it is ALWAYS the skill and experience of the surgeon that contributes the most to the overall safety of Laser Eye Surgery for the correction of nearsightedness, farsightedness and astigmatism.

The best way for you or someone you know to find out if they are a good candidate for All Laser Bladeless LASIK is to have an evaluation, examination and consultation at Eyecare Medical Group. Please feel free to schedule an appointment by calling us Toll Free at 888.374.2020.

Tuesday, October 18, 2011

Can a Cataract Grow Back?

“A Cataract is a clouding of the crystalline lens of the eye. Once we remove the Cataract-the cloudy crystalline lens-it can’t come back,” remarked Maine Cataract Surgeon Bruce Cassidy, MD of Eyecare Medical Group in Portland. “What does sometimes happen is that a condition called “posterior capsular opacification” can occur that makes it seem as if the Cataract is growing back-but it’s not.”

The crystalline lens of the eye is where a Cataract forms. The crystalline lens has a soft protein center and is surrounded by a capsule. A Cataract forms because the protein becomes cloudy. “During Cataract Surgery we use microscopic instruments to break up and remove the cloudy material as this is what blurs your vision-and we leave the “capsule” in place. We will actually place the intraocular lens implant (IOL) inside the capsule to help correct your vision,” said Robert Daly, M.D. a Cataract Surgeon and Glaucoma Specialist at Eyecare Medical Group. In some patients the capsule becomes “opacified” some time after surgery leaving the patient’s vision cloudy and often with glare sensitivity, much like the symptoms they had from the Cataract. “Fortunately, using a YAG Laser, we are able to quickly, safely and effectively create an opening in the capsule along the visual axis which restores the vision almost instantly”, said Dr. Daly. This procedure called a “YAG Capsulotomy” takes only a few minutes and is often performed using simple eye drop anesthesia without discomfort.

Please feel free to contact us with your questions about Cataracts, Cataract Surgery or Lens Implants by calling Eyecare Medical Group Care Toll Free at 888.374.2020.

Friday, October 14, 2011

The Impact of Daily Contact Lens Wear

A recent study on the impact of contact lens wear and visual display terminal work was published in The American Journal of Ophthalmology. The purpose of the study, which included 69 contact lenses wearers and 102 non contact lens wearers of the same age and sex, “was to evaluate the effect of contact lens (CL) wear and visual display terminal work on the ocular surface and tear functions.” A dry eye symptom questionnaire was used to evaluate the signs and symptoms of dry eye, and multiple ocular surface and tear function tests, including stainings using fluroescein and rose bengal, Schirmer test, tear meniscus height measurement, and tear film break-up time were performed.

The study concluded that contact lenses wearers are more prone to dry eye. Findings showed that contact lens wearers who spent more than four hours at a visual display terminal had significantly higher incidence of dry eye and a lower tear meniscus volume, as well as more visual symptoms triggered by environmental factors. According to the results of the study, contact lens wearers are at a higher risk of dry eye from sitting at a visual display terminal, such as a computer, than those who are not contact lens wears when all other factors, such as age, sex, and hours spent at a visual display terminal, are the same.


Tuesday, October 11, 2011

Glaucoma & Intraocular Eye Pressure

Intraocular pressure, or IOP, is the fluid pressure inside the eye or the eye pressure. This fluid, called aqueous humor nourishes the cornea, iris and lens. Its production must be balanced by the rate of drainage in order for the eye to remain healthy. If there is a buildup of aqueous humor the intraocular pressure can increase. IOP measurements are important in the diagnosis and management of Glaucoma. The measurement is taken with an instrument called a tonometer, which either touches the surface of the eye or puffs air into the eye. A normal IOP reading is 10-21 mmHg, or millimeters of mercury.

A check of the intraocular pressure is generally done as a part of a routine eye exam. If you have a family history of Glaucoma, it is especially important that you have routine IOP checks to make sure that your pressure stays normal. If you or someone you know has a family member with Glaucoma they should have their IOP checked. Please feel free to call Eyecare Medical Group at 1-888-374-2020 to schedule an eye exam.

Thursday, October 6, 2011

Astigmatism: What is It?

Many people have astigmatism without actually knowing what it is. Astigmatism is a very common condition, and in fact, most people have some degree of astigmatism. It often occurs with other vision conditions such as myopia, or nearsightedness, or hyperopia, or farsightedness. These conditions are referred to as refractive errors because they affect how the eye bends (refracts) the light as it enters the eye.

Astigmatism is characterized by an abnormal shape, or curvature, of the cornea. The human eye is naturally spherical in shape, so when light enters the eye, it is refracted normally. An astigmatic eye is shaped like a football, or the back of a spoon, which causes light entering the eye to refract more in one direction or the other. Because of this, objects appear blurry.

Astigmatism can be corrected with glasses, contact lenses or Laser Eye Surgery for Laser Vision Correction such as LASIK. Eyeglasses used to correct astigmatism have a cylindrical lens prescription in them that provides for additional lens power in certain areas of the lens. Contact lenses that correct astigmatism are called toric contact lenses and are made of the same material as regular contact lenses but have added correction for cylindrical aberration. They can be more difficult for the wearer as well, as they have a top and a bottom and are not symmetrical. Because of this, toric lenses cannot be rotated. Laser Eye Surgery for Laser Vision Correction such as LASIK or PRK can correct for astigmatism by reshaping the cornea through the use of a laser.

If you or someone you know has astigmatism and would like to learn more about it and how to correct it, please call Eyecare Medical Group at 1-888-374-2020 to set up an appointment!

Tuesday, October 4, 2011

Eye Injury Prevention Month in Maine

Eyecare Medical Group wishes to announce that October has been designated Eye Injury Prevention Month by the American Academy of Ophthalmology. When most people go out to mow the lawn, jump-start the car or get ready to do some spring cleaning, the last thing they think about is protecting their eyes, but it should be first on their mind. It is a good idea to think about protecting your eyes from the extraordinary damage often caused by the most ordinary of activities.

Many household chemicals, such as cleaning fluids, detergents and ammonia, are extremely hazardous and can burn the eye's delicate tissues. When using chemicals, always read instructions and labels carefully, work in a well-ventilated area and make sure spray nozzles point away from you and others before spraying. Be sure to wash your hands thoroughly after use.

Before using a lawnmower, power trimmer or edger, check for debris. Stones, twigs and other items can become dangerous projectiles shooting from the blades of a lawnmower, potentially injuring your eyes or those of innocent bystanders. Prevention is the first and most important step in avoiding serious eye injuries, so be sure to protect your eyes with appropriate protective eyewear. Please feel free to contact us with your questions or to schedule an examination by calling Eyecare Medical Group Care Toll Free at 888.374.2020.

Tuesday, September 20, 2011

Intravitreal Implants for Retinal Disease

Implantation of medications such as dexamethasone and fluocinolone acetonide into the eye are becoming more and more commonplace as treatment for retinal diseases. These implants are being used to treat inflammatory retinal issues such as macular edema after branch or central vein occlusions, uveitis, choroiditis, and chorioretinitis, and are being studied to treat other diseases of the retina, including diabetic macular edema.

The benefits of intravitreal implants over traditional methods of treatment are that they deliver a continuous concentration of drug over a prolonged period of time. Before the inception of intravitreal implants, patients would have to have injections into the eye, which could be as often as monthly. Intravitreal implants last longer, sometimes up to a year depending on the medication, so the discomfort and inconvenience to the patient is minimized. It also provides more constant relief to the patient, as it releases a continuous concentration of the medication.

Thursday, September 15, 2011


Keratoconus is the degeneration of the structure of the cornea, causing the cornea to become conical in shape instead of round. The causes of keratoconus are unknown, although there is substantial evidence to suggest that it is genetic. The disease generally presents itself in adolescence and can be identified by blurred vision that cannot be corrected with glasses. Keratoconus can cause serious distortions in a persons vision, including sensitivity to light and streaking, and is generally characterized by nearsightedness, or myopia.
Corneal topography is helpful in the diagnosis of keratoconus. A map of the cornea is taken, which identifies irregularities in the shape of the cornea. As the disease progresses, vision gets worse and worse until it is no longer correctable with glasses. Gas permeable contact lenses are a common treatment for keratoconus as they help to reshape the cornea.

Keratoconus can cause total loss of vision if the disease progresses or is left untreated. “Advanced cases of keratoconus can require surgical intervention” says Ravi Shah, MD, of Eyecare Medical Group. Corneal transplantation is a common treatment for severe keratoconus along with newer treatments, such as intrastromal corneal ring segments and corneal collagen cross linking.

Wednesday, September 7, 2011

Nutritional Supplements as Treatment for Dry Eye

A study published in the July 2011 issue of “Current Opinion in Ophthalmology” shows some promising new information about the treatment of dry eye symptoms . Although more investigation is still necessary, the study concluded that systemic and topical omega-3 fatty acids and omega-6 fatty appear to be effective in treating symptoms of dry eye. Essential fatty acids have previously been used in the treatment of other eye diseases and are most notably associated with a reduced risk in age related macular degeneration.

The study summarized that “the use of essential fatty acids as a nutritional supplement is a novel treatment for patients with dry eye syndrome”.

Eyecare Medical Group currently recommends the use of supplements such as flaxseed oil and fish oil for dry eye patients that include essential fatty acids.

Thursday, September 1, 2011

International Prize for EMG Photographer

Darrin Landry, EMG’s photographer, won 2nd place in this years European Vision Research Institute’s 3rd Annual Picture Competition. Darrin had previously won 4th place last year. “The Best Photo in Vision Research” competition ran from May 10th-June 30th, 2011. The contest, which was comprised of an international review board with members from the private and public sector, received high quality contributions from all over the world.

The photo Darrin submitted was of a patient who has pigmentary dispersion syndrome. The photo displays some pigment cells in the iris that have come off and the result is a thinning of the peripheral iris. “Using a slit lamp digital system, I was able to shine the light directly into the pupil, and the reflection from the retina (which is the same reflection seen in “red-eye” pictures) shines through the thinning area, giving it a red ring appearance” says Darrin Landry, CRA, OCT-C.

Congratulations, Darrin! Keep up the excellent work!!!

Tuesday, August 30, 2011

Ambulatory Surgical Center

The Ambulatory Surgical Center here at Eyecare Medical Group operates four days a week. Our Our AAAHC approved outpatient surgery center has two operating rooms and is fully staffed to do surgery Monday - Thursday. Our ASC generally starts surgery around 7:30 am and often goes all day. There is a separate entrance to our surgery center so patients do not have to exit through our busy lobby. Each day is carefully scheduled so that all of our 8 surgeons have surgery time each week, leaving room for emergency surgeries when necessary. We have the ability to perform cataract surgeries, corneal transplants, trabeculectomies, and repair retinal detachments, among other things, every day here at EMG.

In addition to the doctors and technicians who use the OR to operate, our ASC is staffed by about 10 nurses and support staff that work in the surgery center full time. We also have a full time anesthesiologist that works with us in the ASC.

Friday, August 26, 2011

Posterior Capsule Opacity Photo

Darrin Landry, CRA, OCT-C, our photographer here at Eyecare Medical Group, entered the photo contest “The Best Photo in Vision Research and Ophthalmology” and won 4th place in the international competition in 2010. “The Best Photo in Vision Research and Ophthalmology” is sponsored by Vision Research, a European organization that focuses on networking researchers, ophthalmologists, academic institutions and research industries together to share information.
The contest, which is held every year, receives over a hundred submissions from all over the world.

The photo that Darrin took that won him 4th place was a posterior capsule opacity taken on a slit lamp camera at EMG.

Darrin has also submitted a photo for the 2011 competition but will not know anything until the fall.

Good luck, Darrin! Thank you for sharing your photo with us!

Wednesday, August 24, 2011

Lucentis for Diabetic Eye Disease

“We are thrilled that our clinical experiences have been confirmed by the positive results of a two-year clinical study of the vascular endothelial growth factor inhibitor (VEGF) drug Lucentis when used to treat Diabetic Macular Edema (DME) which is a cause of significant vision loss in patients with diabetes”, said Maine Vitreoretinal Specialist Scott Steidl , M.D. of Eyecare Medical Group in Portland. “Patients with Diabetic Retinopathy in the form of DME who received the drug experienced rapid and sustained improvement in vision compared to those who received a placebo injection.”

Diabetic Macular Edema or DME is the swelling of retina in people with diabetic eye disease called diabetic retinopathy, which causes damage to the blood vessels of retina. The DME patients suffers fluid leak from the damaged blood vessel to the central portion of retina, causing it to swell leading to blurred vision, severe vision loss and blindness.

“Of the 26 million U.S. people with diabetes, a portion of up to 10 percent tends to develop DME during their lifetime and up to 75,000 new cases of DME are estimated to develop each year”, said Vitreoretinal Surgeon Jackie Nguyen, M.D. of Eyecare Medical Group. Currently, most DME patients are treated with laser surgery that helps seal the leaky blood vessels to slow the leakage of fluid and reduce the amount of fluid in the retina.

Lucentis is approved for use by the U.S. Food & Drug Administration (FDA) for the treatment of “Wet” Age-Related Macular Degeneration (AMD) and for Macular Edema following Retinal Vein Occlusion. In 2011, Lucentis was approved for treatment of visual impairment due to DME in Europe.

If you or someone you know has diabetes or is even prediabetic they should have regular eye exams as early detection, diagnosis and treatment of diabetic retinopathy is the key to protect their eye health and vision. Please feel free schedule an appointment at Eyecare Medical Group by calling us Toll Free at 888-374-2020.

Friday, August 19, 2011

Meet Diane Grover at EMG

Diane Grover has worked at Eyecare Medical Group for 22 years as an administrative assistant. She is in charge of ordering all of our supplies, and planning just about any event that EMG holds. Diane multitasks with the best of them, filling in where needed around the office and always finding a way to remember what everyone needs. She has covered for every secretary in the building at one point or another and also covers in the OR, checking patients in for surgery, when she is needed. She does all of the planting in the spring, and all of the holiday decorating in the winter. She is in charge of Employee Appreciation Week, and she plans all of the birthday parties, retirement parties, and baby showers at EMG. She also plans a big party every summer for optometrists from all over Maine, and she does the menus and all of the setting up for the annual optometry seminars that EMG holds.  Thanks for ALL of your hard work, Diane!!

Tuesday, August 16, 2011

My LASIK Evaluation-What to Expect?

LASIK can be an excellent vision correction option but it really requires that patients be carefully selected. The only totally reliable way to determine whether Laser Vision Correction or Laser Eye Surgery of any type is going to help you achieve your personal vision correction goals is to have a thorough consultation” commented Maine Corneal and LASIK Specialist Ravi Shah, M.D. of Eyecare Medical Group on Portland Maine.

Your LASIK consultation should consist of a number of clinical tests including:

 Measurement of your uncorrected visual acuity

 Measurement of your visual acuity with your current eyeglasses or contact lenses

 Optical measurement of the current prescription that you are wearing in your eyeglasses and/or a review of your current contact lens prescription

 A thorough review of your medical and eye history including all prescription and non-prescription medication that you have been or are currently taking

 A refraction-automated or manual-to determine your current prescription

 A topography measurement to digitally map the shape of your cornea

 A pachymetry measurement of the thickness of your cornea

 A measurement of pupil size

 A microscopic evaluation of the health of your cornea and tear film including testing for dry eyes.

From this testing it can be determined whether you should proceed to the final level of testing whereby the actual preoperative measurements are taken for your treatment and a thorough examination of the Retina and Optic Nerve can be performed. In addition to the actual clinical testing, your LASIK evaluation should include a full discussion of LASIK risks, benefits and complications and a thorough analysis of the personal goals and objectives that you feel are important to your success.

The best way for you or someone you know to find out if they are a good candidate for All Laser Bladeless LASIK or PRK is to have an evaluation, examination and consultation at Eyecare Medical Group. Please feel free to schedule an appointment by calling us Toll Free at 888.374.2020.

Thursday, August 11, 2011

Great LASIK Prices

EMG is running a special on LASIK surgery now through September 30th. We are offering bladeless, all laser LASIK surgery for $1995 an eye. If you want physicians and staff you can trust- a team with over 15 years of clinical experience in Laser Vision Correction who are dedicated to getting you the best possible possible results at a reasonable price, call now for a free consultation!!  We can help you find out if you are a good candidate for any kind of refractive surgery, at no cost to you.  Like us on Facebook to get more details about our great LASIK prices!

Tuesday, August 9, 2011

Ophthalmic Technicians at EMG

Eyecare Medical Group encourages all of their clinical staff to be certified in some way. Certification for clinical personnel is generally done through JCAHPO, the Joint Commission of Allied Health Professionals in Ophthalmology. JCAHPO is an international organization and is the standard in ophthalmic certification. There are several different levels of certification for ophthalmic technicians. COA, or certified ophthalmic assistant, is considered the entry level certification into ophthalmology for clinical personnel. COT, or certified ophthalmic technician, is the intermediate level. COT’s have usually been in ophthalmology for some time and worked as a COA for at least a year. COMT’s, or certified ophthalmic medical technologist, is JCAHPO’s highest level of certification. COMT’s are generally among the top trained and educated among ophthalmic personnel and have generally worked in ophthalmology for an extended period of time. EMG has a clinical staff of 34, of which 5 are COT’s, 1 is a COMT, and about 20 are COA’s. Of that staff of 34, 21 are also credentialed to assist in surgery.

EMG has several other employees which are certified in different areas. There are several paraoptometric professionals; that is, those who are certified through the American Optometric Association. Our photographer is a CRA, or certified retinal angiographer. We also have 2 RN’s who are also CRNO’s, or certified registered nurses in ophthalmology, and they are certified through ASORN, the American Society of Ophthalmic Registered Nurses.

Anyone who holds a certification through any of these organizations is required to have extensive knowledge and training in their field and must pass a test in order to be granted certification. They are all required to maintain their individual certifications through continuing education credits and retesting when required.

Thursday, August 4, 2011

Is LASIK or PRK a Better Choice?

LASIK and PRK are two types of Laser Eye Surgery for vision correction of nearsightedness, farsightedness and astigmatism that have advantages and disadvantages. Both allow us to provide excellent results when we carefully select patients and explore the risks and benefits with them as well as help them to set realistic expectations and personal goals”, said Maine Corneal Specialist and LASIK surgeon Ravi Shah, M.D. of Eyecare Medical Group in Portland. “While the long term visual results of PRK and LASIK are identical there are some differences that we like our patients to be aware of.”

Patients who have LASIK may have very slightly reduced contrast sensitivity in dim illumination. If one uses extremely sensitive clinical measuring methods they can sometimes find a slight reduction in “low contrast” vision. Often it is so slight that the patient does not notice it except in the testing conditions or in very extreme instances of reduced contrast situations such as driving at dusk in the rain. Thus it is a limited problem for most patients.

The real differences between PRK and LASIK are based on the fact that PRK is a “surface treatment” and LASIK is a “lamellar treatment” which means that PRK is performed on the surface of the cornea whereas LASIK is performed between the layers of the cornea. “When I perform All Laser Bladeless LASIK it is really a 3-step procedure. First I create the “layer” or “flap” using a femtosecond laser-without the use of a blade or any cutting. Second, I apply the excimer laser to reshape the cornea to the correct prescription for your clear vision. Third, I replace the “flap” in its original position where it positions and adheres without the need for sutures”, said Dr. Shah. PRK is really a single step procedure where the excimer laser is simply applied to the surface of the cornea to reshape it into the proper prescription. Whenever you have a multi step eye surgery procedure there is always a greater chance of risks, side effects and complication. Fortunately the risks, side effects and complications of LASIK are relatively few and minor if you are indeed a good candidate and under the care of a top laser surgeon. So, PRK does offer a safer risk profile because it is a single step procedure.

However one of the not so subtle differences is that because it is a lamellar procedure, LASIK does not disturb the surface of the cornea during treatment. This provides patients with a much faster visual recovery and significantly less discomfort than PRK. This is why from the patient perspective most patients want LASIK eye surgery more than PRK. LASIK patients can get back to pretty much normal activities within a couple of days without any real pain-just some mild discomfort-and with good vision. Most LASIK patients are able to pass a drivers test with 24-48 hours of their laser treatment. PRK patients often experience moderate discomfort that can last a few days and depending on the degree of their prescription can take a week or so to achieve good functional comfortable vision.

The best way for you or someone you know to find out if they are a good candidate for All Laser Bladeless LASIK or PRK is to have an evaluation, examination and consultation at Eyecare Medical Group. Please feel free to schedule an appointment by calling us Toll Free at 888-374-2020.

Tuesday, August 2, 2011

Children's Eye Health Month

Eyecare Medical Group wishes to announce that August has been designated as Children’s Eye Health and Safety Month by Prevent Blindness America. Eye and vision problems affect one in twenty preschoolers and one in four school aged children. Parents should be aware that it is possible for their children to have a serious vision problem without even being aware of it. Infants should be screened for common eye problems during their regular pediatric appointments and vision testing should be conducted for all children starting at around three years of age. If there is a family history of eye problems or if an eye problem is apparent, it is important to bring it to the attention of and eye doctor so that they can advise the parents about when and how often their child’s eyes should be examined.

Among the conditions an eye doctor will look for are amblyopia (lazy eye), strabismus (crossed eyes), ptosis (drooping of the upper eyelid), color deficiency (color blindness) and refractive errors (nearsightedness, farsightedness and astigmatism).

Thursday, July 28, 2011

Optical Shop for Eyeglasses at EMG

Eyecare Medical Group has recently had some exciting new changes in staffing in our Optical Shop!

John FitzGerald, a Retina technician who works with Dr. Scott Steidl, has become the manager of our Optical Shop. He will be joining Susan Yelvington, who works full time as an optician. John will continue his responsibilities in Retina, working up patients and assisting in surgery, but will also supervise the optical shop and work in that area as needed. John worked as an optician before working in Retina, so his experience will be welcome in our Optical Shop.

EMG also recently welcomed another new employee to the Optical Shop, Leslie Beaudette. Leslie comes to us from an optometry and ophthalmology office in Brunswick and has been in optical for 11 years. We’re very excited to have her join our team!

Tuesday, July 26, 2011

Eyelid Surgery at EMG in Portland Maine

Eyelid surgery, otherwise known as blepharoplasty, is a surgery that is routinely performed here at EMG. “Droopy eyelids” or ptosis is a condition that occurs when the eyelid muscles start to deteriorate over time and the skin around the eyelids starts to sag, often times obstructing ones vision. Surgery can clear the peripheral vision and allow patients to see clearly again by removing excess skin on the eyelids and tightening up the eyelid muscles. Upper lid blepharoplasty can be considered medically necessary, as opposed to lower lid blepharoplasty, which is always considered cosmetic.

If it is determined that a patient is a candidate for blepharoplasty surgery, then a visual field test and 5 point photos will be taken by an ophthalmic technician. The information will be submitted to the patients insurance company to see if the surgery can be covered under the patients insurance policy. We allow up to 30 days for this determination to be made. If the insurance company approves the upper eyelid blepharoplasty, then the surgery will be covered according to the provisions of the patients insurance policy. If the insurance company denies the surgery as not medically necessary, the patient will be responsible for paying for the procedure out of pocket.

If your vision is being obstructed by droopy eyelids and you believe that you would be a good candidate for an upper lid blepharoplasty surgery, please call Eyecare Medical Group toll free at 1-888-374-2020 to schedule an exam.

Thursday, July 21, 2011

Visian ICL™ Lens Implant

Eyecare Medical Group is proud to offer the Visian ICL (implantable collamer lens, or implantable contact lens) to our refractive patients. The Visian ICL™ is a possible solution for those who are nearsighted but who are not candidates for LASIK surgery because of high myopia or thin corneas.

“The Visian ICL™ is a great option for those who are not candidates for LASIK but want to get rid of their dependence on glasses or contact lenses,” says Dr. William Holt, refractive surgeon at Eyecare Medical Group.

Although the Visian ICL™ is a phakic IOL, it is different than the IOL’s used during cataract surgery because it does not replace the natural lens of the eye. Instead, the Visian ICL™ is inserted behind the iris and in front of the natural lens of the eye in a short outpatient procedure. The Visian ICL™ stays in place but can be removed at anytime if necessary.

The best way to determine if you are a candidate for a Visian ICL is to have an examination at Eyecare Medical Group. Please call us toll free for a free consultation at 1-888-374-2020.

Tuesday, July 19, 2011

Dry Eye Clinic at EMG in Portland Maine

Every other Thursday afternoon, Dr. Jordan Sterrer hosts a Dry Eye Clinic here at EMG. The clinic is run differently than a normal exam, although an appointment is still required. The doctor and technician see the patients together, and do an extensive history and life style evaluation. “There are three basic layers to the tear film- oil, water, and mucus. Problems with any of these layers may cause dry eye symptoms” says Dr. Jordan Sterrer. Signs and symptoms of dry eye, or Dysfunctional Tear Syndrome, include:

 Stinging, burning, or scratchy sensation

 Grittiness, or a feeling that something is in the eye

 Blurred vision

 Sensitivity to light

 Difficulty wearing contact lenses

Different diagnostic tests, such as a Schirmer’s test, and the use of dyes and stains, are done to diagnose the patient. A life style evaluation is done to determine if the patient has any medical conditions, such as diabetes or rheumatoid arthritis or are on any medications such as birth control pills or antihistamines that may put them at an increased risk for dry eye. Based on all of these factors, Dr. Sterrer will decided which treatment is appropriate for each patient.

Cutting edge therapies for dry eye, such as autologus serum, may be suggested as treatment. Patients may be required to come back for additional visits to dry blood to make the serum, or to have follow up appointments to see how the treatment is progressing.

If you are experiencing eye discomfort or believe that you may have dysfunctional tear syndrome, please call today at 1-888-374-2020 to set up an appointment in our Dry Eye Clinic.

Thursday, July 14, 2011

Meet Retina Technician Theresa Libby

Theresa Libby is one of the Retina technicians here at Eyecare Medical Group. She has been with EMG for 12 years, and has worked with 5 different Retina specialists in her tenure here at EMG.

Theresa currently works as a technician for Dr. Scott Steidl, one of our two vitreoretinal specialists. She works up office patients, preps patients for injections, and goes into the OR to assist in surgeries. She also assists both Dr. Steidl and Dr. Jackie Nguyen with retinal surgeries that have to be done off site at one of the hospitals in the area.

Theresa is currently a COA, or certified ophthalmic assistant. She has served on many committees while at EMG, including the Health and Safety Committee and the Quality Improvement Committee. She is also the Continuing Education Coordinator, so she is in charge of planning and coordinating seminars and workshops for ophthalmic assistants, technicians and nurses, and making sure employees comply with continuing education requirements. In addition to working full time here at EMG, she is also working on finishing her last year of nursing school at Southern Maine Community College.

Tuesday, July 12, 2011

Ophthalmologist Dr. Jennifer Mok Visits

Eyecare Medical Group recently welcomed a visit from Dr. Jennifer Mok, an ophthalmologist visiting from Hong Kong. Dr. Mok was with a team of 5 other physicians from Hong Kong and Mongolia who were here as part of a Rotary International exchange team. The Rotary Club of Portland hosted the exchange team here in Maine; they also visited various other locations in Massachusetts and New Hampshire.

Dr. Mok expressed an interest to see how an ophthalmology practice in the U.S. was run, and she was referred here to EMG. She was able to spend a day here and meet with all of our physicians and some of our staff. She had a tour of our facility and was able to see several surgeries, including a cataract surgery and an oculoplastics surgery.

Dr. Mok was able to share some of her experiences as a practicing physician in Hong Kong. She was also able to offer information on the differences in the healthcare system here in the United States versus the healthcare system on Hong Kong, as well as some of the differences in how healthcare is administered.

Thank you for visitng us, Dr. Mok!

Thursday, July 7, 2011

Dry Eye Dysfunctional Tear Syndrome

If Reading this Makes your Eyes Tired or Blurry, it could be Related to your Tears

By Dr. Ravi A. Shah

Many people are surprised to learn that dysfunctional tear dysfunctional tear syndrome or dry eye syndrome can actually cause blurred vision. The surface of the eye is normally covered with a smooth layer of tears called the tear film. The tear film is composed of three layers: oil, water, and mucous. An abnormal mixture in the tear film is one of the most common causes of blurred vision, eye discomfort, and eye redness.

When the tear film layer is healthy it is smooth like the surface of a lake. The light entering the eye is properly focused. When the tear film layer is abnormal, the light entering the eye is distorted. The view becomes blurred in the same way that it is difficult to see out of a car windshield when it is covered with raindrops. Blinking helps refresh the tear film, but activities like reading or driving will reduce blinking and increase tear film irregularity.

It is intuitive that someone with dry eyes would have symptoms include stinging, pain, and redness. Other symptoms that a person might not realize are caused by this condition include sensitivity to light, and the feeling that there is a speck of dirt in the eye. It may seem strange, but dry eye can actually cause the eyes to water. This happens when the eyes become irritated and a reflex tearing response is activated. This reflex is very similar to the kind of tearing that occurs when a small particle gets into the eye.

Dysfunctional tear syndrome, affects millions of Americans. It is estimated that dry eyes affect up to 11% of people aged 30 to 60 years of age and 15-30% of those 65 years of age or older. It is a condition that can easily be missed or overlooked during routine eye care. The chance of having dry eye increases with age and can significantly impact quality of life.

Most people who have dry eyes experience mild irritation with no long-term effects. If the condition is left untreated or becomes severe however, eye damage and vision loss can occur. Severe problems with dry eye can lead to eye inflammation, corneal infection, and scarring.

Awareness of dry eye conditions has been increasing among eye care providers though not all doctors use the same tools to diagnose and treat dry eye. Recent science has provided several new treatment options. A significant portion of the diagnosis is based on symptoms. Be sure to consult your doctor if you suffer from any of the problems listed earlier. If you do suffer from dry eyes it is reasonable to start with over-the-counter artificial tears and lubricants. If symptoms persist it is advisable to consult an eye care professional who is experienced in treating dysfunctional tear syndromes.

Tuesday, July 5, 2011

Maine Fireworks Eye Safety Awareness Month

Eyecare Medical Group wishes to announce that Prevent Blindness America has designated July as National Fireworks Eye Safety Awareness Month.

Contrary to what you might think, there is no safe way for nonprofessionals to use fireworks. It is only safe to enjoy the splendor and excitement of fireworks at a professional display. According to the U.S. Consumer Product Safety Commission, fireworks are involved in approximately 10,000 injuries per year that are treated in U.S. hospital emergency rooms. Of those, 2/3 occurred during the one month period surrounding the July 4th holiday. It is important to note that

• Eyes were the Second Most Commonly Injured Part of the Body!
• Males Were Injured 3x More than Females.
• Approximately 25% of Injuries are to Children Under 15.

Fireworks and celebrations go together, especially during the Fourth of July. But there are precautions parents can take to prevent these injuries. The best defense against kids suffering severe eye injuries and burns is to not let kids play with any fireworks. Do not purchase, use or store fireworks of any type. Protect yourself, your family and your friends by avoiding fireworks. Attend only authorized public fireworks displays conducted by licensed operators, but be aware that even professional displays can be dangerous. If an eye accident does occur, what should I know?

• Do not rub the eye.
• Do not attempt to rinse out the eye. This can be even more damaging than rubbing.
• Do not apply pressure to the eye itself- but protecting the eye from further contact with any item, including the child's hand.
• Do not stop for medicine! Over-the-counter pain relievers will not do much to relieve pain. Aspirin (should never be given to children) and ibuprofen can thin the blood, increasing bleeding. Take the child to the emergency room at once.
• Do not apply ointments or drops. They may not be sterile and may make the area around the eye slippery and harder for the doctor to examine.

Once you are seen in the emergency room please feel free to have them call Eyecare Medical Group as we always have an eye doctor “on call” to provide consultation and continued care for you.

Friday, July 1, 2011

Routine Eye Exams at EMG Portland

Routine eye exams are important even if you do not have any existing eye issues. A routine eye exam generally consists of eye refraction, a slit lamp exam, tonometry, and visual acuity and functional tests. Routine eye exams are important even if you do not have any existing eye problems. Most insurance companies allow for a routine eye exam every two years.  It is important not to skip these exams as this is often when eye conditions or problems that may not have symptoms are diagnosed.  A routine eye exam can diagnose vision problems early when they can still be easily treated. They can diagnose glaucoma, which according to the World Health Organization is the second leading cause of blindness globally.  Routine eye exams can diagnose early retinal problems. They can even help diagnose diseases that are in other parts of the body but have ophthalmic manifestations.  Glasses and contact lens wearers need to have regular routine eye exams to make sure their prescriptions are current. If you haven’t had a routine eye exam recently, now is the time to call and schedule one!!!

Tuesday, June 28, 2011

Eye Care and Surgery Payment Options

Regardless of what kind of service you are having- whether it is an elective surgery such as LASIK or PRK, a multifocal or astigmatism correcting intraocular lens implants, treatment for diabetic retinopathy,  or glaucoma surgery, we at Eyecare Medical Group try to make the services we offer affordable.  This is why we offer several different payment options to our patients. For your convenience, we are participating with all local medical insurance plans and we will work with your insurance company to find out if a service is covered or not.  For those who are qualified, and for the elective procedures such as LASIK, that are not covered by your insurance, we offer up to 24 interest free financing.  Our billing department will work with you on an individual basis to set up a payment plan if necessary.  Don’t let money be the reason to stop receiving the care that you need.

Thursday, June 23, 2011

Intraocular Lens Implants (IOL)-What You Should Know

“Intraocular Lens Implants or as they are more commonly called Intraocular Lenses or IOLs, are tiny artificial plastic lenses that we use to correct vision after Cataract Surgery”, commented Maine Cataract Surgeon and Glaucoma Specialist Robert Daly, M.D. at Eyecare Medical Group in Portland, Maine.

Before the U.S. Food and Drug Administration approved the use of intraocular lenses in 1981 patients who had Cataract Surgery were forced to wear thick eyeglasses or contact lenses to improve their vision. Today there are several types of advanced technology IOLs that can help Cataract patients get the best possible vision correction after Cataract Surgery.

Monofocal Lens Implants vs. Multifocal Lens Implants (IOL)
Traditional IOLs were of a type called Monofocal Lens Implants as they provide improvement in vision at one set distance-usually for seeing far away. For many Cataract patients this is adequate. But for others who would like to be able to see at distance as well as at arm’s length and near without necessarily having to wear glasses to do so, another option is a multifocal or accommodating lens implant . “These types of Lens Implants offer our patients the ability to see more clearly at a range of distances by replacing the eye’s natural lens with a new artificial lens”, said Maine Cataract Surgeon William Holt, M.D. of Eyecare Medical Group.

Astigmatism Correcting Toric Lens Implants (IOL)
“Until recently patients who had astigmatism before their Cataract Surgery generally had to also either wear eyeglasses to correct the astigmatism after their Cataract Surgery or even have an additional surgical procedure to correct the astigmatism”, said Maine Cataract Surgeon and Glaucoma Specialist Samuel Solish, M.D. of Eyecare Medical Group. Today if freedom from glasses for distance vision is important to you, you now have a better option. Drs, Cassidy, Holt, Daly, Solish and Sterrer are able to implant a unique type of intraocular lens- astigmatism correction IOL to correct your vision and provide significantly improved distance vision without the need for eyeglasses.

Aspheric Lens Implants (IOL)
Most patients’ eyes have optical distortions or imperfections called aberrations. Aberrations result in a decrease in vision and visual function. One more common type of aberration is called spherical aberration. Spherical aberration is generally associated with blurriness, halos, lost of contrast and poor night vision. Eyecare Medical Group Cataract Surgeons Drs. Cassidy, Holt, Daly, Solish and Sterrer are now able to implant aspheric lens implants to provide patients with improved image quality and enhanced clarity. “My Cataract Surgery patients who have aspheric lens implants report that they have excellent vision in dim illumination such as on foggy or rainy days and really notice the improvement in their night driving comfort”, said Jordan Sterrer, M.D.

If you think you have a Cataract or have been told you have a Cataract and would like to be less dependent on glasses it is worthwhile to learn more about Cataracts, Cataract Surgery and Lens Implants by scheduling an examination and consultation. Please feel free to call Eyecare Medical Group Toll Free at 888.374.2020.

Tuesday, June 21, 2011

About Eye Drops after Eye Surgery

It is very important to remember to follow your post op instructions, especially when it comes to using your eye drops. Regardless of what kind of eye surgery a patient has, it is imperative to listen to the technicians and doctors and use the eye drops as prescribed by your physician.

Steroid drops are important in the healing process and help fight infection. Antibiotic drops also help fight infection. Nonsteroidal drops are important in reducing and preventing post surgical swelling. All of the eye drops recommended for use by your physician serve a purpose, and it’s very important to remember to use them exactly as prescribed. All of the physicians at EMG give written post op instructions on exactly how to use each eye drop. A doctor or technician will also discuss all of the drops with you before surgery. If you have any questions about how to use your post op medications, please contact your physician.

Friday, June 17, 2011

Cataract & Prostate Cancer Treatment

A recent study about the risk of developing Cataracts  (Annals of Epidemiology: November 2010) reported that Cataract risk may be higher in patients being treated for prostate cancer with Androgen Deprivation Therapy (ADT). The side effects of ADT such as weight gain, insulin resistance and blood lipid level problems have been linked to Cataract formation. Although further prospective study is necessary to truly understand the findings, researchers from Karmanos Cancer Institute in Detroit used the Surveillance, Epidemiology and End Results Medicare database to analyze cataract formation in prostate cancer patients and found a demonstrable increase in Cataract risk.

Wednesday, June 15, 2011

What is a YAG?

A YAG laser capsulotomy is a procedure that is sometimes required after Cataract Surgery. “At least 30% of patients who have cataract surgery will develop a secondary cataract over time and require a YAG laser” says Dr. Jordan Sterrer of Eyecare Medical Group.

When a patient has their natural lens removed during Cataract Surgery, the capsule of the original lens is left intact to support the new intraocular lens that is implanted. Sometimes, a cloud forms in the capsule and vision becomes blurred. This is what is referred to as a secondary Cataract. The procedure to relieve this problem is a YAG laser capsulotomy. A small opening is created in the center of the capsule, and vision is restored. A YAG laser procedure is painless and generally takes about 15 minutes. Because a secondary Cataract does not develop in all patients, a YAG laser procedure is considered a separate procedure from the original Cataract Surgery.

Thursday, June 9, 2011

Insurance Counseling at EMG

Meet Chelsea Cormier from the billing department here at EMG. Chelsea’s job is a little different from the ordinary billing position because she works face to face with patients all day, counseling them on the billing process and letting them know what their cost shares are going to be after surgery.

Chelsea’s desk is located in the lobby at EMG and she generally has a line of patients and technicians waiting at it. She speaks with every patient who is brought to her desk about our billing process, gives them written outline of what she has discussed with them, as well as her business card with all of her contact information, and then she calls their insurance companies to verify their benefits. After she has figured out if the patient will have a balance, and what that balance is, she calls them to notify them so there are no surprises to the patient after their surgery.

Chelsea also obtains authorizations from insurance companies for all patients who are having surgeries. She answers questions about billing and coverage, and often goes into exam rooms to speak with patients who are having procedures for the first time, or simply do not understand why they may get a bill for their service.

If you have any questions about your bill or concerns about the cost of an upcoming procedure, you can stop by and see Chelsea at your next visit, or call 1-888-374-2020 to speak with Chelsea or another billing representative.

Tuesday, June 7, 2011

Eyecare Medical Group Cataract Awareness Month

Eyecare Medical Group wishes to announce that Prevent Blindness America has designated June as National Cataract Awareness Month. Cataracts are the leading cause of blindness worldwide. About 20.5 million Americans age 40 and older have cataracts and more than half of all Americans develop cataracts by age 80.
Many patients do not actually know that a cataract is a clouding of the crystalline lens of the eye preventing light rays from passing through it easily. This results in a clouding and blurring of vision. They need to understand that cataracts are not a growth or a film over the eye. For many patients cataracts start out slowly and have little effect on vision at first. But, as the cataract becomes denser, so does the impact on vision. The most common symptoms that bother patients with cataracts include:

• blurring of vision

• sensitivity to light and glare

• double vision in one eye

• poor night vision

• fading or yellowing of colors

• frequent changes in glasses or contact lens prescriptions

When cataracts do begin to interfere with daily activities or with patient comfort and safety, they can be treated surgically. Cataract surgery is one of the safest and most frequently performed surgeries in the United States. Today, at Eyecare Medical Group in Portland, Maine Drs. Cassidy, Holt, Daly, Solish and Sterrer provide a full range of Intraocular Lens Implants (IOL) available that allow us to correct near vision as well as distance vision without requiring bifocals or reading glasses for the vast majority of patients. Please feel free to contact us with your questions about Cataracts, Cataract Surgery or Lens Implants by calling Eyecare Medical Group Care Toll Free at 888.374.2020.