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.